Education Commons^™

The Lived Experience Of The Dnp-To-Phd Nursing Graduate: Examining The Journey, Bonni S. Cohen

UNLV Theses, Dissertations, Professional Papers, and Capstones

The traditional route of obtaining a Doctor of Philosophy (PhD) in nursing is vertical: a Master of Science in Nursing (MSN), followed by PhD in nursing. An ongoing shortage of PhD- prepared nurses—nurse educators and nurse researchers, in particular, has spurred the creation of more pathways to obtaining a PhD in Nursing. In recent years, there has been a drive to increase the number of nurse scientists with doctoral degrees through innovative pathways. A newer terminal nursing degree, the Doctor of Nursing Practice (DNP), has taken root over the past decade to produce nurse leaders who are experts at translating …

Investigating Students’ Lived Experience With Prebriefing Structure And Elements In Nursing Simulation Education, Meghan Liebzeit

UNLV Theses, Dissertations, Professional Papers, and Capstones

Prebriefing is a growing body of knowledge in nursing simulation education. It is recognized as an important factor in the simulation experience, however the practice of prebriefing varies widely making it difficult to understand what methods best prepare students for the simulation scenario. While research over the last decade has identified prebriefing increases confidence, skills, and clinical judgment, what content is important to include in prebriefing, or how it promotes the achievement of outcomes is under recognized.Implementing an intervention based on a pedagogically sound eight-week simulation clinical course, developed with the theoretical underpinnings of Vygotsky’s Zone of Proximal Development, Kolb’s …

No Scrubs: Nursing Applicant Trajectories After Rejection, Jennifer Torgerson

UNLV Theses, Dissertations, Professional Papers, and Capstones

There is a nursing shortage in the United States which has become even more apparent during the COVID-19 pandemic. Despite qualified applicants, thousands of students are turned away from educational programs each year as programs reach capacity limits. The rejection may have social, psychological, and economic consequences for the student. Students faced with rejection need to make decisions whether to continue their pursuit of nursing or go a different direction. This exploratory quantitative study aims to understand the trajectories of students that are not admitted into a capacity restricted nursing program at a community college in the Southwestern United States. …

Health Literacy And The Feasibility Of Using Video-Based Education In The Emergency Department, Jenifer Carvell

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The Department of Health and Human Services (HHS) defines health literacy as the degree to which an individual has the capacity to find, understand, and use information and services to inform health-related decisions and actions for themselves and others. In the emergency department (ED), it is estimated that the prevalence of inadequate health literacy can reach as high as 88 percent. There is a need to implement literacy-sensitive interventions in the ED. Purpose: The purpose of this project was to engineer an intervention that explored the feasibility of the use of personal technology to deliver video-based education to adult …

Leveraging Simulation To Understand Nursing Student Learning In Technologically Complex Environment, Deborah Rojas

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction The adoption of simulation technologies in schools of nursing has increased significantly over the last 5 years. Results regarding the use of simulation technology have been positive. The use of simulation technologies has been developed to include complex nursing situations that resemble real clinical settings. Research has demonstrated that memory recall is better in an environment that is the same or similar to the environment in which the learning took place (Krokos et al., 2018). For this reason, educators have used simulation technologies to create realistic environments where students can learn. However, learning outcomes in simulations are affected by …

Strategic Plan For Genomic Competencies Into Undergraduate Nursing Curriculum, Myerann Royce M. Mangalino

UNLV Theses, Dissertations, Professional Papers, and Capstones

Problem: As genomics research continues to grow in medicine and in popular culture, an educational gap in nursing is inevitable. Nurses must have a strong understanding of genetics and genomics to effectively integrate them into current practice.Objectives: The objective is to identify gaps in the current undergraduate curriculum and build threads that may be incorporated into the current curriculum to fill the identified gaps. Methods: The foundation of this project was the Essentials of Genetic and Genomic Nursing: Competencies, Curricula Guidelines, and Outcome Indicators, 2nd Edition (Consensus Panel on Genetic/Genomic Nursing Competencies, 2008). A strategic plan was created to increase …

