Medicine and Health Sciences Commons^™

Racial Disparities In Pain Management In Primary Care, Miriam Ezenwa

Journal of Health Disparities Research and Practice

This descriptive, cross-sectional, secondary data analysis was conducted to examine racial disparities in pain management of primary care patients with chronic nonmalignant pain using chronic opioid therapy. Data from 891 patients, including 201 African Americans and 691 Caucasians were used to test an explanatory model for these disparities. We predicted that: (1) African American patients would report worse pain management and poor quality of life (QOL) than Caucasians; (2) the association between race and pain management would be mediated by perceived discrimination relating to hopelessness; and (3) poor pain management would negatively affect QOL. Results revealed significant differences between African …

The Meaning Of The Lived Experience Of Nursing Faculty On A Dedicated Education Unit, Deborah Ann Demeester

UNLV Theses, Dissertations, Professional Papers, and Capstones

In 2011, 58,327 qualified applicants were denied admission to U.S. baccalaureate programs due to an inadequate number of qualified faculty, insufficient clinical placement sites, and resource constraints. Nursing faculty leaders are being challenged to increase enrollment to address a projected worsening nursing shortage and to transform prelicensure nursing education to ensure that program graduates have the nursing skills and competencies to meet the health care needs of the population.

Collaborative educational partnerships offer promising strategies to diminish the nursing faculty shortage, educate more students, and provide stable, rich learning environments. The Dedicated Education Unit (DEU) model is one of these …

Program Evaluation Of Preceptor Preparation And Effectiveness In A Local Nurse Residency Program, Margaret Covelli

UNLV Theses, Dissertations, Professional Papers, and Capstones

Preceptors are vital to the success of new graduate registered nurses in their transition to practice as they assist the new nurse in developing skills, competency, and confidence. Most residency programs may include training for preceptors but there may not be evidence that preceptor preparation makes a difference in the retention of nurse residents or the relationship to favorable evaluations of preceptors from the residents. This study evaluated and compared the effects of preceptor training on competency levels of the resident and therefore retention.

The methodology was a post hoc descriptive study of variables that included demographics, surveys from residents …

Provider Variations In Cesarean Section (Cs) And Vaginal Birth After Cesarean (Vbac) Practice, Rita Elizabeth Marrero

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Centers for Disease Control and Prevention's National Center for Health Statistics (2010) report that nearly one-third of babies were born by Cesarean section (CS) in 2007. Of interest, six states, including Nevada, experienced increases of more than 70% in the last 10 years (CDC, 2007). Based on the increased rate of CS deliveries, the National Institutes of Health (NIH) convened a consensus panel in 2010, which urged the medical community to reduce barriers to women who want to try a vaginal birth after Cesarean delivery (VBAC) in the hope this would safely decrease the total CS rate. For clinicians …

Nutritional Management Of The Extremely Low Birth Weight Infant: An Evidence Based Clinical Practice Guideline, Dana J. Lunde

UNLV Theses, Dissertations, Professional Papers, and Capstones

Premature birth has risen steadily over the last decade resulting in an increased number of infants needing neonatal intensive care. The demand for neonatal intensive care has lead to many improvements in the delivery of such care with an increase in the survival of the smallest and most premature infants. However, most of these infants are being discharged from neonatal intensive care units (NICU) with severe extrauterine growth restriction (EUGR).

Extremely low birth weight (ELBW) infants born at 23-27 weeks gestation and who have a weight of less than 1,000 grams are at the highest risk for EUGR because of …

Program Evaluation Of Stroke In Rural Nevada Hospital, Starla Cheri Ricks

UNLV Theses, Dissertations, Professional Papers, and Capstones

The overall goal of this Doctor of Nursing Practice (DNP) scholarly project is to complete a program evaluation using the Centers of Disease Control (CDC) Framework for Program Evaluation to measure the effectiveness of a stroke protocol in a rural Nevada hospital. This (DNP) scholarly project evaluates program strategies over third and fourth quarters of 2010 as well as the first, second, and third quarters of 2011, that have been initiated to reduce the burden of neurological disease with the application of a stroke protocol that complies with defined evidence-based strategies for assessment and management of stroke victims. As part …

Cultural Competence In The Baccalaureate Degree Nursing Curriculum, Angela Elizabeth Silvestri

UNLV Theses, Dissertations, Professional Papers, and Capstones

Health care providers are members of a helping profession and need to provide quality care to all members of society. As a result of current and projected demographic changes within the United States (U.S.), health care professionals are faced with the challenges of providing culturally competent care and fulfilling the role as the "helping profession." In the past 10 years, minority populations have increased in the U.S. For example, the African American population experienced an approximate 12.3% increase, and the Hispanic population increased by 43%. Just as it is necessary for health care professionals to respond to the increase in …

