Biography

My interest in aging and caring for older adults began as a teenager, at the age of 13,  when I volunteered as a nursing assistant at a nearby nursing home.  Listening to elders stories helped me to gain understanding of their unique perspectives and behavioral responses. After graduating from nursing school with a BSN degree, I immediately sought graduate study to specialize in care of older adults and became a nationally certified Gerontological Nurse Practitioner.

As a clinical scholar for nearly 35 years, grounded in Gerontological Nursing and academic practice, I founded and directed one of the first nurse-led Falls Assessment and Prevention Programs in the country at UMDNJ-School of Osteopathic Medicine. Here I spearheaded an interdisciplinary team evaluation of older adults who fell from the community. My clinical practice work in falls spurred my interest to pursue a doctoral degree in nursing science where my doctoral dissertation research examined the lived experience and meaning of a serious fall to older adults. 

I am a Post-Doctoral alumni and clinical scholar of the National Hartford Center for Gerontological Nursing Excellence and an emerging nurse scientist with national recognition as an expert in care of older adults (geriatric nursing) and falls prevention. As an advance practice nurse, I am grounded in practice, with legacy of leadership in translational health services research in nursing homes.  My program of research concerns quality of care and patient safety in the aftermath of a fall within nursing homes. As a clinical scholar, I am dedicated to teaching excellence, creation of research evidence for best practice in falls prevention and collaboration for policy change at the state and national level. 

Teaching

I teach across all levels of nursing education both in person and through on-line learning. I have a long history of mentoring undergraduate nursing, graduate nursing, and bio engineering students in conducting clinical research with older adults in long-term care. I have 35 years experience in teaching, mentoring and designing innovative curricular models in teaching faculty how to care for older adults. Currently I am teaching:

            NGR 6812 Evidenced Based Practice for Nursing (graduate level)

 

Research

The scholarship during my professional career has centered on research in the prevention of falls among older adults in nursing homes, older adult’s perceptions of “serious” falls (qualitative research of lived experience), clinical care of frail elders, and enhancing geriatric nursing education. My research innovation includes tool development, validity, clinical congruency and feasibility testing of the Post-Fall Index, a 30-item, a comprehensive post-fall assessment tool and process of care measure available for use by registered nurses in nursing homes. As the primary investigator of a three year cohort health services research study (2006-2009), I, along with an interprofessional team demonstrated the clinical effectiveness of the Post-Fall IndexTM to reduce falls facility-wide by 30%. This clinical decision support tool has the potential to change the current practice paradigm of falls prevention in long-term care.

As part of my clinical translational research with regard to falls prevention in nursing homes, I have spearheaded several university-based research initiatives with collaborators in biomedical engineering to assess and measure balance in older adults using mobile technology and sensory apps.  Our pioneering work will one day lead to a better understanding of the human response in relation to balance impairment and falls prevention.

Current research activities are focused on:

  • Health services research related to innovative solutions for falls prevention in older adults
  • Mobile technology for training and assessing balance in older adults in long-term care

 

Grants Awarded

Principal Investigator:

Gray-Miceli, D., William Craelius, W. Mobile Technology for Training and Assessing Balance in Older Adults. Aresty Research Center, Division of Undergraduate Academic Affairs, Rutgers University.  September 2016-2017    

Gray-Miceli, D., Chase, S. “ I’m Falling and I Can Get Up”: Exploration of- and Metrics Used- in the Balancing Act.   Aresty Research Center, Division of Undergraduate Academic Affairs, Rutgers University. September 2016-2017

Gray-Miceli, D., William Craelius, W. Mobile Technology for Training and Assessing Balance in Older Adults. Three $1,000.00 Research Scholarship Funds Awarded to three Undergraduate Students in Research Project Development Aresty Research Center, Division of Undergraduate Academic Affairs, Rutgers University. 2015-2016.

