Digital Commons Network^™

Pfas Exposure And Human Health Risk Management - A Policy Review, Callie Sierra Totaro

Master's Projects and Capstones

For centuries, new chemicals and compounds have been invented to improve material longevity or make a product cheaper to produce. Throughout this time, emerging chemicals have often gone through inadequate testing that may not consider all long term environmental and human health effects before they have gone to market in the United States. As a result, thousands of harmful chemicals have ended up in the food supply, water sources, and everyday items of people in the United States with the negative health effects often not being discovered for decades after the start of circulation. By this point, removal and assessment …

Releases Of Hazardous Materials And Waste From Transportation Incidents In The Us: An Analysis To Increase Environmental Resiliency, Elizabeth Irene Tautges

Master's Projects and Capstones

Excessive amounts of hazardous materials and waste are released into the environment from transportation incidents. The United States federal government has regulations on the movement of hazardous material and waste during transportation, but preventing environmental releases is not a major priority. Multiple external factors influence the release of hazardous material and waste into the environment. Transportation incidents can be prevented by modifying the information collected in emergency reports, adjusting transportation patterns and conditions, and expressing negative environmental impacts, preparing responder efforts to communicate effectively. The components of previous hazardous materials and waste releases emphasize the needed improvements for increasing environmental …

Evaluating The Impact Of Wildfires On Mixed Conifer Forest Regeneration And The Effectiveness Of Usfs Management Strategies On Restoring Ecosystem Services, Wyatt Farino

Master's Projects and Capstones

Wildfires are increasing in frequency, duration, and severity across Western North America. 20,438,720 acres (20.1%) of California has burned at least once since 2010. Projections suggest a statewide increase in burned area between 36% and 74% by 2085, with some forested areas in Northern California exceeding 100% in all modeled scenarios. Fire regimes have deviated far from their historical norm, significantly increasing the risk of type conversion from forest to other ecosystems. Californians rely on the myriad of ecosystem services produced by these forests to meet their basic needs. Access to these fundamental services will be severely reduced if appropriate …

An Inventory Of Tidal Marsh Restoration Opportunities In Humboldt Bay And Their Impact On Greenhouse Gas Emissions, Nicholas Rowlands

Master's Projects and Capstones

Blue carbon ecosystems like tidal marshes, mangroves, and seagrass are efficient carbon sinks that release minimal methane under saline conditions. However, coastal wetlands globally are under threat, and on the U.S. West Coast some 85% of historic tidal wetlands have been lost. As such, there is increasing interest in their restoration as a necessary climate mitigation strategy. This GIS analysis identifies potential tidal marsh restoration sites in Humboldt Bay, California, and estimates the post-restoration greenhouse gas benefits. An elevation-based model of Humboldt Bay’s full estuary extent developed by West Coast researchers was combined with data from the California Aquatic Resources …

Exploring And Assessing Sustainable Flood Mitigation Strategies In Response To Rising Sea Levels In Boston, Elizavyeta Dmitrieva

Master's Projects and Capstones

With projections indicating up to a 30 cm rise in sea level along the US coastline by 2050, flooding emerges as a critical hazard for coastal communities. Boston, a pivotal urban center, anticipates experiencing 50-70 flood days per year by 2050. Addressing the inevitability of these events necessitates the implementation of robust and equitable flood mitigation strategies to alleviate stress on the city and its residents. This paper delves into the causes of sea level rise, flooding projections for Boston, and the City’s plans to mitigate these risks. Concentrating on the two neighborhoods most vulnerable to flooding—East Boston and South …

Hafekasi: The History, Identity & Cultural Perspectives Of Multi-Ethnic Tongans, Katrina Nt Tu'akoi

Master's Projects and Capstones

Tongans are a Polynesian people similar in identity to their close cousins in neighboring Samoa, Hawai’i, New Zealand, and Tahiti. Tonga is the last surviving Polynesian kingdom in the Pacific. It is a nation comprised of over 170 islands which are both coral and volcanic. The islands were also called “The Friendly Islands” by British Captain James Cook in the 1700s because of their warm and welcoming people. Tongans have intermarried for many centuries, more so than ever before in recent decades. They have intermarried amongst other Polynesians like Samoans. The first official mixing across racial lines occurred with Fijians …

Assessing Threats And Protections For The Elusive Marbled Murrelet On Land And Sea, Alessandra Guadalue Navas

