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Aug 18, 2020

As part of the 2020: YEAR OF THE NURSE series, we are highlighting the work of Tracey L Yap, PhD, RN, WCC, CNE, FGSA, FAAN. Dr. Yap is an Associate Professor at Duke University School of Nursing and a Senior Fellow in the Duke University Center for the Study of Aging and Human Development. 

In 2019 she was the recipient of the Presidential Early Career Award for Scientists and Engineers (PECASE). The PECASE is the highest honor bestowed by the United States Government to outstanding scientists and engineers who are beginning their independent research careers and who show exceptional promise for leadership in science and technology.  She was nominated for this prestigious award by the National Institute of Nursing Research (NINR). Only a handful of nurse scientists have ever been awarded.

In this week’ episode, you’ll learn more about:

  • Pressure injuries which are a serious health concern for older adults living in nursing homes

Part One of ‘2020: Year of the Nurse - An Interview with Tracey Yap’

The overarching goal of Dr. Yap’s research is to improve the quality of care delivered by nursing staff regardless of setting. She aims to advance nursing’s ability to improve healthcare outcomes by increasing the mobility and movement of all nursing home residents through cueing approaches for staff, 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. 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. 

“Believe in yourself because there are people that will [need you].” — Tracey L Yap, PhD, RN, WCC, CNE, FGSA, FAAN (20:35-20:38)

After graduating from high school, she was advised to pick nursing as a career and was told, “If you do nursing, there are many ways to grow.” That was the best advice she’s ever heard, and it has been a fabulous career. Admittedly, she didn’t know what nurses could do until she was in nursing school. 

 

Tracey’s husband is an MD with a family practice, and at the time of her graduation with a PhD, he was the medical director of a nursing home that had a big problem with pressure ulcers (also known as pressure sores or bedsores). He asked her to write a grant proposal and came up with an idea to literally play music to remind the nursing staff to move people. This study demonstrated a 45% protective effect against pressure ulcers for ALL residents - not just preventing pressure injuries in high-risk residents.

 

Tracey stated that it was fascinating to watch the whole thing unfold. Residents were encouraged to share their unique stories and memories associated with the chosen music - and  all of the nursing home employees participated when the music played, not just the nursing staff.

Part Two of ‘2020: Year of the Nurse - An Interview with Tracey Yap’

Music has the power to connect generations. Over 60% of nursing home residents have some form of cognitive impairment, but even in very advanced Alzhiemer’s disease, music and rhythm are retained.  So, if the resident hears their favorite song from young adulthood, they may be able to   sing all the words when they can't talk to you anymore. Music is a great way to build a relationship with them.

 

One of the challenges in preventing pressure injuries is the nursing staff coming in every two hours to position you. This 2-hour interval was established by one study conducted in 1964. Since that time, we have made significant advances with pressure-relieving mattresses. Her current clinical trial, funded by the NINR combines cueing approaches with these new mattress to determine if resident turning should be at 2-, 3-, or 4-hour intervals if they are bedridden.



“Most people that work in nursing homes are there because they truly care and love those residents.” —  Melissa Batchelor, PhD, RN, FNP, FAAN (20:55-21:01)

Here's good advice from Dr. Yap, who's currently helping develop the new standard of care for pressure injury prevention: "Keep believing in yourself, because there are people that will. Naysayers think there's a specific path that you need to be on. I would advocate that you run with whatever it is that interests you."

How to Connect More with Tracey Yap

LinkedIn: https://www.linkedin.com/in/tracey-l-yap-b0966660/

About Melissa

 

I earned my Bachelor of Science in Nursing (‘96) and Master of Science in Nursing (‘00) as a Family Nurse Practitioner (FNP) from the University of North Carolina Wilmington (UNCW) School of Nursing (SON). I truly enjoy working with the complex medical needs of older adults. I worked full-time for five years as FNP in geriatric primary care across many long-term care settings (skilled nursing homes, assisted living, home and office visits) then transitioned into academic nursing in 2005, joining the faculty at UNCW SON as a lecturer. I obtained my PhD in Nursing and a post-Master’s Certificate in Nursing Education from the Medical University of South Carolina College of Nursing (’11) and then joined the faculty at Duke University School of Nursing as an Assistant Professor. My family moved to northern Virginia in 2015 and led to me joining the faculty at George Washington University (GW) School of Nursing in 2018 as a (tenured) Associate Professor where I am also the Director of the GW Center for Aging, Health and Humanities. Find out more about her work at https://melissabphd.com/.