Gray-Miceli, D, Willard S, Cadmus E, Gayle Pearson, Robert Strayer: Leaders Impacting the Healthcare of Frail Elders (LIHFE):  $804,465.00. Human Resources and Services Administration (HRSA): Comprehensive Geriatric Education Program. Grant approved for funding, but unfunded. 2012

Gray-Miceli D, Crane G, Ratcliffe S.Staff Nurses Determination of Assessment, Intervention, Enablers and Barriers for the Prevention of Recurrent Falls in Older Adult. 2010-2011. Frances E. Parker Memorial Home Foundation, Inc. New Brunswick, NJ Principal Investigator:   $25,000.00.  

Gray-Miceli D, Johnson J, Ratcliffe S. Feasibility of using the Post Fall Index with older Nursing Home Residents. University of Pennsylvania, Division of Geriatric Medicine Academic Long-Term Care Network Grant Program. Philadelphia, PA. 2006-2009.   $20,000.00. 

Gray-Miceli, D. Post-fall assessment: development and validation of a tool for use with older nursing home residents. Sigma Theta Tau, Xi Chapter Research Award, University of Pennsylvania, School of Nursing, Philadelphia 2003-2004. $1,000.00     

Gray-Miceli D. Post-fall assessment: development and validation of a tool for use with older nursing home residents who fal. Frank Morgan Jones Fund (University of Pennsylvania School of Nursing) 2003. $2,414.00.

Gray-Miceli DDevelopment of a model to predict older adult’s engagement in an intervention to reduce future falls. American Academy of Nursing: Building Academic Capacity for Geriatric Nursing. Mentor: Neville Strumpf, PhD, FAAN, University of Pennsylvania. 2002-2005 $100,000.

Gray-Miceli D, Mentor to A. Elshinawy, (second year medical student): Fear of falling as a result of risk factors among home dwelling older adults. UMDNJ-SOM, Student Research Support Grant. 1998-1999. $2,000.00.

Gray-Miceli D, Waxman H, Cavalieri T. Prodromal falls in nursing home patient. UMDNJ-SOM, Bio-medical Research Support Grant 1988-1989. $1,100.00.

 

Co-Investigator:

Holly C, Gray-Miceli D & Kelly S. Redesigning Nursing Education to Address the Challenges and Opportunities of Elder Population Health. Robert Wood Johnson Foundation. Population Health Grant. $50,000.00.

Cavalieri T, Gray-Miceli, D. Osteopathic Manipulative Therapy: Effect on Falls in the Elderly. American Osteopathic Association.  1996-1998 $50,000. 

Cavalieri T,  Gray-Miceli D. Shreve, S. Comparison of the geriatric team approach versus standard medical approach in caring for the institutionalized elderly; UMDNJ-SOM, Bio-Medical Research Support Grant. 1986-1987. $1,100.00

Recent Publications

Gray-Miceli, D, Mazzia, LM, Crane, G. Advanced practice nurse-led statewide collaborative to reduce falls in hospitals. Journal of Nursing Care Quality 2017 32:2: 120-125.

Gray-Miceli, D, Ratcliffe, SJ, Thomasson,A, Quigley, PQ, Li, K, Craelius, W. Clinical risk factors for orthostatic hypotension: Results among elderly fallers in long-term care. Journal of Patient Safety, October 20, 2016.

Gray-Miceli, D, de  Cordova PB, Quigley P, Crane G, & Ratcliffe SJ.  Nursing Home Registered Nurses’ and Licensed Practical Nurses’ Knowledge of Causes of Falls. Journal of Nursing Care Quality, Apr-June; 31 (2): 153-60.

Manchester JA, Gray-Miceli D, Metcalf J, Paolini C, Coogle CL, Owens MG. Facilitating Lewin’s  Change Model with Collaborative Evaluation in Promoting Evidence Based Practices of Health Professionals. Journal of Professional Education 47 (2014), 82-90.

Gray-Miceli, D, Wilson LD, Stanley J, Watman R, Shire A, Soafer S, Mezey M. 2014. Improving the Quality of Geriatric Nursing Care: Enduring Outcomes from the Geriatric Nursing Education Consortium. Journal of Professional Nursing 30: 6, 447-455. 

