Nursing Commons^™

Determining The Effectiveness Of Nonpharmacological Treatment Modalities For Adult Patients With Chronic Low Back Pain: An Integrative Review, Sydia Nichole Spence

Doctoral Dissertations and Projects

Chronic low back pain continues to be a major health issue, affecting a significant percentage of the population worldwide. It is one of the major contributors to long-term disability. People with ongoing and recurrent low back pain experience lowered quality of life, long-term disability, lost productivity, and medical costs due to urgent and emergency care visits. Pharmacological treatment modalities often present with serious safety concerns, ineffectiveness due to limited evidence-based studies, undesirable side effects, and the possibility of addiction. Therefore, many clinicians and patients seek alternative approaches to remedy persistent low back pain. Various nonpharmacological therapies have shown favorable results …

A Phenomenological Study Exploring The Lived Experience Of Students Who Have Failed A Nursing Course: Try Again Or Move On?, Deborah K. Tonelli

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to examine the lived experiences of students after failing a nursing course, resulting in the students either sitting out a semester prior to repeating the course or making the decision not to return to a program at all. The central research question for this study was “what are the lived experiences of students who fail a nursing course?” This study retrospectively examined the failure of nursing students to better understand how they processed the event, gained meaning from the experience, and found supportive measures that were useful in moving forward to the …

Resiliency In Nursing: An Integrative Review, Valerie Yvonne Moke

Doctoral Dissertations and Projects

Nurses have been placed under tremendous pressure throughout their careers and the culmination of this pressure was the COVID-19 pandemic. Nurses had to remain stoic despite longer hours, heavier workloads, lack of PPE and the fear of becoming infected or infecting their families. A review of the current literature was accessed to see how nurses built their stamina to withstand those pressures and create interventions to improve patient outcomes. The research was used to evaluate ways to improve nurse retention, reduce nursing shortages, and improve job satisfaction for those nurses and future nurses. The evidence showed that nurses with support, …

Increasing Adherence To Psychotherapy Treatment In Adult Mental Health Patients Through The Use Of Tele-Behavioral Services: An Integrative Review, Almaz Assefaw

Doctoral Dissertations and Projects

Telebehavioral therapy has been developing in recent years as a viable alternative to in-person provider treatment. This was due, in part, to the recent COVID-19 pandemic necessitating rapid and widespread adoption of remote care services in general. Before this event, and despite years of development in telemental and telebehavioral technology, the U.S. rate of adoption of such services had been low. As psychotherapy is an effective way to treat mental health issues with or without the use of psychotropic drugs, ways to increase patient adherence to psychotherapy must be studied to provide high-quality mental health outcomes. One measure that has …

Tiered Centralized Education In The Transition-To-Practice Program To Improve Nurses' Level Of Confidence On Nursing Sensitive Indicators Outcomes, Froiland Agana Ascaño

Doctoral Projects

A tiered Centralized Education in the Transition-to-Practice (TTP) Program is crucial to improving nurses' Level of Confidence on nursing-sensitive quality indicators. The benefits of a structured orientation program taught by trained content experts are evident in the literature. In addition, training transition-to-practice RNs during onboarding with training and assessment sessions throughout the orientation program to increase frequency provides skills acquisition. This study examined the impact of a house-wide education program on the nurses' confidence levels of CLABSI prevention, a measured nursing-sensitive quality indicator. This quasi-experimental quality improvement study measured the confidence and comfort levels of transition-to-practice RNs and identified that …

A Quantitative Job Satisfaction Comparison Between Certified Nursing Assistants (Cnas) Providing Care In Patients’ Homes Versus In Long-Term Care (Ltc) Facilities In The Omaha Metropolitan Area, Rusheena Shah

Capstone Experience: Master of Public Health

This capstone project looks at overall job satisfaction comparison between two groups of Certified Nursing Assistants (CNAs) – CNAs who provide home care in patients’ homes and CNAs who provide care in Long-term Care (LTC) facilities in the Omaha Metropolitan Area. In this quantitative study, a survey was sent to CNAs who provide home care to patients and CNAs who provide patient care at different nursing home facilities in the Omaha area. Prior research has indicated that even though CNAs perform similar job duties irrespective of the work environment; they experience varying degrees of job satisfaction which could be attributed …

How Did Covid-19 Impact The Mental Health Of Nurses, Pamela Bedoya

Senior Honors Projects

No abstract provided.

