Nursing Commons^™

Implementation Of An Asthma Action Plan In A Pediatric Outpatient Clinic, Noelle Cerdan

UNLV Theses, Dissertations, Professional Papers, and Capstones

A combination of asthma evidence-based education by nurse practitioners and other healthcare providers as well as self-management by patients with asthma and their caregivers are necessary to provide effective asthma care. According to the National Asthma Education and Prevention Program (NAEPP) guidelines from the National Institute of Health (NIH), effective asthma care includes a detailed Asthma Action Plan (AAP). However, despite this evidence-based recommendation for all patients with asthma, studies suggest many healthcare providers do not routinely utilize an AAP.

The purpose of this Doctor of Nursing Practice (DNP) project was to develop and evaluate a process for the integration …

Assessing The Long-Term Effects Of A Cultural Immersion Experience On Nursing Practice, Karen H. De La Cruz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Cultural immersion has been identified as a preferred method of teaching cultural competence in undergraduate nursing education. Multiple qualitative and quantitative studies have shown that baccalaureate nursing students enjoy international learning experiences and, based on self-efficacy evaluations, feel they have increased cultural competency following immersion experiences. However, there is little evidence to indicate concepts learned during undergraduate cultural competency course work is retained or integrated into nursing practice after leaving the milieu of academia.

To inform future cultural competency educational efforts, I conducted a qualitative phenomenological study to provide a baseline of evidence regarding the impact of a cultural immersion …

A Guide For A Shared Governance Program, Lydia Joan Lefchuck

UNLV Theses, Dissertations, Professional Papers, and Capstones

Shared governance (SG) within an organization promotes professional growth with the expectation that employees will be active contributors in attaining organizational goals. Healthcare organizational leaders ultimately have a fiduciary responsibility to stakeholders to seek quality improvement initiatives. SG leads to a healthy workplace environment staffed by empowered nurses. Having a committed workforce practicing within SG leads to increased employee satisfaction and engagement, and longer nursing tenures with loyalty to their organization. The low nursing turnover rates, associated with a satisfied and engaged staff, translate into efficient productivity, continuous quality improvement, better patient outcomes, and operational cost savings.

Health systems administrators …

Implementing A Heart Failure Education Program For Bedside Nurses In The Acute Care Setting, David L. Morrow

UNLV Theses, Dissertations, Professional Papers, and Capstones

Heart failure is a chronic disease in which a weakened heart is no longer able to deliver adequate blood flow to supply the body with needed oxygen and nutrients. Heart failure is the most common reason for hospitalization in the United States for patients age 65 and over, accounting for over 1,000,000 hospital admissions annually. Due to the chronic nature of this debilitating condition and associated symptoms, patients discharged from the hospital with a diagnosis of heart failure are at high risk for readmission. Effective self-care behaviors have been shown to reduce readmissions and improve quality of life for these …

A Guide For Outcomes Evaluation And Sustainability Of A Dedicated Education Unit Within An Academic-Practice Partnership, Jennifer Pfannes

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Dedicated Education Unit (DEU) has emerged as an innovative approach to providing a positive, high-quality, collaborative clinical learning environment that fosters the growth and learning of undergraduate nursing students. Additionally, the DEU model has demonstrated success in beginning to bridge the education-practice gap, tackling the faculty shortage, and easing the new graduate transition from education to practice; however, developing, evaluating and sustaining an economically successful DEU takes thoughtful,

strategic planning. The challenging nature of developing and sustaining a DEU that mutually benefits both the academic and clinical partner over time, reveals the need for more guidance to secure long-term …

A Group Development Program Based On Transformational Leadership To Improve Team Performance, Anne-Marie Schenk

UNLV Theses, Dissertations, Professional Papers, and Capstones

As reimbursement models move from volume-based to value-based, organizations increasingly depend on meeting patient outcome goals in order to achieve their budgetary targets. Leadership teams are a vital part of healthcare organizations and their performance is crucial to the overall organization’s performance. The organization of interest saw a group of strong individual leaders struggle with outcome production due, in part, to overall team dysfunction. To address this need, this DNP project is a group development program, based on the concepts of transformational leadership. As functional groups and transformational leaders are known to drive outcomes, when implemented, this program’s goal is …

An Exploration Of Nursing Communication Competence During The Handoff Report, Megan Elizabeth Smith

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction Nurse handoff reporting is a crucial time for communication exchange in healthcare settings. During the handoff report, patient information is exchanged between senders and receivers transferring responsibility for care with the main purpose of providing accurate and timely information about the patient. The Joint Commission reports that shortcomings related to communication can be directly related to an increase in patient care errors, with approximately 80% of medical errors resulting from miscommunication during the handoff process. Numerous intervention studies focus on standardizing information, developing physical locations and environments for ideal handoffs, and creating tools for structured information exchange between different …

