Category Archives: Nursing homes

May 6 2013

Turn-Turn-Turning the Tables on a Pervasive Problem in Long-Term Care

Tracey L. Yap, PhD, RN, CNE, WCC, is an assistant professor at the Duke University School of Nursing, a John A. Hartford Foundation Claire M. Fagin Fellow, and a senior fellow at the Duke University Center for Aging and Human Development. With funding from the Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative (INQRI), Yap and her co-investigators developed a cost-effective, nurse-led intervention that aimed to reduce the prevalence of pressure ulcers in long-term care facilities by increasing resident mobility through a musical prompting system specifically tailored to each facility. This is part of a series of posts for National Nurses Week, highlighting how nurses are driving quality and innovation in patient care.


It started with a boombox and the Byrds.

Those are hardly the first things that come to mind when you think about pressure ulcers, also referred to as bed sores—the wounds that are caused by continuous, unrelieved pressure on the skin and that often develop in people who have impaired mobility. Yet that’s just how my husband, a physician who has a large population of patients in long-term care, inspired this research by suggesting that I pursue a grant related to this serious issue.


At one long-term care facility, my husband had a maintenance person use a boombox over the public address system to play “Turn, Turn, Turn” at two-hour intervals. It was a creative, simple, and fun way to remind staff to move patients, and it appeared to be effective in preventing pressure ulcers.

We were in Kentucky at the time, and I was teaching at the University of Cincinnati College of Nursing. When I took my husband’s suggestion and applied for an INQRI grant, it radically changed my life—and the lives of many long-term care residents—for good. In my PhD studies, I’d focused on occupational health, and the INQRI grant helped me apply that knowledge in a new way and ultimately led to my current work at Duke University.

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Mar 14 2013

Balancing Work, Family and Health Disparities

Cassandra Okechukwu, MSN, ScD, is an assistant professor in the department of social and behavioral sciences at the Harvard School of Public Health, and an alumna of the Robert Wood Johnson Foundation Health & Society Scholars program.


With the arresting title of “Why women can’t have it all,” Anne-Marie Slaughter’s Atlantic magazine article generated many discussions on the issues women face in balancing competing work and family demands. However, these discussions have not addressed the vast disparities in the types of work-family issues women face and the limited resources available to many working women. Also painfully missing from the discussion are the health implications of these competing work and family demands.

One group for which these issues cannot be separated is nursing home workers. Data from the Bureau of Labor Statistics (BLS) show that the majority of nursing home workers are drawn from racial/ethnic minority groups and low-income communities; as such, many face significant health disparities. For example, racial/ethnic minority and low-income populations have a disproportionate burden of diagnosis of several cancers that are related to adiposity—including cancers of the lung, esophagus, endometrium, colon and rectum, kidney, pancreas, gallbladder and thyroid.

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Jan 12 2011

Moving to Music

"We've had classical. We've had rock. We've had country. We've had instrumental. You can see the staff and residents bop their head[s] to different ones," Pam Larimore-Skinner, director of nursing at Signature HealthCare of Trimble County in Bedford, Kentucky, told the Cincinnati Enquirer.

But she’s not talking about a dance party. She’s talking about a unique tool created by RWJF Interdisciplinary Nursing Quality Research Initiative (INQRI) grantees. INQRI grantees Tracey Yap, Ph.D., a nurse researcher, and Jay Kim, Ph.D., an engineer, of the University of Cincinnati, are testing a sustainable, system-wide program designed to prevent pressure ulcers and enhance the mobility of long-term care residents.

Every two hours during the day, music is played over a speaker system at nursing homes. The music serves to remind nurses that it’s time to re-position bedridden patients. This subtle reminder prompts busy nurses to stop other tasks and give immobile patients the care they need to prevent bed sores. The music also serves as a reminder to other staff members to invite or encourage patients who are mobile to get up and walk.

The study, which is being conducted at multiple facilities, will conclude in April.

Read more about the project and the INQRI program.