Digital Commons Network^™

Positive Reinforcement In Leadership, Jen Lee Williams

M.S. in Leadership

This project examined whether leaders’ use of positive reinforcement
improves team retention, satisfaction, and performance across Generation
X, Millennials, and Generation Z. Jen Williams selected this topic due to the
rising turnover challenges and lack of consistent reinforcement training in
leadership practice. Using mixed-methods design, the study combined a
quantitative survey of 13 working professionals with a qualitative interview
from a Generation X leader participant. Results showed that over 92% of
the participants felt motivated by recognition, and 72% linked
reinforcement to increased satisfaction and desire to stay with their
organization. Generational differences appeared in frequency, authenticity,
and emotional sensitivity …

Improving Perinatal Outcomes With The Mood Disorder Questionnaire: A Quality Improvement Project To Increase Identification And Referral, Elizabeth R. Bargardo

Master's Theses and Capstones

Abstract

Background: Perinatal mental health is a growing concern, with under identification and lack of access to mental health as contributing factors. Screening tools such as the Mood Disorder Questionnaire are one way to increase identification of patients at risk for bipolar-spectrum disorders and subsequent postpartum psychosis and initiate referrals to appropriate mental health services.

Local Problem: One outpatient women’s health center has a 94% screening rate for the Edinburgh Postnatal Depression Score (EPDS) for anxiety and depression but has not implemented a screening for bipolar disorder. In addition, while approximately one in five perinatal patients struggles with a mental …

Nightmare, Phoebe E. Bowen

Honors Theses and Capstones

No abstract provided.

Sensory Need Or Treatable Behavior? Self-Stimulatory Behavior In Autism Spectrum Disorder: A Systematized Review, Anne Grace, Kathryne Brewer

Honors Theses and Capstones

This study examined the current dialogue about Autism Spectrum Disorder (ASD) and

self-stimulatory behavior (stimming), based on a systematized literature review. Stimming is

often framed as a maladaptive or disruptive behavior that negatively impacts autistic individuals.

It is important to investigate whether these claims are supported by current research. The

following research question was used to guide this paper: How does current research on ASD

conceptualize stimming, as a form of sensory self-regulation or a treatable behavior?

Reconceptualizing Madness: Charlotte Perkins Gilman's Autobiography And The Cultural Landscape Of Insanity, Gender, And The Illness Experience, Claire Paley

Honors Theses and Capstones

No abstract provided.

Project Tackle 12 Years Of Cia And Taiwanese Joint Reconnaissance Overflights, Maximilian Digiovanni

Honors Theses and Capstones

Project TACKLE was a joint collaborative project between the CIA and the Taiwanese government to facilitate U-2 spy plane missions flown by Taiwanese pilots over China. These missions, conducted from 1962 to 1974, provide critical insights regarding the US and Taiwan’s fluctuating relationship during this period. TACKLE missions played a crucial role in informing policymakers on a variety of subjects, such as the progress of China’s rapidly evolving nuclear weapons program. This paper situates the TACKLE missions within the broader political context of their time to highlight the constant prioritization challenge that plagued the program.

Hit Me, Baby, One More Time: A Critical Discourse Analysis Of The Celebrity Gossip Magazine Shaming Of Britney Spears, Anna Rae Drabik

Honors Theses and Capstones

Britney Spears is an American pop star who rose to fame in the late 1990s at the age of 17 with her music, performances, and fashion. Spears was a prominent figure in celebrity gossip magazines, a genre which grew to prominence alongside and, in many ways, because of Spears. The distinct aesthetic and style of celebrity gossip magazines involved stories, blurbs, and images which wielded praise and shame—directly and indirectly—as tools to enforce norms and expectations for both female celebrities and female readers. Through a critical discourse analysis of 378 People and Us articles throughout the first ten years of …

A Study In The Student Experience Of Care – What It Looks, Sounds, And Feels Like For Students In A Rural Public High School, Steven Mark Chamberlin

Doctoral Dissertations

Students' voices are essential to understanding their perceptions, experiences, and viewson care. Many schools prioritize standardized test outcomes over individual care for each child, which leads to disengagement and a lack of agency. Students who feel cared for tend to achieve greater success in school.

This question guided the inquiry: How do students perceive, experience, and understandcare in their secondary school in New Hampshire? Twelve individual interviews were conducted with students who had varying degrees of academic success and special education identification.

