Nursing Commons^™

An Evaluation Of A Structural Competency Training For School Nurses, Rachel J. Torres

Doctoral Projects

The aim of this quality improvement project was to use structural competency as a tool to highlight the broad social, political, and economic structures that influence health and subsequent inequities and disparities. A one group, pre-and post-design quality improvement project was used to determine whether the Structural Competency Working Group curriculum influenced school nurses’ thought processes regarding the factors that influence health outcomes. The curriculum was adapted to a 1.5-hour training and delivered to a group of school nurses from a highly populated and socially, economically, and culturally diverse urban county in northern California. The results showed that after the …

Expanding Labor Support Education To Nurses Caring For Women In Labor, Ana L. Viera-Martinez

Doctoral Projects

The ability to provide emotional and physical support to a patient during one of the most significant moments of her life is a privilege afforded to intrapartum nurses who attend to laboring and delivering mothers. Labor support improves birth outcomes, reduces cesarean birth rates, and decreases anesthesia use. More labor support education needs to be made available to intrapartum nurses. Within the hospital context, this quality improvement (QI) project investigated the effects of educating intrapartum nurses about labor support and providing them with hands-on training. Surveys, including the Self-Efficacy Labor Support Scale, were as given pre- and post-education to evaluate …

Improving Breastfeeding Rates Through Education, Julianna Youssef

Doctoral Projects

Background: Breastfeeding is beneficial for newborn babies, but there are many challenges that new mothers face that prevent them from exclusively breastfeeding.
Objective: To evaluate if re-educational training in RN’s and LVN’s is an effective way to increase the exclusive breastfeeding rates in the hospital setting.
Methods: We utilized a pretest/post-test quasi-experimental design and had the goal sample size was about 50 nurses. The nurses were given an educational PowerPoint at a monthly staff meeting. Pretests were given to the staff immediately before and posttests two weeks later. Additionally, exclusive breastfeeding rates were monitored for the three months before the …

A Systematic Literature Review On Long-Term Care Quality Improvement Initiatives In The United States, Daisy D. Pang

Capstone Experience: Master of Public Health

As the number of people 65 and older increases due to the baby boomer population, there will be a greater demand for long-term care (LTC) services. Quality improvement in LTC is essential to ensure positive health outcomes, patient satisfaction, and reduction in healthcare costs. The purpose of this systematic literature review is to identify the current quality initiatives for LTC in the United States and evaluate the outcomes, effects, and values of each quality initiative identified to support the claim that current the quality initiatives have a limited effect on quality improvement in LTC settings. The Preferred Reporting Items for …

The Association Of Apgar Score Outcomes With The Number Of Midwife Antenatal Care Visits Among Infants Born To Rohingya Refugees In Cox’S Bazar, Bangladesh, Vickie Doss

Capstone Experience: Master of Public Health

A cross-sectional study was conducted at the HOPE Foundation for Women and Children of Bangladesh Field Hospital in Cox’s Bazar, Bangladesh, to examine the relationship between the number of antenatal care visits (ANCV) and Apgar scores. This study aims to explore the association between the number of ANCV and Apgar scores in neonates born to Rohingya refugee women. The medical records at HOPE Field Hospital of 182 post-delivery Rohingya women in the Mhodhurchora refugee camp were collected through a medical chart review to

obtain the number of ANCV and 1-minute and 5-minute Apgar scores. The Apgar scoring system is a …

The Lived Experience Of The Dnp-To-Phd Nursing Graduate: Examining The Journey, Bonni S. Cohen

UNLV Theses, Dissertations, Professional Papers, and Capstones

The traditional route of obtaining a Doctor of Philosophy (PhD) in nursing is vertical: a Master of Science in Nursing (MSN), followed by PhD in nursing. An ongoing shortage of PhD- prepared nurses—nurse educators and nurse researchers, in particular, has spurred the creation of more pathways to obtaining a PhD in Nursing. In recent years, there has been a drive to increase the number of nurse scientists with doctoral degrees through innovative pathways. A newer terminal nursing degree, the Doctor of Nursing Practice (DNP), has taken root over the past decade to produce nurse leaders who are experts at translating …