Nurses Leading In Bridging The Culture Gap: Communicating With The Deaf Community, Veronica C. Leftridge

Electronic Theses and Dissertations

Nurses provide patient care in clinics, hospitals, homes, churches, schools, communities, and military, as well as on emergency medical helicopters. When a nurse is assigned to care for a patient, the patient expects the nurse to be culturally competent, communicate effectively, and provide safe quality care. However, cultural incompetence is observed when nurses provide care for Deaf patients, but they are unfamiliar with Deaf culture. In addition, communication is a fundamental skill nurses learn in nursing school, but course content in nursing programs rarely touches on how to communicate effectively with Deaf patients. Of the approximately 325 million people in …

Healthcare Screenings In The Occupational And Workplace Setting: Taking Control Over Blood Pressure, Darryl W. Horton

UNLV Theses, Dissertations, Professional Papers, and Capstones

Undiagnosed hypertension continues to be a growing concern worldwide leading to cardiovascular disease and other chronic illnesses and can contribute to death. The prevalence of hypertension continues to increase even with guidelines on screening, hypertension education, disease prevention, disease maintenance, and management. The purpose of this project was to determine if the implementation of a workplace blood pressure screening program would improve hypertension knowledge and reduce the burden of hypertension within workplace. A descriptive, cross-sectional design using convenience sampling was conducted. Participants were screened by measuring blood pressures, and the Hypertension Evaluation of Lifestyle Management scale (HELM) was utilized to …

Parental Education On Human Papillomavirus Vaccination, Marguarette J. Suprien

UNLV Theses, Dissertations, Professional Papers, and Capstones

The human papillomavirus (HPV) is a worldwide condition that produces several diseases, including cervical, anogenital, and oral cancer, among others (Fishman et al., 2014). The Center for Disease Control and Prevention (CDC; 2016a) stated that HPV is among the most reported sexually transmitted diseases in the United States. Over 150 viruses are associated with HPV, and 40 types of the virus can be spread via sexual contact, including vaginal, oral, and anal sex (CDC, 2016; CDC, 2016b; CDC, 2016c). Evidence shows that approximately 79 million individuals are infected in the United States, and 14 million Americans are infected with the …

Increasing Genetic Testing Rates To Improve Early Detection And Prevention Of Breast And Ovarian Cancer In Women, Makensey Beth Durrant

UNLV Theses, Dissertations, Professional Papers, and Capstones

Screening rates for cancer related genetic mutations are low in the primary care setting, despite evidence-based guidelines recommending screening in all patients who meet criteria. Genetic mutations, such as the breast cancer susceptibility 1 and 2 (BRCA1/2) gene mutations, drastically increase breast and ovarian cancer risk in patients. The United States Preventive Services Task Force (USPSTF) and the National Comprehensive Cancer Network (NCCN) provide evidence-based guidelines on criteria for genetic testing in women at risk for breast and ovarian cancer related gene mutations. Primary care providers (PCPs), including advanced practice registered nurses (APRNs), are at the front lines of preventative …

The Road Ahead: An Occupational Therapy Manual To Infant Development For Parents In The Nicu, Nicole Suzuki-Uyeno

UNLV Theses, Dissertations, Professional Papers, and Capstones

Occupational therapists have been collaborating with the parents of our tiniest patients in the neonatal intensive care unit (NICU) for quite some time. They have a wealth of information and expertise in the area on infant development and parent education. Admitting a baby to the NICU is a shock for most parents and can take a toll on a family. The role of the occupational therapist is to help educate the family and to provide the tools to safely take care of their baby and to smoothen the transition from the hospital to home.

In the NICU, the OT has …

Improving Nurse Self-Efficacy Regarding Depression Among Cardiovascular Disease Patients: An Education Intervention, Presten Beatty

UNLV Theses, Dissertations, Professional Papers, and Capstones

Depression is a principal cause of increased morbidity, mortality, and decreased quality of life for cardiovascular disease patients. Low levels of nurse confidence have been the outcomes of several studies and anecdotal reports regarding providing care for and approaching patients with acute and chronic illnesses in conjunction with behavioral and mental health issues. Current literature suggests that improving nursing education on the prevalence and impacts of depression improves nurse confidence. Depression screening tool education provided to nurses, with detailed disease information, empowers nurses in their attitudes, knowledge, and behaviors regarding patient depression. By improving depression screening rates among cardiovascular disease …

