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Improving Women And Family’S Health Through Integrated Microfinance, Health Education And Promotion In Rural Areas, Kahabi Isangula

School of Nursing & Midwifery, East Africa

While increasing number of women enjoys more freedom and power in urban areas, women in rural areas are at a disadvantage in almost all aspects of life when compared to men. Investing in economic empowerment of women particularly in rural areas by supporting them to implement local context based business ideas and basic finance capacity and skills development may reverse these trends, however, when combined with heath education and promotion through trainings focusing on preventive health yields greater impact. This paper is a systematic review of the peer - reviewed research papers and project reports in English language on how …

Breast Health And Mammography Screening In Older Women, Martha A. Ibarra Phd, Msn, Anp, Rn

Dissertations

Age-related health disparities in breast cancer screening are a public health concern. From 2002 to 2006, the median age for newly diagnosed cases of breast cancer was 61 years and the median age for breast cancer mortality was 68 years of age (Surveillance Epidemiology and End Results [SEER], 2009). Mammography is the best available screening tool for breast cancer detection (Susan G. Komen Foundation, 2008). The Centers for Medicare and Medicaid Services (CMS, 2006) reported that only about half of older women who are eligible for mammograms through Medicare obtain a mammogram every two years. The literature identifies psychosocial barriers, …

Tobacco-Use Promotional Environment And Intrapersonal Environment: Predictors Of Smoking Intention Among Young Southern California Thai-American Adolescents, Arpakorn Magkunthod Phd, Msn, Rn

Dissertations

This study explores tobacco-use related environment, intrapersonal factors, and smoking initiation in Thai-American adolescents aged 10 to 16 living in Southern California. A purposive sample of 217 youth was recruited from seven Thai-community centers located in four counties of Southern California: The sample was fairly evenly distributed by gender with female (54.5%) and almost three quarters (70.9%) were born in the United States (70.9%). Age ranged from 10 to 16 years, with the mean age 12.71 years old (SD =1.835); 27% reported age of 11. Data were collected using the 97 item Teen Tobacco-Use Questionnaire. Findings indicated 12 participants (6.3%) …

Nurse Manager Transformational Leadership Practices And Patient Outcomes Among Magnet And Non-Magnet Hospitals, Bridgett Byrd Sellars Phd, Msn, Ma, Rn

Dissertations

In 2004 the Institute Of Medicine called for healthcare leaders to embrace and adopt transformational leadership practices to promote quality of care and favorable patient outcomes. Nurse managers are accountable for 24-hour operations of their departments and influence patient outcomes. The purpose of this research was to examine the relationships among nurse manager transformational leadership practices, patient outcomes and hospital types (Magnet, On The Journey, and Non-Magnet). A correlational study examined relationships between self-reported transformational leadership practices of nurse managers and patient outcomes by hospital types. The study was conducted using a purposive sample of Association of California Nurse Leader …

Relationship Between Delirium And Night-Time Interruptions In Icu, Amy R. Stuck Phd, Rn

Dissertations

Background: This dissertation examined the phenomenon of delirium in the intensive care unit (ICU) setting. Delirium is a form of cognitive disturbance with a physiologic etiology and complex, multifactorial mechanisms of causation and risk. Delirium in the ICU patient presents a significant risk for adverse outcomes including increased mortality, length of stay, falls, and restraint use. ICU delirium can lead to persistent cognitive impairment beyond discharge and frequent skilled nursing placement. Identifying delirium requires accurate diagnosis that is optimized when validated instruments are used. Sleep deprivation has been linked to adverse health consequences including delirium. Previous studies investigating the relationship …

The Effect Of Heart Failure Education On Intermediate Care Unit Nursing Staff's Knowledge Of Heart Failure, Self-Care, And Best Practice Guidelines, Carol Budgin

Evidence-Based Practice Project Reports

Heart failure (HF) is a chronic disease affecting nearly six million people in the United States with an annual cost of nearly 33 billion dollars. If nurses are inadequately prepared to care for and/or educate patients with HF, evidence-based (EB) nursing care will be suboptimal and hospital readmission rates with the subsequent increased costs for care will continue to soar. To address their higher-than-national average HF readmission rates, an EB nursing project was implemented at a local, urban community hospital to assess intermediate care unit (IMCU) nursing staff’s knowledge of HF, selfcare, and best practice guidelines. The Rossworm & Larrabee …

