Medicine and Health Sciences Commons^™

Births In The Mountain West, 2016-2020, Corryn Richardson, Hira Ahmed, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet examines state-level data on births and health indicators from the National Center for Health Statistics (NCHS), a government health statistics unit of the Center for Disease Control and Prevention (CDC). This fact sheet presents data related to births in the Mountain West states of Arizona, Colorado, New Mexico, Nevada, and Utah.

Factors Associated With Immediate Postnatal Care In Lao People's Democratic Republic: An Analysis Of The 2017 Lao People's Democratic Republic Multiple Indicator Cluster Survey, Tressa Quayle

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: This study aimed to identify potential factors associated with immediate postnatal care in Laotian women. Background: The World Health Organization recognizes that approximately half of all maternal deaths occur in the immediate postnatal period or 24 hours after birth. One crucial step to improving maternal mortality is a postnatal check during the first 24 hours following birth. Forty-seven percent of Lao women aged 15-49 who delivered a baby in the last two years received a postnatal health check in the first two days after delivery. Of these, 46.5% of postnatal checks were conducted prior to discharge from the facility …

Metabolic Syndrome And Associated Factors Among Hispanic Americans, Shannon L. Richard

UNLV Theses, Dissertations, Professional Papers, and Capstones

Metabolic syndrome (MetS) is a cardiometabolic condition that may develop into cardiovascular disease and type 2 diabetes mellitus. Early recognition and associated treatment of MetS can help detour disease. Lifestyle factors, sleep-disordered breathing, and psychological well-being influence the development of MetS; electrocardiogram abnormalities are associated with MetS. Hispanics living in the United States are particularly vulnerable to MetS. Although MetS is well-identified in Americans of Hispanic ethnicity, the current literature evaluating protective and contributory factors among Hispanic gender-ethnic subgroups is inconsistent and incomplete. This study aimed to examine the relationships between MetS and select health and lifestyle factors among seven …

A Feasibility Study To Identify If The Induction Of The Relationship Based Care Program Enhance The Caring Skills Of Registered Nurses?, Jennifer Millet

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this Doctor of Nursing Practice project was to educate the Registered Nurses (RNs) to implement the Relationship Based Care (RBC) model and Jean Watson’s Theory of Human Caring principles into their practice. The model and principles were put into practice by the RNs, followed by examining the RNs perception and practices of caring and confidence skills had improved after the intervention. The mission of this project was to promote quality outcomes and patient satisfaction through caring relationships. Strengthening these relationships will help the caregiver experience the essence of care and be able to better connect to another …

Strategic Plan For Genomic Competencies Into Undergraduate Nursing Curriculum, Myerann Royce M. Mangalino

UNLV Theses, Dissertations, Professional Papers, and Capstones

Problem: As genomics research continues to grow in medicine and in popular culture, an educational gap in nursing is inevitable. Nurses must have a strong understanding of genetics and genomics to effectively integrate them into current practice.Objectives: The objective is to identify gaps in the current undergraduate curriculum and build threads that may be incorporated into the current curriculum to fill the identified gaps. Methods: The foundation of this project was the Essentials of Genetic and Genomic Nursing: Competencies, Curricula Guidelines, and Outcome Indicators, 2nd Edition (Consensus Panel on Genetic/Genomic Nursing Competencies, 2008). A strategic plan was created to increase …

Vaccinator Communication Interventions To Address Hpv Vaccine Hesitancy, Joann Rupiper

UNLV Theses, Dissertations, Professional Papers, and Capstones

Human papillomavirus (HPV) vaccination is an effective public health tool to decrease the rates of HPV-related cancers in our communities. Vaccine hesitancy can undermine this effort, and interventions are needed to inform and assist individuals/parents in decision-making to receive vaccines. The COVID-19 pandemic and newly developed vaccines have increased attention and made families hesitant about vaccines. Receiving a provider's strong recommendation for the vaccine is one of the strongest predictors of HPV vaccine uptake. However, not all providers have the knowledge and skills to provide the best approach for families and patients. The primary communication method has been the presumptive …

