Nh 4-H Hippology Contest Entry Information, Unh Cooperative Extension

UNH Cooperative Extension

No abstract provided.

Improving Staff Knowledge And Consistency In Sat And Sbt Practices In The Critical Care Unit: A Quality Improvement Initiative, Morgan Crapo

Master's Theses and Capstones

Abstract

Background: Spontaneous Awakening Trails (SATs) and Spontaneous Breathing Trials (SBTs) are key components of the ICU Liberation Bundle and have been associated with shorter durations of mechanical ventilation, reduced intensive care unit (ICU) length of stay (LOS), and improvement in patient outcomes. Despite having strong evidence supporting their use, implementation remains inconsistent due to knowledge gaps, workflow barriers and interdisciplinary communication challenges.

Local Problem: This quality improvement (QI) project aimed to improve critical care nurses’ knowledge and confidence regarding the implementation of SATs and SBTs through an evidence-based educational intervention.

Methods: Guided by the Plan-Do-Study-Act (PDSA) framework, this QI …

Improving Timely Pain Reassessments And Documentation Using Nurse Education And Visual Reminders: A Quality Improvement Project, Madison Grace

Master's Theses and Capstones

Background: Effective pain management requires nurses to complete and document an entire pain assessment cycle, including the initial assessment, intervention, and reassessment (Wolters Kluwer, paragraph 5, 2020). Timely reassessments are essential for determining whether interventions were effective or if additional actions need to be taken to improve patient pain and comfort. Despite established hospital policies and guidelines, inconsistencies in timeliness of pain reassessments and associated documentation are a common challenge faced.

Local Problem: Baseline chart audits on a 22-bed combined pediatric and adult medical-surgical unit identified opportunities to improve adherence to timely pain assessments and documentation. With only 65% percent …

Implementing A Nurse Re-Education Program To Promote Timely Use Of The Jada® System In The Postpartum Hemorrhage Cascade: A Quality Improvement Project, Maegan E. Doody

Master's Theses and Capstones

Background: Postpartum hemorrhage (PPH), defined as blood loss greater than 1,000 mL after delivery, is a leading cause of maternal morbidity in the United States. Identification of risk factors and timely intervention are critical to improving maternal outcomes after delivery. First-line interventions include manual uterine massage, uterotonic medications, and antifibrinolytic medications; however, when bleeding is not well controlled, the Jada® System (Jada) is a newer vacuum-induced hemorrhage control device with a high efficacy and safety profile, particularly when implemented earlier in the hemorrhage cascade.

Local Problem: In 2025, the annual rate of PPH within the microsystem was 7.29%, …

A Quality Improvement Project: Enhancing Nursing Knowledge And Patient Safety In The Prevention Of Hospital-Acquired Pressure Injuries (Hapis) In A Medical-Surgical Unit, Kristen Vartabedian

Master's Theses and Capstones

Background: Hospital-acquired pressure injuries (HAPIs) are a significant quality indicator within the hospital system. HAPIs increase hospitalization, morbidity, and associated healthcare costs. The current evidence suggests that ongoing nursing education can improve pressure injury prevention and help in the early identification.

Local Problem: Nurses within a medical-surgical unit demonstrated a gap in knowledge in the identification of hospital acquired pressure injuries and lack of accuracy when charting skin findings. Thus, contributing to a delay in recognition and treatment of HAPIs.

Methods: This quality improvement project utilized the Plan-Do-Study-Act (PDSA) framework to guide implementation of educational flipbooks. Materials contained standardized wound …

Reducing Readmissions For Copd Through Improved Education: A Gap Analysis, Raphael Gaughan

Master's Theses and Capstones

No abstract provided.

