Medicine and Health Sciences Commons^™

Nurse-Driven Protocol To Reduce Urinary Catheter Infections: A Quality Improvement Project, Sara Burrington

Master's Projects and Capstones

Costs of healthcare are astronomical, not only in the financial sense, but in many aspects of life for both patients and healthcare providers. Costs include those accompanying healthcare associated infections (HAI), where as a result of environmental factors, a patient acquires an infection during their admission. Since 2008, Medicare and Medicaid no longer reimburse hospitals for infections deemed ‘reasonably preventable.’ The biggest offender of this type of HAI is overwhelmingly, catheter associated urinary tract infections (CAUTI) (Kennedy, Greene & Saint, 2013). With approximately 31% of the inpatient population requiring an indwelling catheter at some point throughout their stay, risk of …

Infection Control: The Nurse's Responsibility, Marisa Francis

UNLV Theses, Dissertations, Professional Papers, and Capstones

Over the last century and a half, infection control measures implemented by nursing staff have continued to evolve, resulting in improved patient outcomes. While this progress is impressive, a decline in rates of hospital acquired infections (HAIs) seems to have slowed, with only a 0.5% decrease in the last seventeen years. Unfortunately, nurses are rarely provided educational support on infection control practices beyond undergraduate and new employee trainings. Meanwhile, the Centers for Disease Control (CDC) is frequently updating their infection control practice recommendations.

The purpose of this project was to observe the current rate of infection control compliance by nurses, …

Restructuring Of The Axon Initial Segment In Mouse Models Of Neurodevelopmental Disorders, Rachel Ali Rodriguez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Neurodevelopmental disorders (NDDs) affect more than 36% of children in countries with low- and middle- incomes (Boivin, 2015; McCoy, 2016). Interestingly, these heterogeneous disorders share a high incidence of epileptic seizures, suggesting a shared pathology. Seizures result when neuronal firing activity becomes disturbed and neurons fire excessively or in unregulated patterns. A key site in the control of neuronal firing patterns is the axon initial segment (AIS), where the local density of proteins and the morphology of the AIS in part determine the firing of neurons. We hypothesized that a disruption in the morphology and/or composition of the AIS can …

Effect Of Bundled Payments As A Care Improvement Initiative On Hospital Care Of Total Joint And Sepsis: A Perspective On Organizational Effectiveness, Pearl Kim

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study investigates the potential impact of the Bundled Payments for Care Improvement (BPCI) initiative from Center for Medicare and Medicaid Services on hospital performance and behavior related to effectiveness and efficiency. The BPCI is under the Affordable Care Act and provides hospitals with a fixed amount of reimbursement for a total episode of care. Building on the agency theory, I argue that the BPCI initiative has the potential to enhance the effectiveness and efficiency of hospital care. This quasi-experimental study examines the changes in hospital care outcomes of patients with replacement of the lower extremity or sepsis in BPCIparticipating …

Evaluating Parents Sociodemographic Factors And Childhood Vaccine Decisions, Mehret Girmay

UNLV Theses, Dissertations, Professional Papers, and Capstones

Vaccination is considered one of the most successful public health achievements of the 20th century. However, with increasing vaccine skepticism emerging over the past decades, there is a threat to the ongoing sustainment of vaccine coverage within all US communities. This study evaluated and compared parents’ sociodemographic factors associated with childhood vaccine decisions. This study is a secondary analysis of 893 parents/guardians, age 18-55 years with child(ren) < 7 years living in the U.S.

Predictive analysis was conducted using multinomial logistic regression modeling was used to examine vaccine decisions (accept, hesitant, and refuse) in relation to parents’ sociodemographic factors. Overall, (66.6%) of parents accepted recommended vaccines, while …

Compounding Effects Of Reducing Nurse Burnout And How It Can Produce An Increase In Patient Safety And Satisfaction, Alexander Mua

Master's Projects and Capstones

The reduction of nurse burnout has shown to have an increase in patient satisfaction and quality of care. It also has shown a decrease in patient-related or sentinel events. Accordingly, with the reduction of nurse burnout, there has also been a reduction of compassion fatigue. This project has illuminated the benefits of acuity-based caseload at the micro-level, including the cost-effective nature of overtime pay, including HCHAPS benefit score. The method of obtaining, planning, and implementing was based on the Plan, Do, Study, Act (PDSA), which required collaboration amongst multiple disciplines, groups, departments, and executives. The process and goals concluded to …

