Making a Difference Through Nursing Research

Faculty Profile: Eileen Carter, PhD, associate research scientist

Woman smiling.

Eileen Carter earned her PhD at Columbia Nursing. She graduated with her BSN from New York University and has worked in the emergency departments of NewYork-Presbyterian/Weill Cornell Medical Center and Brigham and Women’s Hospital in Boston. Under the mentorship of Elaine Larson and Patricia Stone, her doctoral work focused on the relationship between infection prevention practices and crowding in the emergency department. As a PhD student at Columbia Nursing she was selected as a Jonas Nurse Leaders scholar. Carter holds a joint appointment as an associate research scientist at Columbia Nursing and nurse researcher at NewYork-Presbyterian Hospital.

Please tell us about your new joint research position at NYP and Columbia Nursing, which is the first of its kind between the two institutions.

I’m really excited about the position. It allows me to facilitate research among clinical nurses, advance opportunities for collaboration between academia and practice, and pursue my own areas of nursing research. Both Columbia Nursing and NYP value the need for clinical scholarship in advancing the nursing profession and improving patient care. I believe the joint appointment role well-positions PhD-prepared nurses to further nursing science and promote a culture of inquiry among clinical nurses.

At NYP, I work closely with Reynaldo Rivera, DNP, Director of Research and Innovation. I routinely present during nursing grand rounds, unit journal clubs, and committee meetings to emphasize the critical role that nurses play in identifying and implementing best practices. I learned through my work as a nurse and in my research that one of the best ways to engage nurses is to talk about what we are passionate about-- patient care. We enter the field because we want to make a difference. We want to improve the care of patients and patient outcomes. But often when new policies and procedures are instituted in clinical settings, it can be difficult to understand how and why the policy change will positively impact patients.

For example, during a busy night shift that I worked in the ED, I was handed a checklist and told to observe the provider insert a central line in our patient. I remember feeling frustrated and uncertain. I didn’t understand what my role was, and why my observation would improve patient care. I didn't understand how it was even possible to accomplish this task given my busy workflow. If I had I known that observing the physician and using the checklist  were evidence-based strategies instrumental to preventing harmful central line infections in patients, my outlook would have been much different. As a nurse researcher at NYP, I empower nurses to ask themselves, “what” and “why.” What is the care that we are providing and why is it best for patients? In my role, I educate nurses on evidence-based practice and research.  I challenge nurses to critically evaluate their practice and the literature to determine how we can better serve patients.  Nurses are really taking ownership of their practice and I’m happy to be a part of it.  

As an associate research scientist at Columbia Nursing, I am given the freedom to undertake my own areas of research interests. In collaboration with a multidisciplinary research team from Brigham and Women’s Hospital, I led the analysis of a multisite qualitative study that explored EDs with high-performing catheter-associated urinary tract infection (CAUTI) prevention programs. While the ED is a leading setting of urinary catheter insertions, very few studies have looked at CAUTI prevention in the ED, which is surprising. Our findings highlight the unique workflow of the ED in decisions to place urinary catheters and catheter insertion technique, and were recently published in Infection Control and Hospital Epidemiology. What I found particularly interesting, though, was the important role that nursing leaders and frontline nurses had in the development and implementation of strategies, and this is a focus of the second paper that I’m leading. What I really enjoy about both of these analyses, is that study findings have direct clinical relevance and highlight the value that nurses bring to patient care.  (Funded by the Agency for Healthcare Research and Quality, Principal Investigator: Jeremiah Schuur)  

Tell us about some other research studies you are working on through your joint appointment.

In collaboration with the National Student Nurses Association, Associate Dean for Research Elaine Larson; and postdoctoral fellows Amanda Hessels and Ana Kelly, we are conducting a nationwide survey to examine nursing students’ infection prevention knowledge, attitudes, and practices and its relationship to infection prevention course curriculum. We know that nurses are critical to preventing infection, but very few studies have evaluated the education that nursing students receive prior to entering the workflow. Our study will be the first to look at this relationship. Our study results will identify areas of infection prevention course content that are in need of improvement and may be addressed by educational bodies.

I’m passionate about CAUTI prevention in the ED and I am working on a grant that expands upon the work that I’ve done in this area. The joint appointment has also allowed me to expand my network of colleagues. With researchers from the Center for Cardiovascular and Behavioral Health, I am a co-investigator on an AHRQ funded study that explores facilitators and barriers to the implementation of new blood pressure screening guidelines. In addition, I am a co-investigator on a study that will examine nurses’ role in antimicrobial stewardship in collaboration with the Infection Prevention and Control department at NYP.  

You worked as an ED department staff nurse. What experiences did you have that inform your role as a nurse researcher?

Nearly all of my research has been informed by my clinical practice. For example, while working as an emergency department nurse, I realized that the ED environment poses specific challenges to infection prevention, which I focused on as part of my dissertation. I also witnessed firsthand the instrumental role that nurses have in improving patient care and outcomes. Nurses touch nearly all aspects of patient care and the patient experience, and these sentiments are echoed in my research. I think one of the reasons why I like researching infection prevention is because it is relevant to patient outcomes, and because it touches on many aspects of nursing practice that I find so interesting, such as interdisciplinary communication, accountability, and empowerment. 

Why did you go into nursing research?

When I first thought about becoming a nurse, I never thought I’d get my PhD since I didn’t know that this was a path that existed for nurses. And I’m finding that many other young nurses think the same. Working as a bedside nurse was incredibly rewarding –you could nearly always see and feel the difference that you made among patients and patient families. After working for several years at two academic medical centers though, I knew that I wanted to further my education. I saw that doctorally prepared nurses, in academia and in practice, were making important differences, but on broader scales, and I began to feel as if it would be a good fit for me as well. 

You recently presented at the New York-Presbyterian Research Symposium. Tell us about the event.

Over 180 participants attended our sixth annual evidence-based practice symposium held at the New York Academy of Medicine and sponsored by NewYork-Presbyterian.  We had great representation from Columbia Nursing. The symposium was an opportunity for nurses, from within and outside of NYP, to share their work and learn from one another. Speakers presented on how they had effectively prevented central line infections and pressure ulcers, and discussed the strategies they implemented that significantly improved the patient experience. More than 40 posters were on display, which were incredible. Clinical nurses and nurse leaders engaged in thoughtful dialogue around the nurses’ role in clinical scholarship in a panel discussion. The level of excitement and pride in the room was palpable. The event continues to receive excellent feedback and I left feeling very inspired and proud.