Tracey L. Yap, PhD, RN, CNE, WCC, FGSA, FAAN

Tracey L. Yap, PhD, RN, WCC, CNE, FGSA, FAAN, is an associate professor in the Duke School of Nursing, and a Senior Fellow in the Duke University Center for the Study of Aging and Human Development. The overarching goal of her research is to improve the quality of care delivered by nursing staff, regardless of setting, and she aims to advance nursing’s ability to improve health care outcomes by increasing the mobility/movement of individuals through nursing’s use of cueing approaches, such as reminder messages and behavioral alerts. More specifically, she aims to understand and improve the processes that facilitate nursing staff implementation of evidence-based mobility/movement best practices that target common, yet seemingly intractable geriatric conditions, such as facility-acquired pressure injuries/ulcers. She has had research grant funding by Robert Wood Johnson Foundation, National Institute of Nursing Research, National Institute of Safety and Health, and The John A. Hartford Foundation. Dr. Yap teaches in the Doctorate of Nursing Practice program, and is a board member of the National Pressure Ulcer Advisory Panel. In recognition of her accomplishments, she was inducted into the American Academy of Nursing as a Fellow in 2015, and into the Gerontological Society of America as a Fellow in 2018.

Academic Program Affiliations
  • PhD in Nursing Program
  • Doctor of Nursing Practice Program
Education
  • PhD - University of Cincinnati College of Nursing
  • BSN - Northern Kentucky University
Research Interests

Dr. Yap has a strong interest in translational science, and her scholarship has focused on understanding and improving the processes that facilitate nursing staff implementation of best practices for care in settings that range from occupational health care to long-term care. Her initial research focused on developing and implementing a tailored behavioral intervention to increase intentional physical activity among workers in manufacturing settings. Then, with funding from the Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative, she developed a cost-effective, nurse-led intervention that reduced prevalence of pressure ulcers/injuries in long-term care facilities by increasing resident mobility through a prompting system specifically tailored to each facility using musical cues. In the course of the RWJF study, Dr. Yap’s research team recognized that the occupational subculture of nursing in each facility played an important role in implementing the intervention, a discovery which led to development of the Nursing Culture Assessment Tool (NCAT), a new psychometric tool for evaluating the occupational subculture of nursing within an organization. She has since evaluated the clinical relevance of the NCAT to pressure ulcer prevention care practices by re-examining its content validity in this context and exploring focus group perspectives on its accuracy and appropriateness. Similarly, the NCAT has been validated in long-term care settings in the USA and the Scoring has been standardized. Dr. Yap is using the NCAT in her current NINR R01 that aims to determine the safest repositioning interval to prevent pressure ulcers/injuries.

Awards and Honors
  • 2018 || Fellow, Gerontological Society of America
  • 2018 || Mid-Career Researcher Award, Southern Nursing Research Society
  • 2016 || Mid-Career Investigator Award, Southern Nursing Research Society (SNRS) Aging/Gerontology Research Interest Group
  • 2016 || SciComm Fellow, Duke Initiative for Science & Society
  • 2015 || Fellow, American Academy of Nursing
  • 2015 || Rising Investigator Award, Southern Nursing Research Society (SNRS) Aging/Gerontology Research Interest Group
  • 2014 || Selected participant, National Institute on Aging Butler-Williams Scholars Program
  • 2013 || Selected participant, 2014 Leadership Development for Researchers, Duke Leader Program
  • 2012 || Working Group Member, 2014 Pressure UIcer Guideline Development Group, National Pressure Ulcer Advisory Panel (NPUAP), European Pressure Ulcer Advisory Panel (EPUAP), & Pan Pacific Pressure Injury Alliance (PPPIA).
  • 2012 || Claire M. Fagin Fellowship, National Hartford Centers for Gerontological Nursing Excellence
  • 2012 || Inducted, Sigma Xi
  • 2008 || Liberty Leadership Fund's Academic Scholarship, AAOHN Foundation
  • 2008 || Physical Activity & Public Health Course Fellow, University of South Carolina
  • 2007 || Physio-Control Academic Scholarship, AAOHN Foundation
  • 2006 || Inducted, Sigma Theta Tau, Beta Iota chapter
  • 2006 || Medtronic Academic Scholarship, AAOHN Foundation
  • 2005 || T42-OH008432-02 doctoral training grant, National Institute of Occupational Safety and Health (NIOSH)
  • 2004 || Graduate Student Scholarship, University of Cincinnati
  • 2004 || T42-OH008432-01 doctoral training grant, National Institute of Occupational Safety and Health (NIOSH)
  • 2003 || Kay Crist Nursing Scholarship, University of Northern Kentucky
Areas of Interest
pressure ulcer prevention
physical mobility
nursing culture
organizational culture
occupational/environmental health
Representative Publications
  • 2010 -- PubMed # : 20954577 -- Yap, T. L. and Busch James, D. M. Tailored e-mails in the workplace. AAOHN J. October, 2010 58(10); 425-32.
