Nursing Commons^™

The Relationship Between Clinical Teaching Models And Perceived Clinical Self-Efficacy And Attitude Toward Team Process, Christina H. Plemmons

UNLV Theses, Dissertations, Professional Papers, and Capstones

Nurse educators are called to transform the education of nursing students, a process that is paramount to meet the needs of an increasingly complex health care system. The complexity of health care requires graduate nurses who are self-efficacious, yet also function well as full members of a health care team. In response to this call, clinical instruction, an essential component of nursing education, is receiving increased attention. Clinical education is vital, not only to the development of clinical self-efficacy, but also to the integration of future nurses into a health care team. To further this education process, faculty members from …

Coordinating Community Healthcare Needs To Local Services In Paraiso, Dominican Republic Through Strategic Assessment Strategies, Michelle A. Cole, Christina B. Gunther, Majid Sadigh

Nursing Faculty Publications

Background: The availability of healthcare services is limited in Paraiso, Dominican Republic with the nearest full-service hospital located 34.1 km away. A local, underutilized clinic was unaware of the needs of this disadvantaged community.

Method: Researchers adapted a World Health Organization assessment survey with the goals of determining residents’ priority needs and an appraisal of the current clinic capabilities and gaps in services in order to provide the community with relevant healthcare. 106 families were randomly selected in seven separate geographic areas of Paraiso to participate in the self-report assessment. Researchers, along with a community volunteer, conducted interviews utilizing the …

A Hermeneutic Phenomenological Study Of The Lived Experience Of Adult Female Sexual Assault Survivors, Ann N. Hellman

Electronic Theses and Dissertations

Sexual assault is an international problem affecting hundreds of thousands of women each year. Significant psychological, physical, and financial consequences result from sexual assault. The prevalence of sexual assault suggests that nurses frequently encounter survivors yet minimal literature exists focusing on how nurses should adjust their care to meet the needs of this population.

The phenomenon of sexual assault has been widely studied from multiple perspectives and across disciplines. Likewise, studies of spiritual and religious beliefs and practices and their impact at the end-of-life and in disease, grief, and loss are extensive in nursing literature. However, a nominal number of …

Undiagnosed Depression In The Elderly And Healthcare Education, Nancy J. Wynn-Grundy

Doctoral Projects

This descriptive study examined undiagnosed depression in the elderly and how it affects the elderly from retaining healthcare education. It is estimated by 2029, 20% of the United States population will be age 65 and older (Colby & Ortman, 2014). Depression in the elderly who have chronic diseases, is estimated to be undiagnosed up to 40% (Chaoyang et al., 2009). A hallmark symptom of depression is the inability to concentrate. It is unknown if undiagnosed depression will affect the older adult from retaining pertinent healthcare education. The 30 point Geriatric Depression Scale (GDS) was administered to a class of elderly …

Nursing Input During Interprofessional Rounds In The Intensive Care Unit, Kathrine A. Winnie

Doctoral Projects

Interprofessional rounding has become a standard in intensive care units. Healthcare organizations such as The Joint Commission (2013) and the Institute of Medicine (2010) promote interprofessional teamwork with the goal of improving patient safety and outcomes. The 2010 IOM report, The Future of Nursing – Leading Change, Advancing Health discusses the need for all nurses to work as part of an interprofessional team to improve healthcare. Interprofessional rounding offers a venue for nurses to demonstrate their role as an equal member of the healthcare team. At the hospital of focus, there has been no previous formal attempt to measure the …

Teaching And Evaluation Of Suicidal Assessment, Five-Step Evaluation And Triage (Safe-T) In The Emergency Department, Evangeline Rico

Doctoral Projects

Suicide remains to be a global and a national problem, and it continues to be one of the leading causes of death in the United States (U.S.) The Emergency Department (ED), being the gateway to the hospital can provide a great opportunity to assess each patient for suicidal ideation, and evaluate if patients present with risk factors for suicide. The competency of the ED staff plays a critical role in early recognition of patients who are at risk, and in implementing a plan of care for those with positive screens. However, researchers showed that knowledge deficit and lack of education …

The Impact Of Intensive Case Management On Hospice Utilization, Debra Lowry Hummel

Doctoral Projects

Objective: The purpose of this study is to examine if patients enrolled in multi-disciplinary intensive case management program (ImPACT) alter the patient’s end-of-life path or setting of death.

