Medicine and Health Sciences Commons^™

Social Support Of Mexican Immigrant Women With Gestational Diabetes Mellitus: A Constructivist Grounded Theory Study, Angela Sojobi

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to explore the perception of social support among Mexican immigrant women with gestational diabetes mellitus (GDM) within the context of their culture and discern the process through which social support can influence their adherence to the GDM management protocols. The incidence of GDM is highest in low-income, ethnic minority communities such as the Mexican immigrant community. Adhering to the GDM management protocols may prove challenging for some women, especially if social support is lacking. If uncontrolled, GDM can result in adverse maternal-fetal outcomes. Among Mexican immigrant women, the incidence of poor glycemic control and …

Investigating Acculturation, Health-Promoting Lifestyle, And Health Status Among Nigerian Immigrants In The United States, Frank Uche Akpati

UNLV Theses, Dissertations, Professional Papers, and Capstones

The United States has a significant number of immigrants from Africa. More come from Nigeria than other African countries. Even though acculturation influences health behavior in other cultures, this relationship is understudied in the Nigerian immigrant community in the United States which can influence their health care. This study examined the relationship between acculturation, health-promoting lifestyle, and health status of Nigerian immigrants. Key constructs from Berry’s acculturation model guided the study. Acculturation was conceptualized as occurring through varying levels of ethnic society immersion (ESI) and dominant society immersion (DSI). The study also examined the influence of education on acculturation using …

Factors Associated With Medication Decision Making In African American Families Of Children With Adhd: A Mixed Methods Study, Amy Glasofer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Attention-deficit/hyperactivity disorder (ADHD) is the most common neurobehavioral pediatric disorder in the United States. Pharmacotherapy is a recommended component of treatment for ADHD. While medication treatment of ADHD is not optimized overall, minority groups experience medication treatment disparities. The persistently lower rates of medication treatment in minority groups may have culturally specific origins which cannot be generalized across minorities. The purpose of this dissertation was to assess and extend knowledge regarding medication decision making (MDM) in African American caregivers of children with ADHD. To assess the state of the science on ADHD disparities, a review of 41 descriptive studies exploring …

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, …

Job Burnout: An Examination Of Outpatient Clinics, Aysa M. Chavarria

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to examine job burnout of medical providers in outpatient clinics. Job burnout is a psychological syndrome resulting from job interpersonal stressors; it is measured using three dimensions: (1) emotional exhaustion – feelings of being emotionally overextended and exhausted by one’s work, (2) depersonalization -a unfeeling and impersonal response toward patients, and (3) personal accomplishment – feelings of competence and achievement in one’s work (Maslach & Jackson, 2020). Using a convenience sample, healthcare providers in Southern Nevada were asked to participate. The study was approved by the University of Nevada, Las Vegas, Internal Review Board …

Effects Of A Discourse Intervention On End-Of-Life Knowledge And Attitudes Of Bsn Nursing Students, Jayme Gullone Haynes

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction. A number of challenges exist to providing effective, formalized end of life (EOL) education for undergraduate nursing students. Despite advanced resources provided by the End-of-Life Nursing Education Consortium (ELNEC), many nursing program curricula are overloaded with content and have little opportunity to incorporate other content and information.

In addition, the topic of EOL care may elicit significant emotional responses from nursing students with numerous studies indicating nursing students experience fear and anxiety when caring for patients at EOL. Recent research demonstrates the need to approach emotionally laden topics such as EOL care from a pedagogical perspective that acknowledges and …

New Nurse Reality Shock & Early Burnout: Can Role Transition Education Received During New Nurse Residency Positively Affect Satisfaction?, Bonnie L. Stolzman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Newly licensed nurses are at incredibly high risk for reality shock leading to early burnout which results in many of them resigning their positions or leaving nursing altogether. Common feelings leading to reality shock often involve exhaustion, cynicism, depersonalization, decreased self-efficacy, and decreased job satisfaction. The result of early burnout presents significant financial strain and quality concerns for our already struggling healthcare systems. In the 1960s and early 1970s, Marlene Kramer brought her research regarding newly licensed nurses and their experience of “reality shock” to publication. Kramer felt strongly that reality shock was a key factor that led newly licensed …

The Effects Of Real-Time Computerized Needle Tip Location Feedback On State Anxiety And Immediate Performance Of Simulated Ultrasound-Guided Regional Anesthesia, Joseph Janakes

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Complications of ultrasound-guided regional anesthesia (UGRA) in the clinical setting are severe and frequently related to improper needle tip placement, which is a challenging skill for novice student learners. Accordingly, anesthesia education programs are incorporating simulation-based teaching methods that use expensive procedural task trainers to aid in UGRA training. However, it was unknown if the task trainers with real-time computerized needle tip location feedback affect student anxiety and immediate simulated UGRA performance, leaving educators wondering if the cost was justified.Aims: The purpose of the study was to examine the effects of real-time computerized needle tip location feedback on students’ …

Health Disparities And Covid-19 Pandemic: Increasing Clinical Research Participation Among African Americans, Kashica J. Webber-Ritchey, Abbi D. Lane-Cordova

Journal of Health Disparities Research and Practice

Health disparities in African Americans is a persistent issue. Higher rates and severity of the novel coronavirus-19 [COVID-19] among African Americans only widens health disparities. Effective COVID-19 treatment options are imperative, requiring representation of African Americans in clinical research. However, low participation and under-representation of African Americans is complex in nature. This article describes health disparities, the impact of COVID-19, and participation in clinical research among African Americans. We offer strategies for researchers to enhance the inclusion of African Americans. We also offer strategies in conducting clinical research during COVID-19.