Master's Projects and Capstones

Marbled Murrelets (Brachyramphus marmoratus) are a federally and state protected seabird in California, Oregon, and Washington. Marbled Murrelet populations have been unstable over the past few decades, primarily due to habitat loss. Logging, wildfires, and windthrow have either destroyed or fragmented coastal old-growth forests, which provide high- quality nesting habitat for Marbled Murrelets. Despite the various management strategies and protections for the species across its range, population trends indicate that Marbled Murrelet populations are declining in Washington, despite positive trends in California and Oregon. The goal of this research was to identify gaps in current conservation strategies through …

Impacts Of Atmospheric Rivers On Communities In Northern California: Comparative Analysis Of Sonoma County Hazard Mitigation Plans, Cristina Vance

Master's Projects and Capstones

Climate change increases the frequency of extreme weather events and affects California’s hydroclimate, thereby increasing flood vulnerability of all communities in Sonoma County. An example of extreme weather phenomena is atmospheric rivers (ARs), which are long narrow water vapor transported by winds across the Pacific Ocean. ARs have a history of causing major flood events that have swept through Sonoma County and negatively impacted cities along the lower Russian River, such as the unincorporated town of Guerneville, California. Major floods cause detrimental impacts to the economy. Social inequalities become evident when unincorporated communities located along floodplains are more vulnerable to …

From Pixels To Plants: Remote Sensing Of California Invasive Plants, Kenneth Rangel

Master's Projects and Capstones

Invasive plants cause significant impacts to ecosystems, the economy, and human health. California has experienced significant plant invasions and is well suited to future invasion because of its Mediterranean climate and human disturbance. Eradication or control of invasive plant species requires a detailed understanding of their spatial distribution, which typically involves on the ground surveys that can be expensive or inconsistent. Remote sensing offers a potential alternative or supplement to in-person invasive plant mapping. This study performed a comparative analysis of 41 remote sensing studies that mapped the distribution of California invasive plants. I found that while high spectral resolution …

Assessing The Use Of Regenerative Agriculture In California Almonds As Climate Change Resilience, Skyler M. Seamons

Master's Projects and Capstones

The agriculture sector is responsible for 10% of the United States’ greenhouse gas emissions. In turn, anthropogenic climate change threatens crops. With its Mediterranean climate, California is the country’s largest agricultural-producing state. Many California crops are at risk due to increasing temperatures and changed precipitation patterns. This paper investigates regenerative farming techniques as a tool to protect California crops from a changing climate. Almonds are used as a case study to analyze the soil management practices, finances, and policies underlying regenerative agriculture in California. A literature review and comparative analysis are used to compare regenerative and conventional soil management practices …

The Potential Of Southeast Florida’S Coral Reef Tract To Enhance Climate Resilience Of Ecosystems And Communities, Michaella C. Sena

Master's Projects and Capstones

Increasing anthropogenic greenhouse gas emissions have led to more heat being trapped in the atmosphere, raising our overall global temperature. The hottest recorded sea surface temperatures in Southeast Florida occurred in 2023 causing extreme coral bleaching and high mortality in part of the Florida Reef Tract (FRT). Coral reefs play a vital role in protecting coastal communities from storm surge and sea level rise, reducing wave energy by up to 97% across whole reefs. However, with increasing ocean acidity and thermal stress from climate change, coral ecosystems are struggling to maintain their structural complexity and overall health, much less provide …

U.S. International Climate Finance: An Analysis Of Historical Shortfalls And A Proposal For More Equitable Distribution, Maria-Cristina Kealey

Master's Projects and Capstones

Least-developed countries experienced 69% of deaths from climate disasters over the past 50 years despite comprising only 13% of the world’s population. Low-income and climate vulnerable nations around the world are suffering disproportionately as wealthy, high-emitting countries, such as the U.S., profit from the climate crisis. This research provides a comprehensive overview of past U.S. contributions to international climate finance efforts, assesses the climate finance deficit globally and specifically for developing countries, and proposes a more equitable share of U.S. funding from a quantitative and restorative climate justice approach. The primary analyses included quantifying the U.S. share of global greenhouse …

Elevating Urban Landscapes: How Green Roofs Enhance Biodiversity And Address Climate Change In California, Jeffrey R. Beaudoin