Improving Nurse Leaders’ Knowledge And Confidence In Transformational Leadership Skills In The Online Environment, Tanya Haight

UNLV Theses, Dissertations, Professional Papers, and Capstones

Leadership is critical to the success of most organizations, and the achievement of an organization's goals is largely dependent on the leaders' ability to engage, motivate, and influence their teams—often referred to as Transformational Leadership. This is especially true for healthcare organizations wherein the morbidity and mortality of patients may be affected by the quality of leadership. At the start of the COVID-19 pandemic, in-person meetings transitioned to the online format without nurse leaders' formal training. Leaders cited this lack of orientation as impeding their ability to sustain an online-virtual transformational leadership presence with their teams. They reported varying degrees …

Is Dietary Teaching Via Telehealth Effective In Lowering Hgba1c In Adult Patients With Prediabetes Or Type 2 Diabetes?, Mia Mccallum-Crawford

UNLV Theses, Dissertations, Professional Papers, and Capstones

Prediabetes and Type 2 diabetes mellitus (T2DM) are two common conditions diagnosed in the primary care setting. Both conditions benefit from a healthy lifestyle, managing blood sugar levels, and getting diabetes self-management education and support (DSMES). Within the past two decades, the healthcare community in the US has witnessed a substantial rise in diabetes among adults. Overall, the self-management of diabetes continues to worsen nationally. The purpose of this project is to improve patients’ self-management of both Prediabetes and T2DM through nutrition and show how nutritional counseling via telehealth provided by a nurse practitioner can improve HgbA1C values over 3 …

Improving Self-Efficacy And Knowledge While Reducing Anxiety In High-Risk Breast Cancer Patients Through Standardized Education, Shelley Miles

UNLV Theses, Dissertations, Professional Papers, and Capstones

Breast cancer is the leading cause of death of women in the United States. Patients at high risk for developing cancer are more easily identified in today’s world. Early identification might be due to strong family history or genetic mutations, such as BRCA1 or BRCA2. Screening and risk reduction guidelines have been developed over recent years for these patients. Adherence to these guidelines continues to be a problem. The factors stemming from this problem include lack of knowledge about being high-risk, understanding the guidelines, and anxiety and depression about the perceived risk of developing breast cancer. These factors can cause …

Relationships Between Mindfulness, Nonacademic Factors, Stress, And Test Performance: A Cross-Sectional Study, Rebecca A. Baumeister

UNLV Theses, Dissertations, Professional Papers, and Capstones

Successful test performance is essential to nursing students. Poor performance comes with consequences such as inability to progress or removal from the program, leading to attrition. The influence of academic factors on test performance have been widely researched and stress is known to hinder it, yet other factors may also impact test performance.

Dispositional mindfulness has the potential to support test performance, but no known studies have focused on these two variables among undergraduate nursing students. A gap also exists in relation to the influence of nonacademic factors on undergraduate nursing students’ test performance. Due to the ongoing nursing shortage, …

Implementation Of A Protocol In The Freestanding Emergency Department To Screen For And Identify Possible Victims Of Human Trafficking, Joe Alvarado

UNLV Theses, Dissertations, Professional Papers, and Capstones

Human trafficking (HT) victims often seek medical care in the emergency room setting. In a recent study among HT survivors, 88% attested to receiving medical care while in captivity, with 63% treated in the emergency care setting. Freestanding emergency departments typically have lower acuity and lower patient volumes than hospital-based emergency departments. This setting creates shorter wait times and minimizes the length of stay at every point during the emergency room experience. For traffickers, this is an ideal situation if their victim needs medical attention, and they want to get in and get out of the emergency room with less …

The Effect Of Asynchronous Versus Synchronous Online Course Delivery On Hesi Scores And Student Engagement For Rural Pre-Licensure Nursing Students, Susan Luke Belliston

UNLV Theses, Dissertations, Professional Papers, and Capstones

Since nurses are the primary providers of direct patient care in the United States, a shortage in any community can impact the quality of health care available. Rural areas were among the first to be affected by the current nursing shortage. Further challenges to the rural nurse supply include a lack of access to nursing education, particularly baccalaureate education.Both distance and online education options allow for the increased reach of higher education to rural areas. Existing nursing education literature focuses on graduate nurse education and baccalaureate completion education. The pre-licensure nursing student is mostly absent from the existing literature concerning …