Evaluating Risk-Appropriate Perinatal Care In Nevada, Janice Enriquez

UNLV Theses, Dissertations, Professional Papers, and Capstones

In the United States, (U.S.) technological advancement and increased accessibility to health care resources have not deterred the increasing maternal morbidity and mortality rates (CDC, 2022). In 2019, 754 maternal deaths were reported; in 2020, 861 deaths were reported. In a span of one year, the maternal mortality rate increased by 14% (CDC,2022). American Indian/Alaska Native and Black birthing people are 2 to 3 times more likely to die from a pregnancy-related cause than White birthing people (CDC, 2019). 80% percent of all pregnancy related deaths can be prevented (CDC, 2022). Risk-appropriate care is a strategy used to improve perinatal …

Investigating Students’ Lived Experience With Prebriefing Structure And Elements In Nursing Simulation Education, Meghan Liebzeit

UNLV Theses, Dissertations, Professional Papers, and Capstones

Prebriefing is a growing body of knowledge in nursing simulation education. It is recognized as an important factor in the simulation experience, however the practice of prebriefing varies widely making it difficult to understand what methods best prepare students for the simulation scenario. While research over the last decade has identified prebriefing increases confidence, skills, and clinical judgment, what content is important to include in prebriefing, or how it promotes the achievement of outcomes is under recognized.Implementing an intervention based on a pedagogically sound eight-week simulation clinical course, developed with the theoretical underpinnings of Vygotsky’s Zone of Proximal Development, Kolb’s …

The Covid-19 Pandemic And On-Time Vaccine Completion In The Childhood Population: A Strategic Plan, Chris Elaine Mariano

UNLV Theses, Dissertations, Professional Papers, and Capstones

In March 2020, the entire world was placed into lockdown due to the COVID-19 virus, which impacted everyday life, including healthcare. People were scared to leave their homes and obtain preventative services, including vaccinations from birth to adulthood. There was a significant decrease in childhood vaccinations due to the COVID-19 pandemic. A strategy mix is defined as an intervention utilized for vaccination improvement. Strategy mixes were implemented to improve vaccination administration, and ultimately, vaccination rates. However, due to the COVID-19 pandemic, these strategy mixes or interventions were placed on hold causing immunization administration to decrease which could cause vaccine-preventable diseases …

No Scrubs: Nursing Applicant Trajectories After Rejection, Jennifer Torgerson

UNLV Theses, Dissertations, Professional Papers, and Capstones

There is a nursing shortage in the United States which has become even more apparent during the COVID-19 pandemic. Despite qualified applicants, thousands of students are turned away from educational programs each year as programs reach capacity limits. The rejection may have social, psychological, and economic consequences for the student. Students faced with rejection need to make decisions whether to continue their pursuit of nursing or go a different direction. This exploratory quantitative study aims to understand the trajectories of students that are not admitted into a capacity restricted nursing program at a community college in the Southwestern United States. …

Fear Of Recurrence As A Mediator Of Illness Perception And Perceived Stress In Acute Myocardial Infarction Survivors, Sarah E. Zvonar

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The primary objective of this study is to evaluate fear of recurrence as a mediator of illness perception and perceived stress. This research will determine how illness perceptions and fear of recurrence affect perceived stress in the acute myocardial infarction (AMI) population. Other aims will observe how demographics predict patients who may experience increased fear of recurrence and stress in the AMI population, how the variables of fear of recurrence change over time, and if fear of recurrence is still a significant mediator after controlling for depression and anxiety.Rational/ Conceptual Basis/ Background: Acute myocardial infarctions (AMIs) are often accompanied …

Impact Of Personalized Interactive Storytelling On Suspension Of Disbelief In Clinical Simulation, Audra Renee-Smith Xenakis

Electronic Theses and Dissertations

The literature review found suspension of disbelief (SOD) in clinical simulation heavily weighted on educators alone within high-fidelity environments. The project examined a co-created narrative background story applied to a simulated patient’s clinical profile to determine achieving an improved connectedness toward the simulated patient leading to enhanced SOD and enhanced levels of learning and reaction. The studied population was third-semester associate degree nursing students over 18 years of age with prior clinical simulation experience who were not repeating the semester. The research methodology used a quantitative experimental design with cluster sampling, randomization, and post-Likert-scored questionnaires. The intervention group co-created personalized …

