Nursing Commons^™

“I Done Been Through Hell”: An Existential Phenomenological Study Of The Lived Experience Of Fathers Who Have Lost A Child, Dynisha Wigginson

Electronic Theses and Dissertations

The rise in American pediatric death led to a shift in pediatric end-of-life care from focusing care only on the dying pediatric patient to include focus on the family. Most literature has focused only on mothers’ experiences or the combined experiences of mothers and fathers. Fathers’ experiences at their child’s end of life, as an individual phenomenon, is overlooked and ignored. Hence, significant knowledge gaps exist related to the repeated exclusion of fathers’ individual experiences. This study aimed to begin to fill this gap. Using the lens of Merleau-Ponty, this existential phenomenological study aimed to describe the lived experiences of …

Effect Of Community-Based Interventions Targeting Female Sex Workers Along The Hiv Care Cascade In Sub-Saharan Africa: A Systematic Review And Meta-Analysis, Lydia Atuhaire, Olatunji Adetokunboh, Constance Shumba, Peter S. Nyasulu

School of Nursing & Midwifery, East Africa

Background: Female sex workers are extremely vulnerable and highly susceptible to being infected with human immunodeficiency virus. As a result, community-based targeted interventions have been recommended as one of the models of care to improve access to HIV services and continued engagement in care. We conducted a systematic review to (1) assess the effect of FSW-targeted community interventions on the improvement of HIV services access along the treatment cascade and (2) describe community-based interventions that positively affect continuation in HIV care across the HIV treatment cascade for FSWs in sub-Saharan Africa.

Methods: We defined the 5 steps that …

Treatment Access For Dual Diagnosis Substance Use And Mental Health Disorders, Pedro Banuelos

Electronic Theses, Projects, and Dissertations

In 2018, of 1.3 million Latinx adults in the United States facing concurrent issues with substance use disorders (SUD) and mental health disorders (MHD) 93% remained untreated for either diagnosis. This is concerning since Substance Abuse and Mental Health Services Administration (SAMHSA) data reveals that this population is at greater risk for suicidal thoughts, plans, and attempts. They also face structural barriers such as employment, housing, legal involvement, and insurability that further impede access to treatment.

This study’s purpose was to examine barriers to accessing treatment for Latinx populations confronting co-occurring SUDs and MHDs. This study used a qualitative design …

Using Electronic Data And A Mixed-Methods Approach To Evaluate Short Peripheral Catheter Outcomes In Acute Care, Aimee A. Woda, Cailin Ford, Kelsey Meise, Maharaj Singh, Mary Hook

College of Nursing Faculty Research and Publications

Short peripheral catheters (SPCs) are commonly used in hospitals, guided by evidence-based standards to optimize dwell time and limit adverse outcomes. Although SPC insertions are common, real-world evaluation is rare. A theory-based framework and mixed-methods design were used to analyze findings from a unit-level survey and electronic data to evaluate SPC care delivered on units at a large quaternary medical center over a 6-month period (quarters 1 and 2, 2017). Dissemination without adoption and maintenance may limit effectiveness. The convergent results confirmed the feasibility of extracting electronic data to be used by leaders to clinically evaluate staff knowledge and use …

Using A Four-Phased Process When Implementing A Multisite Simulation Study, Aimee A. Woda, Kristina Dreifuerst, Jamie Hansen

College of Nursing Faculty Research and Publications

Multisite simulation studies are critical in nursing research as they allow researchers to obtain larger sample sizes, however, many components need to be addressed to ensure adequate compliance with research protocols. Multisite studies are important in research as they help promote generalizability. Many components go into successfully conducting multisite simulation studies. The purpose of this paper is to describe how the four-phase process of planning, project development, study execution, and dissemination of study findings were contributed to the success of this multisite simulation study. Locating sites that met inclusion criteria, keeping consistent communication with all sites, and ensuring that participants …

Polycystic Ovarian Syndrome And Insulin Resistance: An Evaluation Of Treatment Modalities And Complication Prevention, Sarah Mann