Experiences Of Hospitalized Patients With Dementia, Samantha Bainbridge

HIM 1990-2015

People with dementia are hospitalized for a variety of reasons. The combination of dementia with additional health conditions creates a unique challenge to caregivers in acute care settings. There is a dearth of information available to provide guidance to the nursing staff caring for these patients. This integrated review of the literature examined the experiences of hospitalization from the perspective of the older adult with dementia, the family caregiver, and the patient care staff. Results showed a limited body of literature that addressed hospital experiences of people with dementia and those of family and professional caregivers. Additionally, few studies addressing …

An Evaluation Of Tracheostomy Care Anxiety Relief Through Education And Support (T-Cares) A Pilot Study, William Crosby

HIM 1990-2015

Background: Home care of a patient with a tracheostomy after surgery for head and neck cancer requires the caregiver to be proficient with new equipment and required skills. The responsibility of managing an artificial airway, may lead to an increase in caregiver anxiety. Education of caregivers varies; it is often a 1:1 impromptu instruction provided by the patient's nurse and/or respiratory therapist. The purpose of this study was to evaluate the effect of the T-CARES course on caregiver anxiety and tracheostomy suctioning competency. Method: A quasi-experimental non-randomized control group design was used. The independent variable was method of instruction (T-CARES …

Emergency Preparedness Nursing, Emily A. Ganjei, Patricia Grimes

Senior Honors Projects

Emergency Preparedness at Newport Hospital

Emily A. Ganjei

Sponsors: Carolyn Hames and Lisa Lima-Tessier, Nursing

The subject of my project is emergency nursing and emergency preparedness in the Emergency Department (ED) of Newport Hospital. I am working alongside Lisa Lima-Tessier, Clinical Nurse Manager of the ED, and Pat Grimes, Assistant Clinical Nurse Manager/Emergency Preparedness Coordinator.

As an undergraduate in the College of Nursing, the topic of emergency preparedness has been discussed in many courses, in particular community health nursing. In community nursing we discussed different types of disaster situations and reviewed hospital policies regarding triage and the nurse’s role in …

Family Planning, Natural Family Planning, And Abortion Use Among U. S. Hispanic Women, Dana Rodriguez, Richard J. Fehring

College of Nursing Faculty Research and Publications

Hispanics are the largest minority group in the U. S. and they contribute to over 50 percent of Catholics under the age of 25. The purpose of this study was to determine the patterns of contraceptive use (current and ever), natural family planning (NFP), and abortion among U. S. Hispanic women between the ages of 15 and 44 years and to compare their patterns of use to non-Hispanic women of the same age range. A particular interest was to determine the influence of faith on the choice of family-planning methods among the sexually active U. S. Catholic Hispanic women. Data …

Predictors Of New Graduate Nurses’ Organizational Commitment During A Nurse Residency Program, Marilyn Meyer Bratt, Holly M. Felzer

College of Nursing Faculty Research and Publications

Retaining newly graduated nurses is critical for organizations because of the significant cost of turnover. Since commitment to an organization is associated with decreased turnover intent, understanding factors that influence new graduates’ organizational commitment is important. In a sample of nurse residency program participants, predictors of organizational commitment over time were explored. Perceptions of the work environment, particularly job satisfaction and job stress, were found to be most influential.

Nurse residency programs provide extended opportunities to model professional role behaviors for new nurses, enhance knowledge development and clinical application, and promote successful integration to the work environment (Bratt, 2009). Despite …

Elementary School Based Health Centers As Providers Of School Entry Health Exams: Do They Meet The Standards?, Roberta Bavin

UNLV Theses, Dissertations, Professional Papers, and Capstones

The health of today's children is crucial for the future of our society. There are many children without access to healthcare in these turbulent economic times; times that are increasingly uncertain as society maneuvers its way through the maze of healthcare reform. School based health centers (SBHCs) provide a safety net for children needing basic healthcare who are otherwise underserved. School entry health examinations (SEHE) are legal requirements in many states, and are a proven method for identifying health conditions early enough in a child's life that they can be corrected. Treating identified health conditions facilitates academic success for children, …