Methods: The quality improvement project is a quantitative retrospective study that compared patients receiving standard primary care vs intensive case management (ImPACT) during 2/2013-1/2014. It is a secondary analysis of a larger study of a quality improvement evaluation that took place at the Veterans Administration facility in Palo Alto, Ca.

Results: Among the 82 patients who died, 19 were enrolled in ImPACT for approximately 249 days compared to 63 who received standard …

Therapeutic Listening Communication In Children With Autism And Hyperacusis, Jennifer Margaret Hughes

Doctoral Projects

Hyperacusis, or auditory hypersensitivity, is defined as abnormally sensitive hearing and in some cases an extreme sensitivity, where normally tolerated sounds are perceived as excessively, even painfully loud. This is a debilitating condition for children with autism, causing activity limitations and participation restrictions, also leading to peer isolation and habitual sound avoidance behaviors.

This research explores a means of modifying the auditory environment of a child with hyperacusis in a safe, effective way for the purpose of improving attention span and facilitating learning. The small pilot study (n=4) was a single-subject, multiple-baseline design, conducted with school-aged children in the special …

Effect Of An Emergency Nurse Heart Failure Educational Intervention, Lori Hudgens

Doctoral Projects

Background: Research indicates many nurses lack the appropriate heart failure (HF) education necessary to assist with readmission reduction efforts. Employer approved nurse HF education has resulted in improved nurse HF knowledge, and, reduced readmissions.

Problem: ED nurses require a competent knowledge of heart failure to effectively educate heart failure patients upon admission to the ED. No research has been conducted with ED nurse specific populations to assess ED nurse knowledge of heart failure, and, to determine if heart failure educational interventions increase ED nurse' HF knowledge.

Aims: To evaluate the effectiveness of an ED nurse b.eart failure educational intervention in …

How To Start A Nurse Practitioner Faculty Managed Clinic: Missing Components?, Johnna Edmunds

Doctoral Projects

A serious need exists for improved access to primary care for vulnerable populations. Nurse Practitioner Faculty Managed Clinics (NPFMC) can help to alleviate this problem. The purpose of this qualitative, descriptive study was to identify and examine the beginning components necessary for implementing this inter-professional collaboration. A comprehensive literature review identified the absence of these components, which were then revealed through the interviews with founders of NPFMCs. Prior to the interviews two manuals were reviewed about the process of starting a free clinic. Questions were explored relating to the participants’ experiences in starting a NPFMC. Review of the manuals was …

Using An Online Learning Module In A Nursing Program To Improve Knowledge And Skills To Prevent Falls In The Community Dwelling Older Adult Population, Susan Kane Patton

Graduate Theses and Dissertations

Nationally, 28.4% of older adults fall each year. Falls and resulting injury result in decreased mobility, functional impairment, loss of independence, and increased mortality. Utilization of evidence based protocols by providers to identify older adults at risk of falling is limited and rates of participation by older adults in prevention activities is low. Because of nursing’s increasing role in caring for older adults, development of fall prevention education for nursing students would result in increased awareness of the need for fall prevention in community dwelling older adults and increased access of older adults to falls risk assessment. There is a …

Clinical And Demographic Variables Associated With Cognitive Deficits, Symptom Severity, And Duration After Concussive Injury In Adolescents: A Retrospective Study, Seema S. Aggarwal

Dissertations and Theses (Open Access)

Background: Concussions in adolescents are a public health concern with the growing popularity of high school sports. Recent legislation mandates that athletes who are suspected of a concussion be cleared to return-to-play by a clinician. More research is needed to develop a concussion predictive model to identify populations at risk for more severe and prolonged symptoms and long-term neurologic deficits.

Aims: The aims of this study were to (1) examine the effect of race and gender on neurocognitive and symptom scores and (2) determine which clinical (e.g., number of concussions, migraine history, learning disabilities/ attention deficit disorders) and demographic factors …

Becoming Baby Friendly: Rooming-In For Patient Centered Care In The Maternal Setting, Liana Macdonald

Honors College Theses

This thesis paper discusses the concept of rooming in on the maternity unit while pertaining to the QSEN nursing competency of patient centered care. Through an extensive review of the literature, the following question will be addressed: On the post-partum unit, does having the newborn rooming in with his or her mother improve patient-centered care compared to rooming in the nursery? After an introduction of the problem and its significance to patient-centered care, research that was conducted will be reviewed that discusses the importance of rooming in. A case example of a maternal-newborn couplet is provided, demonstrating the relevance of …