Role Of Echocardiography In Diagnostic Evaluation Of Patients Admitted To Observation Unit., Muhammad Arslan Cheema, Hafez Mohammad Ammar Abdullah, Waqas Ullah, Yasar Sattar, Shujaul Haq, Khadija Cheema, Asrar Ahmad, Zain Ali, Asoka Balaratna

Abington Jefferson Health Papers

BACKGROUND: Syncope is a transient loss of consciousness due to transient decrease in cerebral perfusion. Syncope accounts for a 3-6% of all emergency department visits. Etiology of syncope can be neural, cardiogenic, or vascular. Previous studies have evaluated the types and management of syncope. Echocardiography is a commonly used test in the evaluation of causes of syncope. Whether the benefit compared to financial burden of this diagnostic study is in all subsets of syncope cases remains unclear.

AIM: To evaluate the impact of echocardiography in the diagnostic evaluation of syncope and to evaluate the subset of patients that would benefit …

The Symbolism Of Play Behavior In Child-Centered Play Therapy, Kaitlin Andrewjeski

UNLV Theses, Dissertations, Professional Papers, and Capstones

Child-Centered Play Therapy (CCPT) is an evidence-based approach for mental health treatment with children. CCPT is based on the belief that play is a child’s natural language and so the therapist is required to make inferences of themes through observations of free play; however, there is no standard process by which themes are identified. The purpose of the current study is to gain detailed descriptions of play behavior in order to describe how themes emerge and how they are displayed in child-centered treatment. The themes were then used to describe the progression through the typical stages of child-centered play therapy. …

Trade-Offs Between Survival And Reproduction In Starvation-Selected Drosophila Melanogaster, Tammara Beeghly

UNLV Theses, Dissertations, Professional Papers, and Capstones

Evolutionary outcomes are demonstrated by traits that affect an organism’s schedule of reproduction and survival. These life history traits are reflected in an organism’s physiology, development and behavior. Environmental changes, such as availability of nutritional resources, can profoundly affect evolutionary outcomes of individuals and populations. When shortages arise, there will be trade-offs in the allocation of resources, where one trait prevails at the expense of another.

In the laboratory, we can mimic conditions in nature and study the specific effects of the conditions that we re-create. In our case, over 100 generations of Drosophila melanogaster have been selected for starvation …

Reconciling Incongruencies: Examining The Meaning And Influencing Factors Of Oncology Nurses' Professional Quality Of Life, Rebecca Lynne Boni

UNLV Theses, Dissertations, Professional Papers, and Capstones

Nurses often witness suffering and loss. These experiences are intrinsic to the practice of nursing and can exert a strong, cumulative effect on nurses’ professional quality of life (QOL). Stamm (2010b) conceptualizes professional QOL as a composite of compassion fatigue and compassion satisfaction. Inferior professional QOL has been linked to numerous negative healthcare outcomes. Oncology nurses are particularly vulnerable to compassion fatigue. The Professional Quality of Life Scale (ProQOL), created by Stamm (2009), is the current survey used to measure professional QOL, but it may not be specific enough for oncology nurses.

The purpose of this grounded theory study was …

A Retrospective Survey Of Exercise Habits In Low-Income Female Senior Citizens, Kelly L. Bumgarner

UNLV Theses, Dissertations, Professional Papers, and Capstones

American adults spend at least 50% of their time sedentary with the most inactive demographic being low-income women over 60. This is detrimental because routine physical activity benefits for senior women include balancing hormones, maintaining bone mineral density, and decreasing the risk of breast cancer. Statements like “good exercise habits begin during youth; children should play sports to establish healthy habits they’ll continue throughout their lives” are common, but not clearly supported by literature. Objective: The purpose of this retrospective, cross-sectional study was to identify whether physical activity/exercise habits during youth and young adulthood predict old age physical activity/exercise habits …

Community Exposure To Particulate Matter And Its Impact For Students And Residents Near A Construction Asphalt Plant: A Case Study, Aman Gebremariam Gebreselassie

UNLV Theses, Dissertations, Professional Papers, and Capstones

Particulate matter (PM) consists of various small particles in the atmosphere that has been associated with environmental health risk factors for many deadly diseases. PM2.5 is particulate matter 2.5 micrometers or less in diameter, PM10 is particulate matter 10 micrometers or less in diameter and are both respirable particles that can penetrate the lungs and increase risk of cardiovascular problems and respiratory illness, among other health issues. Exposure to particulate pollution in the environment tends to cause lost income from work absence, students’ absences from school, hospital admissions as well as emergency and doctor room visits.