Gray-Miceli, D, Ratcliffe, S.J., Thomasson, A.2013.Ambulatory assisted living elderly fallers at greatest risk for head injury. Journal of the American Geriatrics Society 61 :10, 1817-1819.

G ray-Miceli, D, Ratcliffe SJ., Liu S., Watland D., & Johnson J, Orthostatic hypotension in elderly nursing home residents who fall: are they dizzy? 2012. Clinical Nursing  Research 21 (1), 64-78.

Gray-Miceli, D,  Aselage, M., Mezey, M. Teaching strategies for atypical presentation of illness in older adults. 2010. Journal of Gerontological Nursing 36:7, 38-43.

Gray-Miceli, D, Ratcliffe, S, Johnson, J. 2010. Use of a postfall tool to prevent falls. Western Journal of Nursing Research 32(7): 932-48, 2010.

Gray-Miceli, D., Strumpf, NE., Johnson, J.C., Dragascu, M., Ratcliffe, S. 2006. Psychometric properties of the Post-Fall Index. Clinical Nursing Research 15:3, 157-176, 2006.

Gray-Miceli, D, Strumpf NE, Reinhard SC, Zanna MT, Fritz E. 2004. Current approaches to post-fall assessment in nursing homes. Journal of the American Medical Directors Association, Nov-Dec, 5 (6): 387-394.

Gray-Miceli, D, Waxman, H., Cavalieri, T., Lage, S. 1994. Prodromal falls among older nursing home residents.  Applied Nursing Research 7:1, 18-27, 1994.

Cavalieri, T., Chopra, A., Gray-Miceli, D., Shreve, S., Waxman, H., Forman, L.1993. Geriatric assessment teams in nursing homes, do they work?  Journal of the American Osteopathic Association 3:12, 1269-1272.

Journal Articles: Clinical & Other

Gray-Miceli D. Impaired Mobility and Functional Decline in Older Adults: Evidence to Facilitate a Practice Change.  Nursing Clinics of North America 2017 52: (3) 469-487.

A Smartphone to Help Keep the Elderly Safe. Rutgers Today. May 31, 2016.

Sheng C, Gray-Miceli, Craelius, W. New Approach to Assess Balance of Elders. Today’s Geriatric Medicine 9:5, September,2016.

Gray-Miceli, D.  Post-fall emotional response. Today’s Geriatric Medicine 9:1, 18, 2016.           

Gray-Miceli, D. Part I: Falls in the environment: Faulty footwear or footing? :

Interdisciplinary case-based perspectives. Annals of Long-Term Care: Clinical Care and Aging, A Clinical Journal of the American Geriatrics Society18(4), 32-36, 2010

Gray-Miceli D, Johnson, JC, Strumpf, NE. A stepwise approach to comprehensive post-fall assessment. Annals of Long-Term Care: Clinical Care and Aging 13(12), 16-24. 2005.

Gray-Miceli, D.  Falls associated with dementia: how can you tell? Geriatric Nursing 26:2, March/April issue, 106-111, 2005.

Gray-Miceli, D.  Leona’s legacy.  Geriatric Nursing 23 (6): 311, 2002.

Cole, JM, Gray-Miceli D. The necessary elements of a dermatological history and physical evaluation.  Dermatology Nursing 14:6, 1-7, 2002.       

Gray-Miceli, D.  Changed lives: The hidden impact of falls in the elderly. Advance for Nurse Practitioners 10:7, 39-40, 2002.

Gray-Miceli, D. Psychological aspects of falls.  Advance for Nurse Practitioners 5:7, 41-44, 1997.

Gray-Miceli, D, and Leaman, D.  Evaluation and management of problem pressure-sores: enzymatic debridement as part of treatment.  Advance for Nurse Practitioners,1996 .

Cavalieri, TC. & Gray-Miceli D.  Evaluation and preventing falls among the elderly population. Journal of the American Osteopathic Association 94:7, 1996.