  • 2009 -- PubMed # : 19650604 -- Yap, T. L. and Davis, L. S. and Gates, D. M. and Hemmings, A. B. and Pan, W. The effect of tailored E-mails in the workplace. Part II. Increasing overall physical activity. AAOHN J. August, 2009 57(8); 313-9.
  • 2009 -- PubMed # : 19639858 -- Yap, T. L. and Davis, L. S. and Gates, D. M. and Hemmings, A. B. and Pan, W. The effect of tailored E-mails in the workplace. Part I. Stage movement toward increased physical activity levels. AAOHN J. July, 2009 57(7); 267-73.
  • 2009 -- PubMed # : 19103982 -- Yap, T. L. and Hemmings, A. and Davis, L. S. The systematic development of a tailored e-mail intervention for health behavior change toward increasing intentional physical activity. West J Nurs Res. April, 2009 31(3); 330-46.
  • 2009 -- PubMed # : 19203673 -- Gillespie, G. L. and Yap, T. L. and Singleton, M. and Elam, M. A summative evaluation of an EMS partnership aimed at reducing ED length of stay. J Emerg Nurs. January, 2009 35(1); 5-10.
  • 2008 -- PubMed # : 18330383 -- Yap, T. L. and Davis, L. S. Physical activity: the science of health promotion through tailored messages. Rehabil Nurs. March-April, 2008 33(2); 55-62.
  • 2007 -- PubMed # : 18165665 -- Yap, T. L. and Yap, W. Y. Using clinical trial summary results to establish quality measures. JAMA. December, 2007 298(23); 2740-1; author reply 2741.
  • 2007 -- PubMed # : 17896651 -- Yap, T. L. and Davis, L. S. Process of behavioral change as it relates to intentional physical activity. AAOHN J. September, 2007 55(9); 372-8; quiz 379-80.
  • 2011 -- PubMed # : 21675395 -- Yap, T. L. and Kennerly, S. M. A nurse-led approach to preventing pressure ulcers. Rehabil Nurs. May-June, 2011 36(3); 106-10.
  • 2012 -- PubMed # : 22523245 -- Kennerly, S. M. and Yap, T. L. and Hemmings, A. and Beckett, G. and Schafer, J. C. and Borchers, A. Development and psychometric testing of the Nursing Culture Assessment Tool. Clin Nurs Res. November, 2012 21(4); 467-85.
  • 2013 -- Hemmings, A. and Beckett, G. and Kennerly, S. and Yap, T. Building a community of research practice: Intragroup team social dynamics in interdisciplinary mixed methods inquiry Journal of Mixed Methods. July, 2013 7(3); 261-273.
  • 2012 -- PubMed # : 22842762 -- Kennerly, S. M. and Yap, T. and Miller, E. A nurse-led interdisciplinary leadership approach targeting pressure ulcer prevention in long-term care. Health Care Manag (Frederick). July-September 2012 31(3); 268-75.
  • 2013 -- Yap, T. L. Turn-Turn-Turning the Tables on a Pervasive Problem in Long-Term Care Human Capital Blog (Robert Wood Johnson Foundation). May 6, 2013 .
  • 2013 -- PubMed # : 24028358 -- Yap, T. L. and Kennerly, S. M. and Simmons, M. R. and Buncher, C. R. and Miller, E. and Kim, J. and Yap, W. Y. Multidimensional team-based intervention using musical cues to reduce odds of facility-acquired pressure ulcers in long-term care: a paired randomized intervention study. J Am Geriatr Soc. September, 2013 61(9); 1552-9.
  • 2014 -- Yap, T. L. and Kennerly, S. and Corazzini, K. and Porter, K. and Toles, M. and Anderson, R. A. Evaluation of cueing innovation for pressure ulcer prevention using staff focus groups. Healthcare. July 25, 2014 2(3); 299-314.
  • 2014 -- Yap, T. L. and Kennerly, S. M. and Flint E. P. Nursing Culture Assessment Tool (NCAT): Empirical validation for use in long-term care. International Journal of Nursing Sciences. September, 2014 1(3); 241-249.