Fluctuating Cohesion: A Grounded Theory Study Of Nursing Students Engaged In A Hybrid Debriefing Format, Carol Lynn Senette

UNLV Theses, Dissertations, Professional Papers, and Capstones

Debriefing is a key component of simulation that promotes development of students’ reflective processes. Instructor-led debriefing (ILD) is considered the gold standard; however, research conducted over the past decade demonstrates the negative effects of anxiety on student reflection during ILD. Nursing students’ experiences with ILDs have been substantially investigated; yet scant research explores students’ perceptions and experiences of more learner-centered debriefing formats that deemphasize the instructor role.

The purpose of this grounded theory study was to explore undergraduate nursing students’ perceptions and experiences of a hybrid debriefing format consisting of peer-led debriefing followed immediately by ILD. Specifically, I aimed to …

An Exploration Of The Numeracy Skills Required For Safe, Quality Nursing Practice, Anna Wendel

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to explore the numeracy skills required for safe, quality nursing practice. Using a descriptive mixed methods design, this study answered two research questions: 1) What numeracy skills do nurses perceive as important for providing safe, quality nursing care in the first three years of practice? 2) How do nurses incorporate numeracy skills into daily patient care during the first three years of practice? Early career nurses from a not-for-profit health care organization in the mid-Atlantic region of the United States (n=109) responded to an online survey tool developed by the student investigator that ranked …

Increasing Nurses' Knowledge Of Advance Care Planning, Jocelyn K. Allen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Advance care planning (ACP) is a process that seeks to ensure patients receive medical care that is consistent with their values and preferences. The process has proven benefits for patients and their loved ones but is under-utilized in clinical practice. Nurses are capable of successfully supporting patients through ACP; however, they encounter barriers that prevent their engagement in the process. These barriers include a lack of knowledge regarding ACP, poor understanding of their role in the process, and a lack of confidence to embrace the practice.

The purpose of this DNP Project was to create an evidence-based educational intervention to …

The Impact Of Culturally-Tailored Education On Knowledge And Behavior Related To Screening And Lifestyle Management Of Blood Pressure In African Immigrants, Sarah Erskine

UNLV Theses, Dissertations, Professional Papers, and Capstones

The number of African Immigrants in the United States is increasing. The prevalence of hypertension among Blacks, including African Immigrants are high. In addition to the increased susceptibility to hypertension, lack of disease awareness and unhealthy lifestyle are documented barriers to achieving adequate blood pressure control. The purpose of this project was to determine the impact of implementing a 30-minute, culturally-tailored, evidence based educational session on hypertension to promote knowledge and initiate behavior change in African Immigrants. This was a descriptive, cross-sectional study. Blood pressures were measured and survey instruments such as the Hypertension Evaluation of Lifestyle and Management scale …

Health Literacy Intervention For Low Income Uninsured Population, Laura Larson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Health literacy (HL) requires basic skills in writing, reading, numeracy, and communication all within a health context (Berkman et al., 2011). HL is a critical element for individuals to take an active role in managing their health. The National Assessment of Adult Literacy found only 12% of adults had a “proficient” HL level. Hispanics were found to be at greatest risk for lower HL than all other ethnic groups (Kutner, Greenberg, Jin, & Paulsen, 2006). Low HL can lead to poor health outcomes including: decreased utilization of preventative services, difficulty in managing chronic conditions, and increased disparities in access …

Assessing The Long-Term Effects Of A Cultural Immersion Experience On Nursing Practice, Karen H. De La Cruz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Cultural immersion has been identified as a preferred method of teaching cultural competence in undergraduate nursing education. Multiple qualitative and quantitative studies have shown that baccalaureate nursing students enjoy international learning experiences and, based on self-efficacy evaluations, feel they have increased cultural competency following immersion experiences. However, there is little evidence to indicate concepts learned during undergraduate cultural competency course work is retained or integrated into nursing practice after leaving the milieu of academia.

