Nursing Commons^™

Assessing The Cost-Benefit Of Hiring A Deu-Prepared Rn Graduate: Does It Help Reduce Organizational Costs?, Tonya D. Bryant

UNLV Theses, Dissertations, Professional Papers, and Capstones

Costs associated with training new nurses from the time of hire to the time of independent practice can cost organizations nearly $100,000 per nurse (Acuna, Yoder, Madrigal-Gonzalez & Yoder-Wise, 2017; Silvestre, Ulrich, Johnson, Spector, & Blegan, 2017; Trepanier, Early, Ulrich & Cherry, 2012). New-hire costs for a dedicated education unit (DEU)-prepared newly qualified newly hired nurse (NQNHN) may be prohibitive for some hospitals when considering the cumulative amount of time and costs dedicated to training these specially prepared nurses who have previous clinical and organizational experience from their time as nursing students within the organization over the duration of their …

Creating A Structural Empowerment Culture: A Professional Development Module For The Novice Nurse Leader, Beth A. Hock

UNLV Theses, Dissertations, Professional Papers, and Capstones

Nursing leadership shoulders the responsibility for the performance of their nurses (McNeeseSmith, 1992). When a nurse leader creates a culture of structural empowerment, the work environment is more likely to produce higher quality patient outcomes and highly satisfied healthcare consumers. Novice nurse leaders are often ill-equipped early in their careers to forge a structural empowerment culture. Unfortunately, education programs to address the developmental needs related to structural empowerment do not seem to exist. Incorporating the theoretical underpinnings from Kanter theory (1977, 1993) and the Donabedian model (1966) to create an educational tool for the novice nurse leader in learning how …

The Need For Change In Emergency Medical Approach When Caring For Individuals With Autism, Hannah Watkins

Undergraduate Theses and Capstone Projects

This paper highlights the need for policy changes and additional training related to caring for individuals with autism in emergency situations. Individuals with autism spectrum disorder are at risk of receiving inadequate care due to the challenges that come with such a complex diagnosis. Depending on the severity of autism for each individual, behavioral outbursts and aggression can often occur due to the overwhelming amount of stimulation in the emergency department environment. While medical professionals have the potential to be a great help during times of crisis, there is often very little training given to providers in regard to delivering …

Transitioning For Success: A Pilot Program For New Nurse Graduates In A Pediatric Intensive Care Unit, Valerie Charisa Barboa

UNLV Theses, Dissertations, Professional Papers, and Capstones

Global nursing shortages, increasingly complex patients, and rapidly evolving medical knowledge and technology make it necessary for today’s new graduate nurse (NGN) to enter practice with an already well developed set of skills (clinical judgment, technical skills, and a sound knowledge base). The protracted nursing shortage has prompted health care organizations to hire NGN’s directly into intensive care units (ICU), a rare, and previously unheard-of occurrence. Many NGN’s are unprepared for the highly complex, critically unstable patient in the ICU or the fast paced, independent, yet simultaneously collaborative nature of the ICU workplace. These deficits can quickly compromise patient safety …

Improving Type 2 Diabetes Mellitus In The Older Adult Population Utilizing Shared Medical Appointments In Primary Care Setting, Mailo Brantner

UNLV Theses, Dissertations, Professional Papers, and Capstones

The overall management of Type 2 diabetes mellitus (T2DM) and its comorbidities is complex and costly. The American Diabetes Association (ADA, 2019c) recommends the use of team-based care and self-management tools to optimize the management of T2DM. Unfortunately, there is a national shortage of endocrinologists and certified diabetes educators (Stewart, 2008) along with a primary care provider shortage (Simmons & Kapustin, 2011). Thus, it is essential to implement a care model to increase efficiency while also promoting patient knowledge and self-management of T2DM to improve health outcomes. An example of an innovative care model is the shared medical appointment (SMA), …

The Impact Of Culturally-Tailored Education On Knowledge And Behavior Related To Screening And Lifestyle Management Of Blood Pressure In African Immigrants, Sarah Erskine

