Medicine and Health Sciences Commons^™

The Effect Of Guided Observation On Learning Outcomes In Simulation-Based Learning, Jamil Norman

Nursing Theses and Dissertations

Nurse educators have been faced with the challenge of providing adequate clinical preparation for nursing students. Implementation of simulation-based learning (SBL) has been used to meet these challenges. Current research indicates that students and faculty are both satisfied with simulation; however, faculty concerns with improving student learning during SBL have led to a research intervention on the use of an Observation Guide. The purpose of this research was to examine differences in knowledge, self-confidence, satisfaction, and collaboration between baccalaureate nursing students using an Observation Guide when observing a simulated clinical experience (SCE) and those observers without an Observation Guide. Additionally, …

The Use Of Positive Deviance To Deliver Patient-Centered Care, Jodie Gary

Nursing Theses and Dissertations

What happens when critical care nurses find themselves in situations where patient care needs are not covered by practice guidelines or standard orders or when the needs conflict with those guidelines and orders? Sometimes usual practices such as call the supervisor, call the physician, or follow the protocol just do not meet the needs of the patient at the exact time and place. Experienced critical care nurses often discuss such situations in private; however, there is little information in the literature about the types of situations encountered and the decision- making processes used in these situations. Those discussions that were …

Differences In Substance-Related Risk Behavior Between Dual And Triple Diagnosed Severely Mentally Ill Adults, Michelle Hampton, Linda Chafetz, Carmen Portillo

Faculty Publications

No abstract provided.

Chattanooga Community Members Willingness To Use Retail Clinics: A Quantitative Approach, Yasmine M. Swistek, Casey M. Waddle

Graduate Research Projects

This study explored the willingness of Chattanooga community members to utilize retail clinics for simple ailments rather than the area EDs. Specifically, community members ages 25-45 were surveyed and asked to rate their willingness to use a retail clinic for their acute healthcare needs rather than the overcrowded local EDs. Additionally, this study explored community members’ perceived barriers to use retail clinics. Results were compared between demographic variables such as yearly income, race, gender, and age.

The Meaning Of Parenteral Hydration To Family Caregivers And Patients With Advanced Cancer Receiving Hospice Care., Marlene Z. Cohen, Isabel Torres-Vigil, Beth E. Burbach, Allison De La Rosa, Eduardo Bruera

Journal Articles: College of Nursing

CONTEXT: In the U.S., patients with advanced cancer who are dehydrated or have decreased oral intake almost always receive parenteral hydration in acute care facilities but rarely in the hospice setting.

OBJECTIVES: To describe the meaning of hydration for terminally ill cancer patients in home hospice care and for their primary caregivers.

METHODS: Phenomenological interviews were conducted at two time points with 85 patients and 84 caregivers enrolled in a randomized, double-blind, controlled trial examining the efficacy of parenteral hydration in patients with advanced cancer receiving hospice care in the southern U.S. Transcripts were analyzed hermeneutically by the interdisciplinary research …

Ethanol Lock Therapy In The Treatment And Prevention Of Catheter-Related Bloodstream Infections, Breanna Anderson

HIM 1990-2015

Ethanol lock therapy is a novel technique that is being studied for its efficacy in eradicating catheter related bloodstream infections. A systematic review of interdisciplinary studies from CINAHL, Medline, Academic Search Premier, Biological Abstracts, and Web of Knowledge databases was performed. This meta-analysis examined the findings of thirty-five studies on ethanol lock therapy. Twenty-six of these studies compared ethanol to a placebo and nine studies performed a direct comparison of ethanol to other agents frequently used in antimicrobial lock technique. Ethanol lock therapy was shown to be effective as both a prophylactic therapy and as an active treatment in eradicating …

Triage; A Literature Review Of Key Concepts, Khairulnissa Ajani

School of Nursing & Midwifery

The emergency department (ED)--sometimes termed the emergency room (ER), or the accident & emergency (A&E) department--in a hospital or primary care facility that provides initial treatment to patients with a broad spectrum of illnesses and injuries, some of which may be life-threatening or requiring immediate attention. The earliest patients-physician encounter is the triage doctor/nurse who completes the preliminary evaluation before transferring care to another area of the ED or a different department in the hospital. A strong triage system is the backbone of an efficient ED. It indicates that the staff is capable of differentiating critically ill from the sick, …

Managing Work-Role Transition: From Nurse Clinician To Nurse Educator, Shirin Rahim, Munira Prasla

School of Nursing & Midwifery

Change in any aspect of human life is often challenging and requires significant efforts for readjustment from the individual and could result in improving or worsening existing situation. Change in work-role is also a significant event in a person's life. Present study attempts to analyse management of work-role transition from clinical nurse to nurse educator. The study is based on systematic and critical review of articles that appeared in peer-reviewed Journals. Research articles were searched from databases CINAHL, PubMed, Sage, and Science Direct using various combinations of keywords. 20 shortlisted articles were subjected to analysis for common theme of work-role …