Master's Projects and Capstones

Green roofs are increasingly valued for mitigating the Urban Heat Island effect, providing thermal comfort amidst rising temperatures of climate change, enhancing hydrological properties, and improving urban biodiversity. In this report, I explore the environmental benefits and practical challenges of green roofs, with a specific focus on California. My study evaluates the effectiveness of green roofs in enhancing environmental sustainability using a weighted rating system. I categorize the benefits of green roofs into key areas: thermal performance, stormwater management, ecological support, mental health benefits, noise reduction, air quality improvement, and water quality enhancement. Green roofs have shown the potential for …

Managing The Environmental And Socio-Economic Impacts Of Rohingya Refugees In Bangladesh, Mousume Azad

Master's Projects and Capstones

In August 2017, nearly 1 million Rohingya people fled to Bangladesh to save their lives from the genocide inflicted by the military of Myanmar. At present, over 1.3 million Rohingyas are staying at Cox’s Bazar, Bangladesh, in 34 overcrowded refugee camps. This research examined the environmental impacts especially the change in vegetation cover and land surface temperature as well as the socioeconomic alteration of the host country after the refugee influx. The research found a 5488 ha or 9.58% decrease in forest area, accompanied by an 8.25% increase in refugee settlement areas, an increase in average land surface temperature within …

Enhancing Peripartum Care Through Standardized Nurse Knowledge Exchange, Gabriela Ochoa

Master's Projects and Capstones

Problem Inconsistent handoff practices during patient transfers can cause mistakes and adverse outcomes. Hospital A's peripartum unit has no set policy for Nurse Knowledge Exchange (NKE) during transfers. This project will introduce a standard handoff guide to enhance communication and prevent harmful results after patient transfers.

Context The quality improvement project was conducted in a peripartum mesosystem within an urban hospital in Northern California. This specific area of the hospital comprised 21 postpartum rooms and nine laboring rooms.

Intervention The project involved a methodical strategy that encompassed engaging stakeholders, conducting a literature review, and analyzing data to pinpoint areas for …

Unlocking The Potential Of Peripartum Handoff: Standardizing Nurse Knowledge Exchange (Nke), Kiana Killian

Master's Projects and Capstones

Problem The absence of a structured and standardized handoff during patient transfers may result in the unintentional omission of patient information, medical errors and adverse events. No standardized bedside handoff process, referred to as Nurse Knowledge Exchange (NKE), was observed in Hospital A’s peripartum mesosystem during patient transfers from the Labor and Delivery (L&D) unit to the Postpartum unit. Context Hospital A is a medium-sized urban hospital located in Northern California. The peripartum mesosystem includes 21 postpartum rooms and nine laboring rooms. Intervention Through the recruitment of stakeholder engagement, review of literature supporting evidence-based practices, and a mesosystem assessment, a …

Enhancing Pain Documentation In Medical Surgical Units: Integrating Supportive Tools With Pain Nursing Education, Mariana Arias

Master's Projects and Capstones

Problem: Pain management in in-patient care, particularly involving opioids, is critical due to the associated risks. Proper pain assessment is essential to ensure safe medication administration and mitigate adverse effects.

Context: This quality improvement (QI) project aimed to improve opioid assessment and documentation rate above 90% compliance in two medical-surgical units, focusing on bedside nurses who play a crucial role in patient safety and effective pain management.

Interventions: A baseline survey provided nurses' understanding on compliance criteria and assessment timing. Interventions included visual reminders, informational posters, and instructions on how to access individual compliance reports.

Measures: A post intervention survey …

Optimizing Emergency Department Triage Documentation Workflow In An Urban Hospital, Diego F. Valencia

Master's Projects and Capstones

Problem California ranks ninth nationwide in terms of longest emergency department wait times. This project aims to reduce triage assessment time in the emergency department. Context This quality improvement project took place in the emergency department microsystem of a large urban Bay Area hospital. Intervention The proposed intervention was changes to the triage documentation workflow such as: elimination of redundant questions, consolidation of related categories, and logical reorganization of triage topics. Measures Measures used in this project were triage times and nursing opinion surveys. Results Due to time constraints and other limitations, the intervention was not implemented. However, pre-implementation surveys …

Increasing Opioid Pain Pre-Assessment And Reassessment Documentation Rate In Medical-Surgical Units, Hae Rim (Helen) Hwang

Master's Projects and Capstones

Problem The fifth vital sign, pain, requires proper pain management in hospital settings, often involving opioids with significant risks of adverse reactions. Appropriate pain assessment and management is vital to ensure safe medication administration and mitigate potential adverse reactions.