UNLV Theses, Dissertations, Professional Papers, and Capstones

The number of African Immigrants in the United States is increasing. The prevalence of hypertension among Blacks, including African Immigrants are high. In addition to the increased susceptibility to hypertension, lack of disease awareness and unhealthy lifestyle are documented barriers to achieving adequate blood pressure control. The purpose of this project was to determine the impact of implementing a 30-minute, culturally-tailored, evidence based educational session on hypertension to promote knowledge and initiate behavior change in African Immigrants. This was a descriptive, cross-sectional study. Blood pressures were measured and survey instruments such as the Hypertension Evaluation of Lifestyle and Management scale …

The Implementation Of A Respiratory Syncytial Virus Prevention And Awareness Pamphlet In The Daycare Setting, Kaylie Marie Humphreys

UNLV Theses, Dissertations, Professional Papers, and Capstones

Respiratory Syncytial Virus (RSV) is the number one cause of bronchiolitis in children under five years of age and regretfully the number one cause of hospitalization in the first year of life. RSV leads to over three million hospitalizations, two million outpatient visits, and 200,000 deaths in the pediatric population globally each year. While no vaccine is currently available to prevent the spread of RSV, efforts must be shown in spreading awareness of strategies utilized in infection prevention such as hand hygiene and properly covering a cough or sneeze.

This project aimed to present this education to a target population …

Management Of Atrial Fibrillation With Smartphone Technology, Teresa Praus

UNLV Theses, Dissertations, Professional Papers, and Capstones

Atrial fibrillation is the most common arrhythmia affecting over six million people; it is predicted to increase two-fold by the year 2050. This arrhythmia results in a lack of

atrial/ventricular communication, accompanied by ineffective atrial contraction, suboptimal ventricular filling, and thrombus formation. This may lead to stroke, and ultimately heart failure. The current economic burden related to the complications of atrial fibrillation is estimated to be greater than $6 billion annually with potentially catastrophic events, further increasing expenditure.

When patients experience symptoms related to atrial fibrillation, it is common for them to present to a hospital emergency department. These visits, …

Patients Enabled, Engaged, And Empowered: Implementation Of A Mobile Patient Engagement Technology, Jud Simonds

UNLV Theses, Dissertations, Professional Papers, and Capstones

Patient engagement technologies present an opportunity to enhance the patient experience by providing patient access to information throughout the entire, often complex, continuum of care. Growing evidence indicates that a lack of patient engagement is a significant contributor to preventable deaths. In contrast, engaging patients in their healthcare can positively affect patient outcomes and the overall patient experience. Unfortunately, traditional patient care models involve face to face patient-provider interactions, thereby limiting reach and impact. Exploring new roles for information technology (IT) within healthcare can contribute to addressing barriers encountered in more traditional healthcare models. Innovative IT solutions can assist patients …

Implementation Of A Training Program In The Use Of The Electronic Medical Record To Improve Performance On Quality Measures And Reduce Burnout Among Healthcare Providers, Mary Monica Nara

UNLV Theses, Dissertations, Professional Papers, and Capstones

Rapid adoption and implementation of the electronic medical record (EMR) in health care has contributed to worsening burnout among healthcare providers (HCPs), particularly primary care physicians. Other HCPs such as nurse practitioners (NPs) and physician assistants (PAs) who provide primary care have been equally affected by the increased clerical burden related to the increasing documentation requirements from payers and are at risk for burnout. Rates of burnout in NPs are currently not well known. Burnout has been linked to decreased quality of care for patients. Inadequate training and lack of skills in the use of the EMR have contributed to …

Development And Validation Of A Scale To Measure Nurse/Medical Resident Physician Collaboration, Bruce St. Amour, W. Brady Dehart

HCA Healthcare Journal of Medicine

Introduction: The purpose of this pilot study is to investigate the reliability of an interprofessional collaboration measurement scale used for nursing interactions with resident physicians. To date, the collaboration between nurses and residents has not been adequately investigated and a validated tool specifically for this purpose is not yet available. Our objective is to adapt a previously validated interprofessional scale for health care settings to the specific nurse/resident physician collaboration.