Hidden Voices Of Hermaphrodites, Zohra Asif Jetha, Nasreen Sulaiman Lalani, Gulnar Akber Ali

School of Nursing & Midwifery

Gender is a psychological component which is given by the society to a person, while sex is a biological component which is awarded by the God. However, there are certain conditions in which the biological aspects are put to challenge with the social and psychological aspects of gender. Hermaphrodites are a third gender role, who is neither male or female man nor woman but contains the element of both. One may question that if they are neither male nor female then who they are and whether they are equally treated in our society. Looking at the challenges faced by hermaphrodites, …

The Role Of Faith And Spirituality In The Work Of End-Of-Life Caregivers, Edward P. Stannard

Master of Arts in Religious Studies (M.A.R.S. Theses)

Nurses, certified nursing assistants and other healthcare workers who care for those who are terminally ill face issues of mortality and even existential questions every day on the job. These professionals, who have intimate contact with their patients daily, must find an inner source of strength and perseverance in order to face people who are at the end of their lives, who may be in pain, and who frequently are alone in their rooms aside from the institution’s staff. This study asks whether an inner sense of religious faith or spirituality helps end-of-life healthcare workers conduct their daily tasks and …

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 …

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 …

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. …

Nutritional Management Of The Extremely Low Birth Weight Infant: An Evidence Based Clinical Practice Guideline, Dana J. Lunde

UNLV Theses, Dissertations, Professional Papers, and Capstones

Premature birth has risen steadily over the last decade resulting in an increased number of infants needing neonatal intensive care. The demand for neonatal intensive care has lead to many improvements in the delivery of such care with an increase in the survival of the smallest and most premature infants. However, most of these infants are being discharged from neonatal intensive care units (NICU) with severe extrauterine growth restriction (EUGR).

Extremely low birth weight (ELBW) infants born at 23-27 weeks gestation and who have a weight of less than 1,000 grams are at the highest risk for EUGR because of …

Provider Variations In Cesarean Section (Cs) And Vaginal Birth After Cesarean (Vbac) Practice, Rita Elizabeth Marrero

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Centers for Disease Control and Prevention's National Center for Health Statistics (2010) report that nearly one-third of babies were born by Cesarean section (CS) in 2007. Of interest, six states, including Nevada, experienced increases of more than 70% in the last 10 years (CDC, 2007). Based on the increased rate of CS deliveries, the National Institutes of Health (NIH) convened a consensus panel in 2010, which urged the medical community to reduce barriers to women who want to try a vaginal birth after Cesarean delivery (VBAC) in the hope this would safely decrease the total CS rate. For clinicians …

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 …

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 …

The Efficacy Of An Audio Program And Discussion Guide In Promoting Exclusive Breastfeeding In Cameroon, Africa, Kathryn R. Reinsma

Loma Linda University Electronic Theses, Dissertations & Projects

Background: In the Northwest Region of Cameroon, approximately 90% of women initiate breastfeeding; however, only 34% continue exclusive breastfeeding for the recommended six months (Kakute, et al., 2005; WHO, 2008). Entertainment-education is a mass-media communication strategy of placing educational information into media such as television programs, movies, and radio programs (Siegel & Lotenberg, 2007). This form of behavioral change communication has proven effective in addressing health-related issues in developing countries.

Purpose: The aim was to design an audio program and discussion guide to test the hypothesis that an audio program and discussion guide improves exclusive breastfeeding knowledge, beliefs, benefits, self-efficacy, …

A Qualitative Descriptive Study Of The Work Of Nurses In Interventional Radiology, Brenda Naef Boone Phd

Dissertations

This dissertation study explored the work of nurses in interventional radiology. Interventional radiology (IR) is an emerging field of practice in health care. More and more procedures that were historically done in the operating room are being performed in IR. This has led to higher acuity patients and an increased need for specialized nursing care. The work of nurses in this area of practice is not well described and as such can lead to a lack of understanding of nursing involved in high tech low touch areas. This qualitative descriptive research study was conducted to shed light on this under …

Pain Management In Triage And Reducing Percentage Of Left Without Being Seen In An Overcrowded Ed, Christina Ballejos-Campos Phd

Dissertations

Although in most emergency rooms, the patient is seen first by a highly trained triage nurse, the ED physician is trained to determine if the patient can safely leave the ED prior to in-depth exam, treatment and diagnosis. The goal is to keep the left without being seen by a physician percentage low, since a high number would indicate poor quality, additionally patients who present with pain, and then leave the ED prior to being seen can pose a greater risk. This study examined the association of nurse-initiated triage pain protocol on the LWOBS percentage rate of patients who present …

Acute Leukemia Care In A Community Hospital: We Did It And So Can You!, Barbara Labriola Msw, Ba, Rn, Cmsrn, Donna Wegner Rn

Patient Care Services / Nursing

No abstract provided.

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 …