Medicine and Health Sciences Commons^™

The Lived Experiences Of Acute-Care Bedside Registered Nurses Caring For Patients And Their Families With Limited English Proficiency, Jami-Sue Coleman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Approximately 8.6% of the total U.S. population is considered limited English proficient (LEP), a term that has been used by official US federal policy and will be used throughout this study. In a landmark report, the Institute of Medicine found that minorities received lower-quality health care than Caucasians even when insurance status, income, and other factors were equivalent. These differences were tied to issues such as bias, stereotypes and communication barriers between patients and their caregivers. In the hospital setting, registered nurses provide the most direct contact with patients and their families. Effective communication between patients and health care professionals …

Developing Ethical Competence: The Perspective Of Nurse Educators From Pre-Licensure Baccalaureate Nursing Programs Accredited By The Commission On Collegiate Nursing Education, Jennifer Lee Bartlett

UNLV Theses, Dissertations, Professional Papers, and Capstones

Nurses face ethically-charged situations every day, yet ethics education is not universally integrated into pre-licensure baccalaureate nursing programs. Like other forms of competence, ethical competence requires development. Nurse educators are poised to impact on the competence of their students, both defining the ethics content and designing students' exposure. The purpose of this study is to describe the concept of ethical competence from the perspective of baccalaureate nursing faculty and describe current methods of integration and evaluation of ethics education in pre-licensure baccalaureate nursing programs. This research will be conducted using a sequential (quantitative-qualitative) mixed method approach. The first phase of …

The Lived Experience Of The Novice Nursing Dean: Exploring The Meaning And Significance, Melissa Rae Bouws

UNLV Theses, Dissertations, Professional Papers, and Capstones

Deans of nursing hold a unique position for the future of the profession. Few others have the potential to bring about change within the academic setting, or hold such a strong influence on the future of nursing and on our students. Current statistics reveal multiple vacancies in nursing dean positions. Further understanding of how nursing deans begin their role, attain their identity as dean, and successfully execute this important position is needed to recruit and retain strong leaders who have the methods and skills to develop and support the advancement of the nursing profession. Understanding the process of becoming nursing …

Testing A Reflection Education Intervention On Baccalaureate Nursing Students' Level Of Reflection During Online Clinical Post Conference, Jaime Alicia Hannans

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background

The majority of faculty-student interactions are at low cognitive levels during nursing clinical post conference (CPC), a time often utilized for reflective thinking. Strategies have been implemented to promote or even teach reflection, but the level of reflection or impact of the intervention in nursing, such as the relationship to student attributes or clinical reasoning, is often not evaluated.

Specific Aims

The specific aims of this study are to (a) test the effect of a reflection education intervention on the baccalaureate students' level of reflection during online CPC, (b) examine the relationship between student attributes and level of reflection, …

The Meaning Of Visual Thinking Strategies For Nursing Students, Margaret M. Moorman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Nurse educators are called upon to provide creative, innovative experiences for students in order to prepare nurses to work in complex healthcare settings. As part of this preparation, teaching observational and communication skills is critical for nurses and can directly affect patient outcomes. Visual thinking strategies (VTS) are a teaching method that has been studied in primary education to develop communication and observational skills. VTS holds the possibility to improve these same skills in nursing students, but it has only been studied once with nursing students in a quantitative study. Therefore, this qualitative research study sought to explore how nursing …

Evaluation Of An Educational Intervention On Perceptions Of A Patient Safety Culture Among Staff In Acute Care Nursing Units, Cynthia Ann Parkman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Patient safety has always been a central focus of nursing practice. Current research makes it increasingly clear that what occurs in the surrounding health care environment impacts patient safety. The protracted nursing shortage and nurse turnover may adversely affect patient outcomes and are exacerbated by an environment of disruptive behavior, conflict, and poor communication in the nursing workplace. The Joint Commission has identified these behaviors as key elements that jeopardize the "culture of safety" necessary to assure safe, quality patient outcomes. A culture of safety includes the attributes of teamwork, communication openness, collaboration, and a manager's positive focus on prevention …