Senior Honors Theses

Polycystic ovarian syndrome (PCOS) is a reproductive and endocrine disorder in women of childbearing age. This disorder includes multiple clinical manifestations, namely insulin resistance (IR) and infertility related to hormonal imbalances and anovulation. Despite being a common condition, its etiology and treatment modalities remain poorly defined. Without proper understanding and management of the condition, women may suffer numerous complications besides infertility such as diabetes mellitus type II (DMII), endometrial cancer, and cardiovascular disease. Therefore, further research is critical. This integrative review will create a comprehensive understanding of PCOS' pathophysiology, potential complications, treatment methods, and nursing considerations to promote the health …

The Benefits Of Dogs For Children With Autism Spectrum Disorder, Emma Raugh

Senior Honors Theses

Autism Spectrum Disorder (ASD) is a condition that primarily affects neurological development, causing decreased social aptness, diminished executive function, and abnormal sensory processing, among many other characteristic symptoms. Additional problems that often accompany ASD include anxiety disorders, depression, and attention deficit hyperactivity disorder (ADHD). Canine assisted animal therapy is one non-pharmacologic therapy option that has been researched for children with ASD to improve their social, psychological, mental, and other difficulties. Studies thus far have shown positive results in children with ASD who have dogs as pets or access to therapy dogs, including improved social functioning, decreased anxiety, overall improved behavior, …

Characteristics Of Successful Nurse Mentors And Potential Effects On The Retention And Job Satisfaction Of New Graduate Nurses: An Integrative Review, Toni Cheryl Thompson

Doctoral Dissertations and Projects

Mentoring is a process that has become embedded into new graduate nurses’ transition to professional practice since the 1980s. The Institute of Medicine’s The Future of Nursing identifies mentoring as a mechanism to increase patient safety and satisfaction. Effective mentoring has been categorized as one of the important components of transforming nurses into leaders, improving retention, and increasing job satisfaction. By recognizing the characteristics of successful mentors, organizations can increase the consistency and success of their mentoring programs. The purpose of this integrative review was to examine successful mentor characteristics and identify the effect of mentors on new graduate nurses’ …

The Effect Of A Screening Protocol On Opioid Use: An Integrative Review, Stephen D. Wright Jr

Doctoral Dissertations and Projects

The opioid crisis is a pervasive and social problem in the United States. Since 2001 several hundred thousand people have died from the misuse of prescription and illicit opioids. On average nearly 130 Americans perish every day due to opioid abuse while millions annually struggle with morbidity derived from opioid abuse disorders. This crisis causes tremendous physical and emotional suffering and death and is likely the most profound public health crisis our nation has faced. In 2015 alone, 52,000 people died of drug overdoses, with over 30,000 of those dying from opioid drugs. If left unchecked, the epidemic will continue …

Enhancing Outpatient Participation In Advance Care Planning Via Nurse-Led Intervention: An Integrative Review, Daniel Patrick Arthur

Doctoral Dissertations and Projects

Advance care planning allows for medical care at the end-of-life that is congruent with a patient’s wishes, values, and beliefs. Even with well-known organizations such as the Institute of Medicine recommending advance care planning completion and legislative encouragement such as the Patient Self-Determination Act of 1990, only approximately one-third of American adults have completed any form of advance directive. Barriers to participation include lack of time, lack of knowledge, and misconceptions on the part of healthcare providers and patients. As an integral part of the care team having significant patient contact in most healthcare settings, nurses are in an ideal …

Genetics In The Nicu: Nurses’ Perceived Knowledge And Desired Education, Kathleen Shields

Dissertations and Theses (Open Access)

A large proportion of infants admitted to neonatal intensive care units (NICUs) have genetic conditions. NICU nurses play an important role in providing comprehensive care to these patients and their families. Previous research has demonstrated gaps exist in the genetics knowledge of nurses and that they lack comfort applying genetics information to clinical practice, but no research has been done assessing the knowledge of or comfort with genetics of NICU nurses specifically. NICU nurses (n=122) completed an online survey assessing their perceived knowledge of genetics, comfort with clinical scenarios involving genetics, and desired genetics education. Participants reported the highest levels …

Advance Care Planning Protocols And Hospitalization, Rehospitalization, And Emergency Department Use In Home Health, Sharon Bigger

Electronic Theses and Dissertations

Aim. The aim of this study was to examine the relationship of advance care planning protocols with hospitalization, rehospitalization, and emergency department use rates in U. S. home health agencies (HHA).

