About

Amanda Bettencourt, PhD, APRN, CCRN-K, ACCNS-P, is an Assistant Professor at Penn Nursing within the Center for Health Outcomes and Policy Research in the Department of Family and Community Health. Her professional mission is to leverage her skills as a pediatric advanced practice nurse, leader, and scholar to improve the safety and quality of care. Her research focuses on burn care and pediatric acute care, with an emphasis on implementation science, aiming to accelerate the adoption of evidence-based practices in pediatric hospital settings. Dr. Bettencourt's work includes studying nurse staffing and work environments' impact on patient outcomes, notably demonstrating a relationship between staffing and burn patient mortality. She has received significant research fellowships, including a NINR predoctoral fellowship and a K12 award from NHLBI, and has contributed to the field of implementation science by exploring perceptions of interventions among nurses and physicians. Her long-standing expertise in burn care, disaster medicine, and nursing leadership informs her research, advocacy, and clinical practice. She has held leadership roles in critical care nursing organizations and continues to actively participate in clinical care and advanced practice roles, supporting quality improvement initiatives and mentoring staff in pediatric and burn nursing.

Research topics

• Medicine
• Emergency medicine
• Pediatrics
• Internal medicine
• Medical emergency
• Surgery
• Anesthesia
• Intensive care medicine
• Family medicine

Selected publications

• 100. Nurse Experiences Meeting the Fundamental Care Needs of Critically Ill Adolescents Post-Operative Cardiac Surgery

  Journal of Adolescent Health · 2026-02-13

  articleSenior author
  PublisherDOI

• “I feel abandoned by nursing and not accepted by medicine”: Factors undermining a healthy work environment for hospital-based nurse practitioners in the United States

  Journal of the American Association of Nurse Practitioners · 2026-01-07 · 1 citations

  article

  BACKGROUND: Nurse practitioners (NPs) are a rapidly growing segment of the US health care workforce and are increasingly integral to patient care in hospital settings. Despite their expanding roles, little is known about the work environment factors that affect their well-being in hospital settings. PURPOSE: To examine the factors that influence hospital-based NPs' work environments and identify strategies to enhance their well-being and support retention. METHODOLOGY: This qualitative descriptive study used directed content analysis to examine responses from 493 NPs across 264 hospitals in 10 US states with varying scope-of-practice laws to three open-text survey questions regarding their workplace experiences and work environment, drawn from the 2024 Penn Nurses4All Study. To identify factors influencing healthy work environments, themes were developed using both inductive and deductive analytic approaches, guided by the American Association of Critical-Care Nurses' Healthy Work Environment (HWE) framework. RESULTS: Six emergent themes related to factors that influence NPs' work environments included the following: (1) structural barriers to effective communication; (2) workplace incivility and lack of inclusion; (3) limited clinical autonomy and organizational influence; (4) misalignment between NP roles and staffing demands; (5) invisibility and devaluation of NP contributions; and (6) leadership gaps in supporting NP practice and well-being. CONCLUSIONS: Hospital-based NPs face unique barriers to a HWE that affect their well-being and hinder optimal practice. IMPLICATIONS: Implementing NP-informed strategies can foster supportive work environments that enhance NP well-being, retention, and the quality of patient care.

  PublisherDOI

• Medical Response Framework for Catastrophic Burn and Radiation Mass Casualties after a Potential Ukraine Nuclear Event

  Burns · 2026-02-01

  article
  PublisherDOI

• Development and testing of implementation strategies to increase the use of midline catheters in a paediatric intensive care unit

  Australian Critical Care · 2026-01-08

  articleSenior author
  PublisherDOI

• Context is key: New insights on barriers and facilitators influencing the implementation of skin-to-skin care in the pediatric cardiac intensive care unit

  Journal of Neonatal Nursing · 2025-03-06 · 1 citations

  article
  PublisherDOI

• Improving Discharge Education and Outcomes for Patients with Heart Failure

  AJN American Journal of Nursing · 2025-02-20 · 1 citations

  article

  ABSTRACT: The emerging field of implementation science (IS) facilitates the sustainment of evidence-based practice in clinical care. This article, the fourth in a series on applying IS, describes how a nurse-led team at a multisite health system used IS concepts, methods, and tools to implement a discharge education bundle for patients with heart failure at two community hospitals, with the aim of decreasing readmissions and improving patient functioning and satisfaction.

  PublisherDOI

• Using Implementation Science to Understand Barriers to Telemedicine Use for Burn Care During a Crisis

  Journal of Burn Care & Research · 2025-04-01

  articleOpen access1st authorCorresponding

  During a crisis, hospitals need help to meet the needs of patients with burns. Very few clinicians (1%) of medical doctors and registered nurses and few hospitals (2%) have burn care expertise. Due to these capacity limitations, patients with burns as extensive as 40% TBSA remain outside of burn centers for days to weeks before reaching definitive care. Telemedicine technology (TT) effectively connects a caregiver in any location to an expert burn clinician. However, it remains underused for unknown reasons. Implementation science seeks to uncover the factors affecting the use of innovations like telemedicine to increase uptake. We administered a questionnaire to assess burn center and emergency department clinician perceptions of the feasibility, acceptability, and intention to use TT across a network of 24 hospitals representing 4 of the 6 current American Burn Association disaster response regions. We also collected monthly current TT referral usage rates (# acute burn referrals using TT / # total acute burn referrals). Clinician ratings were generally in the neutral to agreeable (3.04 to 4.01) range for acceptability, feasibility, and intention to use; however, there was no significant relationship between these constructs and the actual use of teleconsultation across the sample. Strong correlations between feasibility and intention to use were observed. However, weaker correlations between ease of use and perceived usefulness suggest that interventions targeting these perceptions are needed to fully realize the potential of teleconsultation in improving the quality of initial and ongoing burn care during a crisis and usual care.