Evaluating Shared Governance For Nursing Excellence, Evette Michelle Wilson

UNLV Theses, Dissertations, Professional Papers, and Capstones

The national challenges of nursing shortages, decreased staffing levels, and increased patient acuities have contributed to nurse's increased workload and job dissatisfaction. Nurses have become frustrated with the professional practice environment. The inability to make decisions about issues that affect their nursing practice and the care provided to their patients results in nurses leaving the work environment in search of higher job satisfaction. Employers are becoming more creative in their strategies to improve the work environment and retain nurses within their organizations. Healthcare leaders have implemented management strategies such as shared governance models. These models focus on providing a satisfying …

Development And Implementation Of A Quality Improvement Initiative: Systematic Follow-Up Of Patients Who Have Spinal Cord Stimulator Implants, Irina Rajala

UNLV Theses, Dissertations, Professional Papers, and Capstones

Recent medical advances and the rising prevalence of chronic pain in the US population contribute to the use of spinal cord stimulator (SCS) implant as a treatment modality for chronic pain management. As the numbers of patients receiving SCS implants steadily increases, the challenge of managing this device grows and the need for SCS implants follow-up programs rises. Follow-up programs need to focus on implant longevity and efficacy to improve the quality of care outcomes.

This Doctor of Nursing Practice (DNP) quality improvement initiative was developed to provide systematic follow-up for patient with SCS implant. The project includes the creation …

A Comparison Of Nursing Service Demand In Title 1 Schools And Non-Title 1 Schools, Karen Ray Stratford

UNLV Theses, Dissertations, Professional Papers, and Capstones

Children from low-income families are known to struggle academically, but lack of health services may also impact their education. School nurses must identify and manage health problems in the school-age child to improve academic success. Unfortunately, the school nurse-to-student ratio may limit the amount of time nurses can give to the recognition of health problems and appropriate follow-up. The Elementary and Secondary Education Act of 1965 provides Title 1 funding to schools whose enrollment includes at least 40% of low-income families. These federal funds are intended to be used to bridge the achievement gap between low-income students and other students. …

Predictors Of Resilience And Their Influence On Adaptation After Elective Abortion, Anna Marie Antonio

UNLV Theses, Dissertations, Professional Papers, and Capstones

The literature has inconsistent findings on the impact of an induced abortion on a woman's physical and psychological well-being. The purposes of this survey research design using correlation and multiple regression analyses were to determine the relationship between protective factors, risk factors, resilience, and outcomes (positive or negative). Additionally, this study investigated whether resilience, protective factors, and risk factors could be predictive of positive or negative outcomes following induced abortion. A convenience sample of 216 women was recruited nationally from hospitals, clinics, and various organizations. Inclusion criteria included women, 18 years of age or older, living in the United States, …

Perceptions Of Hospital Patient Safety Culture In Department Of Veterans Affairs Station 593 Southern Nevada, Kimberly Falco

UNLV Theses, Dissertations, Professional Papers, and Capstones

Opportunities for error exist, adverse events occur, and challenges endure. However, patients will continue to experience preventable adverse events unless steps are taken. Efforts to improve patient safety are critical to today's healthcare environment. The Department of Veterans Affairs (VA) believes that the identification of adverse events allows for creation of system improvements to increase patient safety.

Implementing safety culture requires a proper assessment of existing barriers and potential challenges. Patient safety culture assessments start by evaluating the current patient care environment. This assists the organization in identifying barriers to patient safety and in working toward creating a culture of …

Firefighter Fitness-For-Duty Medical Screening: A Peer Review Quality Improvement Pilot, Julie Collings Rochefort

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite the overwhelming evidence that sudden cardiac death is the most frequent cause of firefighter fatalities, many fire departments do not have a program to measure or maintain basic firefighter fitness and health. This project evaluated and compared medical screening outcomes of four industrial fire brigades within a multinational oil and gas corporation and introduced a quality improvement plan. The goal of this project was to apply the evidence and measure outcomes to determine the most effective way to ensure that firefighters in a corporate setting are healthy. This was accomplished by utilizing established guidelines in developing an educational program …