Use Of Continuous Glucose Monitors In Type-1 Diabetes: An Analysis Of Wave Form Versus Glycemic Values In The Improvement Of Glucose Control And Fear Of Hypoglycemia, Tomas Charles Walker

UNLV Theses, Dissertations, Professional Papers, and Capstones

Type-1 diabetes is a disease of subtle complexities. Patients struggle to understand glucose patterns and their responses to insulin or food intake while maintaining hectic lifestyles. Minor misjudgments in treatments can result in disastrous consequences with significant hypo- or hyperglycemic excursions.

Despite improvements in technologies available for diabetes management, including home monitoring of blood glucose, more predictable insulin therapies, and improved insulin delivery via insulin pump, the average HbA1c has remained relatively unchanged. Poor diabetes control is recognized as contributing to long-term diabetes comorbidities including neuropathy, nephropathy, retinopathy, and micro- and macrovascular disease.

Real-time continuous glucose monitors, such as the …

Elementary School Based Health Centers As Providers Of School Entry Health Exams: Do They Meet The Standards?, Roberta Bavin

UNLV Theses, Dissertations, Professional Papers, and Capstones

The health of today's children is crucial for the future of our society. There are many children without access to healthcare in these turbulent economic times; times that are increasingly uncertain as society maneuvers its way through the maze of healthcare reform. School based health centers (SBHCs) provide a safety net for children needing basic healthcare who are otherwise underserved. School entry health examinations (SEHE) are legal requirements in many states, and are a proven method for identifying health conditions early enough in a child's life that they can be corrected. Treating identified health conditions facilitates academic success for children, …

Increasing Labor And Delivery Nurse Knowledge Of Triaging Non-Obstetrical Medical Emergencies In Pregnant Women Through The Use Of Simulation, Julie Hoffman

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to evaluate the effect simulation training has on an OB nurse's ability to correctly triage pregnant patients. Registered Nurses (RNs) working in OB triage must be able to correctly and expediently identify the care a pregnant patient needs. OB triage nurses are trained to recognize pregnancy related issues that commonly present during the months leading up to delivery. It is as important for these nurses to have the skills to realize when a pregnant patient is having a non-obstetrical health crisis. A group of OB triage RNs participated in simulation-training scenarios based on non- …

The Relationship Between Self-Efficacy And Fluid,And Dietary Compliance In Hemodialysis Patients, Ansy Paul John

UNLV Theses, Dissertations, Professional Papers, and Capstones

Patients with end-stage renal disease (ESRD) who receive hemodialysis often fail to follow a prescribed diet and fluid regimen, which undermines the effectiveness of care and leads to unpredictable disease progression and greater likelihood of complications. Non-adherence to dietary and fluid limitations compromises the outcomes of patients receiving hemodialysis. Noncompliance can lead to detrimental long-term outcomes including deterioration of the cardiovascular system, heart failure, hypertension, and pulmonary edema as well as short-term problems such as edema, itching, bone pain, and breathlessness.

Many studies have demonstrated that self-efficacy strategies are associated with improved dietary and fluid compliance among individuals receiving hemodialysis. …

Clinical Practice Guidelines For Primary Care Providers' Evaluation Of Patient Fitness To Fly, Kerry Colleen Palakanis

UNLV Theses, Dissertations, Professional Papers, and Capstones

Commercial air travel is amongst the safest forms of transportation yet the environment within the aircraft cabin to which the passenger is exposed may have adverse physiological and psychological effects on passengers, especially for those with pre-existing medical issues. A comprehensive, systematic review and analysis of current literature was performed to develop evidenced-based guidelines for evaluation of passenger fitness to fly for integration into primary care practice. Recommendations from the most current fitness to fly guidelines and disease-specific published research related to in-flight medical issues were evaluated and the Grades of Recommendation Assessment, Development and Evaluation (GRADE) method was utilized …

Improving Evidence Based Asthma Management In An Urban University Student Health Center, Hedian Cho Swanson

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this project was to improve asthma management through focused staff education and training on national asthma guideline recommendations. The Student Health Center (SHC), located in a university in the southwest United States, performed annual reviews of asthma-related electronic medical records (EMR) in an effort to provide quality health care. These reviews used 23 quality improvement (QI) parameters extracted from the 2007 National Asthma Education and Preventive Program Expert Panel Report 3 (NAEPP EPR 3). The SHC QI findings were consistent with current asthma management literature indicating asthma control is often overestimated and undertreated. This project (a) provided …