Relationships Between Healthcare Technology Experience, Acceptance, Attitudes, Self-Efficacy And Readiness In Pre-Licensure Nursing Students, Emily Lynne Boyce

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Technology is embedded in many aspects of healthcare. This is especially true in nursing, where technology is used daily in charting, medication administration, clinical decision-making, healthcare team communication, and information resource utilization. In nursing programs, students are exposed to healthcare technologies and expected to use them once entering the workforce. Healthcare technologies such as electronic health records (EHR), barcode medication administration, medication dispensing machines, and mobile technologies are critical to adopt to leverage their efficiencies and safety mechanisms to provide the best patient care. Despite evidence indicating the benefits of using healthcare technologies, new graduate nurses enter the workforce …

Health Literacy And The Feasibility Of Using Video-Based Education In The Emergency Department, Jenifer Carvell

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The Department of Health and Human Services (HHS) defines health literacy as the degree to which an individual has the capacity to find, understand, and use information and services to inform health-related decisions and actions for themselves and others. In the emergency department (ED), it is estimated that the prevalence of inadequate health literacy can reach as high as 88 percent. There is a need to implement literacy-sensitive interventions in the ED. Purpose: The purpose of this project was to engineer an intervention that explored the feasibility of the use of personal technology to deliver video-based education to adult …

Telehealth In Patients With Type 2 Diabetes Mellitus, Saghi Nassrouie

UNLV Theses, Dissertations, Professional Papers, and Capstones

Description: Type 2 diabetes mellitus (DM2) is an epidemic that has many factors involved in its management to maintain control. Patients with DM2 require routine evaluations and blood work to provide comprehensive care. COVID-19 caused major shifts in traditional care which sparked an increase in the utilization of technology like telehealth. Telehealth can be an effective tool used to manage diabetes and help attain better glucose control, but its effectiveness during the COVID-19 pandemic warrants further investigation.Purpose: The purpose of this project was to determine if telehealth visits were more effective in reducing Hemoglobin A1c (HbA1c) in adult patients with …

Leveraging Simulation To Understand Nursing Student Learning In Technologically Complex Environment, Deborah Rojas

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction The adoption of simulation technologies in schools of nursing has increased significantly over the last 5 years. Results regarding the use of simulation technology have been positive. The use of simulation technologies has been developed to include complex nursing situations that resemble real clinical settings. Research has demonstrated that memory recall is better in an environment that is the same or similar to the environment in which the learning took place (Krokos et al., 2018). For this reason, educators have used simulation technologies to create realistic environments where students can learn. However, learning outcomes in simulations are affected by …

Communication Assessment Tools For Emergency Department Nurses Who Interact With Individuals With Intellectual And Developmental Disabilities, Holly Hunt

Doctor of Nursing Practice Scholarly Projects

Abstract/Executive Summary

Problem Statement: Communication is an essential part of every nurse-patient interaction. During the best of times the patient and nurse can clearly understand each other and engage in successful interaction with positive patient outcomes. Individuals with intellectual and developmental disabilities (IDD) often use nontraditional ways of communicating that can complicate the ideal nurse-patient interaction. When a patient presents with a different method of communicating, the nurse must possess tools available to facilitate a successful interaction. Identifying such a tool or if one cannot be found building a sample tool is vital for positive patient outcomes for individuals with …

The Effectiveness Of Targeted Education On Improving Nurses’ Self-Efficacy In Caring For Psychiatric Patients On Medical Surgical Units, Rachel Shirey

Doctor of Nursing Practice Scholarly Projects

Individuals with mental illness are occasionally hospitalized on medical units, specifically medical-surgical units. Nurses working on medical-surgical units may find patients with mental illness more challenging due to the complexity of care they sometimes require. Nurses’ perceived ability to provide quality care for these patients is reduced in comparison to their perceived ability to care for patients without mental illness. Consequently, low self-efficacy can result in the provision of a lower quality of care for this population. The purpose of this quality improvement project was to improve the care that patients with mental illness receive while hospitalized on medical-surgical units. …