Evidence-Based Intervention To Improve Health Literacy Among Older Adults With Newly Diagnosed Atrial Fibrillation, Johana Rowe

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Significance: Atrial fibrillation (AFib) is the most common arrhythmia encountered in the healthcare setting. As of 2018, approximately 6.1 million people in the United States were living with AFib which is projected to increase to 12.1 million by 2030. Older adults are at higher risk of developing AFib and its complications. AFib is a chronic condition that requires targeted patient education by healthcare providers in different healthcare settings. Patient’s low health literacy regarding the condition is a significant barrier to therapy adherence. Given the high rate of poor health literacy among individuals newly diagnosed with AFib and the …

The Effects Of A Dedicated Education Unit On Nurse Retention And Turnover, Cherilyn Campbell

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite the fast growth of healthcare jobs in the United States, there is a deficit in the nursing workforce. Literature has shown high nurse turnover within the first year as a new graduate nurse. Healthcare organizations will need to explore innovative ways to impact nursing retention and turnover to keep up with the growing demand. The purpose of this Doctor of Nursing Practice (DNP) project is to perform and evaluate a comprehensive review to determine the effect of a dedicated education unit (DEU) on nurse retention and turnover within an academic-practice partnership. Literature has shown the benefits of the DEU …

Evaluating Repetitive Transcranial Magnetic Stimulation To Reduce Opioid Cravings In Opioid Use Disorder, Cameron Duncan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Opioid Use Disorder (OUD) is a multi-faceted, complex ailment affecting many individuals and their families across the globe. Currently, there are multiple interventions used in the treatment of OUD, many of which are designed to reduce cravings for opioids. Cravings for opioids are a strong predictor of relapse in the disorder. However, many of the interventions used in clinical practice have inherent risks including a potential for abuse and diversion. Repetitive Transcranial Magnetic Stimulation (rTMS) is an outpatient procedure that may be effective in reducing cravings for opioids, thereby reducing relapse. Methods: This study employed a randomized, single-blind, experimental design …

Healthcare Screenings In The Occupational And Workplace Setting: Taking Control Over Blood Pressure, Darryl W. Horton

UNLV Theses, Dissertations, Professional Papers, and Capstones

Undiagnosed hypertension continues to be a growing concern worldwide leading to cardiovascular disease and other chronic illnesses and can contribute to death. The prevalence of hypertension continues to increase even with guidelines on screening, hypertension education, disease prevention, disease maintenance, and management. The purpose of this project was to determine if the implementation of a workplace blood pressure screening program would improve hypertension knowledge and reduce the burden of hypertension within workplace. A descriptive, cross-sectional design using convenience sampling was conducted. Participants were screened by measuring blood pressures, and the Hypertension Evaluation of Lifestyle Management scale (HELM) was utilized to …

Exploring Gen Z Nursing Students’ Experience And Emotional Processing In Simulation: A Grounded Theory Study, Wendy Matthew

UNLV Theses, Dissertations, Professional Papers, and Capstones

Simulation is an integral teaching methodology used within current nursing curricula. The goal of simulation is to promote learning, develop clinical judgment and reasoning, and ultimately improve patient care. However, some factors can disrupt the goals of the simulation learning experience. Students may experience uncomfortable emotional responses, such as anxiety, during simulation events, which impairs students' thinking processes leading to decreased learning, poor performance, an inability to assess knowledge, and potentially prohibits the transfer of knowledge to practice. Over 90% of the general Generation Z (Gen Z) population report uncomfortable emotions such as stress and anxiety. Simulation is used in …

Is Dietary Teaching Via Telehealth Effective In Lowering Hgba1c In Adult Patients With Prediabetes Or Type 2 Diabetes?, Mia Mccallum-Crawford