Although asphalt plants are …

Disparities In Administrative Pediatric Asthma Prevalence In Clark County, Aaliyah Goodie

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: Asthma is one of the most common chronic diseases affecting young children nationally and globally. Asthma affects more than 25 million people in the nation, of which 6

million are children. Lifetime asthma prevalence for children in Nevada is 11.5% (CDC, 2016). This is likely an underestimate due to a large undocumented Hispanic population. In Clark County School District (CCSD) during the 2016-2017 school year, 20,235 students (8%) listed asthma in school records as a health concern. Asthma burden varies by sociodemographic group with highest rates documented among Black/African American, Hispanic/Latino, and pediatric populations. The Centers for Disease Control …

Visual Attention And Emotion Regulation In Schizophrenia, Bern Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

Emotion regulation and emotion processing deficits cut across the varying symptom presentations of schizophrenia. Emotion processing deficits are inadequately treated by pharmacologic interventions and are related to real-world functional impact and disability. This study investigated behavioral and psychophysiological responses to a series of emotion regulation tasks while concurrently collecting eye tracking data as an index of visual attention. A brief neurocognitive assessment was also completed in order to examine potential cognitive determinants of emotion. Participants completed tasks designed to assess cognitive change and directed attention strategies for down-regulation of unpleasant and pleasant emotion. For each of our two unpleasant emotion …

Benson’S Relaxation Response: Psychological And Physiological Responses Among Patients With Copd, Crista Reaves

UNLV Theses, Dissertations, Professional Papers, and Capstones

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States. In patients with COPD, distress is significantly prevalent and can have adverse psychological and physiological effects. Considering the increased rate of COPD, a mind-body intervention focusing on the reduction of both psychological and physiological responses such as anxiety, elevated blood pressure (BP), heart rate (HR), dyspnea, and respiratory rate must be integrated into the patient’s plan of care. The relaxation response (RR) is a term coined by Dr. Herbert Benson in the 1970s describing the body’s ability to counter the fight-or-flight response to decrease …

Carbon Management And Volatile Fatty Acid Production In Primary Clarifiers At A Wastewater Treatment Plant, Brittany Nicole Radke

UNLV Theses, Dissertations, Professional Papers, and Capstones

An increasing number of treatment plants are required to remove nutrients from domestic wastewater to lessen the impact of nutrient loading to water bodies. Enhanced Biological Phosphorus Removal (EBPR) is one of the processes commonly used to remove phosphorus from domestic wastewater. The presence of an adequate quantity of volatile fatty acids (VFA) in the wastewater influent to EBPR is important for process efficiency and stability. The objective of this research was to investigate the production of VFAs through fermentation of sludge in primary clarifiers as it related to improving nutrient removal, primarily targeting phosphorus.

The research tested, in full-scale, …

An Evaluation Of Factors Associated With The Perceptions Of Diabetes In A Filipino American Sample Residing In Clark County, Nevada, Lawrence Nartatez Sagadraca

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study assessed beliefs about the contribution of the Filipino diet and genetics to diabetes burden and its ability to control it without medical interventions. The data from a need’s assessment survey of 200 Filipino Americans residing in Clark County, Nevada, were analyzed by using the logistic regression model. A significant proportion of the participants believed that diabetes is a problem in the Filipino community (79%) and is related to the Filipino diet (75%) and genetics (69.0%), and that it can be controlled without medical intervention (52.4%). In univariate analyses, age (Odds ratio [OR]: 1.03, 95% confidence interval [CI]: 1.01 …

A Community Of Care: Patterns Of Pathology And Trauma With A Focus On The Bioarchaeology Of Care At Carrier Mills, Il (10,000 – 1000 Bp), Alecia Schrenk

UNLV Theses, Dissertations, Professional Papers, and Capstones

Illness and injury are universal human experiences which are endowed with cultural meaning. Bioarchaeology has only recently begun to engage with the socioeconomic impacts of illness, injury, impairment, and healthcare provisioning in the past. This study examines how the Middle Archaic (6000 – 300 BC) and Early Woodland (1000 – 200 BC) hunter-gatherer community of Carrier Mills, Illinois was affected by and managed the socioeconomic burdens of poor health. The data presented in this study used bioarchaeological analyses to reveal patterns of poor health and healthcare provisioning within the Carrier Mills community. Bioarchaeology is ideally situated for such investigations since …

