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 …

Prioritizing Safety Through Evidence-Based Fall Prevention Signage: A Medical-Surgical Quality Improvement Project, Sonila Murati

Master's Theses and Capstones

Background: Falls in the inpatient setting can result in prolonged hospitalization, injury, and increased healthcare costs. Older adult patients are particularly vulnerable due to age-related physiological decline and comorbidities, underscoring the need for effective fall prevention strategies.

Local Problem: In a medical-surgical telemetry unit at a New Hampshire hospital, monthly patient falls continued to be a persistent concern. Leadership identified inconsistent adherence to fall precautions as a key contributing factor, particularly concerning a predominantly older adult population with high fall risk. This project aimed to reduce preventable falls by reinforcing staff awareness through visual reminders.

Methods: Guided by the Plan-Do-Study-Act …

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. …

A Quality Improvement Initiative To Reinforce Education To Increase Nurses’ Knowledge And Confidence In Patient-Centered Labor Positioning, Larkyn Baum

Master's Theses and Capstones

Background: Cesarean section (CS) delivery is an important and necessary intervention, yet comes with increased risks to the patient and fetus compared to vaginal birth. CS rates have been increasing globally, and implementing interventions to promote vaginal birth, especially for nulliparous, term, singleton, vertex (NTSV) patients is of interest to patients, providers, and institutions.

Local Problem: In 2024, the CS rate within the microsystem was 32%, more than double the WHO-recommended benchmark of 10–15%. Of all CS deliveries in 2024, 31% were nulliparous, term, singleton, vertex (NTSV) patients, who are considered optimal candidates for vaginal delivery. Given the elevated rate …

Enhancing Triage Accuracy And Nursing Confidence Of The Emergency Severity Index To Improve The Effectiveness Of Triage Through Targeted Education: An Evidence-Based Quality Improvement Project, Mia K. Saucedo

Master's Theses and Capstones

Background: The Emergency Severity Index system is a standardized triage scoring guide used by emergency department nurses to efficiently assess patients based on severity and projected recourse needs. Studies have found that knowledge and confidence gaps among nurses may lead to improper triage score, leading to the misallocated spread of resources and longer wait times, increasing rates of morbidity and mortality. Early recognition of patient severity is vital for providing proficient patient care and improving patient outcomes and increased education is needed to improve this gap in nursing knowledge and confidence.

Local Problem: At a small, critical care access center …

Reinforcing Nursing Staff Knowledge For Accurate Cam-Icu Assessment And Documentation In A Medical Icu: A Quality Improvement Project, Tiffany Rzepka

Master's Theses and Capstones

Background: Delirium is an acute state of confusion that can lead to increased morbidity and longer hospital stays. Patients in the ICU are at high risk for developing delirium due to additional risk factors such as mechanical ventilation and sedation. The Confused Assessment Method for the Intensive Care Unit (CAM-ICU) is a tool used by nursing staff to document and assess for delirium.

Local Problem: The microsystem in this project is a 16-bed medical ICU in central New Hampshire. In the microsystem, CAM-ICU documentation compliance is tracked monthly, but the accuracy of the documentation is not routinely assessed. Stakeholders have …

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 …

Directing Patient Hand Hygiene Before Meals In The Icu: A Quality Improvement Project To Enhance Patient Safety, Nicholas Davini

Master's Theses and Capstones

BACKGROUND:

Hospital-acquired infections (HAIs) are a major problem in healthcare, increasing patient morbidity, mortality, and costs. While staff hand hygiene is a well-established infection control measure, less attention is paid to patient hand hygiene (PHH) despite CDC recommendations.

LOCAL PROBLEM:

An intensive care unit (ICU) in northeastern Massachusetts had no formal policy for patient hand hygiene, and hospital leadership expressed support for enhancing infection control practices.

METHODS:

Using the Plan-Do-Study-Act model, a quality improvement project was implemented to encourage PHH before meals. Baseline PHH rates were collected through observation. The intervention involved registered nurses (RNs) directing patients to use hand …

Optimizing Surgical Count Accuracy And Efficiency Through Enhanced Operating Room Communication To Promote Patient Safety: A Quality Improvement Project, Jessica L. Limbocker

Master's Theses and Capstones

Abstract

Background: Retained surgical items (RSIs) are classified as “never events” because they are preventable and pose significant risks to patient safety. This quality improvement (QI) project aimed to reduce the risk of RSIs, particularly during Cesarean sections by identifying gaps in surgical count practices and implementing targeted interventions.

Local Problem: At the project site, baseline assessments revealed gaps in surgical count practices. These included inconsistent documentation, absence of formal education on count procedures, and communication barriers among the intraoperative team—all contributing to increased risk of RSIs.