  PublisherOA PDFDOI

• Scaling up low barrier wound care for people who use drugs: a mixed methods study

  Harm Reduction Journal · 2025-05-21 · 1 citations

  articleOpen access

  BACKGROUND: People who use drugs (PWUD) have long required wound care-a need that has become more urgent with the rise of xylazine, an animal tranquilizer in the street opioid supply associated with necrotic wounds. When PWUD visit the hospital for wound care, they often face discrimination from healthcare staff and leave the hospital before treatment completion. Low barrier wound care, community-based wound care that is grounded in harm reduction, is promising for meeting PWUD where they are and providing trustworthy, high quality care. Yet, access to low barrier wound care remains limited. This study explored determinants of and strategies for scaling up low barrier wound care for PWUD. METHODS: We utilized a prospective sequential exploratory mixed methods design, including semi-structured 1:1 interviews, community advisory board (CAB) meetings, and an online survey. The study was conducted from April 2024-September 2024 in Philadelphia, Pennsylvania and surrounding regions. We included wound care providers, administrators, and recovery specialists of low barrier sites with walk-in, flexible services and harm reduction approaches. The interviews identified determinants of scaling up low barrier wound care, guided by the Consolidated Framework for Implementation Research. We then facilitated CAB meetings and conducted a survey of CAB members to identify community-generated implementation strategies and assess acceptability, feasibility, and appropriateness of CAB-generated strategies. We also generated evidence-based implementation strategies using the Expert Recommendations for Implementing Change compilation. RESULTS: Participants identified many barriers, including stigma, social needs, local policies, unstable funding, lack of specialized knowledge, and unstandardized evidence. Promising implementation strategies include using mass media to address stigma, developing resource sharing agreements between sites, revising professional roles to spread knowledge, and building academic partnerships to develop evidence. The most acceptable, feasible, and appropriate strategy rated by the CAB was offering social needs services (e.g., food, showers) within low barrier wound care sites. CONCLUSIONS: Many factors at different levels influence the availability and quality of low barrier wound care for PWUD. Our results suggest that communities would benefit from a local needs assessment to identify and tailor strategies for scaling up care. Future work will test the effectiveness and implementation of identified strategies.

  PublisherOA PDFDOI

• Examination of the implementation determinants of skin-to-skin care in the pediatric cardiac Intensive Care Unit

