Medicine and Health Sciences Commons^™

Reconciling Incongruencies: Examining The Meaning And Influencing Factors Of Oncology Nurses' Professional Quality Of Life, Rebecca Lynne Boni

UNLV Theses, Dissertations, Professional Papers, and Capstones

Nurses often witness suffering and loss. These experiences are intrinsic to the practice of nursing and can exert a strong, cumulative effect on nurses’ professional quality of life (QOL). Stamm (2010b) conceptualizes professional QOL as a composite of compassion fatigue and compassion satisfaction. Inferior professional QOL has been linked to numerous negative healthcare outcomes. Oncology nurses are particularly vulnerable to compassion fatigue. The Professional Quality of Life Scale (ProQOL), created by Stamm (2009), is the current survey used to measure professional QOL, but it may not be specific enough for oncology nurses.

The purpose of this grounded theory study was …

Benson’S Relaxation Response: Psychological And Physiological Responses Among Patients With Copd, Crista Reaves

UNLV Theses, Dissertations, Professional Papers, and Capstones

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States. In patients with COPD, distress is significantly prevalent and can have adverse psychological and physiological effects. Considering the increased rate of COPD, a mind-body intervention focusing on the reduction of both psychological and physiological responses such as anxiety, elevated blood pressure (BP), heart rate (HR), dyspnea, and respiratory rate must be integrated into the patient’s plan of care. The relaxation response (RR) is a term coined by Dr. Herbert Benson in the 1970s describing the body’s ability to counter the fight-or-flight response to decrease …

Infection Control: The Nurse's Responsibility, Marisa Francis

UNLV Theses, Dissertations, Professional Papers, and Capstones

Over the last century and a half, infection control measures implemented by nursing staff have continued to evolve, resulting in improved patient outcomes. While this progress is impressive, a decline in rates of hospital acquired infections (HAIs) seems to have slowed, with only a 0.5% decrease in the last seventeen years. Unfortunately, nurses are rarely provided educational support on infection control practices beyond undergraduate and new employee trainings. Meanwhile, the Centers for Disease Control (CDC) is frequently updating their infection control practice recommendations.

The purpose of this project was to observe the current rate of infection control compliance by nurses, …

Methodology For Sampling Women At High Maternal Risk In Administrative Data, Jennifer Vanderlaan, Anne Dunlop, Roger Rochat, Bryan Williams, Susan E. Shapiro

Nursing Faculty Publications

Background: In population level studies, the conventional practice of categorizing women into low and high maternal risk samples relies upon ascertaining the presence of various comorbid conditions in administrative data. Two problems with the conventional method include variability in the recommended comorbidities to consider and inability to distinguish between maternal and fetal risks. High maternal risk sample selection may be improved by using the Obstetric Comorbidity Index (OCI), a system of risk scoring based on weighting comorbidities associated with maternal end organ damage. The purpose of this study was to compare the net benefit of using OCI risk scoring vs …

Adolescent Pregnancy: A Clinical Guideline For School Nurses In New Mexico, Karin Ludi

UNLV Theses, Dissertations, Professional Papers, and Capstones

The overall purpose of this project is to ensure that school nurses and health assistants are knowledgeable and have the resources to care for pregnant adolescents in the public school system. New Mexico has consistently ranked in the top 10 in the United States for teen births to women aged 15-19 years. The New Mexico School Health Manual is currently used to guide school nurses and health assistants in the care of pregnant adolescents, but it is vague and addresses emergencies such as labor and bleeding.

From this author’s experience as a school nurse in the public school system, it …

Cultural Factors Affecting Resilience Of Filipino Immigrant Women, Andrew Reyes

Nursing Faculty Publications

This presentation describes the results of a descriptive study exploring the relationship between resilience, acculturative stress, and cultural family beliefs about disclosing mental health problems among Filipino immigrant women living in the United States.

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 …

A Guide For Outcomes Evaluation And Sustainability Of A Dedicated Education Unit Within An Academic-Practice Partnership, Jennifer Pfannes

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Dedicated Education Unit (DEU) has emerged as an innovative approach to providing a positive, high-quality, collaborative clinical learning environment that fosters the growth and learning of undergraduate nursing students. Additionally, the DEU model has demonstrated success in beginning to bridge the education-practice gap, tackling the faculty shortage, and easing the new graduate transition from education to practice; however, developing, evaluating and sustaining an economically successful DEU takes thoughtful,

strategic planning. The challenging nature of developing and sustaining a DEU that mutually benefits both the academic and clinical partner over time, reveals the need for more guidance to secure long-term …

An Exploration Of Nursing Communication Competence During The Handoff Report, Megan Elizabeth Smith

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction Nurse handoff reporting is a crucial time for communication exchange in healthcare settings. During the handoff report, patient information is exchanged between senders and receivers transferring responsibility for care with the main purpose of providing accurate and timely information about the patient. The Joint Commission reports that shortcomings related to communication can be directly related to an increase in patient care errors, with approximately 80% of medical errors resulting from miscommunication during the handoff process. Numerous intervention studies focus on standardizing information, developing physical locations and environments for ideal handoffs, and creating tools for structured information exchange between different …