Background. Since 2003, CMS has required HHAs to report on quality outcomes such as hospitalization, rehospitalization, and emergency department use rates, made publicly available online. Advance care planning (ACP) is a conversation about beliefs, goals, values, future treatment choices, and designation of a surrogate decision-maker, that someone has in advance of a health crisis. Most existing studies on ACP have taken place outside of HHAs among populations with serious …

Impact Of Leader Rounds On Perceptions Of The Culture Of Safety, Heather D. Ray

Electronic Theses and Dissertations

A culture of safety in healthcare settings supports a caring environment and practices that produce quality patient outcomes. Leadership is instrumental in creating a culture of safety. The purpose of this quantitative pretest-posttest design project was to determine if the implementation of leader rounds in an acute care hospital had an impact on staff nurses’ perceptions of safety culture as measured by the Safety Attitudes Questionnaire. The setting was a midsize acute care hospital with a target population of dayshift nurses working in the telemetry service line. Leader rounds were conducted over a six-week timeline by the department director. Data …

Increasing Perioperative Outpatient Nurses’ Knowledge Of Pediatric Anxiety Through Use Of A Developed Clinical Guide, Christine Oliver

UNLV Theses, Dissertations, Professional Papers, and Capstones

Elevated perioperative anxiety levels in the pediatric population is a main concern when providing nursing care in a specialty area. In the United States, over five million pediatric patients will have some type of surgery each year and greater than 65 percent of those pediatric patients will exhibit preoperative anxiety. The care of pediatric patients in the outpatient surgical setting has grown significantly, and pediatric care is no longer restricted to specialized facilities or hospitals. This increased number of pediatric patients in day surgery centers has created a shift in nursing care for perioperative nurses. Anxiety has been directly related …

Nursing Toolkit For Care Of The Pediatric Patient With Suicidal Ideation, Christine Young

UNLV Theses, Dissertations, Professional Papers, and Capstones

Nevada’s pediatric suicide rate is one of the highest in the country. Many patients require inpatient stabilization, either in an emergency department setting or on a pediatric unit, until they are ready for discharge to home or a subsequent behavioral health facility. In many instances, patients are assigned to nurses who have had no formal training on caring for pediatric patients with suicidal ideation. Providing care for these patients can increase nurses’ emotional stressors. Purpose: The purpose of this DNP project was to increase the knowledge of pediatric nurses in Nevada using a nursing toolkit containing information to aid in …

Facilitating Implementation Of In-Room Whiteboards In The Skilled Nursing Environment Using The Parihs Framework, Ashley Lubbers

Dissertations

The application of research to practice is a difficult task to successfully carry out for many healthcare professionals and organizations. The Promoting Action on Research Implementation in Health Services (PARIHS) framework is a tool that acts as an implementation guide for translating research evidence to practice. This study explored the use of an adapted version of the PARIHS framework as a guide to implementing in-room whiteboards in a skilled nursing facility (SNF) on their short-term rehabilitation wing. While the utility of in-room whiteboards has been demonstrated in the acute care setting, there are few studies of their use in SNFs. …

Assessing The Perceptions And Attitudes Of Burnout Syndrome In Nurse Practitioners In Primary Care Settings, Keisha D. Mckinsey

Electronic Theses and Dissertations

The implications of workload and personal and patient-related burnout have been identified in numerous physicians’ studies. While burnout syndrome has become a subject of great interest for examining provider burnout to assess successful solutions, there is minimal research unique to nurse practitioners in primary care settings. This project was intended to determine the prevalence and effect of nurse practitioners’ burnout in primary care settings and make recommendations for improving nurse practitioners’ overall health and well-being. The key outcomes of concern for this project were, first, improvement in burnout scores on the Copenhagen Burnout Inventory tool pre- and posteducational intervention, and …

A Study Of Communication Practices Between Office And Field-Based Personnel In Home Healthcare Agencies, Ruth M. Bates-Hill

Dissertations

The population of developed countries is rapidly aging. People want to age in their residence, and as they advance in years, most people will need assistance with activities of daily living and perhaps medical assistance to remain at home. Home health aides provide a large portion of such care. However, the annual turnover rate of home health aides exceeds 60% due to factors such as low wages, poor benefits, and a challenging work environment. Many studies have been conducted to elucidate the factors contributing to job satisfaction in the home health aide population, yet despite decades of research, turnover among …