  Journal of Pediatric Nursing · 2025-08-22

  articleOpen accessSenior author
  PublisherOA PDFDOI

• Bridging the Gap: The Crucial Role of Nurses in Implementation Science

  Journal of Advanced Nursing · 2025-08-14 · 2 citations

  editorialOpen access

  As the largest segment of the global healthcare workforce and at the forefront of patient care, nurses have a deep understanding of the daily complexities of healthcare delivery. However, nurses have traditionally had very limited active involvement in the evidence implementation process. In this special issue of the Journal of Advanced Nursing, we challenge the notion that nurses have a limited role in driving the effective implementation of evidence into routine practice. We highlight the nursing profession as an effective change agent, which is an essential partner in closing that 17-year gap between evidence generation and implementation (Rubin 2023). One message stands out: nurses must play an active role in implementation science teams, particularly in the adoption and adaptation of new interventions and practice changes. More than knowledge consumers, nurses must be empowered as knowledge mobilisers, able to tailor and embed interventions that reflect the realities of complex care settings. Implementation science, which focuses on strategies to embed research findings and evidence-based practices into everyday healthcare, represents an important goal for health systems globally (Eccles and Mittman 2006). Implementation science aims to make available evidence-based practices and interventions from what we know have worked in controlled environments to work in real-world settings. This means that implementation science in the healthcare setting relies heavily on a well-informed and sustainable implementation strategy with a clinician-partnered approach. We turn our attention to the invaluable contributions of nurses as implementers and drivers for change who can and should help lead evidence translation. The inclusion of nurses in implementation teams brings a relational and pragmatic lens to implementation planning—nurturing team cohesion, patient engagement and local contextual understanding. Nurses are often the first point of contact for patients, and their proximity and holistic approach place them at the centre of healthcare delivery. Several studies in this special issue highlight the pivotal role of nurses in implementation science. For example, nurse-led trials for early antiretroviral therapy demonstrate how nurses can drive innovative intervention strategies, improving outcomes for vulnerable populations (Zhou et al. 2024). Similarly, the development and implementation of sexual and gender minority curricula for advanced practice nursing illustrate how nurses can champion inclusivity and responsiveness in care (Tsusaki et al. 2024). Studies examining barriers and facilitators to culturally responsive care in general practice nursing, and the implementation of clinical supervision, reinforce the idea that nurses are not just passive recipients of change—they are active agents who shape, adapt and sustain new practices (Oakley et al. 2024; Ryu et al. 2024). Their insights into the realities of care delivery are invaluable for uncovering the context for change efforts; what works, for whom and under what circumstances. Importantly, nurse-led initiatives often reflect a systems-thinking approach—simultaneously addressing clinical, relational and organisational levels of change. Implementation science is not about generating knowledge; it is about making a tangible difference in the lives of patients and communities by ensuring new knowledge reaches them. The special issue includes studies that employ a range of methodologies—to address real-world challenges. For example, qualitative analyses of barriers to preventing hospital-acquired pressure injuries in paediatrics, and systematic reviews on determinants of vascular access device selection, provide actionable insights that can inform practice guidelines and policy (Fernández-Fernández et al. 2024). Nurses, with their deep understanding of patient needs and system constraints, are essential partners in these efforts. Their involvement ensures that interventions are not only evidence-based but also feasible, acceptable and sustainable in everyday practice. The development of competency-measuring tools for health professionals, as featured in this issue, further supports nurses in fostering evidence-based practice and continuous professional development (Wang et al. 2024). Moreover, nurse-led implementation efforts often go beyond clinical efficacy to incorporate patient experience, workforce well-being and health equity—dimensions that are too often overlooked in top-down implementation models. The advancement of implementation science depends on robust frameworks and effective leadership. This issue showcases the use of the i-PARIHS framework to evaluate mentorship programmes, and the Behaviour Change Wheel to redesign sepsis pathways for emergency clinicians (Munroe et al. 2024; Nyholm et al. 2024). These frameworks provide structured approaches to understanding and addressing the complexities of practice change. Nurse managers and leaders play a critical role in guiding teams through the implementation process. The evaluation of implementation leadership training programmes for nurse managers highlights the importance of equipping nurse leaders with the skills and knowledge to drive change (Chen et al. 2024). The cultivation of implementation leadership across all career stages—not just managerial levels—is essential for sustaining a culture of evidence-informed care. Leadership at all levels of nursing is essential for fostering a culture of innovation and continuous improvement. A recurring theme in this special issue is the pursuit of equity in healthcare. Studies on translating proportionate universal healthcare into system designs, and adaptations to psychosocial support in oncology during COVID-19, underscore the need for implementation strategies that address disparities and promote access for all (Fjordkvist et al. 2024). Nurses, who often serve marginalised and underserved populations, are well placed to advocate for and implement equitable care models. Community-driven interventions, such as peer-led mental health cafés and family support initiatives in intensive care units, further demonstrate the power of engaging nurses in co-designing and delivering services that resonate with local needs (Murphy et al. 2025). The Baby-Friendly Community Initiative, for example, exemplifies how nurses can lead the way in promoting maternal and child health through evidence-based, community-centred approaches (Lok et al. 2024). End-of-life and specialised care require sensitivity, expertise and a commitment to patient-centred values. The development and implementation of new approaches to dementia care, and the Practice Programme for Upright Positions in the Second Stage of Labour, highlight the nuanced role of nurses in supporting patients and families during critical moments (Huang et al. 2023). By actively participating in the design and delivery of these interventions, nurses ensure that care is compassionate, respectful and aligned with patient preferences. In doing so, nurses anchor implementation efforts in values of justice, dignity and responsiveness—principles central to both nursing and implementation science. The studies featured in this special issue collectively advance our understanding of implementation science and its potential to transform healthcare. However, the further impact of these innovations is strengthened through the engagement and leadership of nurses. As frontline providers, nurses are not only implementers but also innovators, advocates and champions of change. Their active participation in implementation science is essential for translating evidence into practice, improving outcomes and achieving health equity. To realise this potential, structural and cultural shifts are needed to embed nurses in all stages of implementation—planning, execution, evaluation and scale-up. Investment in education, leadership development and collaborative research will ensure that nurses continue to drive progress in implementation science—turning knowledge into action and action into better health outcomes for all. The authors declare no conflicts of interest.

  PublisherOA PDFDOI

Frequent coauthors

• Colleen M. Ryan

  Harvard University

  237 shared

• John Schulz

  Spaulding Rehabilitation Hospital

  202 shared

• Gary Vercruysse

  University of Arizona

  172 shared

• William L. Hickerson

  American Burn Association

  171 shared

• Tina L. Palmieri

  University of California, Davis

  168 shared

• Robert Cartotto

  University of Toronto

  104 shared

• Kathleen S Romanowski

  Shriners Hospitals for Children - Northern California

  103 shared

• Renata Fabia

  The Ohio State University

  102 shared

Awards & honors

• National Institutes of Nursing Research (NINR) T32 predoctor…
• 2-year K12 research fellowship from the National Heart, Lung…
• National Clinician Scholars Program (NCSP) cohort (2019-2021…
• United States Department of Defense’s Military Burn Research…