  • 2015 -- PubMed # : 26035553 -- Hummer, D. B. and Silva, S. G. and Yap, T. L. and Toles, M. and Anderson, R. A. Implementation of an Exercise Program in an Assisted Living Facility. J Nurs Care Qual. Oct.-Dec., 2015 30(4); 373-9.
  • 2016 -- PubMed # : 26066791 -- Yap, T. L. and Kennerly, S. M. and Bergstrom, N. and Hudak, S. L. and Horn, S. D. An Evidence-Based Cue-Selection Guide and Logic Model to Improve Pressure Ulcer Prevention in Long-term Care. J Nurs Care Qual. January-March, 2016 31(1); 75-83. PMC4659758
  • 2015 -- Kennerly, S. M. and Heggestad, E. D. and Myers, H. and Yap, T. L. Using the Nursing Culture Assessment Tool (NCAT) in long-term care: An update on psychometrics and scoring standardization. Healthcare. July, 2015 3(3); 637-647.
  • 2015 -- PubMed # : 26336042 -- Yap, T. L. and Rapp, M. P. and Kennerly, S. and Cron, S. G. and Bergstrom, N. Comparison Study of Braden Scale and Time-to-Erythema Measures in Long-term Care. J Wound Ostomy Continence Nurs. Sep-Oct, 2015 42(5); 461-7.
  • 2015 -- Kennerly, S. and Boss, L. and Yap, T. L. and Batchelor-Murphy, M. and Horn, S. D. and Barrett, R. and Bergstrom, N. Utility of Braden Scale nutrition subscale ratings as an indicator of dietary intake and weight outcomes among nursing home residents at risk for pressure ulcers. Healthcare. September, 2015 3(4); 879-897.
  • 2015 -- Yap, T. L. Facilitation of nursing care delivery for the prevention of pressure ulcers in older adults. Research and Reviews: Journal of Nursing and Health Sciences. May 22, 2015 1(1); 15-16.
  • 2007 -- PubMed # : 17896647 -- Yap, T. L. and Davis, L. S. Health at every size. AAOHN J. August, 2007 55(9); 344-6; author reply 346-7.
  • 2015 -- Kennerly, S. and Batchelor-Murphy, M. and Yap, T. L. Clinical insights: understanding the link between nutrition and pressure ulcer prevention Geriatric Nursing. November-December, 2015 36(6); 477-481.
  • 2016 -- Repique, R.J.R., Vernig, P.M., Lowe, J., Thompson, J.A. & Yap, T.L. Implementation of a Recovery-Oriented Training Program for Psychiatric Nurses in the Inpatient Setting: A Mixed-Methods Hospital Quality Improvement Study Archives of Psychiatric Nursing. 2016 .
  • 2016 -- Colón-Emeric, C., Toles, M., Cary, M. P., Batchelor-Murphy, M., Yap, T., Song, Y., Hall, Rasheeda, Anderson, A., Burd, A., Anderson, R. A. Sustaining complex interventions in long-term care: a qualitative study of direct care staff and managers Implementation Science. 2016 11(1); 1-10.
  • 2016 -- Ross, A., Yap, T.L., van der Nest, J., Martin, K., & Edie, A. Increasing Primary Care Access Close to Home for Residents of Remote Communities in Northern Alberta Healthcare Quarterly. 2016 .
  • 2016 -- PubMed # : 27888966 -- Repique, R. J. and Vernig, P. M. and Lowe, J. and Thompson, J. A. and Yap, T. L. Implementation of a Recovery-Oriented Training Program for Psychiatric Nurses in the Inpatient Setting: A Mixed-Methods Hospital Quality Improvement Study. Arch Psychiatr Nurs. 30(6); 722-728.
  • 2016 -- Colón-Emeric, C., Toles, M., Cary, M. P. Jr., Batchelor-Murphy, M., Yap, T., Song, Y., Hall, R., Anderson, A., Burd, A., & Anderson, R. A. Sustaining complex interventions in long-term care: a qualitative study of direct care staff and managers. Implementation Science. 2016 11(1); 1-10.
  • 2017 -- PubMed # : 28414584 -- Evans, K. A. and Yap, T. and Turner, B. Screening Commercial Vehicle Drivers for Obstructive Sleep Apnea: Tools, Barriers, and Recommendations. Workplace Health Saf. 65(10); 487-492.
