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October 2009 Issue

Tracey Yap (front) will work with (from left to right) Elaine Miller, PhD, Jay Kim, PhD, and Susan Kennerly, PhD, to test whether a simple alert system can reduce bed ulcers in patients residing at long-term care facilities. Also collaborating, but not pictured, is Ralph Buncher, ScD.
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Grant Fuels Nursing Effort to Improve Long-Term Care

By Angela Koenig
Published October 2009

An interdisciplinary team of researchers at UC has secured a prestigious, six-figure grant to determine whether a simple audio reminder can prompt a nurse-led team to make sure patients in long-term facilities move, or get moved, in order to prevent pressure ulcers.

Principal investigator Tracey Yap, PhD, and her team—co-investigators Susan Kennerly, PhD, and Elaine Miller, PhD, also of the College of Nursing; Jay Kim, PhD, of the College of Engineering; and biostatistician Ralph Buncher, ScD, of the College of Medicine—were awarded a two-year, $300,000 grant from the Robert Wood Johnson Foundation as part of the Interdisciplinary Nursing Quality Research Initiative.

The team competed with more than 100 other applicants for the funds.

The Robert Wood Johnson Foundation has a 35-year history of focusing on pressing health care issues. It is the nation’s largest philanthropy devoted exclusively to improving the health and health care of all Americans.

“The study involves the ambulatory residents, who can get up themselves, and the bedridden, who need to be turned, with the assistance of staff,” according to Yap, an assistant professor and program coordinator of the occupational health nursing program at the College of Nursing. 

Pressure ulcers are a serious complication of being immobile. Their incidence is on the rise and
is of growing concern to health care professionals, says Yap; thus, the team has partnered with Signature HealthCare of Florida to conduct the study at 10 of the company’s Kentucky long-term health care facilities.

“This study is among the first to use an interdisciplinary team approach that involves all nursing and non-nursing staff members, patients and their families to increase patient mobility,” says Kennerly, an associate professor in the College of Nursing.

The nurse-led mobility program will treat patient groups at five sites, with five sites for comparison (folding the comparison sites into the intervention before the study is completed).

The treatment will consist of playing a musical prompt every two hours at a rate that increases resident mobility through activities, such as standing, walking or repositioning according to the resident’s condition.

“The musical prompt is a reminder for patients that ‘you need to get up’ and for staff
that this is the time to move those who cannot do so themselves,” Yap says.

While the practice guidelines are that patients be moved at least every two hours, “we know that the compliance of staff is frequently not what we want it to be; therefore, we are engaging everyone from the staff to the patients to participate,” says Miller, a professor of nursing and coordinator of the college’s Center for Aging with Dignity.

This study, Yap says, offers an opportunity to reshape current approaches to increasing mobility and to make a difference by keeping patients free of pressure ulcers. 

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