UNLV Theses, Dissertations, Professional Papers, and Capstones

Prediabetes and Type 2 diabetes mellitus (T2DM) are two common conditions diagnosed in the primary care setting. Both conditions benefit from a healthy lifestyle, managing blood sugar levels, and getting diabetes self-management education and support (DSMES). Within the past two decades, the healthcare community in the US has witnessed a substantial rise in diabetes among adults. Overall, the self-management of diabetes continues to worsen nationally. The purpose of this project is to improve patients’ self-management of both Prediabetes and T2DM through nutrition and show how nutritional counseling via telehealth provided by a nurse practitioner can improve HgbA1C values over 3 …

Ultrasonography-First Imaging Algorithm For Acute Appendicitis Diagnosis, Steven Lamar Moore

UNLV Theses, Dissertations, Professional Papers, and Capstones

Acute appendicitis (AA) is the most common cause of acute abdominal pain requiring surgery in pediatric, adult, and pregnant patients. Several etiologies are believed to trigger luminal obstruction, which causes mucus and bacteria proliferation, resulting in inflammation and wall tension with subsequent necrosis and rupture of the appendix. Most AA patients present with the primary complaint of abdominal pain, which Murphy first described the characteristic diagnostic sequence seen in approximately 50% of patients as colicky centralized abdominal pain with subsequent vomiting with the migration of pain to the right lower quadrant (RLQ), specifically, the right iliac fossa. The typical AA …

Identifying Gaps In Social Determinants Of Health Among Patients 65 Years And Older With Congestive Heart Failure: A Secondary Data Analysis, Sandra Pierre-Louis

UNLV Theses, Dissertations, Professional Papers, and Capstones

Congestive heart failure (CHF) is one of the most common healthcare problems for older adults. Because of its high and rising prevalence in this population and its significant influence on healthcare costs and quality of life, CHF is becoming a serious public health issue in the United States. More effective strategies for preventing and managing CHF in older people are desperately needed (Rich, 2015). The disease accounts for 3% of hospital admissions in the United States and affects more than 6.5 million Americans (White-Williams et al., 2020). Further, CHF is exacerbated by adverse social determinants of health (SDOH). This study …

Family-Centered Psychosocial Care For Pediatric Oncology Patients, Jessica W. Casey

UNLV Theses, Dissertations, Professional Papers, and Capstones

Psychosocial conditions are prevalent in pediatric oncology patients (Kahalley et al., 2013). Family and social support are essential aspects of a patient's health care outcomes (Merck & McElfresh, 2019). Anxiety and depression are common in pediatric oncology patients due to trauma during treatment (Pao & Kazak, 2015). These patients also can have preexisting developmental or behavioral conditions before starting treatment. Treatment side effects can also cause cognitive and behavioral changes (Nixon, 2014b). Nurses should be knowledgeable and confident in their ability to care for patients' psychosocial health and development. The purpose of this Doctor of Nursing Practice (DNP) project is …

Increasing Genetic Testing Rates To Improve Early Detection And Prevention Of Breast And Ovarian Cancer In Women, Makensey Beth Durrant

UNLV Theses, Dissertations, Professional Papers, and Capstones

Screening rates for cancer related genetic mutations are low in the primary care setting, despite evidence-based guidelines recommending screening in all patients who meet criteria. Genetic mutations, such as the breast cancer susceptibility 1 and 2 (BRCA1/2) gene mutations, drastically increase breast and ovarian cancer risk in patients. The United States Preventive Services Task Force (USPSTF) and the National Comprehensive Cancer Network (NCCN) provide evidence-based guidelines on criteria for genetic testing in women at risk for breast and ovarian cancer related gene mutations. Primary care providers (PCPs), including advanced practice registered nurses (APRNs), are at the front lines of preventative …

Increasing Human Papillomavirus Vaccination Intent And Knowledge Through An Educational Intervention, Angelica E. Musumeci