Gray-Miceli, D.  Evaluation and Treatment of Falls- Ideas for protocols and practice. Advance for Nurse Practitioners 29:32, 50, 1995.

Gray-Miceli, D.  The role of the gerontological nurse practitioner in comprehensive dementia evaluation program at UMDNJ-SOM. Advance for Nurse Practitioners 1 3, 8-10, 1993.

Gray- Miceli, D.  Evaluating your older patient’s ability to function. American Academy of Nurse Practitioners, 5 (4), 167-174, 1993.

Gray, D.  Care of Alzheimer’s patients in an extended care setting: an impetus for change.  The Journal of the N.J.  Association of Osteopathic Physicians and  Surgeons, 86 (8), 21-22, 1987.

Gray, D.  Problems for elderly diabetics with urine testing.  Geriatric Nursing 6(6), 332-334, 1985

Book Chapters:

Gray-Miceli D & Quigley P. (2016). Preventing Falls in Acute Care. In Evidence-Based  Geriatric Nursing Protocols for Best Practice, 5th edition (Eds.). Boltz M, Capezuti E, Fulmer T, Zwicker D.  (Chapter 19, pp 283-309). Springer Publishing Co. 

Gray-Miceli D & Quigley P. (2012). Fall prevention: assessment, diagnoses and intervention strategies. In Evidence-Based Geriatric Nursing Protocols for Best Practice, 4th edition (Chapter 15, pp 268-297). Springer Publishing Co.

Gray-Miceli, D. (2008). Preventing falls in acute care. In Evidence-Based Geriatric  Nursing Protocols for Best Practice, 3rd edition (Eds.). Capezuti, E., Zwicker, D., Mezey, M., Fulmer, T. Associate Editor: Gray-Miceli, D. and Kulger, M (3rd ed) (Chapter 9, pp. 161-198). Springer Publishing Co.  

Gray-Miceli, D.  (2008).  Fall Prevention. In Ackley, EJ, Ladwig, GB, & Swan, BA, (eds.).  A Clinical Guide To Evidenced-Based Practice in Nursing. Mosby: Elsevier Publishers, p.345-347.

Gray-Miceli, D.  (2006).  Post-fall patient assessment (chapter 5) in Falls: Prevention  Strategies in Healthcare Settings. Emergency Care Research Institute [ECRI] (ed.), Plymouth Meeting, PA.

Gray-Miceli, D. (2007). Falls and public policy: Creating a blueprint for change In Mason, D., Leavitt, J.K., Chaffee, M.W. (eds.) Policy and Politics in Nursing  and HealthCare, 5thEdition, Saunders, Imprint of Elsevier Science., 17 pages, 4 Tables.

Meiner, S.E. & Gray-Miceli, D.  (2000).  Safety.  In Lueckenotte, A. (ed.) Gerontological Nursing, 2nd edition, Mosby, Inc.  232-255.

Gray-Miceli, D.  (1996). Sleep and activity.  In Lueckenotte, A. (ed.).  Gerontological Nursing, 1st edition, Mosby, Inc. 224-243.

Gray-Miceli, D. & Cotter, V. (1993).  Dementia and the family.  In Fawcett, C. (ed.).  Family Psychiatric Nursing, Mosby-Year Book, Inc. Philadelphia

Gray, D.  (1990).  History taking in the elderly.  In Smith & Newman, D (eds.). Geriatric Care Plans.  Philadelphia: Springhouse.

Gray, D. (1990).  Physical Examination of the Older Adult.  In Smith & Newman D. (eds.). Geriatric Care Plans.  Philadelphia: Springhouse.

Gray, D. & Haddad, J.  (1990).  Diabetes Mellitus.  In Smith & Newman, D.  (eds.), Geriatric Nursing Care Plans.  Philadelphia: Springhouse.

