Medicine and Health Sciences Commons^™

Babywearing's Influence On Parent And Infant Heart Rates, Joo-Hee Han

UNLV Theses, Dissertations, Professional Papers, and Capstones

Babywearing is the practice of carrying an infant in a baby carrier close to the body. It provides an environment that allows the bodies of the parent and infant to be close together. The closeness of parent and infant improves the well-being and coregulation of the parent and infant, which could be estimated with heart rate (HR). Few studies have examined mother-infant dyads, but even fewer have examined father-infant dyads. This study examined mother-infant and father-infant dyads, especially for infants with neonatal abstinence syndrome (NAS). The significance of studying babywearing in this vulnerable population is that if babywearing is associated …

Evaluating Risk-Appropriate Perinatal Care In Nevada, Janice Enriquez

UNLV Theses, Dissertations, Professional Papers, and Capstones

In the United States, (U.S.) technological advancement and increased accessibility to health care resources have not deterred the increasing maternal morbidity and mortality rates (CDC, 2022). In 2019, 754 maternal deaths were reported; in 2020, 861 deaths were reported. In a span of one year, the maternal mortality rate increased by 14% (CDC,2022). American Indian/Alaska Native and Black birthing people are 2 to 3 times more likely to die from a pregnancy-related cause than White birthing people (CDC, 2019). 80% percent of all pregnancy related deaths can be prevented (CDC, 2022). Risk-appropriate care is a strategy used to improve perinatal …

Investigating Students’ Lived Experience With Prebriefing Structure And Elements In Nursing Simulation Education, Meghan Liebzeit

UNLV Theses, Dissertations, Professional Papers, and Capstones

Prebriefing is a growing body of knowledge in nursing simulation education. It is recognized as an important factor in the simulation experience, however the practice of prebriefing varies widely making it difficult to understand what methods best prepare students for the simulation scenario. While research over the last decade has identified prebriefing increases confidence, skills, and clinical judgment, what content is important to include in prebriefing, or how it promotes the achievement of outcomes is under recognized.Implementing an intervention based on a pedagogically sound eight-week simulation clinical course, developed with the theoretical underpinnings of Vygotsky’s Zone of Proximal Development, Kolb’s …

The Covid-19 Pandemic And On-Time Vaccine Completion In The Childhood Population: A Strategic Plan, Chris Elaine Mariano

UNLV Theses, Dissertations, Professional Papers, and Capstones

In March 2020, the entire world was placed into lockdown due to the COVID-19 virus, which impacted everyday life, including healthcare. People were scared to leave their homes and obtain preventative services, including vaccinations from birth to adulthood. There was a significant decrease in childhood vaccinations due to the COVID-19 pandemic. A strategy mix is defined as an intervention utilized for vaccination improvement. Strategy mixes were implemented to improve vaccination administration, and ultimately, vaccination rates. However, due to the COVID-19 pandemic, these strategy mixes or interventions were placed on hold causing immunization administration to decrease which could cause vaccine-preventable diseases …

Telehealth In Patients With Type 2 Diabetes Mellitus, Saghi Nassrouie

UNLV Theses, Dissertations, Professional Papers, and Capstones

Description: Type 2 diabetes mellitus (DM2) is an epidemic that has many factors involved in its management to maintain control. Patients with DM2 require routine evaluations and blood work to provide comprehensive care. COVID-19 caused major shifts in traditional care which sparked an increase in the utilization of technology like telehealth. Telehealth can be an effective tool used to manage diabetes and help attain better glucose control, but its effectiveness during the COVID-19 pandemic warrants further investigation.Purpose: The purpose of this project was to determine if telehealth visits were more effective in reducing Hemoglobin A1c (HbA1c) in adult patients with …

Fear Of Recurrence As A Mediator Of Illness Perception And Perceived Stress In Acute Myocardial Infarction Survivors, Sarah E. Zvonar

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The primary objective of this study is to evaluate fear of recurrence as a mediator of illness perception and perceived stress. This research will determine how illness perceptions and fear of recurrence affect perceived stress in the acute myocardial infarction (AMI) population. Other aims will observe how demographics predict patients who may experience increased fear of recurrence and stress in the AMI population, how the variables of fear of recurrence change over time, and if fear of recurrence is still a significant mediator after controlling for depression and anxiety.Rational/ Conceptual Basis/ Background: Acute myocardial infarctions (AMIs) are often accompanied …

Relationships Between Healthcare Technology Experience, Acceptance, Attitudes, Self-Efficacy And Readiness In Pre-Licensure Nursing Students, Emily Lynne Boyce

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Technology is embedded in many aspects of healthcare. This is especially true in nursing, where technology is used daily in charting, medication administration, clinical decision-making, healthcare team communication, and information resource utilization. In nursing programs, students are exposed to healthcare technologies and expected to use them once entering the workforce. Healthcare technologies such as electronic health records (EHR), barcode medication administration, medication dispensing machines, and mobile technologies are critical to adopt to leverage their efficiencies and safety mechanisms to provide the best patient care. Despite evidence indicating the benefits of using healthcare technologies, new graduate nurses enter the workforce …

The Lived Experience Of The Dnp-To-Phd Nursing Graduate: Examining The Journey, Bonni S. Cohen

UNLV Theses, Dissertations, Professional Papers, and Capstones

The traditional route of obtaining a Doctor of Philosophy (PhD) in nursing is vertical: a Master of Science in Nursing (MSN), followed by PhD in nursing. An ongoing shortage of PhD- prepared nurses—nurse educators and nurse researchers, in particular, has spurred the creation of more pathways to obtaining a PhD in Nursing. In recent years, there has been a drive to increase the number of nurse scientists with doctoral degrees through innovative pathways. A newer terminal nursing degree, the Doctor of Nursing Practice (DNP), has taken root over the past decade to produce nurse leaders who are experts at translating …

No Scrubs: Nursing Applicant Trajectories After Rejection, Jennifer Torgerson

UNLV Theses, Dissertations, Professional Papers, and Capstones

There is a nursing shortage in the United States which has become even more apparent during the COVID-19 pandemic. Despite qualified applicants, thousands of students are turned away from educational programs each year as programs reach capacity limits. The rejection may have social, psychological, and economic consequences for the student. Students faced with rejection need to make decisions whether to continue their pursuit of nursing or go a different direction. This exploratory quantitative study aims to understand the trajectories of students that are not admitted into a capacity restricted nursing program at a community college in the Southwestern United States. …

Health Literacy And The Feasibility Of Using Video-Based Education In The Emergency Department, Jenifer Carvell

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The Department of Health and Human Services (HHS) defines health literacy as the degree to which an individual has the capacity to find, understand, and use information and services to inform health-related decisions and actions for themselves and others. In the emergency department (ED), it is estimated that the prevalence of inadequate health literacy can reach as high as 88 percent. There is a need to implement literacy-sensitive interventions in the ED. Purpose: The purpose of this project was to engineer an intervention that explored the feasibility of the use of personal technology to deliver video-based education to adult …

Leveraging Simulation To Understand Nursing Student Learning In Technologically Complex Environment, Deborah Rojas

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction The adoption of simulation technologies in schools of nursing has increased significantly over the last 5 years. Results regarding the use of simulation technology have been positive. The use of simulation technologies has been developed to include complex nursing situations that resemble real clinical settings. Research has demonstrated that memory recall is better in an environment that is the same or similar to the environment in which the learning took place (Krokos et al., 2018). For this reason, educators have used simulation technologies to create realistic environments where students can learn. However, learning outcomes in simulations are affected by …

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 …