Program Evaluation Of Preceptor Preparation And Effectiveness In A Local Nurse Residency Program, Margaret Covelli

UNLV Theses, Dissertations, Professional Papers, and Capstones

Preceptors are vital to the success of new graduate registered nurses in their transition to practice as they assist the new nurse in developing skills, competency, and confidence. Most residency programs may include training for preceptors but there may not be evidence that preceptor preparation makes a difference in the retention of nurse residents or the relationship to favorable evaluations of preceptors from the residents. This study evaluated and compared the effects of preceptor training on competency levels of the resident and therefore retention.

The methodology was a post hoc descriptive study of variables that included demographics, surveys from residents …

Increasing Labor And Delivery Nurse Knowledge Of Triaging Non-Obstetrical Medical Emergencies In Pregnant Women Through The Use Of Simulation, Julie Hoffman

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to evaluate the effect simulation training has on an OB nurse's ability to correctly triage pregnant patients. Registered Nurses (RNs) working in OB triage must be able to correctly and expediently identify the care a pregnant patient needs. OB triage nurses are trained to recognize pregnancy related issues that commonly present during the months leading up to delivery. It is as important for these nurses to have the skills to realize when a pregnant patient is having a non-obstetrical health crisis. A group of OB triage RNs participated in simulation-training scenarios based on non- …

The Relationship Between Self-Efficacy And Fluid,And Dietary Compliance In Hemodialysis Patients, Ansy Paul John

UNLV Theses, Dissertations, Professional Papers, and Capstones

Patients with end-stage renal disease (ESRD) who receive hemodialysis often fail to follow a prescribed diet and fluid regimen, which undermines the effectiveness of care and leads to unpredictable disease progression and greater likelihood of complications. Non-adherence to dietary and fluid limitations compromises the outcomes of patients receiving hemodialysis. Noncompliance can lead to detrimental long-term outcomes including deterioration of the cardiovascular system, heart failure, hypertension, and pulmonary edema as well as short-term problems such as edema, itching, bone pain, and breathlessness.

Many studies have demonstrated that self-efficacy strategies are associated with improved dietary and fluid compliance among individuals receiving hemodialysis. …

Clinical Practice Guidelines For Primary Care Providers' Evaluation Of Patient Fitness To Fly, Kerry Colleen Palakanis

UNLV Theses, Dissertations, Professional Papers, and Capstones

Commercial air travel is amongst the safest forms of transportation yet the environment within the aircraft cabin to which the passenger is exposed may have adverse physiological and psychological effects on passengers, especially for those with pre-existing medical issues. A comprehensive, systematic review and analysis of current literature was performed to develop evidenced-based guidelines for evaluation of passenger fitness to fly for integration into primary care practice. Recommendations from the most current fitness to fly guidelines and disease-specific published research related to in-flight medical issues were evaluated and the Grades of Recommendation Assessment, Development and Evaluation (GRADE) method was utilized …

Program Evaluation Of Stroke In Rural Nevada Hospital, Starla Cheri Ricks

UNLV Theses, Dissertations, Professional Papers, and Capstones

The overall goal of this Doctor of Nursing Practice (DNP) scholarly project is to complete a program evaluation using the Centers of Disease Control (CDC) Framework for Program Evaluation to measure the effectiveness of a stroke protocol in a rural Nevada hospital. This (DNP) scholarly project evaluates program strategies over third and fourth quarters of 2010 as well as the first, second, and third quarters of 2011, that have been initiated to reduce the burden of neurological disease with the application of a stroke protocol that complies with defined evidence-based strategies for assessment and management of stroke victims. As part …

Improving Evidence Based Asthma Management In An Urban University Student Health Center, Hedian Cho Swanson

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this project was to improve asthma management through focused staff education and training on national asthma guideline recommendations. The Student Health Center (SHC), located in a university in the southwest United States, performed annual reviews of asthma-related electronic medical records (EMR) in an effort to provide quality health care. These reviews used 23 quality improvement (QI) parameters extracted from the 2007 National Asthma Education and Preventive Program Expert Panel Report 3 (NAEPP EPR 3). The SHC QI findings were consistent with current asthma management literature indicating asthma control is often overestimated and undertreated. This project (a) provided …