  • 2017 -- PubMed # : 28186618 -- Colón-Emeric, C. S. and Corazzini, K. and McConnell, E. and Pan, W. and Toles, M. and Hall, R. and Batchelor-Murphy, M. and Yap, T. L. and Anderson, A. L. and Burd, A. and Anderson, R. A. Study of Individualization and Bias in Nursing Home Fall Prevention Practices. J Am Geriatr Soc. 65(4); 815-821. PMC5397322
  • 2017 -- Colón‐Emeric, C.S., Corazzini, K., McConnell, E., Pan, W., Toles, M., Hall, R., Batchelor‐Murphy, M., Yap, T.L., Anderson, A.L., Burd, A. and Anderson, R.A. Resident Vignettes for Assessing Care Quality in Nursing Homes Journal of American Medical Directors Association. 2017 .
  • 2017 -- PubMed # : 28973516 -- Colón-Emeric, C. S. and Corazzini, K. and McConnell, E. S. and Pan, W. and Toles, M. and Hall, R. and Cary Jr, M. P. and Batchelor-Murphy, M. and Yap, T. and Anderson, A. L. and Burd, A. and Amarasekara, S. and Anderson, R. A. Effect of Promoting High-Quality Staff Interactions on Fall Prevention in Nursing Homes: A Cluster-Randomized Trial. JAMA Intern Med. 177(11); 1634-1641. PMC5710274
  • 2018 -- PubMed # : 29463211 -- Yap, T. L. and Kennerly, S. M. and Horn, S. D. and Bergstrom, N. and Datta, S. and Colon-Emeric, C. TEAM-UP for quality: a cluster randomized controlled trial protocol focused on preventing pressure ulcers through repositioning frequency and precipitating factors. BMC Geriatr. 18(1); 54. PMC5820803
Grant Funding (Selected)
  • Preventing pressure ulcers with repositioning frequency and precipitating factors
    National Institutes of Health, National Institute of Nursing Research
    R01 NR016001-01A1
    07/2016 to 03/2021
    Role: PI
    Determine differences in the incidence of new pressure ulcers in nursing home residents at low, moderate, and high risk using viscoelastic surfaces and repositioned at 2, 3, or 4 hour frequencies, in nine randomly assigned nursing homes
  • Adaptive and Technical Challenges Associated with Use of Nursing Home Resident Monitoring Technology in Pressure Ulcer Prevention: A Pilot Study.
    Duke University School of Nursing ADAPT Center Small Grant Program (funded by NINR/NIH)
    1P30 NR014139-01
    07/2015 to 06/2016
    Role: PI of pilot grant
    This research addresses the unacceptably high rates of pressure ulcers acquired in U.S nursing homes. This study will advance our knowledge about effects of resident repositioning using technology that will facilitate staff with care delivery technical challenges. This study will also provide new knowledge about the residents’ response to repositioning, thereby leading to a deeper understanding of methods that are required to prevent pressure ulcers.
  • Implementing a Deliberate Practice Approach to Support Adaptive Dementia Care: A Comparison Study Between the U.S. and China
    DUSON Office of Research Affairs International Research Award
    n/a
    12/2014 to 12/2016
    Role: Co-investigator
    This study examines the feasibility of using deliberate practice to teach adaptive cueing for dementia care to master trainers in both the US and China, as a strategy for large-scale workforce development in dementia care. The study is a critical step in preparation for an international PCORI application that will compare an adaptive leadership approach to basic dementia skills implementation to the deployment of task-specific workers (technical approach) in reducing neuropsychiatric symptoms of dementia during basic care.
  • The Turn for Ulcer ReductioN (TURN) study revisited: nutritional impact on pressure ulcer development
    Theodore J. and Mary E. Trumble Endowment, UT Health Houston
    n/a
    01/2015 to 12/2015
    Role: Co-investigator
    A secondary analysis of TURN trial data to investigate nutritional influences among long-stay nursing home residents at moderate or high-risk for pressure ulcer development.
  • Feasibility and Accuracy of Triaxial Accelerometers as a Measure of Turning, Repositioning, and Shifting Movements
    University of North Carolina Charlotte, Faculty Research Grant
    01/2014 to 01/2015
    Role: Co-investigator
    Establish the feasibility of using accelerometers to validate movement that would be typical of LTC residents so that future research can then examine movement of patients at risk for developing pressure ulcers.
  • Psychometric Evaluation and Scoring Standardization of the Nursing Culture Assessment Tool and Evaluation of Workplace Relationships Affecting Culture
    University of North Carolina Charlotte, Faculty Research Grant
    01/2014 to 01/2015
    Role: Co-investigator and Co-mentor
    Extension of earlier work on NCAT that confirmed construct validity and dimensionality of the tools factors by now standardizing the scoring approach and establishing norm-referenced scoring.