Leadership Development In Nursing: Planning From The Bedside To The Executive Suite, Janet C. Wright

UNLV Theses, Dissertations, Professional Papers, and Capstones

Nurses comprise the largest portion of the healthcare sector workforce over 4 million professional nurses licensed in the United States (National Council of State Boards of Nursing, 2019). Leading within a vast workforce such as nursing requires the nurse leader to have the expertise of the nursing profession along with leadership and business skills to maintain competitiveness in the complex healthcare industry. Consequences of effective leadership include improved patient outcomes, decreased staff turnover, and decreased costs to the organization related to patient outcomes and turnover costs. These results suggest the importance for organizations to ensure their leaders are properly trained …

Health Literacy Intervention For Low Income Uninsured Population, Laura Larson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Health literacy (HL) requires basic skills in writing, reading, numeracy, and communication all within a health context (Berkman et al., 2011). HL is a critical element for individuals to take an active role in managing their health. The National Assessment of Adult Literacy found only 12% of adults had a “proficient” HL level. Hispanics were found to be at greatest risk for lower HL than all other ethnic groups (Kutner, Greenberg, Jin, & Paulsen, 2006). Low HL can lead to poor health outcomes including: decreased utilization of preventative services, difficulty in managing chronic conditions, and increased disparities in access …

Development Of A Breast Cancer Survivorship Care Toolkit, Lauren Elaine Scott

UNLV Theses, Dissertations, Professional Papers, and Capstones

A breast cancer survivor’s journey does not end with treatment. After treatment, most breast cancer survivors go on to face many life-long physical and mental challenges caused by their cancer and treatment. Once active cancer treatment is completed, patients enter the next important step in cancer care, cancer survivorship. Cancer survivorship is a comprehensive approach to post-oncology management that promotes the best outcomes for survivors as they transition from oncology care to primary care; and new breast-cancer survivorship guidelines have emerged. Research suggests that primary care NPs’ lack of awareness of the current 2016 American Cancer Society/American Society of Clinical …

Lightning Talk: Can This Be Redacted? Developing An Institutional Repository And Addressing Privacy Issues, Pamela Pierce

Digital Initiatives Symposium

“Can This Be Redacted? Developing an Institutional Repository and Addressing Privacy Issues” will explore privacy issues in terms of patient health information that have emerged as Oregon Health & Science University expands their institutional repository beyond theses and dissertations. The lighting talk presentation will focus specifically on student projects from the physician assistant program, School of Nursing, and the Northwest Native American Center, a center specifically focused on the health care needs of Native Americans in the U.S. The impact of a migration out of Bepress and into Samvera will also be discussed.

Problem Based Learning With Teamstepps®, Dana Clairmont

Nursing Capstones

No abstract provided.

Ohiohealth Grove City Methodist Hospital: Workday Implementation, James Eastep

Masters Theses/Capstone Projects

No abstract provided.

Poster: Creating Voice In School Nurses Through Increasing Self-Efficacy, Kate King

Doctor of Nursing Practice Scholarly Projects

Creating voice in school nurses is essential to implement and promote health care in schools. Increasing self-efficacy, the knowledge, practice and internal belief of the nurse that he or she is an expert, creates voice and thus, the ability to assist students and families navigate various concerns and health issues. Therefore, the purpose of this project was to increase self-efficacy by providing school nurses with an interactive educational module that focused on social modeling and persuasion, responses to stress reaction experiences and attainment and application of evidence based practice, all skills of self-efficacy. The interactive educational model was presented to …

Poster: The Opioid Epidemic: Assessment Of Primary Prevention Interventions In Muskingum County Public Schools, Terra Armstead

Doctor of Nursing Practice Scholarly Projects

Understanding that the Opioid epidemic is much greater than an epidemic of mortality is critically important. This epidemic is also an epidemic of dependence, addiction, disability, and other severe adverse events affecting millions of people in the U.S. (Franklin, Sabel, Jones, Mai, & Baumgarter, 2015). The opiod epidemic is complex and can be considered a man made epidemic.

The Opioid Epidemic: Assessment Of Primary Prevention Interventions In Muskingum County Public Schools, Terra Armstead

Doctor of Nursing Practice Scholarly Projects

Understanding that the Opioid epidemic is much greater than an epidemic of mortality is critically important. This epidemic is also an epidemic of dependence, addiction, disability, and other severe adverse events affecting millions of people in the U.S. (Franklin, Sabel, Jones, Mai, & Baumgarter, 2015). The opiod epidemic is complex and can be considered a man made epidemic.