Feasibility Of Diffusion And Probabilistic White Matter Analysis In Patients Implanted With A Deep Brain Stimulator., J. Muller, M. Alizadeh, L. Li, S. Thalheimer, C. Matias, M. Tantawi, J. Miao, M. D. Silverman, V. Zhang, G. Yun, V. Romo, F. B. Mohamed, C. Wu

Department of Neurosurgery Faculty Papers

Deep brain stimulation (DBS) for Parkinson's disease (PD) is an established advanced therapy that produces therapeutic effects through high frequency stimulation. Although this therapeutic option leads to improved clinical outcomes, the mechanisms of the underlying efficacy of this treatment are not well understood. Therefore, investigation of DBS and its postoperative effects on brain architecture is of great interest. Diffusion weighted imaging (DWI) is an advanced imaging technique, which has the ability to estimate the structure of white matter fibers; however, clinical application of DWI after DBS implantation is challenging due to the strong susceptibility artifacts caused by implanted devices. This …

Improving Handoff To Decrease Sepsis Mortality: A Quality Improvement Project, Macdana Selecon, Macdana Selecon

Master's Projects and Capstones

A sepsis handoff tool utilized between Emergency Department nurses and unit nurses at a 554-bed acute care hospital were investigated. A survey assessing general knowledge of the facilities sepsis protocol was given to ED nurses, and unit nurses. The electronic health records (EHR) were evaluated for feasibility to transfer the facilities current paper format sepsis handoff tool into the EHR with time sensitive alerts. Three literature reviews supported utilization of standardized handoff tools for improved patient outcomes.

Metaphors We Think By, Aldis H. Petriceks

Journal of Wellness

N/A

Sunburnt At Lunchtime And Other Infrequent Things, Elizabeth Null

Graduate Medical Education Research Journal

No abstract provided.

Gender Difference In Glenoid Remodeling, Kent Rinehart, Matt Teusink, Chris Peters, Ann Zajicek

Graduate Medical Education Research Journal

No abstract provided.

Comparison Of Post-Operative Outcomes Of Ciprofloxacin Otic Suspension Versus Ciprofloxacin-Dexamethasone Otic Drops In Myringotomy With Tube Placement, Andrew W. Logeman, Daniel V. Arkfeld, Jayme R. Dowdall, Dwight T. Jones

Graduate Medical Education Research Journal

No abstract provided.

Patterns Of Opiate Use And Prescription Practices In Isolated Orthopedic Trauma Injuries: Creating Guidelines, Matthew Mormino, Justin Sieber, Sara Putnam, David Kusin, Zachary Bailey, Todd Gilbert, Emmett Gannon, Josh Locker, Matthew Tingle, Matthew Freeman, Mark Amirtharaj

Graduate Medical Education Research Journal

No abstract provided.

Bmi As A Risk Factor For Early Dislocation Of Total Shoulder Arthroplasty, David J. Kusin, Joshua A. Ungar, Kaeli K. Samson, Matthew J. Teusink

Graduate Medical Education Research Journal

No abstract provided.

Do Pre-Operative Emotional And Mental Rand Sf-36 Scores Predict Outcomes After Total Hip And Knee Arthroplasty?, Erik Bowman, Curtis Hartman, Kevin Garvin, Beau Konigsberg, Liz Lyden, Seth Wardyn

Graduate Medical Education Research Journal

No abstract provided.

Three Cases Of Laryngeal Histoplasmosis In The Midwestern United States, Jonathan Blecha, Christopher Bingcang, Justin Oltman

Graduate Medical Education Research Journal

No abstract provided.

Il-Β (Interleukin-Β) And Tnf-Α (Tumor Necrosis Factor-Α) Impact Abdominal Aortic Aneurysm Formation By Differential Effects On Macrophage Polarization, Rishi Batra, Melissa Suh, Jeff Carson, Matt Dale, Trevor Meisinger, Matt Fitzgerald, Jiangtao Luo, Irkalis Pipinos, Wanfen Xiong, Timothy Baxter

Graduate Medical Education Research Journal

No abstract provided.

Effect Of 75% Intestinal Resection On Body Composition In Lean Vs. Obese Rats, Ujwal R. Yanala, Roger Reidelberger, Jon Thompson, Mark Carlson

Graduate Medical Education Research Journal

No abstract provided.