  • Wide Area Patient Mobility Assessment Radar (PMAR) for Pressure Ulcer Prevention
    Information Initiative at Duke - Research Incubator Award
    08/2013 to 07/2014
    Role: Co-PI
    Unique collaboration between the School of Nursing and Department of Electrical and Computer Engineering at the Pratt School of Engineering for the purpose of preventing pressure ulcers among patients in nursing homes and hospitals by developing novel radar signal analysis tools and techniques to monitor patient mobility.
  • Evaluation of the Nursing Culture Assessment Tool as a basis for improving prevention of pressure ulcers in long-term care
    John A. Hartford Foundation Building Academic Geriatric Nursing Capacity: Claire M. Fagin Fellowship award
    07/2012 to 06/2014
    Role: Principal Investigator
    The purpose of the research is to refine the previously developed Nursing Culture Assessment Tool (NCAT) by administering it to nursing staff in contextually different long-term care settings, to determine the clinical relevance of the NCAT in the context of PU prevention care practices by re-examining its content validity in this context and exploring focus group perspectives on its accuracy. Use these findings to guide item refinement and/or development of a protocol manual to standardize NCAT use in future clinical trials.
  • Outcomes of Nursing Management Practice in Nursing Homes
    National Institutes of Health
    2R01-NR003178-09A2
    09/2011 to 06/2016
    Role: Co-investigator
    This research will test the benefit of a new staff interaction intervention (CONNECT) over and above a falls quality improvement intervention in reducing patient fall rates in nursing homes.
  • Occupational Health Nursing Program
    National Occupational Research Agenda
    07/2010 to 06/2011
    Role: Co-PI nursing portion
    Project Goal: Assist graduate students with research projects.
  • Tai Chi a possible way to reduce cardiovascular risk factors in firefighters
    Pilot Research Program of the NIOSH sponsored Educational Research Center at University of Cincinnati
    T42/OH008432-06
    07/2010 to 12/2011
    Role: Co-PI/Mentor
    Project Goal Reduce Firefighters’ cardiovascular risk factors related to sedentary behavior.
  • Workplace Culture: Psychometric Evaluation of the Nursing Culture Assessment Tool
    Pilot Research Program of the NIOSH sponsored Educational Research Center at University of Cincinnati
    T42/OH008432-06
    07/2010 to 06/2011
    Role: Co-Mentor
    Project Goal Develop, test psychometric properties, discover dimensionality, and refine item structure of a nursing culture assessment tool.
  • Development of a Model for CNA Sub-Culture within Long-term Care
    University of Cincinnati’s College of Nursing’s Dean’s Research Award
    01/2010 to 01/2012
    Role: Co-PI
    Project Goal: Field test a qualitative interview instrument & observation guide focused on organizational culture.
  • Interdisciplinary Mobility-Team Approach to Reduction of Facility-Acquired Pressure Ulcers
    Robert Wood Johnson Foundation
    66636
    09/2009 to 08/2011
    Role: Principal Investigator
    Project Goal: 50% reduction of facility-acquired pressure ulcers in long-term care facilities through enhanced resident mobility.
  • Examining the effect that tailored messages have on intentional physical activity
    NIOSH & Health Pilot Research Project Training Program, Univ Cincinnati Educ. & Res. Center Grant
    T42/OH008432-02
    06/2007 to 06/2008
    Role: Principal Investigator
    Project Goal: Evaluate personalized, tailored, email physical activity messages ability to increase intentional physical activity.
  • Tailored E-mails in the Workplace: A Focus Group Analysis
    National Institute of Occupational Safety & Health (NIOSH) — Administrative supplement
    T42-OH 008432-05— Administrative Supplement
    07/2007 to 06/2008
    Role: Co-PI nursing portion
    Project Goal: Administrative supplement to assist MSN students with qualitative research.
  • Tailored messages and their effect on intentional physical activity
    NIOSH & Health Pilot Research Project Training Program, Univ Cincinnati Educ. & Res. Center Grant
    T42/OH008432-01
    06/2006 to 06/2006
    Role: Principal Investigator
    Project Goal: Design, Develop, and establish content validity for a set of tailored email messages for encouraging intentional physical activity.
  • Occupational Health Nursing Program
    National Institute of Occupational Safety & Health (NIOSH)
    T42 OH 008432-05
    07/2005 to 06/2011
    Role: Co-investigator
    Project Goal: Train MSN students in occupational safety & health. Train PhD nursing students for research in occupational safety & health.
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