Daniel David

Faculty

Daniel David headshot

Daniel David

PhD RN

Assistant Professor

1 212 992 5930

433 First Ave
New York, NY 10010
United States

Accepting PhD students

Daniel David is a geriatrics and palliative care (PC) nurse researcher and an Assistant Professor at the Rory Meyers College of Nursing at New York University. As an implementation scientist, he seeks to translate nursing research into feasible, effective, and scalable interventions for under-resourced, community-dwelling older adults and their care partners who are on the cusp of needing nursing home care.

His research program addresses the unmet social, emotional, and serious illness needs of low-income residents living in Medicaid-supported assisted living (AL) facilities in New York City. Notably, he developed the “Someone to Talk To” program in partnership with a community advisory board of AL residents. This initiative pairs residents with community health workers to foster serious illness conversations, explore values and care goals, and bridge care gaps for isolated individuals at high risk of nursing home placement. This work has been recognized nationally through the Center to Advance Palliative Care (CAPC) Tipping Point Challenge (Silver Medal) and internationally by the Gerontological Society of America (GSA) Distinguished Nursing Research Manuscript Award.

Prof. David serves on the editorial board of the Journal of the American Geriatrics Society (JAGS), the advisory council of the American Assisted Living Nurses Association (AALNA), and the research core of the Center of Excellence for Assisted Living (CEAL-UNC). He has received career development awards from the Cambia Foundation and the National Palliative Care Research Center (NPCRC).

Beyond his primary research focus in assisted living, David has served as a Co-Investigator on NIH-funded projects, including a study on the experiences of New York City hospice team members during the COVID-19 pandemic (5R01NR019792). He is currently a Site Principal Investigator at NYU Langone Medical Center for a 40-site trial examining a nurse-led intervention aimed at reducing avoidable hospitalizations among patients living with dementia and their care partners (U19AG078105). Collectively, his research promotes person-centered and community-based approaches to improving care for older adults with serious illnesses.

PhD, Northeastern University
BSN, University of Virginia
MS, University of Colorado
Gerontology
Palliative care
American Geriatrics Society
Gerontological Society of America
Hospice and Palliative Nurses Association
Palliative Care Research Cooperative
Sigma Theta Tau
Junior Investigator, Palliative Care Research Consortium (2018)
VA Quality Scholar, VA Medical Center, San Francisco (2018)
Scholarship, End of Life Nursing Education Consortium (2017)
Sigma Theta Tau, Scholar Research Award, Northeastern University (2016)
Kaneb Foundation Research Award, Regis College (2015)
Scholar, Jonas Center for Nursing Excellence (2014)
Scholar, Summer Genetics Institute, NINR, National Institute of Health (2014)
Sigma Theta Tau, Rising Star Award, Northeastern University (2013)
Sigma Theta Tau, Beta Kappa (2004), Gamma Epsilon Chapter (2013)
Raven Society, University of Virginia (2005)
Distinguished Nursing Student Award, University of Virginia (2005)

Original Research : Understanding Nursing Home Staff Attitudes Toward Death and Dying: A Survey

Bui, N., Halifax, E., David, D., Hunt, L., Uy, E., Ritchie, C., & Stephens, C. (2020). In American Journal of Nursing (Vols. 120, Issues 8, pp. 24-31). 10.1097/01.NAJ.0000694336.19444.5a
Abstract
Abstract
Background:Nearly 70% of nursing home residents are eligible for palliative care, yet few receive formal palliative care outside of hospice. Little is known about nursing home staff attitudes, knowledge, skills, and behaviors related to palliative care.Methods:We administered a modified survey measuring attitudes toward death to 146 nursing home staff members, including both clinical and nonclinical staff, from 14 nursing homes.Results:Nursing home staff generally reported feeling comfortable caring for the dying, but half believed the end of life is a time of great suffering. Pain control (63%), loneliness (52%), and depression (48%) were the most important issues identified with regard to these patients, and there was ambivalence about the use of strong pain medications and the utility of feeding tubes at the end of life. Top priorities identified for improving palliative care included greater family involvement (43%), education and training in pain control (50%) and in management of other symptoms (37%), and use of a palliative care team (35%) at their facility.Conclusions:Findings show there is a need for more palliative care training and education, which should be built on current staff knowledge, skills, and attitudes toward palliative care.