Comparison Of Study/Article Characteristics And Methodological Quality Of International Nurse Workplace Violence Research Published Before And After The Joint Commission Sentinel Event Alert On Disruptive Behaviors, Terressa Margarette Stowell Love

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The majority of new nurses experience workplace violence from other nurses. The purpose of this study was to compare study/research characteristics and methodological quality of international nurse workplace violence research published before and after the 2008 release of the U.S. The Joint Commission (TJC) sentinel event alert on disruptive behaviors.

Methods: Thirty-nine quantitative nurse workplace violence research articles published between 2001 and 2012 were assessed and divided into two groups: articles published (a) before the 2008 TJC sentinel event alert or the same year, i.e., 2001-2008 (BTJC) and (b) after the 2008 TJC sentinel event alert, i.e., 2009-2012 (ATJC). …

School Nurses' Recognition, Attitudes, And Educational Needs Regarding The Care Of Children With School Refusal Behavior, Heather Strasser

UNLV Theses, Dissertations, Professional Papers, and Capstones

School refusal behavior can prevent a child from attending school or staying in class for a full day of instruction. School nurses are often one of the first professionals in the school with the opportunity to interact with these children, recognize school refusal behavior and its debilitating impact, and positively intervene to assist these children to stay in school. Few studies have examined school nurse recognition and attitudes regarding school refusal behavior. The purpose of this study was to assess school nurses' recognition of school refusal behavior, their attitudes regarding the nursing care of children with school refusal behavior, and …

Implementing A Bystander Awareness Program On A University Campus, Robert Joseph Vadovic

UNLV Theses, Dissertations, Professional Papers, and Capstones

Between 17% and 62% of college students experience some form of violence during their time at school. About 25% of female college students experience a sexual assault before graduating. One university had seen an increase in violence, including assaults and bias events. Administrators and nurses implemented a bystander awareness program to help alleviate this growing problem. Members of the college's residence life staff and its Greek organizations (fraternities and sororities) participated in the Step Up program, a prosocial training program to get people to intervene safely when witnessing acts of violence. Participants (N=236) completed surveys prior to the program, immediately …

Sickle Cell Disease: A Quality Improvement Initiative For Emergency Department Providers, Pretrescia Marie Walker

UNLV Theses, Dissertations, Professional Papers, and Capstones

Sickle Cell Disease (SCD) is an incurable, chronic condition that results in a constellation of disorders, frequent emergency department (ED) visits, and repeated hospital admissions. Those affected often suffer from pain crisis, infection, acute chest syndrome, stroke, and multi-organ impairment and frequently do not receive adequate pain management during acute pain episodes because ED providers view them as drug seeking. The majority of patients with SCD are African-American and may be low income, uninsured, or on Medicaid. As a result, these demographics make ED under-treatment of pain in patients with SCD a health equity issue. This was a pre-experimental one …

A Diabetes Prevention Program Provided By Home Care Nurses To Residents Of Public Housing Communities, Robin Whittemore Phd, Alana Rosenberg Mph, Sangchoon Jeon Phd

Journal of Health Disparities Research and Practice

The purpose of this pilot study was 1) to modify the Diabetes Prevention Program protocol collaboratively with home care nurses, health professionals, and residents of public housing: 2) to evaluate the feasibility (reach and implementation) and the preliminary efficacy of the modified diabetes prevention program (mDPP) provided by home care nurses to adults at-risk for T2D on clinical, behavioral, and psychosocial outcomes compared to an enhanced standard care control group. A mixed-method sequential design was used. The sample (n=67) was primarily female (79%), with a mean age of 40 years, and of diverse race and ethnicity (76% non-White). Home care …

Cardiovascular Risk Factors Prevalent Among Filipino-Americans: A Cross-Sectional Study, Alona Angosta

