Medicine and Health Sciences Commons^™

Evaluating A Novel Approach For Type 2 Diabetes Mellitus Patient Education: Modified Team -~ Based Learning, Corine Belle Lazaro

UNLV Theses, Dissertations, Professional Papers, and Capstones

One of the world’s most serious health issues today is the increasing prevalence of diabetes (Chobev, Sotirovska, Mihajilov, 2011). Indeed, the growth of this widespread and pernicious disease has been categorized as epidemic. The antidote for the diabetes epidemic lies in prevention and the use of a chronic care model that focuses on improving diabetes self-management. For both diabetes prevention and self-management, a core component pertains to knowledge—and specifically to improved public health literacy, public health education, and patient education. For example, ongoing patient education is a critical factor in helping patients to manage their diabetes and prevent the micro- …

An Evidence Based Approach To Sepsis: Educational Program, Dolores Perez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Evidence-based guidelines for recognizing and treating sepsis have been available for decades, yet healthcare providers do not adhere to the recommendations. Sepsis can progress rapidly if not recognized early. Literature reports reveal that sepsis is the leading cause of death in non-cardiac intensive care units (ICUs), and it is one of the most expensive conditions to treat. A hospital in the Las Vegas, Nevada area had previously introduced sepsis management prescriptions in 2011 with no formal education of sepsis guidelines to nurses. The original hospital’s sepsis management prescription sets followed guidelines dated 2008. The purpose of this project was to …

The Lived Experience Of Nurses Working In A Modified Therapeutic Community, Victoria Lynn Plagenz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Today over one million U. S. prisoners are being held in federal and state systems for substance use-related crimes. The financial, social, and emotional costs have turned policymakers’ attention to rehabilitation rather than incarceration. In an attempt to meet the challenge of recovery from addiction, prison systems around the nation have explored various options, including residential treatment programs. One such form of residential treatment is the modified therapeutic community (MTC) where inmates participate in a nine-month, cognitive-based treatment program. This model focuses on incarcerated individuals, addicted to substances, to assist them in developing behaviors to reduce antisocial peer associations and …

The Lived Experience Of Registered Nurses With Substance Use Disorder Who Complete An Alternative To Discipline Program Through A State Board Of Nursing, Susan Melanie Ervin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Substance use disorder, defined as the misuse of drugs and/or alcohol, is a major health problem in the United States. Health care providers, including nurses, are at risk for this disorder. Risk factors for substance use disorder (SUD) in nurses include social factors such as family history of the disorder and biological factors such as genetic predisposition. Specific risk factors for nurses include easy access to controlled substances (such as opiates), stressful work environments, the belief that substance use assists with coping and a lack of education related to substance use disorder.

Substance use disorder in nurses is a significant …

Increasing Comfort With End-Of-Life Discussions, Theresa Catherine Berton

UNLV Theses, Dissertations, Professional Papers, and Capstones

End-of-life discussions and advanced care planning are part of the healthcare process, and within the scope of practice for providers. Despite the evidence supporting the effectiveness of these conversations, the system falls short. Talking about death is never easy. At times, it is difficult for healthcare providers to approach the topic with patients who are living with serious life-limiting illness. Reports in the end-of-life literature reveal that healthcare professionals avoid discussions about preparations for end-of-life care due to feeling unprepared, and a lack of framework for such discussions. Purpose: The purpose of this doctoral project was to improve the quality …

Nurse Managers' Hiring Selection Of Newly Licensed Rns: A Grounded Theory Approach, Susan Adamek

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this research study was to construct a substantive grounded theory regarding how acute care nurse managers select the newly licensed RNs (NLRNs) they hire. This is important because a good selection process can reduce expensive employee turnover and improve teamwork on units. There has been extensive research regarding interventions that improve the retention of NLRNs after they are hired, such as residency programs, preceptors, mentors and support groups, but there is very little in the literature about the processes or preferences nurse managers use to select the right candidates to be hired. A constructivist grounded theory approach …

The Impact Of Shift Work On Diabetes Self-Management Activities, Daniel Navarro

UNLV Theses, Dissertations, Professional Papers, and Capstones

In the United States 26 million people are affected by diabetes, which can result in microvascular and macrovascular complications. As a consequence, once a person is diagnosed with diabetes, aggressive clinical management is imperative to minimize poor glycemic control’s devastating outcomes. However, for some patients reaching optimum blood glucose levels is challenging due to the complexity of diabetes’ care. In order for patients with diabetes to achieve good blood glucose control, they must engage in self-care activities that include routine blood glucose checks, dietary control, physical activity, and routine medical provider visits, simultaneously with their medication regimen. Diabetes associated self-care …