“They Don’t Trust Us” : The Influence of Perceptions of Inadequate Nursing Home Care on Emergency Department Transfers and the Potential Role for Telehealth

Stephens, C. E., Halifax, E., David, D., Bui, N., Lee, S. J., Shim, J., & Ritchie, C. S. (2020). In Clinical Nursing Research (Vols. 29, Issues 3, pp. 157-168). 10.1177/1054773819835015
Abstract
Abstract
In this descriptive, qualitative study, we conducted eight focus groups with diverse informal and formal caregivers to explore their experiences/challenges with nursing home (NH) to emergency department (ED) transfers and whether telehealth might be able to mitigate some of those concerns. Interviews were transcribed and analyzed using a grounded theory approach. Transfers were commonly viewed as being influenced by a perceived lack of trust in NH care/capabilities and driven by four main factors: questioning the quality of NH nurses’ assessments, perceptions that physicians were absent from the NH, misunderstandings of the capabilities of NHs and EDs, and perceptions that responses to medical needs were inadequate. Participants believed technology could provide “the power of the visual” permitting virtual assessment for the off-site physician, validation of nursing assessment, “real time” assurance to residents and families, better goals of care discussions with multiple parties in different locations, and family ability to say goodbye.

Living Wills : One Part of the Advance Care Planning Puzzle

David, D., McMahan, R. D., & Sudore, R. L. (2019). In Journal of the American Geriatrics Society (Vols. 67, Issue 1, pp. 9-10). 10.1111/jgs.15688
Abstract
Abstract
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The quality of family relationships, diabetes self-care, and health outcomes in older adults

David, D., Dalton, J., Magny-Normilus, C., Brain, M. M., Linster, T., & Lee, S. J. (2019). In Diabetes Spectrum (Vols. 32, Issues 2, pp. 132-138). 10.2337/ds18-0039
Abstract
Abstract
The purpose of the study was to investigate the relationship between family support, diabetes self-care, and health outcomes in older, community-dwelling adults. Using the theoretical framework of the Self-Care of Chronic Illness Theory and a cross-sectional design, 60 participants completed questionnaires related to diabetes self-care activities of the individual, supportive and nonsupportive diabetes behaviors of the family, and the quality of family relations. Participants indicated that diabetes self-care behaviors were performed frequently, with exercise reported as the least-performed behavior. Multiple regression analyses revealed that the quality of family relations as measured by the Family Relationship Index contributed significantly (26.0%) to the variability in A1C levels (R2 = 0.260, F(1, 40) = 14.037, P = 0.001). Neither family supportive behavior nor the quality of family relations contributed to diabetes self-care. It is recommended that health care providers include family members to assess diabetes family support and family relationships in the care of older adults with diabetes.

Rehabbed to death

Flint, L. A., David, D., & Smith, A. K. (2019). In New England Journal of Medicine (Vols. 380, Issues 5, pp. 408-409). 10.1056/NEJMp1809354
Abstract
Abstract
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Rehabbed to Death : Breaking the Cycle

Flint, L. A., David, D., Lynn, J., & Smith, A. K. (2019). In Journal of the American Geriatrics Society (Vols. 67, Issues 11, pp. 2398-2401). 10.1111/jgs.16128
Abstract
Abstract
Many older adults transfer from the hospital to a post-acute care (PAC) facility and back to the hospital in the final phase of life. This phenomenon, which we have dubbed “Rehabbing to death,” is emblematic of how our healthcare system does not meet the needs of older adults and their families. Policy has driven practice in this area including seemingly benign habits such as calling PAC facilities “rehab.” We advocate for practice changes: (1) calling PAC “after-hospital transitional care,” rather than “rehab”; (2) adopting a serious illness communication model when discussing new care needs at the end of a hospitalization; and (3) policies that incentivize comprehensive care planning for older adults across all settings and provide broad support and training for caregivers. In realigning health and social policies to meet the needs of older adults and their caregivers, fewer patients will be rehabbed to death, and more will receive care consistent with their preferences and priorities. J Am Geriatr Soc 67:2398–2401, 2019.

Patient Activation : A Key Component of Successful Advance Care Planning

David, D., Barnes, D. E., McMahan, R. D., Shi, Y., Katen, M. T., & Sudore, R. L. (2018). In Journal of palliative medicine (Vols. 21, Issues 12, pp. 1778-1782). 10.1089/jpm.2018.0096
Abstract
Abstract
Background: Patient activation - or knowledge, confidence, and skill managing overall health - is associated with improved health behaviors such as exercise; it is unknown whether it is associated with advance care planning (ACP). Objective: To determine whether patient activation is associated with ACP. Design: This is a cross-sectional study. Setting/Subjects: A total of 414 veterans (≥60 years) with serious and chronic illness enrolled in an ACP trial. Measures: Patient characteristics and self-report surveys included the validated 13-item patient activation measure (PAM, five-point Likert) (e.g., "Taking an active role in your own healthcare is the most important factor⋯") categorized into four levels (e.g., Level 1: "disengaged and overwhelmed" to Level 4: "maintaining behaviors"). ACP was measured with the ACP Engagement Survey including 57-item process scores (i.e., knowledge, contemplation, self-efficacy, readiness, 5-point Likert scale) and 25-item action scores (i.e., surrogate designation, yes/no items). Associations were determined with linear regression. Results: Participants were 71.1 ± 7.8 years of age, 43% were non-white, 9% were women, and 20% had limited health literacy. Higher PAM levels were associated with higher finances, having adult children, lower comorbidity, and more social support (p < 0.05). After adjusting for these characteristics, higher PAM (Level 4 vs. Level 1) was associated with higher ACP engagement (ACP process scores, 2.8 ± 0.7 vs. 3.8 ± 0.7 and action scores 9.7 ± 4.4 vs. 15.1 ± 6.0, p < 0.001). Conclusions: Higher patient activation to manage one's overall healthcare is associated with higher engagement in ACP. Interventions designed to foster general patient activation and self-efficacy to engage in health behaviors and disease management may also improve engagement in the ACP process.