A Group Development Program Based On Transformational Leadership To Improve Team Performance, Anne-Marie Schenk

UNLV Theses, Dissertations, Professional Papers, and Capstones

As reimbursement models move from volume-based to value-based, organizations increasingly depend on meeting patient outcome goals in order to achieve their budgetary targets. Leadership teams are a vital part of healthcare organizations and their performance is crucial to the overall organization’s performance. The organization of interest saw a group of strong individual leaders struggle with outcome production due, in part, to overall team dysfunction. To address this need, this DNP project is a group development program, based on the concepts of transformational leadership. As functional groups and transformational leaders are known to drive outcomes, when implemented, this program’s goal is …

A Guide For A Shared Governance Program, Lydia Joan Lefchuck

UNLV Theses, Dissertations, Professional Papers, and Capstones

Shared governance (SG) within an organization promotes professional growth with the expectation that employees will be active contributors in attaining organizational goals. Healthcare organizational leaders ultimately have a fiduciary responsibility to stakeholders to seek quality improvement initiatives. SG leads to a healthy workplace environment staffed by empowered nurses. Having a committed workforce practicing within SG leads to increased employee satisfaction and engagement, and longer nursing tenures with loyalty to their organization. The low nursing turnover rates, associated with a satisfied and engaged staff, translate into efficient productivity, continuous quality improvement, better patient outcomes, and operational cost savings.

Health systems administrators …

Leadership Development In Nursing: Planning From The Bedside To The Executive Suite, Janet C. Wright

UNLV Theses, Dissertations, Professional Papers, and Capstones

Nurses comprise the largest portion of the healthcare sector workforce over 4 million professional nurses licensed in the United States (National Council of State Boards of Nursing, 2019). Leading within a vast workforce such as nursing requires the nurse leader to have the expertise of the nursing profession along with leadership and business skills to maintain competitiveness in the complex healthcare industry. Consequences of effective leadership include improved patient outcomes, decreased staff turnover, and decreased costs to the organization related to patient outcomes and turnover costs. These results suggest the importance for organizations to ensure their leaders are properly trained …

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 …

Evidence-Based Practice Guide And Workflows: Improving Hospital Throughput And Reducing Emergency Department Overcrowding, Maulah Halley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Hospitals in the United States are experiencing disruptions to patient throughput. These disruptions create barriers to patients who seek emergent care in the Emergency Department (ED) and who must be moved to hospital inpatient beds after the decision to admit has been made. As a result, patients requiring hospital admission via the ED may have long wait times, which, in turn, contribute to ED crowding and overcrowding. The root causes of ED overcrowding are inefficiencies within the system and the inability of hospitals to meet demand. Although bed capacity on any given unit may not be altered, ED patient’s arrival …

Implementation Of An Asthma Action Plan In A Pediatric Outpatient Clinic, Noelle Cerdan

UNLV Theses, Dissertations, Professional Papers, and Capstones

A combination of asthma evidence-based education by nurse practitioners and other healthcare providers as well as self-management by patients with asthma and their caregivers are necessary to provide effective asthma care. According to the National Asthma Education and Prevention Program (NAEPP) guidelines from the National Institute of Health (NIH), effective asthma care includes a detailed Asthma Action Plan (AAP). However, despite this evidence-based recommendation for all patients with asthma, studies suggest many healthcare providers do not routinely utilize an AAP.

The purpose of this Doctor of Nursing Practice (DNP) project was to develop and evaluate a process for the integration …

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 …

Prevalence And Use Of High-Fidelity Simulation In Family Nurse Practitioner Programs, Christina Rosa Pendrak Pepin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Family nurse practitioner (FNP) programs represent almost 60% of all accredited primary-care NP programs in the U.S. in 2015. Increased enrollments and creation of new NP programs has led to a shortage of appropriate clinical sites and the increased competition for quality clinical sites. FNP programs have turned towards utilizing innovative ways to address this shortage including the use of high-fidelity simulation. However, a lack of literature supports substituting traditional clinical hours with high-fidelity simulation. Only 45 articles were found over a 35-year period describing the use of high-fidelity simulation in an FNP program and of those published since 2014, …

Development Of A Breast Cancer Survivorship Care Toolkit, Lauren Elaine Scott

UNLV Theses, Dissertations, Professional Papers, and Capstones

A breast cancer survivor’s journey does not end with treatment. After treatment, most breast cancer survivors go on to face many life-long physical and mental challenges caused by their cancer and treatment. Once active cancer treatment is completed, patients enter the next important step in cancer care, cancer survivorship. Cancer survivorship is a comprehensive approach to post-oncology management that promotes the best outcomes for survivors as they transition from oncology care to primary care; and new breast-cancer survivorship guidelines have emerged. Research suggests that primary care NPs’ lack of awareness of the current 2016 American Cancer Society/American Society of Clinical …