The findings led to the development of a preliminary model of care that establishesschool culture as the foundation …

The Impacts Of Social Media On Teacher Environment Perceptions, Victoria Puglia

Doctoral Dissertations

Social media significantly influences teachers’ perceptions of their professional environment, shaping job satisfaction, respect, autonomy, and professional support. This dissertation, split into three articles, investigates how exposure to positive, negative, or mixed social media posts impact these perceptions, addressing concerns surrounding teacher well-being and attrition in K-12 education. The study began with a literature review in Article 1 to establish a theoretical framework, followed by a series of validation steps to refine a survey instrument aligned with teaching perception constructs in Article 2. The final survey was administered to 406 K-12 teachers across the United States in Article 3, using …

Feeding With Competence: Empowering Parents In Ng Feeding For Nicu Graduates: A Quality Improvement Project, Karen Marsh

DNP Scholarly Projects

Abstract

Background: Infants who are born prematurely stay in a neonatal intensive care unit (NICU) until they are able to take full enteral nutrition by mouth. While in the NICU a nasogastric tube (NG tube) would be used to supplement the volume needed to be ingested for optimal nutrition. Infants typically feed better with a consistent caregiver and at home in an environment with less stimulation. Allowing infants to be discharged with an NG tube allows the parents to be more involved in their infant's care with a shorter hospital stay. An increased number of infants being discharged home with …

Implementation Of Outpatient Cervical Ripening In The Community Hospital Setting: A Quality Improvement Process, April St Hilaire

DNP Scholarly Projects

Background: Cervical ripening is a critical component of labor induction. Outpatient cervical ripening using mechanical dilators offers a safe patient- centered alternative to inpatient management, with potential benefits in efficiency and patient satisfaction and cost savings.

Local Problem: At a community hospital setting with increasing induction rates, prolonged admission-to-delivery times and prolonged patient stays were observed in patients undergoing inpatient cervical ripening, prompting a need for more efficient, patient centered approaches.

Methods: Using the Plan-Do-Study-Act (PDSA) framework, an outpatient cervical ripening protocol was implemented over a 15-week period to compare inpatient versus outpatient cervical ripening using mechanical …

Optimizing Electronic Health Record Capability To Provide Mindfulness Education To Oncology Patients Experiencing Anxiety, Cynthia Arcieri

DNP Scholarly Projects

Background: The impact of a cancer diagnosis is significant. In 2020, the Centers for Disease Control (CDC) reported over 1.6 million new cases of cancer (National Institutes of Health, 2023). Non-traditional approaches to supporting patients should be considered in providing high-quality cancer care. Mindfulness can help reduce stress reactions and may be beneficial for individuals with anxiety (Vinci et al., 2019). To best support patient care in the landscape of mobile health (mHeatlh) technology, it is essential to adopt best practices that promote patient engagement and empowerment.

Purpose: This quality improvement project aimed to provide oncology patients with a cognitive …

A Quality Improvement Project To Enhance Chronic-Condition And Self-Care Knowledge In Adolescents With Spina Bifida, Ann Paris

DNP Scholarly Projects

Background: Spina Bifida is the most common central nervous system disorder in the United States (CDC, 2024). Even with early surgical repair, patients may have chronic, disabling, multisystem needs (Phillips et al., 2017). Adequate care of Spina Bifida requires a multidisciplinary approach. As such, patients with spina bifida require multiple specialty providers, clinic appointments, care-tasks, and interventions (CDC, 2024, Phillips, et al., 2017). Synthesizing information from multiple care providers can be daunting, especially for adolescents as they grow more autonomous in their care, and especially as they enter the age of pediatric-to-adult transition (Psihogios et al., 2015).

Purpose: …

Enhancing Resilience In Oncology Nurses Through The Implementation Of A Peer Support Program, Denise M. Robinson-Smith

DNP Scholarly Projects

ABSTRACT

Background: Oncology nurses face high rates of burnout and compassion fatigue, contributing to significant turnover and threatening the stability of the oncology nursing workforce. The projected increase in cancer incidence and the resulting demand for oncology services underscore the urgent need for interventions that enhance nurse resilience. Local Problem: At a major hospital in Jacksonville, Florida, it was found that oncology nurses face a significant gap in emotional support, especially during critical incidents such as patient deaths or traumatic events. Existing resources were insufficient to address the unique stressors faced by this team. Methods: A quality …

Implementation Of A Standardized Educational Training Series For Anaphylaxis Recognition And Epi-Pen Administration To Non-Licensed Personnel In A School Setting, Katherine T. Darak

DNP Scholarly Projects

Background: Anaphylaxis is a life-threatening allergic reaction that requires early recognition and administration of intramuscular epinephrine. In the elementary school setting, non-licensed personnel are often the first staff to identify this, making training and preparedness essential. This quality improvement project aims to enhance school personnel knowledge, confidence, and competence in recognizing and managing anaphylaxis through a standardized educational training series.