Methods: In 2019, nurses from two hospitals were contacted via email and were invited to complete an anonymous survey that asked about the nurses’ interaction and collaboration with resident physicians. …

Value-Based Purchasing: Does Educating Direct Care Nurses Result In Value-Based Care?, Ryan Levi

Doctor of Nursing Practice Scholarly Projects

The United States health care system is undergoing the greatest transformation in the country’s history. Health care is rapidly moving away from volume-based reimbursement towards value-based models. The Hospital Value-Based Purchasing (VBP), a Center for Medicare and Medicaid pay-for-performance program, makes Medicare reimbursement contingent on performance in four quality categories. Clinical care, person and community engagement, safety, and efficiency determine an organization’s total performance score (TPS), which is used to impose positive, negative, or neutral payment adjustments. Nursing, more than any other health care profession, impacts hospitals’ TPS and subsequently Medicare reimbursement under VBP. While the literature indicates nurses should …

A Proposal To Implement Assertive Community Treatment Into A Primary Care Shelter Clinic, Julie Churcher-Fields

Theses and Graduate Projects

Individuals who are experiencing homelessness and severe mental illness have a difficult time accessing healthcare systems. Without mental health treatment and stable housing, individuals develop multiple needs that must be addressed during an individual visit. Without treatment for mental health symptoms, individuals may experience a negative impact on their quality of life and the ability to get basic needs met. Community organizations have an obligation to provide integrated care with a goal to improve overall health for this population. As nurse leaders there is an opportunity to be advocates and implement innovative ideas to improve care. In a large adult …

Decreasing Hospitalization In Infants, William Hang

MSN Capstone Projects

Infants are the most vulnerable population at risk for serious diseases. Respiratory syncytial virus (RSV) is a disease that can be detrimental in infants because of their immature lungs and immune system. Palivizumab, a humanized monoclonal antibody medication, given every 28-30 days has been shown to reduces RSV symptoms and decrease rates of hospitalization by 15%. By reducing the rate of hospital stay, it will also reduce cost.

Description Of The Attitudes, Knowledge And Beliefs On Marijuana In Undergraduate Students Compared To Nursing Undergraduate Students, Maifrak Sobrino

Honors Scholar Theses

Introduction: The use of marijuana has drastically increased over the years. Not only is marijuana being used to treat personal symptoms, but some women use marijuana to manage pregnancy-related symptoms.

Objective: To discover the knowledge, attitudes, and beliefs of marijuana in the undergraduate student population at the University of Connecticut.

Method: A cross sectional study conducted through Qualtrics using a 15-questions survey, including 5-point Likert scale questions and 5 yes/no questions.

Result: Forty-nine non-nursing students completed the survey. Non-nursing students in comparison to the population as a whole agreed that marijuana use was okay (M = 3.959, SD = …

Attitudes, Knowledge And Beliefs On Marijuana Use In Pregnant Women In Undergraduate Nursing Students, Jordyn Witkins

Honors Scholar Theses

Introduction: Due to the decriminalization of marijuana use by states in the United States, marijuana use has drastically increased in the general populations and in women who are pregnant. During prenatal care, nurses provide education about pregnancy and fetal development.

Objective: This study explore the attitudes, knowledge and beliefs of undergraduate nursing students on marijuana use for individuals and during pregnancy.

Method: The study design was cross-sectional survey with 15-question survey using Likert scale and yes/no questions. Nursing students and non-nursing undergraduate students responses were compared.

Results: Sixty-four nursing students (female, n=50) completed the survey. Nursing students in comparison to …

Implementing Inter-Professional Patient-Family Centered Plan Of Care Meetings On An Inpatient Hospital Unit, Nicolas Hernandez, Alice Fornari, Sage Rose, Leanne Tortez

Patient Experience Journal

Inpatient plan of care meetings support efforts to encourage collaborative practice and patient-family centered care and result in an effective strategy to enhance communication and patient satisfaction. Clinical team members participated in patient/family centered plan of care meetings at a community hospital in a selected inpatient unit with full time hospitalist physicians. Quantitative data were gathered pre/post implementation from the external Hospital Consumer Assessment of Health Care Providers (HCAHPS) survey. HCAHPS data were collected independently, specifically for questions related to communication between patients, family members/guardians and the medical team and also the effects of care transition. There was a slow …