Self-care in Heart Failure Hospital Discharge Instructions—Differences Between Nurse Practitioner and Physician Providers

David, D., Howard, E., Dalton, J., & Britting, L. (2018). In Journal for Nurse Practitioners (Vols. 14, Issue 1, pp. 18-25). 10.1016/j.nurpra.2017.09.013
Abstract
Abstract
Patients with heart failure (HF) are at risk for frequent readmission potentially due to self-care deficits. Medical doctors (MDs) and nurse practitioners (NPs) both provide discharge instructions. However, each type of provider may emphasize different elements of care. The aim of this study was to analyze and compare the content of the documentation of 50 discharge instructions of heart failure patients written by NPs and MDs. Compared with MDs, NPs placed greater emphasis on symptom identification, and were more likely to advise and schedule follow-up appointments with primary care and cardiology providers rather than advising an appointment was needed without scheduling one.

Behavioral Interventions in Six Dimensions of Wellness That Protect the Cognitive Health of Community-Dwelling Older Adults : A Systematic Review

Strout, K. A., David, D., Dyer, E. J., Gray, R. C., Robnett, R. H., & Howard, E. P. (2016). In Journal of the American Geriatrics Society (Vols. 64, Issues 5, pp. 944-958). 10.1111/jgs.14129
Abstract
Abstract
Objectives: To systematically identify, appraise, and summarize research on the effects of behavioral interventions to prevent cognitive decline in community-dwelling older adults using a holistic wellness framework. Design: Systematic review of randomized controlled trials that tested the effectiveness of behavioral interventions within each of the six dimensions of wellness: occupational, social, intellectual, physical, emotional and spiritual. Databases searched included PubMed MEDLINE, EMBASE, CENTRAL, PsycINFO, CINAHL, ALOIS, and The Grey Literature Report through July 1, 2014. Setting: Community. Participants: Individuals aged 60 and older (N = 6,254). Measurements: Consolidated Standards of Reporting Trials Checklist. Results: Eighteen studies met the inclusion criteria. Interventions in the physical dimension of wellness were most common (11 studies); interventions in the spiritual dimension were least common (0 studies). Fifty-nine different measures were used to measure multiple cognitive domains, with memory being the most commonly measured (17 studies) and language being the least commonly measured (5 studies). Fifty percent of the interventions examined in the 18 studies demonstrated statistically significant outcomes on at least one cognitive measure. Interventions in the intellectual dimension that examined cognitively stimulating activities using pen and paper or a computer represented the greatest percentage of statistically significant outcomes. Conclusion: Intellectual and physical interventions were most studied, with varied results. Future research is needed using more-consistent methods to measure cognition. Researchers should include the National Institutes of Health Toolbox Cognition Battery among measurement tools to facilitate effective data harmonization, pooling, and comparison.

Implementation analysis of a nurse-led observation unit

Murphy, G., Willetts, K., Duphiney, L., Dalton, J., & David, D. (2016). In Journal of Nursing Administration (Vols. 46, Issues 4, pp. 187-192). 10.1097/NNA.0000000000000324
Abstract
Abstract
OBJECTIVE: This implementation analysis of a nurseled observation unit describes the development process and analyzes patients- characteristics, patient satisfaction, and provider perceptions. BACKGROUND: A nurse-led observation unit was developed to createmore inpatient bed capacity and place patients in the clinical area best suited to their needs. METHODS: Descriptive statistics and content analysis were used for analysis. RESULTS: The average length of stay of 467 patients was 1.1 days; 68.1%(n = 318) were female. Elective surgery was the most frequent reason for admission. All of the patients rated the observation unit patient feedback survey factors favorably except for noise. All healthcare providers (n = 64) reported that they communicated well with each other and had resources to provide quality care but rated the environment less favorably. CONCLUSIONS: A nurse-led observation unit was found to be an effective and efficient approach to providing postoperative and postprocedure care, which was generally well received by patients and healthcare providers.