San Diego University School of Public Health graduate, Ms. Carolyn Proskow, who completed her MPH within the health management and policy division was selected to receive an award at this year’s American Public Health Association (APHA) Annual Conference and Expo. Ms. Proskow’s manuscript was selected as the recipient of the 2018 Retirement Research Foundation Master’s Student Research Award. She was presented with this award during the Aging and Public Health Section Awards Ceremony at this year’s conference.
Ms. Proskow’s manuscript evaluated the association of nurse staffing and facility rurality on the proportion of injurious falls in nursing homes within California. Previous research had found that when using Centers for Medicare and Medicaid Services (CMS) quality indicators for injurious falls, rural nursing homes had lower quality than their urban counterparts. Ms. Proskow completed her field practicum in a skilled nursing facility, where she developed her passion for aging research and policy. During her internship, she worked on a project that examined the relationship between call light response times and the number of resident falls, where she found that slower response times were associated with higher instances of resident falls. “This sparked my interest in examining the associations between nurse staffing as defined by nursing hours per resident per day (PRPD) and injurious fall rates among long-stay nursing home residents” states Ms. Proskow.
Her research found that approximately 45 percent of rural nursing homes and 21 percent of urban nursing homes had a high proportion of injurious falls. Furthermore, facilities with increased licensed practical nurse hours PRPD, and rural nursing homes both had greater odds of having a high proportion of injurious falls. Fifty to 75 percent of nursing home residents experience a fall annually, and up to 20 percent of these result in severe bodily injury. The adverse health outcomes and heavy economic burden these injuries can create, make it a high priority issue for all parties, personal and professional, involved.
Ms. Proskow’s manuscript expanded upon previous research which demonstrated the high importance of injurious falls within nursing homes, especially in rural areas. The results found in this study inform a variety of stakeholders in the long-term care industry, which can lead to legislation that optimizes nursing skill mix through increasing licensed practical nurse (LPN) hours PRPD which could in return reduce injurious falls within nursing homes. “A collaborative approach must be taken to address this problem that consists of government and agency support via financial assistance and resources, recruitment and retention of qualified nursing staff, and nurse education on falls and fall prevention. Additional research that includes other institutional characteristics not available in the Nursing Home Compare datasets such as facility-level nurse skill mix would be useful to draw more causal associations between proportions of injurious falls, nurse staffing, and rurality” states Ms. Proskow.
Ms. Proskow is grateful for her former professors and co-authors – Dr. Jong-Duek Baek and Dr. Corinne McDaniels-Davidson – for their support and guidance throughout her research project. She hopes to become more involved in the aging & public health section of the American Public Health Association and pursue additional opportunities to engage in long-term care research.