Eight Steps To Weight Loss: Development Of An Evidence-Based Collaborative Provider-Patient Workbook For Overweight Or Obese Adults, Katherine Ann Wagner

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite decades of effort on the part of health care providers and policy makers to reduce the prevalence of obesity, the prevalence of obesity in the United States remains high (CDC, 2015). In the adult population ages 20 years of age and older, 35.7% are considered obese. The annual medical costs for people who are obese are $1,429 higher than people of a healthy weight (CDC, 2013). Obesity increases the risk for chronic health conditions such as hypertension, type 2 diabetes, hypercholesterolemia, coronary heart disease, stroke, asthma, arthritis, and cancer (Hammond & Levine, 2010). Over-weight and obesity are the main …

Implementation Of The Obesity Prevention And Management (Opm) Guideline To Increase Recognition And Treatment Of Childhood Overweight And Obesity In An Urgent Care Setting, Krystle Denise Apodaca

UNLV Theses, Dissertations, Professional Papers, and Capstones

Childhood obesity carries multiple significant and costly health associated risk factors. Obese children have a higher risk of cardiovascular disease, diabetes, sleep apnea, bone and joint problems, as well as self-esteem issues. Childhood overweight and obesity are associated with $14.1 billion in healthcare utilization each year. New Mexico (NM) has experienced significant increase in overweight and obesity with associated chronic illnesses over the past 15 years. Addressing the public health crisis of childhood overweight and obesity requires an innovative and broad approach beyond primary care and health policy changes. Urgent care settings are highly accessed by pediatric patients. To address …

Doulas Could Improve Foreign-Born Women’S Perinatal And Postpartum Satisfaction And Increase Health Providers’ Cultural Competency In A Multicultural Urban Area Of The United States., Crystal Kazik

Sustainability and Social Justice

Doulas act as a cultural bridge between clients and providers through the support, advocacy, and education they provide. Unfortunately, migrant women may be at a disadvantage for accessing and benefiting from their services due to a variety of socioeconomic and cultural factors including predisposed ideas of care and structure based on experiences in native countries, language barriers, lower health literacy, and a lack of awareness and understanding from hospital/clinic staff.

A strategic multifaceted approach utilizing doulas, such as Boston Medical Center’s collaborative and culturally competent model, may greatly improve foreign-born women’s experience and satisfaction with healthcare when pregnant and giving …

Developing Registered Nurse Competency In Diabetes Care, Elizabeth Ortiz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and purpose: As the cost of health care continues to climb in the United States, hospitals are seeing longer lengths of stay and associated costs resulting from the complications of diabetes mellitus (DM). Registered nurses (RNs) play a critical role in caring for patients with DM. Rapid changes in the care of DM require continuing education on the current trends and the use of evidence-based practices to prevent hypoglycemia as a serious complication of lowering blood glucose levels. This doctoral project assessed the knowledge levels of RNs caring for patients with DM in the hospital setting.

Methods: Eighty-five RNs …

Identifying Learning Acquired During Debriefing, Shelly J. Reed

UNLV Theses, Dissertations, Professional Papers, and Capstones

Debriefing, the reflective activity following an experiential learning exercise, has been identified as the most important part of simulation learning and is also important for learning in other activities utilized in nursing education. There is general agreement that debriefing provides learning and improves performance. However, there is little specific evidence about the phenomenon of learning acquired during debriefing, including how it occurs, how it is defined and identified, and how it is evaluated by debriefing facilitators. In addition, there are no instruments or tools specifically measuring learning acquired during debriefing. Without practical and theoretically grounded tools, simulation activities will continue …

Nursing Perception Of Psychogenic Nonepileptic Spells: Improving Patient Outcomes, Amanda J. Cramer

Doctor of Nursing Practice Scholarly Projects

Patients with psychogenic nonepileptic spells (PNES) have generally poor outcomes and many fail to engage in evidence-based treatments (Thompson et al., 2013). Negative healthcare provider perceptions have been implicated as a barrier to patient engagement in treatment recommendations for PNES (Whitehead, Kandler, & Reuber, 2013; Worsely et al., 2011). Illness perception of these patients has been evaluated from the perspective of physicians in multiple settings but perceptions by nurses are not well studied despite the close interactions that nurses have with these patients.

This project used Pender’s health promotion model to collect information about the nursing experience with patients with …

Polypharmacy And The Importance Of Medication Review In The Elderly Population, Rose Betak Agbor

Nursing Capstones

No abstract provided.