Use Of Continuous Glucose Monitors In Type-1 Diabetes: An Analysis Of Wave Form Versus Glycemic Values In The Improvement Of Glucose Control And Fear Of Hypoglycemia, Tomas Charles Walker

UNLV Theses, Dissertations, Professional Papers, and Capstones

Type-1 diabetes is a disease of subtle complexities. Patients struggle to understand glucose patterns and their responses to insulin or food intake while maintaining hectic lifestyles. Minor misjudgments in treatments can result in disastrous consequences with significant hypo- or hyperglycemic excursions.

Despite improvements in technologies available for diabetes management, including home monitoring of blood glucose, more predictable insulin therapies, and improved insulin delivery via insulin pump, the average HbA1c has remained relatively unchanged. Poor diabetes control is recognized as contributing to long-term diabetes comorbidities including neuropathy, nephropathy, retinopathy, and micro- and macrovascular disease.

Real-time continuous glucose monitors, such as the …

Cultural Competence In The Baccalaureate Degree Nursing Curriculum, Angela Elizabeth Silvestri

UNLV Theses, Dissertations, Professional Papers, and Capstones

Health care providers are members of a helping profession and need to provide quality care to all members of society. As a result of current and projected demographic changes within the United States (U.S.), health care professionals are faced with the challenges of providing culturally competent care and fulfilling the role as the "helping profession." In the past 10 years, minority populations have increased in the U.S. For example, the African American population experienced an approximate 12.3% increase, and the Hispanic population increased by 43%. Just as it is necessary for health care professionals to respond to the increase in …

Use Of Standardized Mastery Content Assessments Given During The First Year Of A Baccalaureate Nursing Program For Predicting Nclex-Rn Outcomes, Deanna Jan Emory

Graduate Theses and Dissertations

The purpose of this study was to evaluate the relationship between standardized content specific mastery assessments and NCLEX-RN outcomes. Three content-specific standardized assessments testing Fundamentals, Pharmacology and Mental Health concepts were used to explain the dichotomous NCLEX-RN outcome of pass or fail. The three assessments were developed by Assessment Technologies Institute, LLC (ATI). The assessments were administered to baccalaureate nursing students (N = 119) during the first year of a nursing program in one public university over a period of five consecutive semesters. Group comparisons between those passing and those failing NCLEX-RN on the first attempt and correlations were calculated …

An Investigation Of Obstetrical Practice Patterns Through Secondary Data Analysis And Qualitative Inquiry, Barbara Shippey Mcalister

Nursing Theses and Dissertations

Mothers and their unborn are a vulnerable population. Despite overwhelming advances in health care and technology, the United States' indicators of maternal and infant mortality are dismal. To lay the foundation for a research trajectory ultimately aimed at improving the experiences and outcomes of pregnancy, two research projects were undertaken to investigate the impact of practice patterns for elective delivery on the current obstetrical paradigm. A qualitative clinical case study explored antepartum recommendations for cesarean section following the implied diagnoses of inevitable labor dystocia secondary to maternal physical stature in two healthy women. The women's perspectives on their experiences of …

Military Service Members’ Attitudes Towards Mental Illness And Access To Mental Health Services: A Matter Of Stigma., Virginia Delbusto-Cohen

Nursing Doctoral

It has been clinically observed and the literature concurs that military service members often fail to access mental health services in spite of availability of care. The reasons for failure to access care appear to be that military service members are fearful of accessing mental health services for fear of being stigmatized. Failure to receive care for mental health problems can result in deleterious results, some of which may culminate in inability to function or even loss of life. Additionally, failure to access mental health care can result in massive monetary costs in terms of loss and replacement of personnel …

The Immigrant Hispanic Population: Perceptions About Cultural Competency In The Healthcare Setting, Cheryl Swanson

Nursing Theses and Dissertations

Cultural competence has been reported as a means of impacting health disparities in minority populations. The Hispanic population has grown exponentially in the United States accounting for over fifty million people on the latest census report. Continued immigration by persons of Hispanic origin occurs for many reasons offering a challenge to nurses and other healthcare workers to provide culturally competent care. The majority of research on cultural competence and the immigrant Hispanic patient has been conducted from the viewpoint of the healthcare provider. Additionally, most research that has taken into account the perspective of the immigrant Hispanic patient focuses on …

