Medicine and Health Sciences Commons^™

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 …

Exploring The Lived Experience Of Early-Career Millennial Nursing Faculty: Deriving Meaning From Their Perspective, Adrian Stamps

UNLV Theses, Dissertations, Professional Papers, and Capstones

An innovative way to combat the protracted nursing faculty shortage is to recruit up and coming generations of nurses to academia. The most recent generation to enter the academic ranks are millennials, often categorized in nursing by a birth year between 1981 and 2000. In contrast to preceding generations, millennials are seeking roles in academia earlier in their careers. Research has shown millennials have unique perspectives on the workplace and a tendency to leave positions if they are not satisfied. This pattern could pose a challenge for sustaining the nursing faculty workforce.

How millennials perceive their initial years in the …

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 …

Becoming Myself: A Constructivist Grounded Theory Study Of The Gender Transition Experiences Of Practicing Nurses, Rhiannon Dawn Sullivan

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to construct a substantive grounded theory specific to the gender transition experiences of practicing nurses in their personal and professional lives and to explore the barriers and facilitative factors to gender transition for practicing nurses. There has been research regarding transgender individuals’ discrimination experiences in their daily lives related to their gender identity. These negative experiences increase their vulnerability to negative health outcomes, such as anxiety, substance abuse and depression. However, there is very little known about practicing nurses who are transgender. This research is important because the mental and physical health of nurses …

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 …

Healthcare-Seeking Behaviours In College Students And Young Adults: A Review, Dieu-My T. Tran, Angela Silvestri-Elmore

Nursing Faculty Publications

Background/aims: To review the literature on college students’ healthcare-seeking behaviours to uncover the current evidence and promote better healthcare-seeking behaviours and essentially better health outcomes in young adults. Methods: The researchers conducted an extensive literature review using CINAHL, Cochrane, PubMed, EBSCOhost and Google Scholar in the years 2018 and 2019. The search was limited to the past 18 years (2000–2018) and to studies reported in the English language focused on the general healthcare-seeking behaviour of college students. The search was also extended to young adults (aged 18–39 years). Results: A total of 56 articles were identified for abstract review and …

An Intervention To Increase Nurses’ Knowledge Of Non-Opioid Pain Management In Post-Operative Elective Knee And Hip Replacement Patients, Kristen K. Grunerud

UNLV Theses, Dissertations, Professional Papers, and Capstones

Post-operative pain control is an enduring problem in health care. The extensive use of opioids since the 1980s has contributed to the current opioid crisis in the United States. In response, healthcare providers have begun to use a more biopsychosocial model to address pain control needs of patients. There is a demonstrated gap in knowledge for nurses in this area, and recent changes to hospital accreditation standards include a requirement to demonstrate both education provisions to staff and the use of non-opioid methods to control pain. The purpose of this Doctor of Nursing Practice (DNP) project was to assess, and …

Rejection Sensitivity And The Intent To Seek Medical Help Among Gender Minority Individuals, Kellyann Garthe

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: As members of a marginalized and socially devalued group, gender minority (GM) individuals regularly experience rejection in healthcare experiences. These rejecting experiences lead to barriers to healthcare access and health disparities. Consequently, GM individuals’ may develop anxious and avoidant attitudes toward their healthcare needs. When considering healthcare, an individual’s inherent attitude informs their intent to seek medical help (ISMH), defined as the attitude that influences one’s decision to seek medical help. When an individual has a hyper-sensitive reaction to perceived rejection, this is termed rejection sensitivity (RS).

Purpose: The purpose of the study was to determine if the independent …

Long-Term Impact Of Mild Traumatic Brain Injuries On Multiple Functional Outcomes And Epigenetics: A Pilot Study With College Students, Hyunhwa Lee, Sungchul Lee, Ipuna Black, Laura Salado, Jonica Estrada, Katrina Isla

Nursing Faculty Publications

People who suffer a mild traumatic brain injury (mTBI) have heterogeneous symptoms and disease trajectories, which make it difficult to precisely assess long-term complications. This pilot study assessed and compared deficits in cognitive, psychosocial, visual functions, and balance performance between college students with and without histories of mTBI. Global DNA methylation ratio (5-mC%) in blood was also compared as a peripheral epigenetic marker. Twenty-five volunteers participated, including 14 healthy controls (64.3% females; mean age of 22.0) and 11 mTBI cases (27.3% females; mean age of 28.7 years) who self-reported mTBI history (63.6% multiple; 2.5 ± 1.29 injuries) with 7.1 years …

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 …

Assessing The Cost-Benefit Of Hiring A Deu-Prepared Rn Graduate: Does It Help Reduce Organizational Costs?, Tonya D. Bryant

UNLV Theses, Dissertations, Professional Papers, and Capstones

Costs associated with training new nurses from the time of hire to the time of independent practice can cost organizations nearly $100,000 per nurse (Acuna, Yoder, Madrigal-Gonzalez & Yoder-Wise, 2017; Silvestre, Ulrich, Johnson, Spector, & Blegan, 2017; Trepanier, Early, Ulrich & Cherry, 2012). New-hire costs for a dedicated education unit (DEU)-prepared newly qualified newly hired nurse (NQNHN) may be prohibitive for some hospitals when considering the cumulative amount of time and costs dedicated to training these specially prepared nurses who have previous clinical and organizational experience from their time as nursing students within the organization over the duration of their …

Improving Type 2 Diabetes Mellitus In The Older Adult Population Utilizing Shared Medical Appointments In Primary Care Setting, Mailo Brantner