Poster: Self-Efficacy And Outcome Expectancy In The Nurse Resident, Amy L. Smith

Doctor of Nursing Practice Scholarly Projects

EBP training is effective in improving nurses’ knowledge of and attitudes toward EBP, however, it does not consistently result in behavior change (Jackson, 2016; Black, Balneaves, Garossino, Puyat & Qian, 2015). Previous studies support the role of self-efficacy in promotion of EBP implementation (Blackman & Giles, 2017; Ryan, 2016). The purpose of this project is to examine how EBP training provided to nurse residents affects their EBP self-efficacy and outcome expectancy. A convenience sample of nurse residents in two acute care hospital residency programs were surveyed using an instrument found to be valid and reliable by Chang and Crowe (2011) …

Evidence-Based Practice Self-Efficacy And Outcome Expectancy In The Nurse Resident, Amy L. Smith

Doctor of Nursing Practice Scholarly Projects

Evidence-based practice (EBP) implementation in healthcare has been associated with improved patient outcome, reduction of costs, and increases in nursing job satisfaction (Melnyk & Fineout-Overholt, 2015); however, a lack of implementation remains (Melynk, Fine-out Overholt, Gallaher-Ford & Kaplan, 2012). Although EBP training is effective in improving nurses’ knowledge of and attitudes toward EBP, such training does not consistently result in behavior change (Jackson, 2016; Black, Balneaves, Garossino, Puyat & Qian, 2015). The results of previous studies support the role of self-efficacy in the promotion of EBP implementation (Blackman & Giles, 2017; Ryan, 2016). The Institute of Medicine’s Initiative on the …

Toward Expert Consensus On Guidelines For The Use Of Yoga In The Treatment Of Anxiety In Children And Adolescents., Laura J. Abels

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Despite clinical evidence to support the use of yoga as a treatment option for children and adolescents with anxiety, clinical practice guidelines do not exist. Purpose: This project used the modified Delphi technique to determine if consensus exists on the need for clinical practice guidelines among experts in the fields of child and adolescent psychiatry, psychology, and yoga. Additionally, this project aimed to determine if consensus exists on what should be included in clinical practice guidelines for the use of yoga as a therapeutic intervention for anxiety in children and adolescents. Methods: Three rounds of questionnaires were used …

Creating Voice In School Nurses Through Increasing Self-Efficacy, Kate King

Doctor of Nursing Practice Scholarly Projects

Creating voice in school nurses is essential to implement and promote health care in schools. Increasing self-efficacy, the knowledge, practice and internal belief of the nurse that he or she is an expert, creates voice and thus, the ability to assist students and families navigate various concerns and health issues. Therefore, the purpose of this project was to increase selfefficacy by providing school nurses with an interactive educational module that focused on social modeling and persuasion, responses to stress reaction experiences and attainment and application of evidence based practice, all skills of self-efficacy. The interactive educational model was presented to …

Poster: Malignant Hyperthermia Preparedness For Labor And Delivery Nurses, Patricia Rabinowitz

Doctor of Nursing Practice Scholarly Projects

Malignant Hyperthermia (MH) is a rare, inherited disorder of skeletal muscle triggered by general anesthesia in susceptible individuals. Although MH can occur later in the anesthetic course as well as post-operatively, it most frequently occurs shortly after induction of general anesthesia.

Operating room (OR) nurses receive extensive training in MH crisis management. On labor and delivery (L&D) units, neuraxial (spinal and epidural) blocks are the safest and most commonly used anesthetics during pregnancy. General anesthesia is utilized only when the life of the mother or infant is in jeopardy or when a neuraxial block is not possible. Under these circumstances, …

Professional Experience At Ohio Council For Home Care & Hospice, Emma T. Hill

Masters Theses/Capstone Projects

No abstract provided.

Malignant Hypothermia Preparedness For Labor And Delivery Nurses, Patricia Rabinowitz

Doctor of Nursing Practice Scholarly Projects

Malignant Hyperthe1mia (MH) is a rare, inherited disorder of skeletal muscle triggered by general anesthesia in susceptible individuals. Although MH can occur later in the anesthetic course as well as post-operatively, it most frequently occurs shortly after induction of general anesthesia. Operating roo1n (OR) nurses receive extensive training in MH crisis 1nanagement. On labor and delivery (L&D) units, neuraxial (spinal and epidural) blocks are the safest and 1nost co1nmonly used anesthetics during pregnancy. General anesthesia is utilized only when the life of the 1nother or infant is in jeopardy or when a neuraxial block is not possible. Under these circumstances, …