Interdisciplinary Research Scholarship Day

Filipino Americans are the 2nd largest Asian subgroup in the United States and their leading cause of death is cardiovascular disease (CVD). Despite this, little is known about their prevalence of CVD risk factors. This study revealed that many Filipino Americans living in Clark County, Nevada are at risk of heart disease because of the presence of CVD risk factors. Intensive lifestyle modification and treatment are recommended to help decrease the prevalence of heart disease in this group and improve their overall health outcomes. Nurses and nurse practitioners are in excellent position to educate their Filipino American clients regarding heart …

Quantifying Head Injury Severity Following Pediatric Patient Falls, Janet Dufek, N.A. Ryan-Wenger, K.C Mefferd

Interdisciplinary Research Scholarship Day

The purpose of this study was to retrospectively calculate the head injury criteria (HIC) values for pediatric patient falls and correlate these values to documented injury severity (MERP) scores. A second purpose was to examine the relationship between child ages and associated HIC15 values in an attempt to scale the values obtained from pediatrics to adult values.

Self-Management And Self-Management Support On Chronic Low Back Patients In Primary Care, Jennifer Kawi

Interdisciplinary Research Scholarship Day

• Chronic low back pain (CLBP) afflicts 28.5% of adults costing $100-200 billion dollars.
• In response, the Institute of Medicine (2011) strongly recommended self-management (SM) to engage patients to care for themselves adequately.
• Healthcare professionals are also urged to provide effective self-management support (SMS) to empower patient’s ability to self-manage.
• SM and SMS have shown success in improving other chronic disease outcomes; current knowledge base are insufficient in non-malignant CLBP

A Single Long-Term Acute Care Hospital Experience With A Pressure Ulcer Prevention Program, Daniel Young, Cathy Borris-Hale

Interdisciplinary Research Scholarship Day

This study describes the experience of a single, long-term care acute hospital (LTAC) with the Medline Pressure Ulcer Prevention Program (mPUPP)

• The growing light being shed on pressure ulcer (PrU) costs for the people that get them and the health care systems that treat them, has challenged care facilities to look for programs to reduce nosocomial PrU
• Each PrU can cost between $700 and $135,000 in medical care related expenses and litigation
• Recent evidence suggests that successful PrU prevention programs have common characteristics

Preliminary Results Of Using A Student Success Facilitator In An Accelerated Baccalaureate Nursing Program, Jennifer Bellsey, Cheryl Perna, Tish Smyer, Carolyn B. Yucha, Antonio Gutierrez,

Interdisciplinary Research Scholarship Day

Competing demands of work, family, friends, and the academic rigor while in an accelerated baccalaureate nursing program often lead to high levels of anxiety and may contribute to unsuccessful student progression. This phenomena is not unique to the UNLV School of Nursing but is an issue that nursing programs grapple with nationwide. While there is nursing research literature related to student success programs there are limited studies that describe the use of a Student Success Facilitator (SSF) coupled with a Student to Student Mentoring Program (SSMP). IRB Exempt #1205-4167

Teaching Qsen Competencies To Entry Level Nursing Students, Brianna Clouet, Melissa Glasper, Cheryl Perna

Interdisciplinary Research Scholarship Day

The University of Nevada Las Vegas (UNLV) is a public state university with a fully accredited School of Nursing (SON), which typically admits 48 students every trimester into their accelerated pre-licensure BSN program. UNLV is:

• Accredited by the Commission on Collegiate Nursing Education (CCNE)

• Fully Approved by the Nevada State Board of Nursing (NSBN),

• Continuously working to meet and uphold external standards and to remain current and competitive.