To inform future cultural competency educational efforts, I conducted a qualitative phenomenological study to provide a baseline of evidence regarding the impact of a cultural immersion …

Implementing A Heart Failure Education Program For Bedside Nurses In The Acute Care Setting, David L. Morrow

UNLV Theses, Dissertations, Professional Papers, and Capstones

Heart failure is a chronic disease in which a weakened heart is no longer able to deliver adequate blood flow to supply the body with needed oxygen and nutrients. Heart failure is the most common reason for hospitalization in the United States for patients age 65 and over, accounting for over 1,000,000 hospital admissions annually. Due to the chronic nature of this debilitating condition and associated symptoms, patients discharged from the hospital with a diagnosis of heart failure are at high risk for readmission. Effective self-care behaviors have been shown to reduce readmissions and improve quality of life for these …

Electronic Health Record Instruction In First-Semester Nursing Students: A Comparative Study, Angela Ruckdeschel

UNLV Theses, Dissertations, Professional Papers, and Capstones

The use of health information technology has been shown to have positive effects on patient outcomes and provider efficiency. New nurses make more than half of the 7 million life-threatening medication errors that occur each year, and electronic health records (EHRs) have been shown to significantly reduce these errors. Nurses now are expected to enter practice with a solid foundation in health information technology and the use of the EHR. Unfortunately, the vast majority of nursing schools do not specifically train their students in effective EHR utilization. Academic EHRs (AEHRs) are software packages with learning features that can be incorporated …

Using Pictorial Action Instructions To Train Low-Literacy Adults To Construct A Basic Humanitarian Engineering Project, Kathleen Paco Cadman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Low- and middle-income countries (LMICs) are often disproportionately faced with environmental hazards, which can cause adverse health outcomes. Although humanitarian engineering projects have been created to mitigate these hazards, LMICs are also frequently impacted by literacy deficits, creating a barrier in training low-literacy individuals to construct these projects. The purpose of this dissertation was to develop, refine, and test the usability of pictorial action instructions (PAI) in training low-literacy individuals to construct a humanitarian engineering project. A concept analysis was completed, including the creation of an operational definition, for “lay worker health literacy.” This analysis and definition set a foundation …

Clinical Instructors' Cultivation Of Pre-Licensure Nursing Students' Pharmacology Ksas, Rieneke Holman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Adverse drug events affect up to 5% of inpatients; half of these events are caused by preventable medication errors (Agency for Healthcare Research and Quality, 2015). Nurses are the final checkpoint between a medication being ordered and the patient taking it. This profound responsibility requires nurses to possess well-developed pharmacology knowledge, skills, and attitudes (KSAs). To acquire these abilities, they must not only receive pharmacology content as part of their educational preparation, but also translate what they have learned during student clinical experiences. This is important in bridging the gap between what is learned in the

classroom and clinical practice. …

Concept Interview Assignment To Foster Intentional Learning In Nursing Students, Sarah Mollman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Intentional learning is the process of acquiring skills and attributes that facilitate knowledge attainment and application, and this process may foster learning skills and attributes in nursing students so they may thrive in student-centered nursing curricula and competently practice in today’s dynamic and complex healthcare system. The purposes of this study were to determine 1) if there are any associations between academic achievement and intentional learning and 2) if there is an effect of a nursing concept interview assignment on academic achievement and intentional learning scores in second-semester nursing students.

The majority of studies on intentional learning were quasi-experimental designs …

Maintaining Nurses' Currency In Informatics, Jennifer Alaine Strawn

UNLV Theses, Dissertations, Professional Papers, and Capstones

Technology has changed how registered nurses (RNs) provide care at the bedside. As more technologies are utilized to improve quality of care, safety of care, maximize efficiencies, and decrease costs of care, one must question how well the information technologies (IT) are fully integrated and utilized by the front-line bedside nurse in his or her practice. Despite the pervasiveness of IT in healthcare, there is a paucity of literature on how Chief Nursing Officers (CNOs) assure the ongoing education and training for nurses to maintain IT competencies in the practice environment.