The Voices Of The People: Lower Sioux Indian Community Members Speak Out On What They Need And Want In A Primary Health Care Clinic On The Reservation, Darin Michael Prescott

UNLV Theses, Dissertations, Professional Papers, and Capstones

American Indian/Alaska Native (AI/AN) people who live on reservations or in urban areas typically receive their health care in clinics that are operated by their tribe or are affiliated with Indian Health Service (IHS), a federal agency that provides care to AI/AN people. The Lower Sioux Indian Community (LSIC) is a federally recognized tribe located in southwest Minnesota near Morton, MN. LSIC members currently receive health care from outside providers at various locations near the reservation. The outsourced services include primary care, emergency care, hospitalization, surgery, dentistry, and podiatry. Because the providers are independent groups and do not work for …

The Predictors Of Cultural Competence In The Baccalaureate Degree Nursing Curriculum: Implications For Nursing Education, Angela Elizabeth Silvestri-Elmore

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.” From 2000 to 2010, the Asian population increased by 43.3%, the Hispanic population grew by 43%, the Native Hawaiian and other Pacific Islander population increased by 35.4%, the American Indian or Alaskan Native population increased by 18.4%, and the African American population increased by 12.3%. …

The Effects Of The Hcahps Learning Module On Undergraduate Nursing Students During The Simulated Hospital Day, Ronnie C. Stout

UNLV Theses, Dissertations, Professional Papers, and Capstones

The introduction of the Affordable Care Act has brought about change in the way the Centers for Medicare and Medicaid Services (CMS) reimburses for hospital care. Hospitals are being rewarded for making the patient experience a positive one as evaluated by the patients. This information is provided through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. These survey results allow consumers to compare hospitals locally and nationally with other hospitals. Patients are able to evaluate the hospitals in their area and make informed decisions about where they want to get their care based on previous patients’ experiences. …

Intraprofessional Nursing Communication And Collaboration: Apn-Rn-Patient Bedside Rounding, Rita M. Herm-Barabasz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Executive Summary

Leading advisory agencies have long advocated that health care must be safe and effective (Institute of Medicine [IOM], 2001). In order for health care to be safe and effective, good communication and collaboration are essential. Research has found that in health care, poor communication and teamwork failures are the major contributors to adverse events (Cornell, Townsend-Gervis, Vardaman, & Yates, 2014; The Joint Commission, 2011; O’Leary, 2012). Such communication-related adverse events can cause avoidable injury, loss of life, and financial devastation. In light of advanced practice nurses’ (APN) increasing contribution in care management, and in order to ensure delivery …

Survival Of The Fittest: The Role Of Linguistic Modification In Nursing Education, Brenda Strauch Moore

UNLV Theses, Dissertations, Professional Papers, and Capstones

This project’s long term goal was to improve English-as-a-Second-Language (ESL) nursing student retention. Improving the quality of multiple choice exams is a first crucial step. ESL students find multiple-choice exams to be one of the most challenging aspects of nursing school. One reason for this is the presence of linguistic errors in exam questions. Linguistic errors include: irrelevant question content, poor sentence structure, and culturally biased words or phrases. Non-ESL students are less affected because exams are written in their native language. Linguistic modification, as part of best practices in item writing, removes these types of errors. The U.S. Department …

Partnering With The Community For Establishment Of Alternate Care Sites During Disasters Or Emergencies: A Staff Training Matrix, Jean Marie Roberts

UNLV Theses, Dissertations, Professional Papers, and Capstones

An approach to fulfill a need for additional hospital beds during emergency and disaster situations has been establishment of alternate care sites (ACS). Kern County, California, with a population of about 856,000 and approximately 1,500 hospital beds, is at significant risk for inability to care for the medical needs of its residents in the face of a disaster or an emergency. Even the most conservative estimates of additional hospital beds requirements in a disaster or emergency would indicate the need for nine to ten ACSs accommodating up to 50 patients each in Kern County.

Recognizing the need for alternatives to …

Improving Transitions Of Care In The Perioperative Setting, Brian Wayne Selig

UNLV Theses, Dissertations, Professional Papers, and Capstones

It is estimated that nearly 200,000 Americans die each year due to preventable medical mistakes (Gupta, 2012), and nearly 80% of all medical errors involve some form of miscommunication between healthcare providers (Joint Commission Center for the Transformation of Healthcare, 2013). Handoffs, or the transitioning of patient care from one provider to another, occur multiple times each day in the hospital setting and done incorrectly can lead to significant mistakes in patient care.

The purpose of this project was to improve the quality of handoffs that occurred between perioperative and inpatient nurses at an urban, tertiary medical center. A shared …