Synergistic Effects Of Incident Diabetes Between Snoring, Family History Of Diabetes, And Obesity, Yoo-Jeong Jeon, Seung Ku Lee, Jin-Young Kim, Chol Shin

Nursing Faculty Publications

Objective: The general public recognizes the connections between obesity, family history of diabetes (FHD), and diabetes, but remains unaware of synergistic effects that occur due to their combination. In this study, we investigate the synergistic effects of event diabetes between snoring, FHD, and obesity. Materials and Methods: Study subjects were selected among participants in the Korean Genome and Epidemiology Study Ansan- Ansung cohort, an ongoing prospective population-based study. Ansan-Ansung cohort initiated in 2001 and 2002 and has been followed biennially. At baseline, the initial cohort of 10.030 subjects, aged 40 to 69 years. A total of 5.759 participants were included …

Serum Micronutrient Status, Sleep Quality And Neurobehavioral Function Among Early Adolescents, Xiaopeng Ji, Charlene W. Compher, Sharon Y. Irving, Jinyoung Kim, David F. Dinges, Jianghong Liu

Nursing Faculty Publications

Objective: To examine associations between serum micronutrients and neurobehavioral function and the mediating role of sleep quality in early adolescents. Design: In this cross-sectional study, peripheral blood samples were analyzed for iron and zinc levels. The Pittsburgh Sleep Quality Index and Penn Computerized Neurocognitive Battery were used to assess sleep quality and neurobehavioral function, respectively. The generalized linear regressions (bootstrap) were performed to estimate the associations. Setting: Jintan, China Participants: 226 adolescents (106 females) from the Jintan Child Cohort study. Results: Adolescents with low iron (< 75 ug/dl) (OR=1.29, p=0.04) and low zinc (< 70 ug/dl) (OR=1.58, p0.05). Conclusion: Iron and zinc deficiencies may possibly be associated with poor sleep and neurobehavioral function among early adolescents. Poor sleep may partially mediate the relationship between micronutrients and neurobehavioral function.

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 …

Acute Care Nurse Practitioners’ Role In The Icu: A Retrospective Analysis Of Central Line Access Delays For Patients In Septic Shock, Violeta Aguirre

UNLV Theses, Dissertations, Professional Papers, and Capstones

Morbidity and mortality related to sepsis management have been popular research topics for a significant part of the last two decades. The Surviving Sepsis Campaign was launched in 2002 with goals to develop medical management guidelines, improving diagnosis by building awareness, expanding healthcare provider education, and improving appropriate treatment (Society of Critical Care Medicine [SCCM], 2019). Professional organizations and governing bodies continuously revise guidelines for the early identification and treatment of sepsis. The latest treatment recommendations for the Hour-1 Bundle of sepsis management (SEP-1) include initiating vasopressors in conjunction with fluid resuscitation to reach the hemodynamic goal of maintaining a …

Transient Ischemic Attacks Evaluation And Management In Specialized Urgent Care Facilities, Zandra Kay Johnson

UNLV Theses, Dissertations, Professional Papers, and Capstones

PURPOSE: Transient ischemic attacks (TIA) are a health problem that affects many people each year. A local Las Vegas organization allowed this DNP student to develop and implement an intervention to increase the perceived ability of providers to manage low-risk TIAs in specialized urgent care facilities. The aim was to raise the comfort level of providers at on-demand medicine also known as urgent care. Additional goals were to increase awareness of stroke and TIA symptoms and educate providers on the new TIA guidelines.

METHODS: This quality improvement DNP study used a convenience sample of 30 providers. Eleven participants completed the …

Factors Influencing The Self-Reported Palliative Care Practices Of Acute Care Nurses, Keshia Ryan Kotula

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction Approximately 40 million people are currently in need of palliative care (PC), and this number is predicted to increase due to the aging population and increasing longevity. Providing PC in the acute care setting leads to better quality and clinical outcomes, reduced inpatient hospital costs, and improved efficiency. Despite evidence indicating the benefits of PC, timely referrals and provision of PC in the acute care setting are lacking in part due to the complex interplay of factors that nurses must navigate, such as limited preparation, knowledge, and self-efficacy; nurse/provider attitudes; and patient/family and institutional barriers. A paucity of research …

Improving Therapeutic Communication In Mental Health Nursing: A Quality Improvement Project, Patricia A. Nill

UNLV Theses, Dissertations, Professional Papers, and Capstones

Over 46 million adults in the United States (U.S.) live with a mental illness. Locally in Nevada, the psychiatrist to patient ratio is approximately 700:1, and patients are seen primarily in the inpatient setting, if seen at all, due to the wait average of 85 hours in the hospital emergency rooms for access into mental health hospitals or specialty units of a general hospital. Moreover, costs for mental health mood disorders alone are estimated at over seven million dollars annually. The Institute of Medicine (IOM) opined the need for change in healthcare to redesign practice and clinical communication with patients …