Purpose: The purpose of this quality improvement project aimed to increase the knowledge, confidence, and competence of non-licensed personnel in managing and responding to anaphylaxis in the school setting. Participants accessed the educational module and hands-on training interventions …

2024 U.S. Globe Partner Yearbook, Globe U.S. Coordination Office

Partner Yearbooks

No abstract provided.

The Forms Of Representation: How To Be A Kantian Realist, Willem A. Devries

Faculty Publications

Sellars argued that Kant did not make certain distinctions concerning space and time, and because of this adopted his transcendental idealism. Once these distinctions are made, the path to realism remains open. Sellars' argument is not entirely clear. This essay attempts to clarify the argument, showing why Sellars believed he could remain a scientific realist while also adopting a Kantian style epistemology.

Introducing A Paper Communication Alternative For Emergency Department Nurse-Technician Delegation To Promote Workflow Efficiency: A Quality Improvement Project, Grant Quinn

Master's Theses and Capstones

Background: Efficient and high quality communication is paramount in the emergency department setting, especially between registered nurses (RNs) and emergency department technicians. In a fluid and high-octane microsystem, poor communication can lead to missed or delayed delegated tasks, which harm teamwork and patient safety and outcomes.

Purpose: By introducing a low-cost, paper-based communication alternative to this microsystem into the workflow it is expected that perceived ease of use and communication quality will both increase when surveying department staff. This intervention offers an alternative means of communicating with the goal of improving communication overall in the microsystem.

Methods: Through use of …

A Quality Improvement Initiative: Enhancing Knowledge And Confidence In Effective Eclamptic Seizure Management Among Maternity Nurses, Emma C. Donigian

Master's Theses and Capstones

Background: Preeclampsia and eclampsia (PE/E) are leading contributors to maternal morbidity and mortality rates globally. Timely recognition and intervention are essential for improving maternal outcomes. However, evidence indicates that healthcare professionals often lack sufficient knowledge and confidence in managing these conditions, highlighting a critical need for ongoing education to ensure safe, effective care.

Local Problem: At a small maternity unit in Northern New England, nurses expressed concern about their preparedness to manage eclamptic seizures, a rare but high-risk obstetric emergency. Although preeclampsia is commonly encountered, eclampsia occurs infrequently, limiting staff exposure and hands-on experience. This combination of low frequency and …

Strafford County 2024 Annual Report Of The Commissioners, Treasurer, Other County Officers, And The Strafford County Delegation For The Year Ending December 31, 2024, Strafford County Representatives

Strafford County, NH Annual Reports

This is an annual report containing vital statistics for 2024 for Strafford County in the state of New Hampshire.

Hit Me, Baby, One More Time: A Critical Discourse Analysis Of The Celebrity Gossip Magazine Shaming Of Britney Spears, Anna Drabik

Comm-entary

Britney Spears is an American pop star who rose to fame in the late 1990s at the age of 17 with her music, performances, and fashion. Spears was a prominent figure.

in celebrity gossip magazines, a genre which grew to prominence alongside and, in many ways, because of Spears. The distinct aesthetic and style of celebrity gossip magazines involved stories, blurbs, and images which wielded praise and shame—directly and indirectly—as tools to enforce norms and expectations for both female celebrities and female readers. Through a critical discourse analysis of 378 People and Us articles throughout the first ten years of …

2025 Cheshire County Advisory Council Agenda & Minutes, Diane Dugray

Advisory Council

No abstract provided.

Model Horse Show, Diane Dugray

UNH Cooperative Extension

No abstract provided.

A Quality Improvement Project: Increasing Nurse Satisfaction With Patient Educational Material Related To Pain Management Options During Labor, Madison Grant

Master's Theses and Capstones

BACKGROUND:

Pain management is a large portion of what nurses manage during the patient’s time on the labor and delivery unit. The primary forms of pain management that is available to women during this time includes epidurals, nitrous oxide, stadol/diphenhydramine, and nonpharmacological options such as breathing techniques. It is essential that patients are aware of all pain management options prior to entering the unit for delivery, however sometimes nurses have to help to close the educational gap.