Breastfeeding After Maternal Anesthesia: A Guideline Development, Megan Berens

Doctor of Nursing Practice Scholarly Projects

Postoperative breastfeeding recommendations for lactating mothers by anesthesia providers are inconsistent and often inaccurate. Inappropriate recommendations have led to withholding of breastmilk to the infant, unnecessary disposal of breastmilk, surgical delay, exposure of an infant to high levels of drugs in breastmilk, and early cessation of breastfeeding. The purpose of the scholarly project was to develop a set of evidenced-based practice guideline recommendations and a proposed implementation plan for anesthesia providers to use in support of breastfeeding mothers who recover from surgery. Many studies in the literature indicate that there are inconsistencies in postoperative breastfeeding recommendations by anesthesia providers. When …

Development And Implementation Of An Ultrasound-Guided Peripheral Intravenous Catheter Insertion Training Program For Student Registered Nurse Anesthetists, Nicholas Colangelo, Zachary Wise

Doctor of Nursing Practice Scholarly Projects

The American Association of Nurse Anesthetists (AANA) has defined the scope of nurse anesthesia practice to include services in acute, chronic, and interventional pain management, as well as the use of ultrasound (U/S) and other diagnostic technologies. However, there are no standard curriculum requirements in place that mandate graduate programs to educate student nurse anesthetists in U/S-related modalities. In addition to the AANA, the use of U/S in nurse anesthesia practice has recently been adopted by The Council on Accreditation of Nurse Anesthesia Educational Programs (COA), which characterizes U/S use by its clinical impact on the reduction in complications, increased …

A Nurse Led Heart Failure Education For Self-Care Symptom Monitoring And Management, Lynda Browning

Doctoral Projects

Title

Nurse-led education heart failure education for symptom monitoring and management

Abstract

Problem Statement: Over six million adults in the United States have heart failure (CDC.gov,2020). According to the Agency for Healthcare Research and Quality (AHRQ), almost 20% of heart failure patients hospitalized are readmitted under 30 days (AHRQ, 2013). The American Heart Association (AHA) (2022) recommends a visual symptom tracking tool for self-care symptom monitoring to increase patient adherence and reduce readmissions. Despite this recommendation, the AHA tool for symptom monitoring is not fully incorporated into the discharge of every heart failure patient often because of nursing management …

Esmolol Compared To Fentanyl For Hemodynamic Attenuation During Intubation: A Scoping Review, Carlie King, Robert Kirby, Mitchell Groome, Cassidy Gubin, Tracy Mcclinton Dnp, Aprn, Agacnp, Ebp-C, Dwayne Accardo Dnp, Crna, Faana

Doctor of Nursing Practice Projects

Purpose/Background

Endotracheal intubation and laryngoscopy potentiate the cardiovascular response in the form of hypertension, tachycardia, and ventricular arrhythmias. Suppression of this adrenergic response is necessary to ensure patient safety. Currently, anesthesia providers employ many methods to attenuate the sympathetic response without established guidelines. As such, our project aimed to determine the effectiveness of fentanyl compared to esmolol in attenuating the hemodynamic response during laryngoscopy and endotracheal intubation within the first five minutes and throughout the intraoperative period.

Methods

A literature review was completed of ten critically appraised articles from the years 2011-2022. Articles in the review included randomized control studies, …

Extubation And Weaning: Implementing A Standard Weaning Protocol, Anna T. Wilhaucks, Caleb J. Fresh, Mohamed N. Khalil, Victoria K. Johnson, Tracy H. Mcclinton Dnp, Ag-Acnp-Bc

Doctor of Nursing Practice Projects

Purpose The purpose of this project is to determine if implementation of a standardized weaning protocol on mechanically ventilated patients affects reintubation rates and decreases adverse outcomes.

Prevention Of Obesity-Related Morbidity & Mortality In Adults, Rachelle Virgin

Masters Theses/Capstone Projects

Poster presentation on the prevention of obesity related morbidity and mortality in adults.