Developing Strategic Partnerships To Impact Population Health: A Professional Development Module, Andra S. Scano

UNLV Theses, Dissertations, Professional Papers, and Capstones

Massive organizational changes occurring in our health care delivery system have provided opportunities for nurse leaders who think in terms of population health, to develop new skills needed to impact the populations they serve. Aspects of these changes include a focus on the delivery of primary and community-based care and the development of partnerships, alliances, and other linkages across settings to build integrated systems (Williams, 2020, p. 17). Turner (2020) asserts that population-focused nurse leaders are charged with creating a new future for healthier communities which often involves strategic partnership development. However, strategic partnership development is a complex task that …

An Evaluation Of Care Coordination In Reducing Depression Symptoms And Emergency Room Visits, Stacy Sumpter

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Individuals living with multiple chronic conditions (MCC) account for 26% of the population; however, they consume 84% of healthcare resources, are three times more likely to have depression than healthy individuals, and have increase emergency room (ER) visits and healthcare resource use. This population requires coordinated health care to reduce unnecessary spending and the misappropriation of healthcare resources. The purpose of this project was to evaluate the efficacy of care coordination (CC) and the support system it provides in lowering depression symptoms and ER visit frequency as a viable measure to reduce overall healthcare costs.

Methods: The healthcare providers, …

Opioid And Naloxone Training In A Rural School District, Allyson C. Waldron

UNLV Theses, Dissertations, Professional Papers, and Capstones

The opioid epidemic is a national health emergency in the United States, with over 128 people dying each day due to an opioid overdose. It is estimated that 4.3 million people over the age of 12 use opioids without a medical need, and 1.3 million youth ages 12-17 use opioids inappropriately. Drug overdose deaths have become the leading cause of accidental death in the United States, prompting the U.S. Surgeon General and the World Health Organization to advise that more Americans have access to naloxone and understand how to use this life-saving drug correctly. Naloxone is an opioid antagonist, used …

Comparison Of 12-Hour Biweekly Shifts Versus 6-Hour Weekly Shifts On Learning Outcomes And Fatigue In Nursing Students On Dedicated Educational Unit, Alena Grewal

UNLV Theses, Dissertations, Professional Papers, and Capstones

Clinical experiences in nursing programs may take many forms and the goal of integrating clinical is to combine knowledge and skills learned in the classroom into the clinical practice setting. The Dedicated Educational Unit is an innovative approach in the State of Nevada and has demonstrated success in closing the gap between education and clinical practice. The Dedicated Educational Unit model is used for the medical-surgical clinical rotations at a local university and has been largely successful. However, some challenges affecting student learning have recently arisen that are not inherent to the Dedicated Educational Unit model. Challenges voiced by nursing …

Improving Self-Care Measures Of Hypertension Through Implementation Of An Education And Action Plan, Crystal Celeste Huffaker

UNLV Theses, Dissertations, Professional Papers, and Capstones

Hypertension (HTN) is a leading cause of morbidity and mortality worldwide and one of the most common conditions seen by primary care providers. Current clinical practice guidelines recommend lifestyle modifications for patients with elevated blood pressure (BP) and diagnosed HTN. Despite these recommendations, many patients diagnosed with HTN make insufficient modifications to their lifestyle. The purpose of this project was to determine the impact of implementing an education session, with development of a patient action plan, along with 4-week, 8-week, and 12-week follow-ups on the adoption of self-care measures for HTN. Participants had their BP, height, and weight measured along …

Nursing Toolkit For Care Of The Pediatric Patient With Suicidal Ideation, Christine Young

UNLV Theses, Dissertations, Professional Papers, and Capstones

Nevada’s pediatric suicide rate is one of the highest in the country. Many patients require inpatient stabilization, either in an emergency department setting or on a pediatric unit, until they are ready for discharge to home or a subsequent behavioral health facility. In many instances, patients are assigned to nurses who have had no formal training on caring for pediatric patients with suicidal ideation. Providing care for these patients can increase nurses’ emotional stressors. Purpose: The purpose of this DNP project was to increase the knowledge of pediatric nurses in Nevada using a nursing toolkit containing information to aid in …

An Intervention To Improve Nurses’ Knowledge, Perceived Safety, And Confidence In Identifying And Managing Workplace Violence: A Translation Of Evidence Into Practice, Kayla Sullivan

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Occupational Safety and Health Administration (OSHA) reports that over two million workers are victims of workplace violence (WPV) (Papa, 2013). Registered nurses are subjected to high risk for workplace violence from patients and visitors, with 25.5% reporting at least one victimization incident (Gillespie et al., 2013). Research indicates that WPV has a significant impact on nurses' quality of working life, job satisfaction levels, turnover rates and has also been shown to negatively impact efficiency and productivity (Gacki-Smith et al., 2009). ED nurses are at substantial occupational risk for workplace violence. Emergency departments have been identified as areas within the …