From this author’s lived experience as a CNO, it …

Succession Planning For Nursing Leaders In A College Of Nursing, Cheryl Ann Tucker

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Institute of Medicine (2011) challenged nursing to ensure the nursing workforce includes a sufficient number of academic nurse leaders, nurse educators, and doctorally prepared nurses for the future healthcare needs of the people of the United States. National data reveals a fragile supply of academic nurse educators and leaders. This tenuous resource is shaped by multifaceted factors including: (1) an aging nursing workforce; (2) impending faculty retirements; (3) lack of qualified faculty; and (4) wage disparity between the academic and clinical settings. As these factors collide, it is imperative that academic nursing plan for the future by retaining, developing, …

Nursing Students’ Nonacademic Barriers To Success On High Stakes Exams, Jennifer Bussen Bussen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Every nursing program wants its graduates to pass the NCLEX-RN licensure examination the first time they take it. For those who fail, entry into practice is delayed until they can pass the NCLEX-RN. The nursing programs that graduated students who fail may experience a loss of reputation, decreased numbers of potential applicants, and, ultimately, state board of nursing sanctions. In an effort to determine which students are likely to be successful in taking the NCLEX-RN, many programs have turned to end-of-program predictor exams such as the Health Education System Inc. (HESI) exit examination (E2) (Lauer & Yoho, 2013; Nibert & …

The Impact Of Nursing Crew Resource Management Training On The Patient Safety Self-Efficacy Of Nursing Students, Deanne Marie Donaway

UNLV Theses, Dissertations, Professional Papers, and Capstones

Quality health care and optimal health outcomes begin by assuring patient safety. This is a shared responsibility of all health care providers. However, nurses have a fundamental obligation to assure patient safety, given their constant presence with patients requiring care. Patients who are cared for by nurses with insufficient or outdated patient safety education and knowledge can and often experience costly and catastrophic outcomes (Institute of Medicine (IOM), 2011). Medical errors now rank as the third leading cause of death in the United States and cost over 17.1 billion dollars/year (Makary & Daniel, 2016; Andel, Davidow, Hollander & Moreno, 2012). …

Student Motivation, Stressors, And Intent To Leave A Nursing Phd Or Dnp Program: A National Study Using Path Analysis, Delene Renee Volkert

UNLV Theses, Dissertations, Professional Papers, and Capstones

The growing need for nurse scientists and nurse faculty researchers has led to the call to double the number of doctorally prepared nurses by 2020 (Institute of Medicine [IOM], 2010). Nursing has responded with more doctoral degree programs resulting in an increase from 122 DNP graduates in 2007 to 8,184 nurses who hold DNP degrees by 2013. PhD programs have also seen 5,306 graduates between the years 2004 through 2013 (American Association of Colleges of Nursing [AACN], 2014a). One troubling aspect that affects nursing and other doctoral programs is high attrition rates. A recent ten year longitudinal study from the …

Delirium Education Program For Critical Care Nurses: A Mixed Methods Study, Meredith Padilla Padilla

UNLV Theses, Dissertations, Professional Papers, and Capstones

Approximately 10-30% of hospital admissions develop delirium where nearly 30-40% of the delirium cases are preventable. Non-detection rates by acute care healthcare workers were reported at 72-75%. Hence, it is crucial for hospitals to develop delirium education programs focused on early recognition and prevention. Thus, the purpose of this mixed method study was to develop and evaluate the effect of a delirium education program (DEP) on improving critical care nurses’ knowledge and self-confidence in identifying delirium and the associated risk factors. In the quantitative strand (Phase I) of the study, both the intervention and control groups completed the online pre-tests …

The Relationship Between Clinical Teaching Models And Perceived Clinical Self-Efficacy And Attitude Toward Team Process, Christina H. Plemmons

UNLV Theses, Dissertations, Professional Papers, and Capstones

Nurse educators are called to transform the education of nursing students, a process that is paramount to meet the needs of an increasingly complex health care system. The complexity of health care requires graduate nurses who are self-efficacious, yet also function well as full members of a health care team. In response to this call, clinical instruction, an essential component of nursing education, is receiving increased attention. Clinical education is vital, not only to the development of clinical self-efficacy, but also to the integration of future nurses into a health care team. To further this education process, faculty members from …