Patient Education In The Hospital-At-Home Care Context, Heli Vaartio-Rajalin, Linda Nyholm, Lisbeth Fagerström

Patient Experience Journal

The objective of this study is to describe adult patients’ and their family caregivers’ experiences of patient education in the hospital-at-home care context. Methods included a cross-sectional descriptive study including three hospital-at-home units in Finland. Adult, non-palliative patients (n = 27) and their family caregivers (n = 18) were interviewed pairwise by telephone, and the data analyzed with inductive thematic content analysis. COREQ guidelines were used to plan and guide the study design. Results concluded both patients and family caregivers seemed to have quite similar knowledge expectations, which only differs slightly from findings in other in- or outpatient contexts. In …

Finding Common Threads: How Patients, Physicians And Nurses Perceive The Patient Gown, Christy M. Lucas, Cheryl Dellasega

Patient Experience Journal

Evidence-based care is standard practice in medicine, but the patient gown has fallen outside the scope of scholarly research. The current gown renders a patient vulnerable, diminishing patients’ sense of identity, agency, and dignity with its one-size-fits-none design. The impact on providers is similarly neglected. Our objective was to explore how patients and providers derive meaning from patient gowns. A convenience sample at an academic medical center was interviewed utilizing a standardized framework developed by a medical student and two PhD-prepared researchers with experience in qualitative methods. The study was inductive in nature, seeking to understand perceptions of the patient …

First Trimester Prenatal Screening: Parent Education, Madison Vandiver

Honors College Theses

The healthcare field is constantly evolving, and consequently the ways that medical procedures are done is always changing. Advancements in medicine have made it possible to screen for chromosomal abnormalities earlier and for the screening to be done more accurately than ever before. This is accomplished through a first trimester screening performed between 11- 13 weeks gestation of the pregnancy. With this screening becoming more integrated into routine prenatal care and being offered to various women with a range of risk factors, it is important to offer many educational opportunities about the screening procedure. Provision of education to patients interested …

Screen Time Reduction, Karmen L. Serda Mrs.

MSN Capstone Projects

Children and adolescents are spending an alarming amount of time engaging in screen time (ST) activities on mobile devices, computers, televisions (TV), and video games; activities include, but are not limited to, watching shows or movies, playing video games, searching the internet, texting, or using social media. This excessive ST is contributing to a vast array of serious childhood complications and health concerns, of which are rarely discussed, acknowledged, or remedied.

The proposed implementation of a structured 3-day elementary school based screen time reduction program (STRP) that would target not only the children and adolescents, but their parents and/or caregivers …

Living Sweet: A Multi-Functional Mobile-Phone Application Strategy For Adults With Uncontrolled Type 2 Diabetes Mellitus, Chantel K. Anderson

Evidence-Based Practice Project Reports

Type 2 Diabetes Mellitus (T2DM), one of the most common chronic diseases, is increasing worldwide, and once diagnosed, lifetime self-management is critical to maintain glycemic control (Vermeire et al., 2005; American Diabetes Association (ADA), 2018). Management of T2DM has been acknowledged as challenging due to the need for strict lifestyle adaptations. From a public health perspective, uncontrolled diabetes leads to increased healthcare costs, secondary complications, and ultimately severe disabilities (ADA, 2018). The purpose of this evidencebased practice (EBP) project was to evaluate the effectiveness of a diabetes-specific mobile health application (MHA) on glycated-hemoglobin (HbA1C), self-care perception (SCP), and self-care behaviors …

Preventing Readmissions Through Community Health Nursing, Stephanie Dawson

MSN Capstone Projects

Incorporating community health nurses to follow patients with a moderate to high risk of readmission post-discharge could improve the risk of readmission for these patients. When a patient is discharged from the hospital, they can become overwhelmed and not be adequately prepared to go home despite the discharge education given (Kenney-Lueptow, 2020). Telephone follow up is a low-cost way to decrease readmissions and provide continued education to the patients (Heitkam, 2019). Utilizing the bedside nurses that have been caring for the patients in the hospital can create a greater sense of community for the hospital and its population. By connecting …

Fear Not...No Falls, Jennifer A. Rabenold Msn, Rn, Cdn

Patient Care Services / Nursing

No abstract provided.