Acute Care Nurse Practitioners’ Role In The Icu: A Retrospective Analysis Of Central Line Access Delays For Patients In Septic Shock, Violeta Aguirre

UNLV Theses, Dissertations, Professional Papers, and Capstones

Morbidity and mortality related to sepsis management have been popular research topics for a significant part of the last two decades. The Surviving Sepsis Campaign was launched in 2002 with goals to develop medical management guidelines, improving diagnosis by building awareness, expanding healthcare provider education, and improving appropriate treatment (Society of Critical Care Medicine [SCCM], 2019). Professional organizations and governing bodies continuously revise guidelines for the early identification and treatment of sepsis. The latest treatment recommendations for the Hour-1 Bundle of sepsis management (SEP-1) include initiating vasopressors in conjunction with fluid resuscitation to reach the hemodynamic goal of maintaining a …

Implementation Of A Protocol In The Freestanding Emergency Department To Screen For And Identify Possible Victims Of Human Trafficking, Joe Alvarado

UNLV Theses, Dissertations, Professional Papers, and Capstones

Human trafficking (HT) victims often seek medical care in the emergency room setting. In a recent study among HT survivors, 88% attested to receiving medical care while in captivity, with 63% treated in the emergency care setting. Freestanding emergency departments typically have lower acuity and lower patient volumes than hospital-based emergency departments. This setting creates shorter wait times and minimizes the length of stay at every point during the emergency room experience. For traffickers, this is an ideal situation if their victim needs medical attention, and they want to get in and get out of the emergency room with less …

Comparison Of 12-Hour Biweekly Shifts Versus 6-Hour Weekly Shifts On Learning Outcomes And Fatigue In Nursing Students On Dedicated Educational Unit, Alena Grewal

UNLV Theses, Dissertations, Professional Papers, and Capstones

Clinical experiences in nursing programs may take many forms and the goal of integrating clinical is to combine knowledge and skills learned in the classroom into the clinical practice setting. The Dedicated Educational Unit is an innovative approach in the State of Nevada and has demonstrated success in closing the gap between education and clinical practice. The Dedicated Educational Unit model is used for the medical-surgical clinical rotations at a local university and has been largely successful. However, some challenges affecting student learning have recently arisen that are not inherent to the Dedicated Educational Unit model. Challenges voiced by nursing …

Transient Ischemic Attacks Evaluation And Management In Specialized Urgent Care Facilities, Zandra Kay Johnson

UNLV Theses, Dissertations, Professional Papers, and Capstones

PURPOSE: Transient ischemic attacks (TIA) are a health problem that affects many people each year. A local Las Vegas organization allowed this DNP student to develop and implement an intervention to increase the perceived ability of providers to manage low-risk TIAs in specialized urgent care facilities. The aim was to raise the comfort level of providers at on-demand medicine also known as urgent care. Additional goals were to increase awareness of stroke and TIA symptoms and educate providers on the new TIA guidelines.

METHODS: This quality improvement DNP study used a convenience sample of 30 providers. Eleven participants completed the …

Factors Influencing The Self-Reported Palliative Care Practices Of Acute Care Nurses, Keshia Ryan Kotula

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction Approximately 40 million people are currently in need of palliative care (PC), and this number is predicted to increase due to the aging population and increasing longevity. Providing PC in the acute care setting leads to better quality and clinical outcomes, reduced inpatient hospital costs, and improved efficiency. Despite evidence indicating the benefits of PC, timely referrals and provision of PC in the acute care setting are lacking in part due to the complex interplay of factors that nurses must navigate, such as limited preparation, knowledge, and self-efficacy; nurse/provider attitudes; and patient/family and institutional barriers. A paucity of research …

Improving Therapeutic Communication In Mental Health Nursing: A Quality Improvement Project, Patricia A. Nill

UNLV Theses, Dissertations, Professional Papers, and Capstones

Over 46 million adults in the United States (U.S.) live with a mental illness. Locally in Nevada, the psychiatrist to patient ratio is approximately 700:1, and patients are seen primarily in the inpatient setting, if seen at all, due to the wait average of 85 hours in the hospital emergency rooms for access into mental health hospitals or specialty units of a general hospital. Moreover, costs for mental health mood disorders alone are estimated at over seven million dollars annually. The Institute of Medicine (IOM) opined the need for change in healthcare to redesign practice and clinical communication with patients …