Impact Of Opioid-Free Anesthesia On Postoperative Nausea & Vomiting: A Scoping Review, Madison Scholl, Miranda Morrison, Abbey Ramsey, Alexandria Sawicki, Dwayne Accardo Dnp, Crna, Aprn

Doctor of Nursing Practice Projects

Purpose The purpose of this DNP Scoping Review is to compare the current literature regarding the incidence of postoperative nausea and vomiting (PONV) in adult patients who underwent general anesthesia when opioids are used intraoperatively versus a multimodal non-opioid-based intraoperative general anesthetic plan Specific Aims: Incidence of postoperative nausea & vomiting Postoperative rescue antiemetic administration Length of stay in postoperative anesthesia care unit (PACU) Incidence of intraoperative adverse events

Ohio Forensic Nurse Examiners: Readiness To Care For Victims Of Sexual Assault With Disability, Deanna Nicole Smith

Doctor of Nursing Practice Scholarly Projects

Forensic nurse examiners (FNEs) care for crime victims in acute care settings. These nurses are specifically trained in trauma-informed care and evidence collection in cases of sexual assault, domestic violence, abuse, and human trafficking (RAINN, 2022). The scholarly project focuses on the care of victims of sexual assault living with disability, as this population is three times more likely to be victimized than any other population (NSVRC, 2022). The project literature review reveals a lack of data on preparation standards for FNEs on caring for victims with disability and providing accommodations during forensic examination. Currently, it is unknown if FNEs …

An Integrative Review: Best Practices For Educating And Engaging Care Partners Of Patients With New Ostomies, Lauren Flook Brown

Master of Science in Nursing Final Projects

PURPOSE: The purpose of this integrative review was to identify and synthesize the best practices of engagement and education for care partners of patients with new ostomies to support adaptation.

METHODS: Five-stage integrative review process: (1) problem identification, (2) systematic literature search, (3) data evaluation, (4) data analysis, and (5) presentation.

RESULTS: Four themes with sub-themes emerged to understand effective engagement and education of care partners: (1) care partner influences on patient outcomes; (2) care partner needs; (3) barriers to care partner adaptation; and (4) diverse engagement strategies. Each theme and sub-themes related to care partners could not be separated …

Support Needs Of People With Younger Onset Parkinson's Disease: An Interpretative Phenomenological Analysis, Clare Stephenson, Allyson Flynn, Anthony Overs, Karen Strickland

Research outputs 2022 to 2026

Background: People with younger onset Parkinson's disease reported trouble navigating the health system and managing their Parkinson's disease symptoms. This impacted their everyday responsibilities, such as maintaining employment, caring for children, or meeting financial commitments. Aim: To understand the experiences of the unmet support needs of people diagnosed with younger onset Parkinson's disease and allow a deeper understanding of their lived experiences. Methods: Data were collected by interviewing four participants about their perceptions of the current supports available. Interpretative phenomenological analysis was applied for in-depth exploration of the participant's experience, allowing the participant and the researcher to ‘make sense’ of …

Decreasing Postop Delirium With Dexmedetomidine Vs Propofol, Isabel Bannister, Rn, Bsn, Srna, Abigail Kurtz, Rn, Bsn, Srna, Abigail Banko, Rn, Bsn, Srna, Reid Blaylock, Rn, Bsn, Srna, Tracy Mcclinton, Dnp, Aprn, Agacnp-Bc, Epb-C, Caitlan Bradford, Rn, Bsn, Srna

Doctor of Nursing Practice Projects

Postoperative delirium (POD) is a common complication that contributes to increased length of hospital stay, impaired recovery, and can affect long-term outcomes. Recently, research has been conducted to determine if certain anesthetic agents decrease the likelihood of developing POD. However, no clear protocol for prevention exists. This scoping review aimed to analyze the current literature to determine the efficacy of dexmedetomidine versus propofol at preventing POD.

Formalized Diabetes Self-Management Education In A Safety-Net Clinic, Emanpreet Kaur

Masters Projects

Diabetes is a complex and chronic illness requiring continuous medical care with multifactorial risk reduction strategies (American Diabetes Association [ADA], 2021). More than 37 million Americans are suffering from diabetes and 90% of them have Diabetes Mellitus Type 2 (DMT2) (Centers for Disease Control and Prevention, 2021). The purpose of this article is to review the background, an organizational assessment, a literature review, and the results of the quality improvement project that took place at a safety-net clinic in the Midwest. This project included 16 patients and data was analyzed through descriptive statistics. Results include improved hemoglobin (Hg) A1c, Body …