Dancing During Labor: Social Media Trend Or Future Practice?, Caroline P. Toberna, Drew Horter, Kayla Heslin, Marie M. Forgie, Emily Malloy, Jessica J. F. Kram

Journal of Patient-Centered Research and Reviews

Over the past 30 years, medical interventions in pregnancy and childbirth have increased. Some pregnant women seek less invasive and nonpharmacological options to manage discomforts during labor. While exercise during pregnancy is recommended, less is known about exercise, specifically dancing, during labor. While anecdotal evidence is supportive, little is known about the implications of exercise and dance during the first stage of labor for pain reduction and labor progression. Some movements common in dance, such as expanding hip circles that loosen and relax muscles of the pelvic floor, may be beneficial to women during labor. Available evidence suggests that dancing …

Reducing Readmissions In The Heart Failure Population, Yvette Castellanos

MSN Capstone Projects

This paper will explore the importance of preventing acute hospital readmissions in the heart failure adult population. Prevention of re-hospitalization is aimed at improving patient care and outcomes as well as reducing the financial stress caused by readmissions. Recurrent hospitalizations are expensive and unnecessarily overutilize resources (Donzé, Lipsitz, Bates, & Schnipper, 2013). Research shows that improving transitions of care during hospitalization and developing specific heart failure interventions healthcare providers can assist in reducing readmissions. For this project the Plan Do Check Act (PDCA) tool combined with the lean methodology. The PDCA cycle consist of planning, to identify the problems, do …

Bedside Shift Report Improves Patient Safety, Scott Meyers

MSN Capstone Projects

In the inpatient setting, Parkland Health & Hospital System has continued to have patient falls with injury above its target goal. This occurred every month throughout 2019. Additionally, multiple egregious IV medication administration errors occurred over the last year related to nurses bypassing established safety practices.

An evaluation of evidence-based literature reveals that the practice of bedside shift report (BSR) leads to a reduction in both patient falls and medication administration errors. Indeed, BSR is evidence-based practice (EBP) that promotes an overall environment of safety, quality care, and improved communication between nurses and patients. Additionally, there is virtually no risk …

Benchmark Nurse Leader Mentorship Program, Ijeoma Anyanwu

MSN Capstone Projects

“Historically, promotion to management positions has been a key pathway by which hospital staff nurses advance their careers, and these promotions typically occur before the nurse has acquired any formal management training” (Weisman, Minnick, Dienemann & Cassard, 1995, p. 296). Nurse managers are often driven to their roles due to sudden vacancies as a result of promotions, resignations, transfers or layoffs. Though willing to take on these challenges, these nurses are nevertheless inadequately prepared. “Nurse leaders are ill-equipped in terms of knowledge and may lack support and guidance to manage the challenges inherent in the role, such as productivity, job …

Dying Well: Improving End-Of-Life For Those Affected By Life-Limiting Illness, Fawna R. Allen

MSN Capstone Projects

Healthcare at End-of-life (EoL) in the older adult with a life-limiting illness is often crisis-driven, incongruent with patient and family preferences, and futile. Advance care planning (ACP) is an effective means of aligning EoL goals of care to values and preferences. ACP near EoL in the United States healthcare system is frequently under-utilized and fragmented. Without timely communication and education regarding EoL care options patients and their families are susceptible to spending their last days consumed by ineffective and potentially painful treatments. Alignment of goals of care with patient and family preferences has been shown to reduce crisis-driven care and …

Official Mentor Program Benchmark Project, Gabriela O'Hara

MSN Capstone Projects

Nursing shortage, turnover, and low job satisfaction are constant issues that often trouble healthcare organizations. These issues have led organizations to implement programs, such as externship, internship, and preceptor programs to strengthen new nurses’ professional practice and skills. However, these issues continue to be organizational challenges. Considering the need for new nurses to have a supportive foundation for their career and to further encourage workplace satisfaction and retention, the following PICOT question was developed: In a healthcare organization, how does an official mentor program, compared with not having a mentor program, influence nursing retention and nursing job satisfaction over 2 …