Context This quality improvement (QI) project aimed to enhance opioid assessment and documentation rate above 90% compliance in two medical-surgical units, with a focus on bedside nurses. Nurses play a key role in administering and documenting pain assessments, a practice crucial to managing patient safety and effective pain management specific to opioid use.

Intervention A baseline survey provided nurses’ understanding on …

Implementation Of Lymphedema Education Toolkit For Nurse Coordinators, Heather Gee

Master's Projects and Capstones

Problem: Lymphedema is a chronic condition that develops secondary to cancer treatments such as chemotherapy, radiation, and surgical removal of affected lymph nodes. This swelling in patient’s limbs can cause discomfort and limit mobility, however lymphedema is often not detected until later stages, delaying treatment and patient education.

Context: This quality improvement project was conducted at Hospital S Women’s Cancer Center, an outpatient center specializing in advanced treatments for breast and gynecological cancers. This center has a multidisciplinary team focusing on both the medical and surgical aspects of oncology treatment.

Interventions: An evidence-based lymphedema education toolkit was created for nurse …

Leveraging Collaboration In Advocacy: An Examination Of The 501(C)(4) Regulatory Framework And Its Utility For Advancing Immigrant Rights, Christine D. Ambegia

Master's Projects and Capstones

The nonprofit sector is uniquely positioned for leading the charge in advocacy through various social justice movements, and their capacity to engage in lobbying work plays a crucial role in advancing policies that contribute to the collective good. The regulations on lobbying that are set forth and enforced by the Internal Revenue Service (IRS) for nonprofit 501(c)(3) public charities can limit them from aggressively engaging in policy and advocacy work that holds legislators accountable to their constituents. Nonprofit 501(c)(4) social welfare organizations are governed by a regulatory framework that has the potential to expand on 501(c)(3) charities’ work because they …

Empowering Nurse-Driven Removal Of Indwelling Urinary Catheters In The Surgical Intensive Care Unit: A Quality Improvement Project, Ellen Ruby Hann

Master's Projects and Capstones

Problem Nurse-driven removal protocols (NRDPs) have been shown to reduce indwelling urinary catheter (IUC) days and prevent catheter-associated urinary tract infections (CAUTIs). Communication barriers prevent consistent implementation of the NDRP, leading to delayed IUC removal and increased risk of CAUTIs. Context The project was conducted in a 16-bed adult surgical intensive care unit (ICU) at a teaching hospital in a major metropolitan area. Interventions Urinary catheter reminder posters displaying IUC days were posted at each bedside to prompt discussion of IUC indication and removal. An email describing the project background was sent to all nurses and physicians by the unit …

Educating Inpatient Pediatric Registered Nurses On The Setup And Administration Of Prolonged Intravenous Antibiotics And The Reduction Of Medication Errors, Kiara Hayden

Master's Projects and Capstones

Problem The acute care unit microsystem of a California children’s hospital encounters issues involving the incorrect set up and administration of prolonged intravenous (IV) antibiotics and medication errors, such as delivery at the wrong rate or time. These problems can result in negative patient health outcomes, delayed healing, antibiotic resistance, and increased length of hospital stay and costs. Context A collaborative quality improvement (QI) project was launched to target the pediatric population of this particular microsystem. The aim of this project was to standardize prolonged IV antibiotic practices, disseminate knowledge while using evidence-based practice (EBP), and improve patient outcomes. Interventions …

Improving Prolonged Antibiotics Education In A Pediatric Unit, Zerena S. Silva Villamonte

Master's Projects and Capstones

Problem Children’s Hospital A's incidence report tool, iCares, demonstrates that 50% of the issues related to prolonged intravenous (IV) antibiotics are categorized as administration issues. This leads to the medication being delivered at the wrong time or rate. Having these issues increases patient length of stay, increasing hospital costs. Context The microsystems for this quality improvement project include inpatient pediatric patient care units (PCU) 300, 360, and 400. Children’s Hospital A is a 361-bed San Francisco Bay Area hospital. Interventions The Clinical Nurse Leader students implemented a presentation defining prolonged IV antibiotics, their rationale, and a video demonstrating the correct …

Increasing Awareness And Communication To Decrease Catheter Days In The Surgical Intensive Care Unit, Kamila Fortney