A team consisting of two Level 4 BSN students and the BSN Coordinator identified the need to better integrate the QSEN competencies into current nursing curriculum. Although the competencies are embedded into …

The Impact Of Interdisciplinary Code Simulation On Perceptions Of Collaboration And Team Performance Among Internal Medicine Residents And Nursing Students, Cynthia Herrick, Michael Michael Nasiak, Aditi Singh, Sandhya Wahi-Gururaj, C. Sue Witt, Jessica Doolen, Kevin Gulliver

Interdisciplinary Research Scholarship Day

• Allows for inter-disciplinary training
• Provides safe environment to practice patient care with immediate feedback-quality improvement
• Results in better adherence to protocols
• Well received by learners
• In one study, almost half of IM residents surveyed felt ill- equipped to lead code teams even after ACLS training

Crisis Resource Management (CRM)

• Communication and cooperation
• Leadership and management
• Situational awareness
• Decision-making

Pre- And Post-Interrvention Perceptions Of Illness, Health, And The Home Environment Among Nevada Healthy Homes Participants, Michelle Ching, Shawn Gerstenberger

Interdisciplinary Research Scholarship Day

The Nevada Healthy Homes Partnership (NVHHP) is a collaborative program between the University of Nevada, Las Vegas (UNLV), Southern Nevada Health District (SNHD), Rebuilding Together (RBT), HELP of Southern Nevada, and other public/private housing authorities and health agencies in Southern Nevada.

Evaluation Of The Childhood Blood Lead Screening Component Of The Southern Nevada Childhood Lead Poisoning Prevention Program, Melissa Breunig, Shawn Gerstenberger

Interdisciplinary Research Scholarship Day

The objective of this paper is to highlight the progress of the lead poisoning prevention program in Southern Nevada. Specifically, we present blood lead screening results for Clark County, Nevada from 2006 through 2011, and review the progress towards recommendations made by Rothweiler et al. for Nevada in 2007.7

Effectiveness Of A Reference Accuracy Strategy For Faculty Scholarship, Kirsten Speck, Barbara St. Pierre Schneider,

Interdisciplinary Research Scholarship Day

The dissemination of scholarly information through scholarly publishing is one of the most important requirements to be successful in academia. Approximately 25-45% of nursing scholarship has at least one reference error. Reference inaccuracy occurs in scholarly publishing because most faculty authors focus more on the writing than on the accuracy of the references or these authors inadvertently miss the reference errors. Nevertheless, inaccurate references hinder the retrieval of material if author names are misspelled or the year or volume number is incorrect. Also, this lack of precision can raise questions about the accuracy of other parts of the material and …

Levels Of Adoption Of Electronic Health Records And Patient Safety: Effectiveness And Efficiency, Scott Neishi, Yili Gan, Christopher R. Cochran, Jay J. Shen

Interdisciplinary Research Scholarship Day

• Patient safety, including hospital acquired infections has become one of the major concerns in healthcare delivery in recent years
• Electronic health records are becoming an integral aspect of the health care delivery
• Health policies have been looking to improve quality / patient safety and efficiency of healthcare through the adoption of electronic health record (EHR) systems
• Can EHR adoption improve patient safety?
• Can EHR adoption reduce cost?
• H1: Patients treated at hospitals with a higher level of EHR adoption are less likely to incur poorer patient safety indicators
• H2: Patients treated at hospitals with a higher level of EHR adoption …

Barriers To Health Care For People With Disabilities And Practice Administrators’ Knowledge Of The Ada: Nevada Compared With The Nation, Jennifer Pharr, Michelle Chino

Interdisciplinary Research Scholarship Day

The purpose of this study was to determine if the number of barriers reported in the clinics could be predicted by characteristics of the administrators or
characteristics of the practice.To increase accessibility to health care, interventions should focus on practices located in buildings built before 1993, practices with administrators who are younger and have limited experience as administrators, administrators with low levels of ADA knowledge and practices with smaller number of patients.

Isolation Of Lesbian, Gay, Bisexual, And Transgender Youth: A Dimensional Concept Analysis, Michael Johnson, Elaine Amella

Interdisciplinary Research Scholarship Day

Present the findings of a dimensional concept analysis of isolation within the context of LGBT youth. LGBT youth are at greater risk for negative health outcomes as compared to heterosexual youth, including depression, anxiety, suicide, substance abuse, and HIV/AIDS. Some studies suggest LGBT feeling and being isolated is related to some negative health outcomes. Other research reveals a relationship between isolation and negative health