Enhancing Patient Safety And Team Communication Via Standardized Unit Handoff Tools In Inpatient Rehabilitation, Julia Rae Before

Master's Theses and Capstones

Abstract

Background: Interdisciplinary safety huddles in healthcare are used to facilitate staff communication, voice patient safety concerns and identify high acuity patients, as well as identify current unit issues that need resolution. Using characteristics of safety huddles, revising patient report sheets to include pertinent safety information often shared during huddles may lead to an increase in staff perception of communication as well as awareness to patient safety concerns. Within an in-patient rehabilitation hospital, anonymous staff reports indicated dissatisfaction with interprofessional communication and microsystem data revealed increased events of adverse patient outcomes and safety concerns. Baseline data indicated inconsistent patient handoff …

A Patient-Centered Approach To Improving Patient And Family Education On Perioperative Processes To Reduce Anxiety: A Quality Improvement Initiative, Ashley Lauren Doherty

Master's Theses and Capstones

Background: Perioperative anxiety is common among surgical patients and their family members. Anxiety may be increased by uncertainty and limited understanding of the surgical experience. Improving perioperative education may enhance understanding, reduce anxiety, and support a more patient and family centered surgical experience.

Local Problem: A Post-Anesthesia Care Unit (PACU) identified knowledge gaps in patient and family education about the perioperative process. The existing waiting room bulletin board was outdated and provided limited information. PACU nurses observed anxiety-related behaviors and confusion among patients and family members about the perioperative process. Patient satisfaction surveys routinely collected by the hospital also demonstrated …

Improving Operating Room First-Case On-Time Starts And Reducing Turnover Times: A Quality Improvement Project, Ashley Cote

Master's Theses and Capstones

Abstract

Background: Delays in first case on-time starts (FCOTS) contribute to decreased operating room (OR) efficiency, increased healthcare costs, workflow disruptions, and reduced staff and patient satisfaction. Evidence suggests that standardized workflows, improved communication, and Lean Six Sigma methodologies can improve perioperative efficiency and reduce delays.

Local Problem: Baseline data from a local OR microsystem demonstrated an FCOTS rate of 77%, below the organizational benchmark of 80%. Root cause analysis identified inconsistent preoperative workflows, communication gaps, and variable staff adherence to standardized processes as primary contributors to delayed first-case starts.

Methods: A quality improvement project utilizing the Define, Measure, Analyze, …

Improving Early Ambulation After Cardiac Surgery Using Nurse Education And Workflow Cues: A Quality Improvement Project, Nathan Seeley

Master's Theses and Capstones

Background: Early ambulation following cardiac surgery is an evidence-based practice that promotes postoperative recovery, reduces complications, and supports earlier discharge (Cook et al., 2024; Engelman et al., 2019; Kanejima et al., 2020). Despite its recognized benefits, consistent implementation remains challenging in busy inpatient settings due to workflow demands, competing priorities, and patient-related barriers.

Local Problem: Inconsistent early ambulation practices were identified on the Cardiac Surgical Step-Down Unit, creating an opportunity to improve adherence to evidence-based postoperative mobility practices.

Methods: This quality improvement project used the Plan-Do-Study-Act (PDSA) model to evaluate the impact of a brief nurse-focused educational intervention on early …

Advancing Safe Medication Administration During Pediatric Emergency Care Through Nurse Education: A Quality Improvement Project, Ciera Hunter

Master's Theses and Capstones

Background: Due to the increased complexities of pediatric medication administration, preventable errors occur at a higher rate than in general adult populations. Rural emergency departments (EDs) often see fewer pediatric patients and have less specialized support available on-site. Nurse continuing education is an evidence-based intervention to reduce medication administration errors making it vital to supporting patient safety and maintaining pediatric readiness.

Local Problem: The microsystem is a rural, critical access hospital in northern New England. In 2021, the microsystem scored 66/81 on the National Pediatric Readiness Project’s (NPRP’s) ED Assessment. In 2026, the score dropped 11 points to 55/81. Contributing …

Improving Effective Completion Of Catheter Care Using A Reminder System To Minimize Incidence Of Catheter-Associated Urinary Tract Infections: A Quality Improvement Project, Morgan K. Leonard

Master's Theses and Capstones

BACKGROUND: CAUTI rates can be decreased by implementing a care cluster for RNs for CAUTI care into morning assessments and medication administration to ensure it is being done regularly with reminders through cards at the computers in patient rooms. LOCAL PROBLEM: The local problem in the microsystem were the catheter-associated urinary tract infection (CAUTI) rates at 1.199, while the national benchmark is 1.000 (Medicare, n.d.).