Master's Projects and Capstones

Problem Nurse-driven removal protocols (NRDPs) have been shown to reduce indwelling urinary catheter (IUC) days and prevent catheter-associated urinary tract infections (CAUTIs). Communication barriers prevent consistent implementation of the NDRP, leading to delayed IUC removal and increased risk of CAUTIs. Context The project was conducted in a 16-bed adult surgical intensive care unit (ICU) at a teaching hospital in a major metropolitan area. Interventions Urinary catheter reminder posters displaying IUC days were posted at each bedside to prompt discussion of IUC indication and removal. An email describing the project background was sent to all nurses and physicians by the unit …

Enhancing Nursing Perspectives And Support Of Stroke Patient Satisfaction Survey, Vanessa Li

Master's Projects and Capstones

Problem A stroke diagnosis is associated with high mortality and increased morbidity that affect the quality of life of both patients and caregivers. Higher satisfaction with stroke care could alleviate both patient and caregiver stress, thereby positively affecting their quality of life. Regulatory guidelines underscore the need for a stroke-specific patient satisfaction survey (SPSS). Context Hospital X houses one of the few comprehensive stroke centers (CSC) in the San Francisco Bay Area, serving patients with various stroke etiologies and complexities. Its Neuro Observation Unit (NOU) currently does not administer a SPSS. Intervention An educational presentation using literature evidence in support …

Increasing Adherence To A Nurse-Driven Removal Protocol To Reduce Indwelling Urinary Catheter Days, Hannah K. Brosnan

Master's Projects and Capstones

Problem

Nurse-driven removal protocols (NRDPs) have been shown to reduce indwelling urinary catheter (IUC) days and prevent catheter-associated urinary tract infections (CAUTIs). Communication barriers prevent consistent implementation of the NDRP, leading to delayed IUC removal and increased risk of CAUTIs.

Context

The project was conducted in a 16-bed adult surgical intensive care unit (ICU) at a teaching hospital in a major metropolitan area.

Interventions

Urinary catheter reminder posters displaying IUC days were posted at each bedside to prompt discussion of IUC indication and removal. An email describing the project background was sent to all nurses and physicians by the unit …

Improving Nurse Support Of Patient Satisfaction Surveys Through Team Huddle Education, Matthew Price

Master's Projects and Capstones

Problem As a leading cause of death and disability in the US, strokes often require complex, multifaceted care. Often ignored, patient satisfaction is a crucial aspect of this care and is positively linked to key health indicators. Regulatory guidelines underscore the need for stroke-specific patient satisfaction survey (SSPS) utilization in post-stroke care. Context Hospital X is a large Comprehensive Stroke Center in the Bay Area, serving patients with various stroke etiologies and complexities. At present, its Neuro Observational Unit (NOU) does not administer a SSPS. Intervention To address this gap in care, an educational presentation using literature evidence in support …

Reducing Barriers To Timely Indwelling Urinary Catheter Removal, Huyen T. Nguyen

Master's Projects and Capstones

Problem Nurse-driven removal protocols (NRDPs) have been shown to reduce indwelling urinary catheter (IUC) days and prevent catheter-associated urinary tract infections (CAUTIs). Communication barriers prevent consistent implementation of the NDRP, leading to delayed IUC removal and increased risk of CAUTIs. Context The project was conducted in a 16-bed adult surgical intensive care unit (ICU) at a teaching hospital in a major metropolitan area. Interventions Urinary catheter reminder posters displaying IUC days were posted at each bedside to prompt discussion of IUC indication and removal. An email describing the project background was sent to all nurses and physicians by the unit …

Raising The Bar: Optimizing Peripartum Handoff Through Standardized Nurse Knowledge Exchange (Nke), Kimberly Martinez Rn

Master's Projects and Capstones

Problem Hospital X’s peripartum microsystem has no policy guiding the Nurse Knowledge Exchange (NKE) process. Variability in handoffs during patient transfers could lead to medical errors and adverse events. This quality improvement (QI) project aims to pilot a standardized handoff guide to improve nurse communication and avoid adverse patient outcomes following patient transfers. Context The setting for this QI project was a peripartum mesosystem at an urban hospital located in Northern California with 21 postpartum rooms and nine labor rooms. Intervention The project employed a systematic approach that involved engaging stakeholders, analyzing microsystems, reviewing literature, and analyzing data to identify …