UNLV Theses, Dissertations, Professional Papers, and Capstones

Human papillomavirus (HPV) is a widely discussed topic in healthcare as it affects patients of all genders and ages who partake in sexual activity. The most significant concern it poses to those at risk is HPV-related cancer. Fortunately, a vaccination exists that targets specific strains associated with these types of cancers. Despite evidence-based research supporting the vaccination’s efficacy and safety, lack of awareness and misinformation diminish the receipt of the vaccine and drive the lack of protection. Thus, educational interventions directed at parents and caregivers, which aims to improve their understanding of HPV and the vaccination’s benefits, is key to …

Decreasing Central Line-Associated Bloodstream Infections In The Critical Care Unit, Kimberly J. Foxworth

UNLV Theses, Dissertations, Professional Papers, and Capstones

Central line-associated bloodstream infections (CLABSI) are a rising problem in the critical care setting in the United States. According to Flogren et al. (2007), "an estimated 248,000 bloodstream infections occur in hospitals across the United States each year, and a significant amount of these infections are associated with the use of a central venous catheter" (p.160). The Center for Disease Control and Prevention (CDC) defines a CLABSI as "recovery of a pathogen from blood culture (a single blood culture for organisms not commonly present on the skin and two or more blood cultures for organisms commonly present on the skin) …

The Road Ahead: An Occupational Therapy Manual To Infant Development For Parents In The Nicu, Nicole Suzuki-Uyeno

UNLV Theses, Dissertations, Professional Papers, and Capstones

Occupational therapists have been collaborating with the parents of our tiniest patients in the neonatal intensive care unit (NICU) for quite some time. They have a wealth of information and expertise in the area on infant development and parent education. Admitting a baby to the NICU is a shock for most parents and can take a toll on a family. The role of the occupational therapist is to help educate the family and to provide the tools to safely take care of their baby and to smoothen the transition from the hospital to home.

In the NICU, the OT has …

Improving Nurse Self-Efficacy Regarding Depression Among Cardiovascular Disease Patients: An Education Intervention, Presten Beatty

UNLV Theses, Dissertations, Professional Papers, and Capstones

Depression is a principal cause of increased morbidity, mortality, and decreased quality of life for cardiovascular disease patients. Low levels of nurse confidence have been the outcomes of several studies and anecdotal reports regarding providing care for and approaching patients with acute and chronic illnesses in conjunction with behavioral and mental health issues. Current literature suggests that improving nursing education on the prevalence and impacts of depression improves nurse confidence. Depression screening tool education provided to nurses, with detailed disease information, empowers nurses in their attitudes, knowledge, and behaviors regarding patient depression. By improving depression screening rates among cardiovascular disease …

A Quality Improvement Project To Improve Health Care Provider Self-Efficacy In Rural Primary Pediatric Care Clinics Through Training Intervention, Alison Borgsmiller

UNLV Theses, Dissertations, Professional Papers, and Capstones

American Association of Pediatrics recommends screening for various developmental delays in children, but it does not explicitly recommend a tool for screening social and emotional development at well-child checks (WCCs). Therefore, provider self-efficacy (SE) is lacking, and screening rarely occurs. This quality improvement (QI) project sought to improve healthcare provider SE using the Ages and Stages Questionnaire: Social-Emotional, Second Edition (ASQ:SE-2), an evidence-based practice screening tool for identifying such delays in children at 30–60-month WCC visits.At rural healthcare centers in San Luis Obispo, California, participants completed the Self-Efficacy Twelve Questionnaire prior to and 30 days following a training intervention. While …

Reducing Door-To-Balloon Time In Stemi Via Er Nurse Driven Protocol, Torrie Clontz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Over 605,000 patients will suffer an ST-segment elevated myocardial infarction in the United States each year. The gold-standard definitive treatment for this is percutaneous coronary angioplasty or the ballooning open and stenting of the blockage. The American Heart Association has set the evidence-based gold standard of 90-minutes from identification of blockage to reperfusion of heart muscle. In a health system in Las Vegas, NV, this goal is frequently missed due to lack of protocols in place to expedite patients towards definitive treatment. The purpose of this evidence-based practice change is to reduce STEMI patient morbidity and mortality via a nursing …