METHODS: Reminder cards were placed in patient rooms on the computers which are highly utilized by staY while providing patient care to serve as a reminder to complete catheter care in a high task burden …

Improving Efficiency In The Intensive Care Unit Through Reduction Of Nurse Burnout: A Quality Improvement Initiative, Johanna Grace Koroma

Master's Theses and Capstones

Abstract

Background: Intensive care unit (ICU) nursing is prone to high levels of burnout, which poses concern for staff wellbeing, patient safety, and microsystem strain (Kerlin et al., 2020). Educational interventions may serve as a means of increasing awareness on the issue and reducing the effects of burnout, through promotion of evidence-based management strategies.

Local Problem: One ICU microsystem identified several key contributing factors to nurse burnout, including staffing shortages, limited resources, competing responsibilities within the macrosystem, and insufficient organizational support (Zhang et al., 2025). Baseline survey data of the population observed a prevalence of 50% “high” burnout profiles among …

Increasing Patient Feedback Survey Completions Through Patient-Centered Nursing Communication: A Quality Improvement Project, Lindsey E. Pawlowski

Master's Theses and Capstones

Background: Patient feedback is essential to providing the best possible nursing care. Positive patient experiences can impact overall patient satisfaction, loyalty, and trust.

Local Problem: On a pediatric unit at a New England hospital, an assessment of the microsystem revealed that there was a low number of monthly patient feedback survey completions, which limited insight into patient experiences.

Aim Statement: The primary aim of this project was to increase the number of monthly National Research Corporation (NRC) surveys to ten by June 30, 2026.

Methods: This quality improvement project was guided by the Plan-Do-Study-Act (PDSA) model. The first stage of …

Incorporating Structured Safety Huddles To Improve Nursing Communication And Reduce Medical-Surgical Inpatient Fall Rates: A Quality Improvement Project, Alexia K. Leonard

Master's Theses and Capstones

BACKGROUND: Patient falls are a significant concern for patient safety in the acute care setting and are typically connected to inadequate communication during shift transitions. Bedside shift report is considered the standard of care, however, barriers are still present when shifting patient care responsibilities among nursing staff. A literature review identified standardized safety huddles as an evidence-based practice to improve areas of communication, teamwork, situational awareness, and patient safety. This quality improvement (QI) project concentrated on the implementation of a standardized evening safety huddle in order to improve nursing communication and reduce patient falls on an inpatient medical-surgical/telemetry unit. METHODS: …

Improving Telemetry Alarm Fatigue By Reducing Perception Of Noise Through Education: A Quality Improvement Project, Emma Bergeron

Master's Theses and Capstones

Background: The perception of excess telemetry noise has a negative impact on nursing staff workflow, emotional stress, physical stress, and alarm fatigue. This can create a distressing workplace, interrupt the ability to answer telemetry alarms in an appropriate amount of time, and further worsen alarm fatigue in nursing staff.

Local Problem: The local problem identified was the perception of telemetry noise and alarm fatigue. The purpose of this study was to assess the extent of alarm fatigue and perception of telemetry noise on the unit.

Methods: The study consisted of an assessment of the microsystem itself and the observed impact …

Enhancing Safety And Efficiency In Cardiac Admission Handoffs Through Implementation Of An I-Pass Checklist: A Quality Improvement Project, Soraia D. Barros

Master's Theses and Capstones

Abstract

Background: Effective care handoff is a necessary step for maintaining patient safety during hospitalizations. The goal of this quality improvement project was to improve the completeness of information, particularly cardiac-related, provided by the ED staff to the CSSU nurses. The implementation involved the creation of a cardiac checklist and applying it to the pre-existing I-PASS forms used during asynchronous handoff.

Local Problem: The macrosystem implemented an updated system for handoffs between the ED and CSSU by substituting an over-the-phone report with a faxed I-PASS sheet. The result, as identified by the CSSU staff, is that reports contain undetailed patient …

Promoting Safe And Effective Ciwa-Ar Protocol Adherence On An Inpatient Psychiatric Unit Through An Educational Reference Poster: A Quality Improvement Project, Kenan J. Gray

Master's Theses and Capstones

Abstract

Background: Alcohol withdrawal syndrome (AWS) can progress to seizures, delirium tremens, and autonomic instability. The Clinical Institute Withdrawal Assessment for Alcohol–Revised (CIWA-Ar) supports symptom-triggered AWS management, but safe use depends on timely nursing assessment, reassessment, and documentation.

