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

Associate Professor
Phone: 
(919) 613-6170
Office: 
3149 Pearson Building

Dr. Tracey Yap is Associate Professor at the Duke University School of Nursing, and a Senior Fellow in the Duke University Center for Aging and Human Development. The overarching goal of Dr. Yap’s scholarship is to improve the quality of care delivered by nursing staff, regardless of setting. Her research in disease prevention and health promotion has been directed toward advancing the ability of nursing to improve health care outcomes by developing interventions that use cueing approaches such as reminder messages and behavioral alerts to increase patient mobility/movement. Her research expertise includes both quantitative and qualitative methods and the tailoring of interventions that permit the study of group behavior change over time related to outcomes of interest.

Dr. Yap is committed to improving the care outcomes of older adults in long-term care settings, particularly with respect to prevention and management of common yet seemingly intractable geriatric conditions such as facility-acquired pressure ulcers. Her research highlights the critical importance of tailoring a combination of knowledge building and change strategies to impact staff and patient behavior and thus improve outcomes. Her current research includes: 1) developing cueing approaches that enable nurses to integrate evidence-based guidelines in long-term care, and 2) evaluating the influence of tailoring and the occupational subculture of nursing on care delivery and the implementation, uptake, adoption, and sustainability of healthcare innovations.

Dr. Yap is a member of the Gerontological Society of America and the Association for the Advancement of Wound Care. She is on the Southern Nursing Research Society Board of Directors as Member at Large, Director of Grants. She is also on the National Hartford Centers for Geriatric Nursing Excellence Board as a Director-at-Large.

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 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 pressure ulcer 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 nursing culture. 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 a co-investigator on the R01 study of Drs. Ruth Anderson and Cathleen Colón-Emeric, which is testing the benefit of combining the new CONNECT staff interaction intervention with a fall-prevention quality improvement intervention, in order to reduce patient fall rates in nursing homes. The R01 team has adopted the NCAT as part of the study, and will administer it in each of the 16 facilities at four time points over a five-year period, thereby yielding invaluable information on how nursing culture changes over time with implementation of the CONNECT intervention. The proposed study will identify important new ways in which long-term care facilities can support older adults through fostering a positive workplace culture that facilitates implementation of practices that produce quality care outcomes.

Awards and Honors

  • 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 Expertise

  • Gerontology
  • Quality of Care / Patient Safety
  • Translational Research

Areas of Interest

pressure ulcer prevention
physical mobility
nursing culture
organizational culture
occupational/environmental health

Representative Publications

  • 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
  • 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 -- 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
  • 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
  • 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
  • 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 -- 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 -- 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

Pages

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.

Pages

Tuesday, September 19, 2017

Tracey Yap was recently featured in an article entitled "Duke School of Nursing launches 5-year patient repositioning study" in the Becker's Hospital Review. Click here to read full article. 

Thursday, September 14, 2017

Tracey Yap was recently featured in a Leaf Healthcare announcement entitled "Duke Study to Determine Optimal Patient Repositioning Intervals to Prevent Pressure Ulcers." The article discusses how her research seeks to identify safe interval times for patient turning or repositioning. The study uses a novel Leaf Patient Monitoring System to assess mobility.

Friday, September 1, 2017

Congratulations to our colleagues whose tenure promotion and appointments were approved at the August 25 Board of Trustees meeting:

Tuesday, August 22, 2017

Tracey Yap and Melissa Batchelor-Murphy were recently featured in an article entitled "Improving Nursing Home Care for People with Dementia" in Health News Digest. The article is an interview with the 21st World Congress of Gerontology and Geriatrics co-chairs and discusses the research findings presented by Yap and Batchelor-Murphy on what is being done to improve the safety of care for nursing home residents with dementia.

Tuesday, May 2, 2017

A report published by the Centers for Disease Control and Prevention predicts that during the next 25 years the population of Americans who are 65 years and older will double to about 72 million. With this increase in the older adult population comes a need to raise awareness of vital aging issues through education, research, clinical practice and community or population health.

Tuesday, May 2, 2017

Tracey Yap was recently selected to serve a partial term on the National Pressure Ulcer Advisory Panel (NPUAP) Board of Directors. Her term, which is an unexpired term of a director who recently resigned, begins immediately and continues until the first Panel Meeting of 2019.

The NPUAP serves as the authoritative voice for improved patient outcomes in pressure injury prevention and treatment through public policy, education and research.

Thursday, March 16, 2017

Tracey Yap will be one of three presenters for the North American Center for Continuing Medical Education Simulcast Sessions at SAWAC Spring on "Reducing Facility-Acquired Pressure Ulcers by Optimizing Patient Turning: Improving Outcomes with Real-Time Monitoring Technology" on April 6.

For more information or to register, click here.

Friday, November 18, 2016

DNP alumna Alison Ross along with Tracey Yap and Alison Edie published an article entitled "Increasing Primary Care Access Close to Home for Residents of Remote Communities in Northern Alberta" in Primary Healthcare. Co-authors include Johan van Der Nest, manager, and Keith Martin, medical director, both with the Slave Lake Family Care Clinic.

Friday, September 16, 2016

Tracey Yap, PhD, RN, CNE, WCC, FAAN, associate professor for Duke University School of Nursing (DUSON) and senior fellow in the Duke University Center for Aging and Human Development, received a research grant of nearly $3 million from the National Institutes of Health, National Institute of Nursing Research for her study titled “Preventing pressure ulcers with repositioning frequency and precipitating factors.” The study will be fu

Friday, September 2, 2016

Tracey Yap, Ashley Schoenfisch and Nancy Crego were selected to participate in the SciComm Fellows Science Communication Program. The program, hosted by the Duke Initiative for Science and Society, provides an opportunity for faculty and postdocs to develop communication skills and put those skills into action.

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