Nursing Commons^™

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 …

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- …

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 …

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 …

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 …

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 …

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 …

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 …

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 …

Patient And Nurse Considerations In Home Health Routing With Remote Monitoring Devices, Jessica Spicer

Graduate Theses and Dissertations

We build on the current consistent vehicle routing problem literature by formulating a novel multi- objective mathematical model of the home health scheduling and routing problem that includes the option of assigning some patient visits to remote monitoring devices, with the objectives of mini- mizing total cost, achieving nurse consistency and creating balanced nurse workloads. A heuristic solution approach that approximates the efficient frontier of this multiobjective problem is pre- sented and validated, and the results of using this methodology to solve several realistic instances are included. We also analyze the assignment of patients to devices and present some managerial …

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 …

Identifying The Relationship Between Benzene Exposure And The Development Of Acute Myeloid Leukemia, Jacqueline G. Tally

Senior Honors Projects

My interest in epigenetic carcinogenesis-related research stems from both academic and personal experiences. I have come to recognize the significance of environmental chemical exposures in the development of cancer through my studies in nursing, and nutrition and food science. I am particularly interested in the epigenetics of acute myeloid leukemia (AML) because I am an AML survivor.

AML is a rare and highly malignant cancer. It is estimated 13,780 new cases of AML will be identified in theUnited Statesthis year with a 74% mortality rate (calculated 10,200 deaths/13,780 new cases). AML develops from alterations in the survival and proliferation of …

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 …

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 …

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 …

The Lived Experiences Of Mexican Heritage Mothers Caring For Overweight Preschool Children, Susan Mcdonald

Nursing Theses and Dissertations

Mexican heritage children are at greater risk to become overweight or obese than children of other ethnic or racial groups. The objective of this study was to gain insight into the lived experiences of Mexican-heritage mothers caring for overweight or obese preschool children. A qualitative, hermeneutic phenomenological design was selected for this study. Saturation was achieved with 12 mothers of Mexican heritage. Data collection and analysis was guided by the phenomenological approach of Max van Manen. Six themes and sixteen subthemes emerged from the data. Maternal caring practices were influenced by their Mexican heritage, emotional burdens, perceptions of child's weight …

Using Structural Equation Model To Study The Impact Of Organization Culture And Nursing Work Environment In Nursing And Patient Satisfaction, Taher Giaedi

MUSC Theses and Dissertations

No abstract provided.

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 …

A Two-Stage Cluster Sampling Method Using Gridded Population Data, A Gis, And Google Earth(Tm) Imagery In A Population-Based Mortality Survey In Iraq, Lp Galway, Nathaniel Bell, Al Shatari Sae, Amy Hagopian, Gilbert Burnham, Abraham Flaxman, Wiliam M. Weiss, Julie Rajaratnam, Tim K. Takaro

Faculty Publications

BACKGROUND:

Mortality estimates can measure and monitor the impacts of conflict on a population, guide humanitarian efforts, and help to better understand the public health impacts of conflict. Vital statistics registration and surveillance systems are rarely functional in conflict settings, posing a challenge of estimating mortality using retrospective population-based surveys.

RESULTS:

We present a two-stage cluster sampling method for application in population-based mortality surveys. The sampling method utilizes gridded population data and a geographic information system (GIS) to select clusters in the first sampling stage and Google Earth TM imagery and sampling grids to select households in the second sampling …

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 …

School Age Children: The Effects Of Hunger, Dacia Bessler

Honors Capstones

Capstone submitted as a graduation requirement for the BSU Honors Program.

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 …

Evaluation Of Methods To Relieve Parental Perceptions Of Vaccine-Associated Pain And Anxiety In Children: A Pilot Study, Karlen E. (Beth) Luthy, Renea L. Beckstrand, Amy Pulsipher

Faculty Publications

Introduction: The pain and anxiety associated with vaccination is a significant reason why parents are reluctant to have their children vaccinated. Distraction methods and vapocoolant sprays may be use to modify the parent's perceptions of their child's pain and anxiety, thus encouraging parents to return for the child's next vaccination.

Methods: A convenience sample of 68 parents with children ranging in age from 2 to 12 years was selected. The parents and the child were randomly assigned to three groups: a control group, a DVD distraction group, or a vapocoolant spray group. After the child was vaccinated, parents evaluated the …

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 …

An Investigation Of The Effects Of Pitocin For Labor Induction And Augmentation On Breastfeeding Success, Megan J. Lewis

Scripps Senior Theses

Rates of labor induction and augmentation have been increasing in recent decades (Glantz, 2005). According to the Listening to Mothers II survey, half of all labors in the U.S. are induced or augmented with Pitocin or other synthetic form of the hormone oxytocin (Declercq et al., 2006). Oxytocin, a naturally occurring hormone released in the pituitary gland, is involved in the stimulation of uterine contractions during labor and in the milk ejection reflex during breastfeeding, and research suggests it also has various effects on the brain, such as eliciting maternal behavior. However, studies have shown that exogenous oxytocin can interfere …

Mild Traumatic Brain Injury: Educational Techniques, Katherine R. Racanelli

Honors Projects

The awareness of mild traumatic brain injury as a health concern has increased across a multitude of athletic settings due to a plethora of research and clinical findings that indicate the serious threat concussions pose, particularly to young athletes. The need to provide risk reduction and health promotion education to athletes and parents necessitates an innovative approach. This study explores the effectiveness of an educational intervention based on information from the Centers for Disease Control and Prevention to promote awareness regarding the pathophysiology, symptoms, consequences, and prevention of sports-related mild traumatic brain injury. An interactive educational program was administered to …