Brief Bio

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

Education

Professional Certifications

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 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

• 2018 -- Pubmed # 29463211 Yap, T. L., Kennerly, S. M., Horn, S. D., Bergstrom, N., Datta, S., 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. February 20, 2018; 18(1); 54 PMCID: PMC5820803

• 2017 -- Pubmed # 28973516 Colón-Emeric, C. S., Corazzini, K., McConnell, E. S., Pan, W., Toles, M., Hall, R., Cary Jr, M. P., Batchelor-Murphy, M., Yap, T., Anderson, A. L., Burd, A., Amarasekara, S., Anderson, R. A. Effect of Promoting High-Quality Staff Interactions on Fall Prevention in Nursing Homes: A Cluster-Randomized Trial. JAMA Intern Med. November 1, 2017; 177(11); 1634-1641 PMCID: PMC5710274

• 2015 -- Kennerly, S., Batchelor-Murphy, M., Yap, T. L. Clinical insights: understanding the link between nutrition and pressure ulcer prevention Geriatric Nursing. November-December, 2015; 36(6); 477-481

• 2017 -- Pubmed # 28414584 Evans, K. A., Yap, T., Turner, B. Screening Commercial Vehicle Drivers for Obstructive Sleep Apnea: Tools, Barriers, and Recommendations. Workplace Health Saf. October 1, 2017; 65(10); 487-492

• 2017 -- Pubmed # 28186618 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., Anderson, R. A. Study of Individualization and Bias in Nursing Home Fall Prevention Practices. J Am Geriatr Soc. April 1, 2017; 65(4); 815-821 PMCID: 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., Anderson, R.A. Resident Vignettes for Assessing Care Quality in Nursing Homes Journal of American Medical Directors Association. 2017;

• 2016 -- Pubmed # 27888966 Repique, R. J., 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. Arch Psychiatr Nurs. December 1, 2016; 30(6); 722-728

• 2016 -- Pubmed # 26066791 Yap, T. L., Kennerly, S. M., Bergstrom, N., Hudak, S. L., 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 PMCID: PMC4659758

• 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

• 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 -- 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

• 2015 -- Pubmed # 26035553 Hummer, D. B., Silva, S. G., Yap, T. L., Toles, M., Anderson, R. A. Implementation of an Exercise Program in an Assisted Living Facility. J Nurs Care Qual. Oct.-Dec., 2015; 30(4); 373-9

• 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;

• 2015 -- Kennerly, S., Boss, L., Yap, T. L., Batchelor-Murphy, M., Horn, S. D., Barrett, R., 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 -- Pubmed # 26336042 Yap, T. L., Rapp, M. P., Kennerly, S., Cron, S. G., 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. M., Heggestad, E. D., Myers, H., 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

• 2014 -- Yap, T. L., Kennerly, S. M., 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

• 2014 -- Yap, T. L., Kennerly, S., Corazzini, K., Porter, K., Toles, M., Anderson, R. A. Evaluation of cueing innovation for pressure ulcer prevention using staff focus groups. Healthcare. July 25, 2014; 2(3); 299-314

• 2013 -- Pubmed # 24028358 Yap, T. L., Kennerly, S. M., Simmons, M. R., Buncher, C. R., Miller, E., Kim, J., 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

• 2013 -- Hemmings, A., Beckett, G., Kennerly, S., 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., Yap, T., 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

• 2012 -- Pubmed # 22523245 Kennerly, S. M., Yap, T. L., Hemmings, A., Beckett, G., Schafer, J. C., Borchers, A. Development and psychometric testing of the Nursing Culture Assessment Tool. Clin Nurs Res. November, 2012; 21(4); 467-85

• 2011 -- Pubmed # 21675395 Yap, T. L., Kennerly, S. M. A nurse-led approach to preventing pressure ulcers. Rehabil Nurs. May-June, 2011; 36(3); 106-10

• 2010 -- Pubmed # 20954577 Yap, T. L., Busch James, D. M. Tailored e-mails in the workplace. AAOHN J. October, 2010; 58(10); 425-32

• 2009 -- Pubmed # 19650604 Yap, T. L., Davis, L. S., Gates, D. M., Hemmings, A. B., 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

• 2007 -- Pubmed # 17896647 Yap, T. L., Davis, L. S. Health at every size. AAOHN J. August, 2007; 55(9); 344-6; author reply 346-7

• 2009 -- Pubmed # 19639858 Yap, T. L., Davis, L. S., Gates, D. M., Hemmings, A. B., 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., Hemmings, A., 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., Yap, T. L., Singleton, M., 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., 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., 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., 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

Grant Funding (selected)

• Preventing pressure ulcers with repositioning frequency and precipitating factors  
  National Institutes of Health, National Institute of Nursing Research
  R01 NR016001-01A1
  07/2016-03/2021
  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
  07/2015-06/2016
  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
  12/2014-12/2016
  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
  01/2015-12/2015
  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
  01/2014-01/2015
  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
  01/2014-01/2015
  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
  08/2013-07/2014
  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
  07/2012-06/2014
  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
  09/2011-06/2016
  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
  07/2010-06/2011
  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
  07/2010-12/2011
  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
  07/2010-06/2011
  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
  01/2010-01/2012
  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
  09/2009-08/2011
  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
  06/2007-06/2008
  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
  07/2007-06/2008
  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
  06/2006-06/2006
  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
  07/2005-06/2011
  Role: Co-investigator
  Project Goal: Train MSN students in occupational safety & health. Train PhD nursing students for research in occupational safety & health.