Tracey Lee-Ann Yap
Associate Professor in the School of Nursing, with tenure

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.

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.

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