Non-Pharmacological Therapies For Mild Depression, Geoffrey Ongaga

Nursing Capstones

No abstract provided.

Reducing Potentially Inappropriate Prescribing In Geriatrics Using The Stopp/Start Tool, Samantha Radel

Nursing Capstones

No abstract provided.

Challenges Of Mass Media Interventions Regarding Mental Health: A Community Exemplar In Kampala Uganda, Moses Wankiiri, P. Petrucka

School of Nursing & Midwifery, East Africa

The Community Psychiatric Support Organization is a registered voluntary not for profit NGO in Uganda working to promote mental health by empowering the community to care for the mentally ill. Mental illness occurring in Uganda is often ‘explored’ or ‘explained’ from non-medical perspectives, including social, cultural, and/or religious belief systems. Over the last two years, the organization has conducted sixty six (66) live radio mental health education talks and twenty six (26) live television talk shows in an effort to reduce stigma towards mental illness. Such campaigns within developing contexts have not be examined extensively, although, in other sectors such …

Honoring Others By Accompaniment, Merrilee Brown

Theses and Graduate Projects

Nurses recognize that access to healthcare for marginalized individuals prevents some from utilizing western medicine basic health services. People living in the margins can experience difficult encounters to healthcare as a system and a culture. Providers in Scott County that offer access to the marginalized are referred to as safety net services, lack individual choice, resource coordination, or a health partnership with individuals struggling in their daily lives. public Health Nurses recognize the need for intentional collaboration among providers. This project began with a Hispanic individual who had accessed all safety net providers in Scott County and still was not …

Essential Nursing Care For The Sole, Teresa A. Miller

Theses and Graduate Projects

This paper illuminates the transformational journey experienced while exploring nursing practice involvement in essential holistic foot care as a Doctor of Nursing-Transcultural Nursing (DNP-TCN) practice project. The underlying theoretical framework is based on the relational caring complexity theory by Marilyn A. Ray and Marian C. Turkel, depicting model complexity concepts essential to holistic health and wellness nursing foot cares. As an advanced practice nurse, this practice shift is an assertion of health and wellness essentials in the model of holistic nursing, as foot health is tied to the health of the physical body and spiritual soul of the living. Individual …

Use Of Insulin Pumps In The Perioperative Patient, Judith Raboy

Nursing Capstones

No abstract provided.

Blood Glucose Management In The Surgical Patient, Alison Lynch

Nursing Capstones

No abstract provided.

Implementation Of Teamstepps In The Operating Room A Quality Improvement Project, Teresa D. Vincent

Graduate Theses, Dissertations, and Capstones

Abstract

This project aimed to determine if implementing Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) at Norton Women’s Kosair Children’s Hospital (NWKCH) main operating room would decrease the occurrence of adverse events leading to patient harm. The TeamSTEPPS’ goal is to create high-reliability teams (HRT) and thus limit the potential for patient harm, including but not limited to wrong site surgery and unintentionally retained foreign objects. In the last decade, the healthcare industry has increased focus on patient safety; however, even with the implementation of evidence-based practice and new technical advances, patient safety within the operating …

Implementation Of Teamstepps In Acute Care Settings, Teresa D. Vincent

Graduate Theses, Dissertations, and Capstones

Abstract

Patient safety in a hospital is the concern of all healthcare team members, whether the patient is in the facility for a few hours or a few days. Even though policies and procedures are in place to reduce the occurrence of errors during the course of a patient’s admission to the hospital, adverse outcomes may still occur. Errors and omissions in communication between team members have been identified as one of the leading reasons for injury to patients and organizations are searching for processes that can assist them in improving team communication. Team Strategies and Tools to Enhance Performance …

Patient Perceptions Of An Aidet And Hourly Rounding Program In A Community Hospital: Results Of A Qualitative Study, Tosha Allen, Tyne Rieck, Stacie Salsbury

Patient Experience Journal

Quantitative evidence links patient satisfaction scores to the use of communication strategies such as AIDET (Acknowledge, Introduce, Duration, Explanation, and Thank you) and Hourly Rounding. However, little is known about patient perceptions of these tools in regards to their hospital experience. Qualitative interviews were conducted with a convenience sample of 14 adult medical/surgical inpatients in one mid-sized, community hospital, following hospital discharge. The interview data was transcribed and opened coded, utilizing constant comparison to identify common themes. Themes emerged in four topical areas: (a) patient experience of hospitalization, (b) AIDET, (c) Hourly Rounding, and (d) unexpected findings. Patients placed significant …