UNLV Theses, Dissertations, Professional Papers, and Capstones

The overall management of Type 2 diabetes mellitus (T2DM) and its comorbidities is complex and costly. The American Diabetes Association (ADA, 2019c) recommends the use of team-based care and self-management tools to optimize the management of T2DM. Unfortunately, there is a national shortage of endocrinologists and certified diabetes educators (Stewart, 2008) along with a primary care provider shortage (Simmons & Kapustin, 2011). Thus, it is essential to implement a care model to increase efficiency while also promoting patient knowledge and self-management of T2DM to improve health outcomes. An example of an innovative care model is the shared medical appointment (SMA), …

Creating A Structural Empowerment Culture: A Professional Development Module For The Novice Nurse Leader, Beth A. Hock

UNLV Theses, Dissertations, Professional Papers, and Capstones

Nursing leadership shoulders the responsibility for the performance of their nurses (McNeeseSmith, 1992). When a nurse leader creates a culture of structural empowerment, the work environment is more likely to produce higher quality patient outcomes and highly satisfied healthcare consumers. Novice nurse leaders are often ill-equipped early in their careers to forge a structural empowerment culture. Unfortunately, education programs to address the developmental needs related to structural empowerment do not seem to exist. Incorporating the theoretical underpinnings from Kanter theory (1977, 1993) and the Donabedian model (1966) to create an educational tool for the novice nurse leader in learning how …

The Implementation Of A Respiratory Syncytial Virus Prevention And Awareness Pamphlet In The Daycare Setting, Kaylie Marie Humphreys

UNLV Theses, Dissertations, Professional Papers, and Capstones

Respiratory Syncytial Virus (RSV) is the number one cause of bronchiolitis in children under five years of age and regretfully the number one cause of hospitalization in the first year of life. RSV leads to over three million hospitalizations, two million outpatient visits, and 200,000 deaths in the pediatric population globally each year. While no vaccine is currently available to prevent the spread of RSV, efforts must be shown in spreading awareness of strategies utilized in infection prevention such as hand hygiene and properly covering a cough or sneeze.

This project aimed to present this education to a target population …

Management Of Atrial Fibrillation With Smartphone Technology, Teresa Praus

UNLV Theses, Dissertations, Professional Papers, and Capstones

Atrial fibrillation is the most common arrhythmia affecting over six million people; it is predicted to increase two-fold by the year 2050. This arrhythmia results in a lack of

atrial/ventricular communication, accompanied by ineffective atrial contraction, suboptimal ventricular filling, and thrombus formation. This may lead to stroke, and ultimately heart failure. The current economic burden related to the complications of atrial fibrillation is estimated to be greater than $6 billion annually with potentially catastrophic events, further increasing expenditure.

When patients experience symptoms related to atrial fibrillation, it is common for them to present to a hospital emergency department. These visits, …

Transitioning For Success: A Pilot Program For New Nurse Graduates In A Pediatric Intensive Care Unit, Valerie Charisa Barboa

UNLV Theses, Dissertations, Professional Papers, and Capstones

Global nursing shortages, increasingly complex patients, and rapidly evolving medical knowledge and technology make it necessary for today’s new graduate nurse (NGN) to enter practice with an already well developed set of skills (clinical judgment, technical skills, and a sound knowledge base). The protracted nursing shortage has prompted health care organizations to hire NGN’s directly into intensive care units (ICU), a rare, and previously unheard-of occurrence. Many NGN’s are unprepared for the highly complex, critically unstable patient in the ICU or the fast paced, independent, yet simultaneously collaborative nature of the ICU workplace. These deficits can quickly compromise patient safety …

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 …

Patients Enabled, Engaged, And Empowered: Implementation Of A Mobile Patient Engagement Technology, Jud Simonds

UNLV Theses, Dissertations, Professional Papers, and Capstones

Patient engagement technologies present an opportunity to enhance the patient experience by providing patient access to information throughout the entire, often complex, continuum of care. Growing evidence indicates that a lack of patient engagement is a significant contributor to preventable deaths. In contrast, engaging patients in their healthcare can positively affect patient outcomes and the overall patient experience. Unfortunately, traditional patient care models involve face to face patient-provider interactions, thereby limiting reach and impact. Exploring new roles for information technology (IT) within healthcare can contribute to addressing barriers encountered in more traditional healthcare models. Innovative IT solutions can assist patients …

An Actigraphy-Based Validation Study Of The Sleep Disorder Inventory In The Nursing Home, Gunnhild J. Hjetland, Inger Hilde Nordhus, Ståle Pallesen, Jeffrey Cummings, Rochelle E. Tractenberg, Eirunn Thun, Eirin Kolberg, Elisabeth Flo

School of Medicine Faculty Publications

Background: Disrupted sleep is common among nursing home patients with dementia and is associated with increased agitation, depression, and cognitive impairment. Detecting and treating sleep problems in this population are therefore of great importance, albeit challenging. Systematic observation and objective recordings of sleep are time-consuming and resource intensive and self-report is often unreliable. Commonly used proxy-rated scales contain few sleep items, which affects the reliability of the raters' reports. The present study aimed to adapt the proxy-rated Sleep Disorder Inventory (SDI) to a nursing home context and validate it against actigraphy. Methods: Cross-sectional study of 69 nursing home patients, 68% …

Geospatial Variation In Caesarean Delivery, Jennifer Vanderlaan, Johnathan A. Edwards, Anne Dunlop

Nursing Faculty Publications

Aim: The purpose of this study was to evaluate the variation in caesarean delivery rates across counties in Georgia and to determine whether county-level characteristics were associated with clusters. Design: This was a retrospective, observational study.

Methods: Rates of primary and repeat caesarean by maternal county of residence were calculated for 2008 through 2012. Global Moran's I (Spatial Autocorrelation) was used to identify geographic clustering. Characteristics of high and low-rate counties were compared using student's t test and chi squared test.

Results: Spatial analysis of both primary and repeat caesarean rate identified the presence of clusters (Moran's I = 0.375; …