LOCAL PROBLEM:

Within the microsystem, it was acknowledged that many patients lacked the education of their pain management options prior to delivery which …

Implementing Nurse-Driven Education On Patient’S Inpatient Boarding Status: An Emergency Department Quality Improvement Project, Jack Wallace

Master's Theses and Capstones

BACKGROUND:

Nurse-led education to inpatient boarding patients in the emergency department is essential to improve patient’s understanding with their care and nurse’s satisfaction surrounding communicating with their patients. Inpatient boarding in the emergency department is associated with poor patient outcomes, adverse events, and reduced communication between patient and nurse.

LOCAL PROBLEM:

Within this microsystem there is a gap in patient understanding of their admission status. This includes who the patient’s provider is, which provider to direct questions to, and why the patient is still in the emergency department.

METHODS:

The plan-do-study-act quality improvement framework was utilized to improve nurse-led patient …

Timing And Temperature Of Newborn Baths: A Qualitative Improvement Initiative Through Nursing Staff Development, Eileen Harwood

Master's Theses and Capstones

Abstract

BACKGROUND: Newborn bathing is a common task performed in a labor and delivery unit of a hospital, a newborn’s bath temperature, timing and how long it is performed, are important metrics to consider. Due to a newborn’s immature thermoregulation, there are multiple implications that come with receiving a bath that is not an optimal temperature or that is too soon after birth. As newborn bathing is often overlooked task due to its quotidian nature, a literature review of current evidence-based practice revealed the urgency to keep the optimal conditions at the forefront of considerations for both nurses and caregivers. …

A Quality Improvement Initiative To Enhance The Effectiveness Of Pre-Anesthesia Documentation And Nurse Satisfaction In The Pacu, Stephanie Colon

Master's Theses and Capstones

Background: Documentation is an essential component of healthcare delivery, especially in perianesthesia nursing. Electronic health records (EHR) have helped create high-quality documentation according to the standards of the American Nurses Association. However, EHRs have been found to be burdensome on nurses when they interfere with their workflow.

Local Problem: The documentation process for pre-operative anesthesia assessments within a nine bed PACU in Southern New Hampshire was found to be inefficient, increased chances of error or mistakes, and delayed patient data being accessible to the team.

Methods: Using the Plan-Do-Study-Act (PDSA) model, a quality improvement project was performed to update and …

A Quality Initiative To Reinforce Nursing Staff Education On Fall Prevention Interventions To Enhance Patient Safety And Outcomes On A Medical-Surgical Unit, Jolena Senesombath

Master's Theses and Capstones

Background:

Patients are at an increased risk for falls on a medical-surgical unit due to a variety of factors such as increased age, medications, altered mobility, and more. Several fall prevention interventions are used to prevent falls, including use of call bells, bed and chair alarms, maintain a clutter free environment, using a fall risk assessment upon admission, and providing patient and staff education. Reinforcing education for nursing staff has been shown to be one of the most effective interventions in preventing and reducing the number of falls as it increases awareness of falls.

Local Problem:

Within the microsystem, patient …

Improving Intensive Care Unit Nurses' Knowledge And Confidence In Performing Effective Spontaneous Awakening Trials: A Quality Improvement Project, Sophia T. Merry-Carreiro

Master's Theses and Capstones

Abstract

BACKGROUND

Mechanically ventilated ICU patents often require sedation for comfort and ventilator compliance. However, oversedation is linked to negative outcomes such as delirium, prolonged ventilation, and increased duration of ICU stay. Current best practices now support the use of daily sedation interruptions such as Spontaneous Awakening Trials (SATs). Despite these recommendations, implementation of SATs remain inconsistent and suboptimal.

LOCAL PROBLEM:

Within the ICU in a northern new England hospital, there was a need to improve nurse confidence and knowledge in SATs practices through staff education.

METHODS:

Using the Plan-Do-Study-Act (PDSA) model, a quality improvement project was developed to improve …

Enhancing Patient Safety By Increasing Daily Weight Measurement For Intensive Care Through Nursing Education: A Quality Improvement Project, Liz Prior

Master's Theses and Capstones

Background: For critically ill patients in the Intensive Care Unit (ICU), accurate daily weight measurements are crucial for monitoring fluid status and ensuring correct medication dosages. However, variations in measurement techniques, accuracy, and documentation can render this data unreliable. This often leads to a reliance on less accurate measures, which may contribute to longer treatment courses and suboptimal patient outcomes.

Local Problem: At a 3-bed ICU in a critical access hospital, staff interviews revealed inconsistencies among nurses in the daily measurement of patient weights. The lack of a standardized protocol created barriers to the usefulness of serial daily weight data. …