Guest Editorials, Book Reviews, Government Publications or Government

Committee Reports:

Halperin, W.E., Gray-Miceli, D.L. Zanna, M.T Center for Health Statistics. (2008). Falls. In Preventing Injuries in New Jersey: Priorities for Action (chapter 3, pages 20-23). New Jersey Office of Injury Surveillance and Prevention, Center for Health Statistics, Office of Policy, NJ Department of Health and Senior Services, Trenton, NJ.

Gray-Miceli D. 2006. State and Territorial Injury Prevention Directors Association (STIPDA), Injury Surveillance Workgroup on Falls [ISW4]. 2006, p. 67. Report: Consensus Recommendation for Surveillance of Falls and Fall related Injuries.

Books:

Gray-Miceli, D. 5 Easy Steps to Prevent Falls: The Comprehensive Guide for Nurses to Keeping Patients of All Ages Safe. (2014). American Nurses Association: Silver Spring, MD. Available on the Internet at: http://www.nursesbooks.org/Homepage/Hot-off-the-Press/5-Easy-Steps-To-Prevent-Falls.aspx.

Leadership and Management Skills for Long Term Care. Ed(s) Sullivan-Marx, E., Gray-Miceli, D.  (2008). Springer: New York. Available on the Internet at www.springerpub.com/prod.aspx?prod_id=59931

Gray-Miceli, D, Capezuti, E, and Lawson, W, Iver, P. (2007). Falls Handbook:  From Public Places to Patient Settings: Clinical and Medical-legalPerspectives Across the Lifespan. Medical Legal Publishers, 128 pages (32,660 words), 10 Tables, 5 figures, 280 references. Available on the Internet at www.medleague.com

Evidence-Based Geriatric Nursing Protocols for Best Practice, 3rd edition. Ed(s) Capezuti, E., Zwicker, D., Mezey, M., Fulmer, T., Associate Editor: Gray-Miceli, D., Managing editor: Kulger, M. 2007. Springer: New York. Available on the Internet at www.springerpub.com/prod.aspx?prod_id=11033

Honors/Awards

 

1982 - Sigma Theta Tau (Epsilon Rho, Xi, and Eta Beta member)

1982 - Clinical Nurse Specialist Scholarship, VA Hospital, Philadelphia, PA

1992 -  Nominee, American Academy of Nurse Practitioner’s“NP of the Year”

1998 - Nancy Tatem Award for Gerontological Nursing Leadership, Delaware Valley Geriatrics Society  

2003 - Fellow, American Academy of Nurse Practitioners

2003 - Associate Fellow, Institute on Aging, University of Pennsylvania

2004 - 2nd place prize, 12th Annual Research Papers Presentation Night, Delaware Valley Geriatrics Society

2005 - Fellow, Gerontological Society of America, Washington, DC

2005 - Visiting Professor, Fairfield University (spring semester)

2007 - Scholar, National Institute of Aging, Summer Research Institute

2011 - Nominee, PINNACLE Distinguished Alumni Award, Fairleigh Dickinson University, Metropolitan Campus, June 2012

2012 - Fellow, American Academy of Nursing

2013 - Distinguished Alumni Award, Fairleigh Dickinson University, Henry P. Becton School of Nursing and Allied Health, Metropolitan Campus, Teaneck, NJ

2014 - Associate, Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ

2016 - Distinguished Fellowship, National Academies of Practice and Distinguished Scholar and Fellow, Nursing Academy, April 9, 2016. Baltimore, MD

2017 - Excellence Award for Research and Evidence-Based Practice. Presented by the Director and Faculty of the Henry Becton School of Nursing and Allied Health at the 65th Gala Celebration of Fairleigh Dickinson University, School of Nursing and Allied Health, December 1, 2017, Montvale, NJ.

Education

  • Post-Doctoral Research Fellow, John A. Hartford Foundation, University of Pennsylvania, School of Nursing, Philadelphia, PA 
  • PhD, 2001, Widener University (retitled in 2008 from DNSc degree to PhD, nursing science)
  • MSN, 1983, University of Pennsylvania, Gerontological Nurse Practitioner
  • BSN, 1982, Fairleigh Dickinson University