Improving Nurse Leaders’ Knowledge And Confidence In Transformational Leadership Skills In The Online Environment, Tanya Haight

UNLV Theses, Dissertations, Professional Papers, and Capstones

Leadership is critical to the success of most organizations, and the achievement of an organization's goals is largely dependent on the leaders' ability to engage, motivate, and influence their teams—often referred to as Transformational Leadership. This is especially true for healthcare organizations wherein the morbidity and mortality of patients may be affected by the quality of leadership. At the start of the COVID-19 pandemic, in-person meetings transitioned to the online format without nurse leaders' formal training. Leaders cited this lack of orientation as impeding their ability to sustain an online-virtual transformational leadership presence with their teams. They reported varying degrees …

The Nursing Leader’S Role In Decreasing Implicit Rationing By Improving The Nursing Work Environment, Allison Mchugh

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite all the literature about missed care and its contributing factors, it is prevalent in most hospitals worldwide. Missed care is the result of care that is implicitly rationed. For this paper, implicit rationing is defined as how nurses decide what care is delivered based on the present work environment. Many factors influence implicit rationing. One such factor is the work environment. The association between the nursing work environment and implicit rationing is well described in the literature. The nursing leader is in a formal position responsible for patient outcomes and the nursing practice environment. Therefore, it is important to …

Improving Self-Efficacy And Knowledge While Reducing Anxiety In High-Risk Breast Cancer Patients Through Standardized Education, Shelley Miles

UNLV Theses, Dissertations, Professional Papers, and Capstones

Breast cancer is the leading cause of death of women in the United States. Patients at high risk for developing cancer are more easily identified in today’s world. Early identification might be due to strong family history or genetic mutations, such as BRCA1 or BRCA2. Screening and risk reduction guidelines have been developed over recent years for these patients. Adherence to these guidelines continues to be a problem. The factors stemming from this problem include lack of knowledge about being high-risk, understanding the guidelines, and anxiety and depression about the perceived risk of developing breast cancer. These factors can cause …

Evaluation Of An Advance Care Planning Workshop To Improve The Self-Efficacy Of Health Care Providers, Joy Patrick

UNLV Theses, Dissertations, Professional Papers, and Capstones

Advance care planning (ACP) involves discussions between the patient and their care providers and those close to them about future care. Every patient is entitled to ACP; however, research has shown that providers do not regularly implement them for various reasons. In addition, multiple barriers may be preventing providers from initiating ACP. Among them are lack of knowledge and confidence, apprehension, time, and fear. This Doctor of Nursing Practice (DNP) addresses the problematic barriers to regular ACP discussions between providers and the patients. Specifically, the purpose of this DNP project is to develop, implement and evaluate an online module to …

Parental Education On Human Papillomavirus Vaccination, Marguarette J. Suprien

UNLV Theses, Dissertations, Professional Papers, and Capstones

The human papillomavirus (HPV) is a worldwide condition that produces several diseases, including cervical, anogenital, and oral cancer, among others (Fishman et al., 2014). The Center for Disease Control and Prevention (CDC; 2016a) stated that HPV is among the most reported sexually transmitted diseases in the United States. Over 150 viruses are associated with HPV, and 40 types of the virus can be spread via sexual contact, including vaginal, oral, and anal sex (CDC, 2016; CDC, 2016b; CDC, 2016c). Evidence shows that approximately 79 million individuals are infected in the United States, and 14 million Americans are infected with the …

Associations Between State Regulations And Midwifery Workforce Access, Acacia Herndon

Undergraduate Research Symposium Podium Presentations

Background: U.S is worst in maternal care; Credible support for CNMs as a solution; Independent licensing has been ineffective; Other factors may influence access