A Quality Improvement Project To Improve Health Care Provider Self-Efficacy In Rural Primary Pediatric Care Clinics Through Training Intervention, Alison Borgsmiller

UNLV Theses, Dissertations, Professional Papers, and Capstones

American Association of Pediatrics recommends screening for various developmental delays in children, but it does not explicitly recommend a tool for screening social and emotional development at well-child checks (WCCs). Therefore, provider self-efficacy (SE) is lacking, and screening rarely occurs. This quality improvement (QI) project sought to improve healthcare provider SE using the Ages and Stages Questionnaire: Social-Emotional, Second Edition (ASQ:SE-2), an evidence-based practice screening tool for identifying such delays in children at 30–60-month WCC visits.At rural healthcare centers in San Luis Obispo, California, participants completed the Self-Efficacy Twelve Questionnaire prior to and 30 days following a training intervention. While …

The Effects Of A Dedicated Education Unit On Nurse Retention And Turnover, Cherilyn Campbell

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite the fast growth of healthcare jobs in the United States, there is a deficit in the nursing workforce. Literature has shown high nurse turnover within the first year as a new graduate nurse. Healthcare organizations will need to explore innovative ways to impact nursing retention and turnover to keep up with the growing demand. The purpose of this Doctor of Nursing Practice (DNP) project is to perform and evaluate a comprehensive review to determine the effect of a dedicated education unit (DEU) on nurse retention and turnover within an academic-practice partnership. Literature has shown the benefits of the DEU …

Family-Centered Psychosocial Care For Pediatric Oncology Patients, Jessica W. Casey

UNLV Theses, Dissertations, Professional Papers, and Capstones

Psychosocial conditions are prevalent in pediatric oncology patients (Kahalley et al., 2013). Family and social support are essential aspects of a patient's health care outcomes (Merck & McElfresh, 2019). Anxiety and depression are common in pediatric oncology patients due to trauma during treatment (Pao & Kazak, 2015). These patients also can have preexisting developmental or behavioral conditions before starting treatment. Treatment side effects can also cause cognitive and behavioral changes (Nixon, 2014b). Nurses should be knowledgeable and confident in their ability to care for patients' psychosocial health and development. The purpose of this Doctor of Nursing Practice (DNP) project is …

Reducing Door-To-Balloon Time In Stemi Via Er Nurse Driven Protocol, Torrie Clontz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Over 605,000 patients will suffer an ST-segment elevated myocardial infarction in the United States each year. The gold-standard definitive treatment for this is percutaneous coronary angioplasty or the ballooning open and stenting of the blockage. The American Heart Association has set the evidence-based gold standard of 90-minutes from identification of blockage to reperfusion of heart muscle. In a health system in Las Vegas, NV, this goal is frequently missed due to lack of protocols in place to expedite patients towards definitive treatment. The purpose of this evidence-based practice change is to reduce STEMI patient morbidity and mortality via a nursing …

Evaluating Repetitive Transcranial Magnetic Stimulation To Reduce Opioid Cravings In Opioid Use Disorder, Cameron Duncan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Opioid Use Disorder (OUD) is a multi-faceted, complex ailment affecting many individuals and their families across the globe. Currently, there are multiple interventions used in the treatment of OUD, many of which are designed to reduce cravings for opioids. Cravings for opioids are a strong predictor of relapse in the disorder. However, many of the interventions used in clinical practice have inherent risks including a potential for abuse and diversion. Repetitive Transcranial Magnetic Stimulation (rTMS) is an outpatient procedure that may be effective in reducing cravings for opioids, thereby reducing relapse. Methods: This study employed a randomized, single-blind, experimental design …

Decreasing Central Line-Associated Bloodstream Infections In The Critical Care Unit, Kimberly J. Foxworth

UNLV Theses, Dissertations, Professional Papers, and Capstones

Central line-associated bloodstream infections (CLABSI) are a rising problem in the critical care setting in the United States. According to Flogren et al. (2007), "an estimated 248,000 bloodstream infections occur in hospitals across the United States each year, and a significant amount of these infections are associated with the use of a central venous catheter" (p.160). The Center for Disease Control and Prevention (CDC) defines a CLABSI as "recovery of a pathogen from blood culture (a single blood culture for organisms not commonly present on the skin and two or more blood cultures for organisms commonly present on the skin) …

Improving Nurse Leaders’ Knowledge And Confidence In Transformational Leadership Skills In The Online Environment, Tanya Haight