Pain Management For Intrauterine Device Insertion And Endometrial Biopsy, Michelle Lipton-Carroll

Evidence-Based Practice Project Reports

Intrauterine device (IUD) insertions and endometrial biopsies (EMB) can be painful in office gynecological procedures. In the clinical setting used for this evidence-based project (EBP) it was noted there was no consistent pain management being used for these procedures. For this EBP project a protocol for pain management during IUD insertions and EMBs was developed and implemented into this clinical setting. The protocol was created from an exhaustive literature search, which yielded six pieces of high-level evidence of good quality. The evidence supported the use of a 1% lidocaine paracervical block prior to IUD insertion and a 2% lidocaine intrauterine …

Moral Ecology In Nursing: A Pluralistic Approach, Darcy Copeland

Nursing Faculty Publications

Moral dilemmas are present in all settings in which nurses work. Nurses are moral agents who must make moral decisions and take moral action in very complex social systems. Nurses are accountable for their actions, and it is therefore imperative that they have a solid foundation in ethics. There are multiple ethical frameworks nurses can utilize to justify their actions. A theory of moral ecology is presented here as a way to conceptualize the relationships between these frameworks. The first two steps of moral action, moral sensitivity and moral judgment, are explored in a pluralistic context. Specifically, multiple ethical frameworks …

Research, Evidence-Based Practice And Quality Improvement, Tonya Traylor

DNP Final Reports

Background: The United States is in the midst of an opioid epidemic. In 2012 alone there were approximately 259 million prescriptions written by primary care providers for opioids painkillers. The U.S. Center for Disease Control (CDC) now has new guidelines and recommendation due to the opioid analgesic epidemic. Education has been found to raise provider awareness and, subsequently, has decreased opioid use. Provider education helps with reinforcing the short-term use of opioids and adjunctive therapies and helps reinforce the idea of an individualized treatment plan for patients. Purpose: The purpose of this intervention is to increase provider education on opioid …

Nursing Students' Knowledge Of Alcohol - Interactive Medications, Andrew Coop

Honors Projects

In 2018, nearly 57% of American adults reported drinking alcohol in the past month, and 41.5% of current drinkers reported taking alcohol-interactive (AI) medications. Consuming alcohol and medications concurrently may result in adverse effects. The purpose of this study was to determine the effectiveness of a one-hour lecture about AI medications in a class of undergraduate nursing students (N = 48) at a small Midwestern university. The Jarvis Nursing Knowledge of Alcohol-Interactive Medications survey was distributed on August 27, 2018, and again on November 19, 2018. A significant increase was found between pretest and posttest on correct identification of …

The Effects Of Implementing A Smartphone Application To Improve Asthma Self-Management In Adults, Lindsay J. Humpfer

Evidence-Based Practice Project Reports

Asthma is one of the most common chronic diseases, affecting 20.4 million adults in the United States (CDC, 2018). While asthma can generally be controlled, patients having an exacerbation may experience missed days of work and school, limitations in daily activities, decreased enjoyment of life, and decreased productivity at home, work, and school (MarcanoBelisario et al., 2013). Therefore, the purpose of this project was to improve patients’ overall asthma control and asthma-related quality of life by encouraging self-management through patient education and the implementation of a mobile smartphone application. A total of 26 adult primary care patients with asthma participated …

Prevention Of Oral Mucositis In Cancer Patients, Patricia E. Biel

Evidence-Based Practice Project Reports

Oral mucositis [OM] is one of the most severe non-hematological problems related to cancer treatments and can impact quality of life. It is linked to poorer outcomes due to the associated weight loss, pain, dehydration, and risk of developing life-threatening infections. The purpose of this evidence-based practice project was to determine if OM is preventable with the use of an oral care protocol and zinc supplementation when compared to use of oral care protocols alone. The Johns Hopkins Nursing Evidence-Based Practice Model was used to guide project implementation in an outpatient oncology office. Recommendations were developed from an exhaustive review …

Effects Of Therapeutic Music On Improving Depressive Symptoms Among Long-Term Care Facility Residents, Yi Jin

Evidence-Based Practice Project Reports

Depression is a common mental disorder that can contribute to both physical and psychological suffering (Skinner, 2014). The prevalence rate of depression is especially high among long-term care facility residents (CounsultGeri, 2018; Lolk & Andersen, 2015). The purpose of this EBP project was to establish a protocol incorporating therapeutic music as an adjunct therapy for managing depressive symptoms among residents of a long-term care facility in the Midwest. Roy adaptation model (Roy, 2009) was utilized as the theoretical framework, and the model for evidence-based practice change (Rosswurm & Larrabee, 2009) guided the project implementation. A total of 13 subjects were …