The Lived Experiences Of Intended Parents During Surrogate Pregnancy And Transition To Parenthood In Relation To The United States Healthcare System., Kim L. Armour

Nursing Theses and Dissertations

Problem: A state of the science surrogate pregnancy manuscript revealed a dearth of research regarding intended parents of surrogate pregnancy. Not one U.S. study could be located. Intended parents are overlooked by the healthcare system during pregnancy due to the fact that that their surrogate is receiving obstetric care. Research was proposed and completed. Purpose: The aim of the research was to fill a gap by improving our understanding of intended parents lived experience during surrogate pregnancy and transition to parenthood with relation to the United States healthcare system Design: A study of phenomenology using van Manen's methodology Participants: Eleven …

A School-Based Intervention Of Adolescent Obesity Prevention In At-Risk Youth, Leah M. Potecha

Senior Honors Theses

Obesity has become an epidemic in the United States, affecting individuals of all ages. Adolescents are particularly susceptible to obesity due to their decrease in physical activity, as well as to the greater availability of foods void of nutritional value. Adolescents’ impressionable natures and changing bodies also contribute to their increased weights. To combat the problem of obesity, many schools have implemented obesity prevention programs. Most of these programs are based on physical education and nutrition education. However, some schools have started mentorship programs, or worked with organizations that employ mentorship programs, to prevent obesity. The Lynchburg Healthy Living program …

Documentation: Delirium In The Hospitalized Older Adult, Jacqueline Fitzgerald Close Phd

Dissertations

Background: Delirium is a common, life threatening and preventable geriatric syndrome. Because this condition is frequently addressed by administering dangerous antipsychotic drugs, it is imperative that accurate systematic assessments are charted to determine the actual need for these medications. The purpose of the study was to describe medical record documentation of a systematic assessment of delirium in older adults who had been administered an antipsychotic medication. Methods: A descriptive correlational retrospective design was used for this medical record data based study. The setting was a 107 bed acute care community hospital located in southern California. Inclusion criteria were medical records …

Nature Versus Nurture: A Study Of Adopted And Biological Children And Their Behavioral Patterns, Courtney Janaye Grenke

Senior Honors Theses

Nurses encounter many different populations of people every day and they must know how to treat them. Adopted children are a population that nurses encounter and there are disagreements concerning whether they are at an increased risk for developing behavioral problems as compared to biological children. It is also debated whether genetics or environment plays a more prominent role in childhood development. Most studies conclude that adopted children are at an increased risk for more behavioral problems due to the unique struggles and challenges they must overcome with genetics playing a bigger role than environment. Nurses can use this information …

A Social Controversy: Autism Spectrum Disorder's Correlation To The Measles-Mumps-Rubella Vaccination, Lindsay A. Frye

Senior Honors Theses

A 1998 research study lead by Dr. Andrew Wakefield linked the measles-mumps-rubella (MMR) vaccination as a probable cause to autism spectrum disorder. This publication has started a significant debate among healthcare professionals and instigated an anti-vaccination movement within the general population. This vaccination controversy was started by parents who readily accepted Wakefield’s findings as truth and frequently would choose to withdrawal the administration of vaccinations from their children’s care plans. There has also been disapproval by healthcare professionals over Wakefield’s study since numerous research teams have been unable to replicate his findings. This disagreement surrounding the MMR vaccination is likely …

Development Of An Advanced Practice Registered Nurse Primary Care Telephone Clinic, Linda G. Kaiser

Dissertations

Abstract Development of an Advanced Practice Registered Nurse Primary Care Telephone Clinic This pilot project developed and implemented a telephone clinic based on established Veterans Affairs telephone policy and procedures and determined patient acceptability of this new visit type as an alternative to face to face visits. The review of the literature produced research that indicates telephone clinics are a viable visit option for patients. Telephone visits provide access to the primary care provider while being convenient and economical for patients. Research studies demonstrate that patients are satisfied with this visit option. The pilot project was successfully implemented in a …