UNLV Theses, Dissertations, Professional Papers, and Capstones

Leadership is critical to the success of most organizations, and the achievement of an organization's goals is largely dependent on the leaders' ability to engage, motivate, and influence their teams—often referred to as Transformational Leadership. This is especially true for healthcare organizations wherein the morbidity and mortality of patients may be affected by the quality of leadership. At the start of the COVID-19 pandemic, in-person meetings transitioned to the online format without nurse leaders' formal training. Leaders cited this lack of orientation as impeding their ability to sustain an online-virtual transformational leadership presence with their teams. They reported varying degrees …

Exploring Gen Z Nursing Students’ Experience And Emotional Processing In Simulation: A Grounded Theory Study, Wendy Matthew

UNLV Theses, Dissertations, Professional Papers, and Capstones

Simulation is an integral teaching methodology used within current nursing curricula. The goal of simulation is to promote learning, develop clinical judgment and reasoning, and ultimately improve patient care. However, some factors can disrupt the goals of the simulation learning experience. Students may experience uncomfortable emotional responses, such as anxiety, during simulation events, which impairs students' thinking processes leading to decreased learning, poor performance, an inability to assess knowledge, and potentially prohibits the transfer of knowledge to practice. Over 90% of the general Generation Z (Gen Z) population report uncomfortable emotions such as stress and anxiety. Simulation is used in …

Is Dietary Teaching Via Telehealth Effective In Lowering Hgba1c In Adult Patients With Prediabetes Or Type 2 Diabetes?, Mia Mccallum-Crawford

UNLV Theses, Dissertations, Professional Papers, and Capstones

Prediabetes and Type 2 diabetes mellitus (T2DM) are two common conditions diagnosed in the primary care setting. Both conditions benefit from a healthy lifestyle, managing blood sugar levels, and getting diabetes self-management education and support (DSMES). Within the past two decades, the healthcare community in the US has witnessed a substantial rise in diabetes among adults. Overall, the self-management of diabetes continues to worsen nationally. The purpose of this project is to improve patients’ self-management of both Prediabetes and T2DM through nutrition and show how nutritional counseling via telehealth provided by a nurse practitioner can improve HgbA1C values over 3 …

The Nursing Leader’S Role In Decreasing Implicit Rationing By Improving The Nursing Work Environment, Allison Mchugh

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite all the literature about missed care and its contributing factors, it is prevalent in most hospitals worldwide. Missed care is the result of care that is implicitly rationed. For this paper, implicit rationing is defined as how nurses decide what care is delivered based on the present work environment. Many factors influence implicit rationing. One such factor is the work environment. The association between the nursing work environment and implicit rationing is well described in the literature. The nursing leader is in a formal position responsible for patient outcomes and the nursing practice environment. Therefore, it is important to …

Improving Self-Efficacy And Knowledge While Reducing Anxiety In High-Risk Breast Cancer Patients Through Standardized Education, Shelley Miles

UNLV Theses, Dissertations, Professional Papers, and Capstones

Breast cancer is the leading cause of death of women in the United States. Patients at high risk for developing cancer are more easily identified in today’s world. Early identification might be due to strong family history or genetic mutations, such as BRCA1 or BRCA2. Screening and risk reduction guidelines have been developed over recent years for these patients. Adherence to these guidelines continues to be a problem. The factors stemming from this problem include lack of knowledge about being high-risk, understanding the guidelines, and anxiety and depression about the perceived risk of developing breast cancer. These factors can cause …

Ultrasonography-First Imaging Algorithm For Acute Appendicitis Diagnosis, Steven Lamar Moore

UNLV Theses, Dissertations, Professional Papers, and Capstones

Acute appendicitis (AA) is the most common cause of acute abdominal pain requiring surgery in pediatric, adult, and pregnant patients. Several etiologies are believed to trigger luminal obstruction, which causes mucus and bacteria proliferation, resulting in inflammation and wall tension with subsequent necrosis and rupture of the appendix. Most AA patients present with the primary complaint of abdominal pain, which Murphy first described the characteristic diagnostic sequence seen in approximately 50% of patients as colicky centralized abdominal pain with subsequent vomiting with the migration of pain to the right lower quadrant (RLQ), specifically, the right iliac fossa. The typical AA …

Increasing Human Papillomavirus Vaccination Intent And Knowledge Through An Educational Intervention, Angelica E. Musumeci