Local Problem: On an adult inpatient psychiatric unit, chart audits identified CIWA-Ar protocol adherence gaps, including missed four-hour assessments and one-hour reassessments after lorazepam.

Methods: This quality improvement project used the Plan-Do-Study-Act model. Three educational reference posters were placed in high-visibility staff areas with QR-linked access to the facility’s AWS protocol and CIWA-Ar scoring guidelines. Outcomes were evaluated using pre- and post-intervention …

A Quality Improvement Initiative: Implementing An Effective Massive Transfusion Protocol Cognitive Aid Tool Within An Operating Room & Post-Anesthesia Care Unit Setting, Jenna L. Farrell

Master's Theses and Capstones

Abstract

Background: Massive Transfusion Protocol (MTP) activations are low-frequency, high-acuity events in the post-anesthesia care unit (PACU) setting.  These events necessitate the rapid formation of codes teams, interdisciplinary communication amongst unfamiliar providers, critical decision-making, high-volume rapid blood transfusions, and critical laboratory marker monitoring.

Local Problem: Due to the infrequent nature of hemorrhagic events in the PACU, nurses may have limited experience participating in these protocols at their institutions, resulting in potential for documentation errors from retrospective back charting, decreased confidence regarding blood product sequencing and laboratory draw timing, and increased cognitive workload overall.  This quality improvement (QI) project implemented …

Improving Nurse Well-Being And Patient Safety Through A Structured Break Buddy System: A Quality Improvement Project, Elizabeth Harrington

Master's Theses and Capstones

Abstract

Background: Nursing burnout has become an increasing concern due to heavy workloads, staffing shortages, and the inability of nurses to consistently take uninterrupted rest breaks during their shifts. Missed breaks contribute to fatigue, emotional exhaustion, decreased job satisfaction, and an increased risk of patient safety events. Evidence suggests that structured break interventions may improve opportunities for recovery during the workday.

Methods: A quality improvement (QI) project was conducted on a respiratory care unit at a midsized hospital in central New Hampshire using the Plan-Do-Study-Act (PDSA) framework. A microsystem assessment identified inconsistent break-taking as a significant gap. A five-question anonymous …

Increasing Nursing Education On Effective Therapeutic Communication For Postpartum Depression: A Quality Improvement Project, Kayley Jade Couture

Master's Theses and Capstones

Introduction
At a nonprofit hospital located in New Hampshire, a 5P assessment was completed to determine a gap in the nursing staff's education on postpartum depression on a labor and delivery unit. Through the use of instructional design, persistent education on postpartum depression shows an overall increase in knowledge resulting in better patient-centered care (Takei, 2023). An important aspect of this quality improvement project was the participation of the nursing staff.

Methods
Using the PDSA framework (Plan-Do-Study Act), registered nurses on a labor and delivery unit participated in a three week quality improvement project to test their knowledge on postpartum …

Ne 4-H Horse Show Bit And Spur Rules And Guidelines, Hannah Majewski, Extension

UNH Cooperative Extension

No abstract provided.

Ne 4-H Horse Forms And Scoresheets 2026, Hannah Majewski, 4-H

UNH Cooperative Extension

No abstract provided.

Do-Reflect-Apply In The Ring, Hannah Majewski

UNH Cooperative Extension

No abstract provided.

Selecting Plants And Informational Resources, Kat Kelleher

UNH Cooperative Extension

Considerations that go into plant selection on a site when thinking about creating resilient spaces that are able to provide more than one function.

Ecosystem Functions And Services - Landscaping For Water Quality (March 25, 2026 Gbnerr), Julia Peterson

UNH Cooperative Extension

No abstract provided.

Marketing Water Quality Friendly Services, Julia Peterson

UNH Cooperative Extension

No abstract provided.

Estuary, Kelle Loughlin

UNH Cooperative Extension

No abstract provided.

2026 Water Quality Considerations In Landscaping, Thomas Swenson

UNH Cooperative Extension

2026 Water Quality Considerations in Landscaping

Assessing And Understanding Soil Characteristics, Amy Papineau

UNH Cooperative Extension

No abstract provided.