Developing Strategic Partnerships To Impact Population Health: A Professional Development Module, Andra S. Scano

UNLV Theses, Dissertations, Professional Papers, and Capstones

Massive organizational changes occurring in our health care delivery system have provided opportunities for nurse leaders who think in terms of population health, to develop new skills needed to impact the populations they serve. Aspects of these changes include a focus on the delivery of primary and community-based care and the development of partnerships, alliances, and other linkages across settings to build integrated systems (Williams, 2020, p. 17). Turner (2020) asserts that population-focused nurse leaders are charged with creating a new future for healthier communities which often involves strategic partnership development. However, strategic partnership development is a complex task that …

An Intervention To Improve Nurses’ Knowledge, Perceived Safety, And Confidence In Identifying And Managing Workplace Violence: A Translation Of Evidence Into Practice, Kayla Sullivan

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Occupational Safety and Health Administration (OSHA) reports that over two million workers are victims of workplace violence (WPV) (Papa, 2013). Registered nurses are subjected to high risk for workplace violence from patients and visitors, with 25.5% reporting at least one victimization incident (Gillespie et al., 2013). Research indicates that WPV has a significant impact on nurses' quality of working life, job satisfaction levels, turnover rates and has also been shown to negatively impact efficiency and productivity (Gacki-Smith et al., 2009). ED nurses are at substantial occupational risk for workplace violence. Emergency departments have been identified as areas within the …

An Evaluation Of Care Coordination In Reducing Depression Symptoms And Emergency Room Visits, Stacy Sumpter

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Individuals living with multiple chronic conditions (MCC) account for 26% of the population; however, they consume 84% of healthcare resources, are three times more likely to have depression than healthy individuals, and have increase emergency room (ER) visits and healthcare resource use. This population requires coordinated health care to reduce unnecessary spending and the misappropriation of healthcare resources. The purpose of this project was to evaluate the efficacy of care coordination (CC) and the support system it provides in lowering depression symptoms and ER visit frequency as a viable measure to reduce overall healthcare costs.

Methods: The healthcare providers, …

Opioid And Naloxone Training In A Rural School District, Allyson C. Waldron

UNLV Theses, Dissertations, Professional Papers, and Capstones

The opioid epidemic is a national health emergency in the United States, with over 128 people dying each day due to an opioid overdose. It is estimated that 4.3 million people over the age of 12 use opioids without a medical need, and 1.3 million youth ages 12-17 use opioids inappropriately. Drug overdose deaths have become the leading cause of accidental death in the United States, prompting the U.S. Surgeon General and the World Health Organization to advise that more Americans have access to naloxone and understand how to use this life-saving drug correctly. Naloxone is an opioid antagonist, used …

Improving Self-Care Measures Of Hypertension Through Implementation Of An Education And Action Plan, Crystal Celeste Huffaker

UNLV Theses, Dissertations, Professional Papers, and Capstones

Hypertension (HTN) is a leading cause of morbidity and mortality worldwide and one of the most common conditions seen by primary care providers. Current clinical practice guidelines recommend lifestyle modifications for patients with elevated blood pressure (BP) and diagnosed HTN. Despite these recommendations, many patients diagnosed with HTN make insufficient modifications to their lifestyle. The purpose of this project was to determine the impact of implementing an education session, with development of a patient action plan, along with 4-week, 8-week, and 12-week follow-ups on the adoption of self-care measures for HTN. Participants had their BP, height, and weight measured along …

Identifying Factors That Influence Conflict Management Styles Of Lebanese Nursing Students’ With Their Clinical Educators, Maha Jalal Dankar, Wafaa Bousily

BAU Journal - Health and Wellbeing

Conflicts in nursing career between students’ and clinical educators result certainly in negative outcomes for the students’ as stress and low assertiveness level, but can be successfully managed. The conflict management styles of the students’ should be well known in detail in order to attain positive outcomes. The present study aims to identify factors that influence conflict management styles of Lebanese nursing students’ with their clinical educators. This study was conducted at different universities and institutions, using a descriptive correlational design. A random sample of 360 nursing students’ was used. Data was collected using one tool consisting of two parts: …