UNLV Theses, Dissertations, Professional Papers, and Capstones

Human papillomavirus (HPV) is a widely discussed topic in healthcare as it affects patients of all genders and ages who partake in sexual activity. The most significant concern it poses to those at risk is HPV-related cancer. Fortunately, a vaccination exists that targets specific strains associated with these types of cancers. Despite evidence-based research supporting the vaccination’s efficacy and safety, lack of awareness and misinformation diminish the receipt of the vaccine and drive the lack of protection. Thus, educational interventions directed at parents and caregivers, which aims to improve their understanding of HPV and the vaccination’s benefits, is key to …

Evaluation Of An Advance Care Planning Workshop To Improve The Self-Efficacy Of Health Care Providers, Joy Patrick

UNLV Theses, Dissertations, Professional Papers, and Capstones

Advance care planning (ACP) involves discussions between the patient and their care providers and those close to them about future care. Every patient is entitled to ACP; however, research has shown that providers do not regularly implement them for various reasons. In addition, multiple barriers may be preventing providers from initiating ACP. Among them are lack of knowledge and confidence, apprehension, time, and fear. This Doctor of Nursing Practice (DNP) addresses the problematic barriers to regular ACP discussions between providers and the patients. Specifically, the purpose of this DNP project is to develop, implement and evaluate an online module to …

Identifying Gaps In Social Determinants Of Health Among Patients 65 Years And Older With Congestive Heart Failure: A Secondary Data Analysis, Sandra Pierre-Louis

UNLV Theses, Dissertations, Professional Papers, and Capstones

Congestive heart failure (CHF) is one of the most common healthcare problems for older adults. Because of its high and rising prevalence in this population and its significant influence on healthcare costs and quality of life, CHF is becoming a serious public health issue in the United States. More effective strategies for preventing and managing CHF in older people are desperately needed (Rich, 2015). The disease accounts for 3% of hospital admissions in the United States and affects more than 6.5 million Americans (White-Williams et al., 2020). Further, CHF is exacerbated by adverse social determinants of health (SDOH). This study …

Evidence-Based Intervention To Improve Health Literacy Among Older Adults With Newly Diagnosed Atrial Fibrillation, Johana Rowe

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Significance: Atrial fibrillation (AFib) is the most common arrhythmia encountered in the healthcare setting. As of 2018, approximately 6.1 million people in the United States were living with AFib which is projected to increase to 12.1 million by 2030. Older adults are at higher risk of developing AFib and its complications. AFib is a chronic condition that requires targeted patient education by healthcare providers in different healthcare settings. Patient’s low health literacy regarding the condition is a significant barrier to therapy adherence. Given the high rate of poor health literacy among individuals newly diagnosed with AFib and the …

A Cohort Comparison Study On Women In Threatened Preterm Labor Given Nifedipine Or Nifedipine And Salbutamol Tocolysis In Air Medical Retrieval, Breeanna Spring Walsh, Fergus W. Gardiner, Dianne Bloxsome, David Ford, Brennen W. Mills, Simon M. Laws

Research outputs 2022 to 2026

Objective: Women with threatened preterm labor in remote Australia often require tocolysis in the prevention of in-flight birth during air medical retrieval. However, debate exists over the tocolytic choice. Methods: A retrospective analysis was undertaken on data containing women who required air medical retrieval for threatened preterm labor within Western Australia between the years 2013 and 2018. Results: A total number of 236 air medical retrievals were deemed suitable for inclusion; 141 received nifedipine, and 95 women received salbutamol + nifedipine. Tocolytic efficaciousness was reported in 151 cases, proportionally more (P < .05) from the women who received salbutamol + nifedipine (n = 68, 71.6%) compared with the women who received nifedipine only (n = 83, 58.9%). Those receiving salbutamol + nifedipine were more likely to suffer maternal tachycardia (n = 87 [91.6%] vs. n = 62 [44.0%]), fetal tachycardia (n = 26 [27.4%] vs. n = 13 [9.2%]), nausea (n = 17 [17.9] vs. n = 5 [3.55%]), and vomiting (n = 12 [12.6%] vs. n = 2 [1.4%]). Three women who received salbutamol + nifedipine had serious side effects including echocardiographic changes, chest pain, and metabolic and lactic acidosis. Conclusion: Salbutamol + nifedipine tocolysis was proven to be more effective than nifedipine only. Although salbutamol + nifedipine had increased temporary side effects, most were nonsevere and managed in-flight.