Methods: This QI project implemented a multi-faceted intervention to enhance …

Enhancing Patient-Centered Suicide Prevention: A Quality Improvement Project Addressing Educational Gaps In Staff Caring For Veterans, Shayla Craigue

Master's Theses and Capstones

Veterans are at significantly higher risk for suicidal ideation (SI) than the general population and often encounter barriers to care such as stigma, trauma, and distrust in healthcare systems. This quality improvement project, conducted at a Veterans Affairs (VA) Urgent Care Clinic, aimed to enhance trauma-informed care by addressing educational gaps among clinical staff. Using the Plan-Do-Study-Act (PDSA) model, the intervention included a pre-intervention survey to assess baseline knowledge, a targeted educational poster informed by survey findings, and a post-intervention survey to measure changes in staff confidence, resource awareness, and understanding of the role of the mental health response team, …

Enhancing Patient Safety And Nursing Satisfaction In The Operating Room By Implementing Standardized Handoff Communication Sheets: A Quality Improvement Project, Hayleigh Mcneil

Master's Theses and Capstones

Background: Communication is essential to workflow in the operating room. In this microsystem, circulating nurses required relief nurses when necessary breaks were needed. Written communication allows for nurses to quickly access information when they are giving handoff reports.

Local Problem: An operating room in a trauma level two hospital in New England had a verbal handoff that was inconsistent and left relief nurses with incomplete reports. This issue caused a decrease in nursing satisfaction with a potential decrease in patient safety.

Methods: Using the Plan-Do-Study-Act model, a written standardized communication sheet was created and implemented. Data was …

A Quality Improvement Project: Increasing Pre-Term Infant Safety By Enhancing Skin-To-Skin Time In The Nicu, Maureen A. Cassidy

Master's Theses and Capstones

Background: Skin-to-skin (STS) contact, also known as kangaroo care, is a critical intervention for preterm infants, especially for those in the neonatal intensive care unit (NICU). It promotes neurodevelopmental outcomes, physiological stability, and parental bonding. However, STS often falls below recommended daily levels due to a variety of berries. Exploring aids like belly bands may help address these barriers and promote improved outcomes.

Local Problem: STS time in this NICU microsystem falls significantly below nationally recommended levels, with most preterm infants receiving less than one to two hours daily compared to the World Health Organization’s recommendation of 8-24 hours per …

Globe Resources For 2025 Summer Reading Programming, Haley F. Wicklein, Globe U.S. Coordination Office

Teacher Resources

No abstract provided.

Globe And Natural Inquirer Crosswalk Ms/Hs: Studying Air Quality And Aerosols, Alicia Carlson, Globe U.S. Coordination Office

Teacher Resources

No abstract provided.

An Active Playful Learning Guidebook For New Hampshire Early Childhood Educators, Unh Early Childhood Education Coaching Initiative, Jennifer Berube, Sarah Bond, Karen Dubois-Garofalo, Kimberly Nesbitt

Play-Based Learning Coaching and Teaching

No abstract provided.

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.

Phosphodiesterases (Pdes) As Potential Targets For Disrupting The Life Cycle Of Nematodes Using Molecular And Chemical Agents, Kranti Galande

Doctoral Dissertations

There are nearly 4,100 species of plant-parasitic nematodes that pose a serious threat toglobal food security, and it is estimated that about $100 billion of crops are damaged annually due to these plant parasitic nematodes. Also, animal-parasitic nematodes pose a major global health challenge, impacting approximately 3.5 billion individuals annually, particularly in tropical and developing areas. PDEs are significant determinants of cellular levels of cyclic nucleotides because the process of lowering active intracellular cyclic nucleotide second messengers (cAMP and cGMP) in cells is mediated through PDEs. Nematode behavior and lifecycle depend on cyclic nucleotide signaling. However, at present, there is …

Eelgrass Distribution In The Great Bay Estuary And Piscataqua River For 2024: Final Project Report Submitted To The Piscataqua Region Estuaries Partnership, Michael Routhier, Raymond Grizzle, Taylor Goddard, Krystin Ward

PREP Reports & Publications

No abstract provided.

Seagrassnet Monitoring In The Great Bay Estuary, Nh/Me Field Season 2023, Kalle Matso, Lara Martin, Trevor Mattera, Thomas Gregory, David M. Burdick, Christopher Thomas Whitney

PREP Reports & Publications

No abstract provided.

Cultivating Plain Language Skills For Engineering Students, Catherine Wong, Cynthia Carlson

Faculty Publications

While engineers are learning the vocabulary of the profession, understandably, they want to practice, and perhaps show their professors that they are proficient. This leads to student writing that is overly complicated and full of jargon. This is not the type of document that would be clear to the public, or even to a professional outside of the narrowly focused field of the particular engineer. After graduation, engineers’ writing becomes exponentially more important. Often approval of projects relies on residents’ or clients’ understanding of engineers’ work. For example, an engineering firm completing an investigation of an important health concern such …

Data Literacy Competencies In Context: Employee Perspectives From The Workplace, Patricia Condon, Wendy G. Pothier

Faculty Publications

Data literacy is essential in today’s workplace, and professionals across roles and experience levels recognize its value. This article reports on findings from interviews with 16 supply chain and logistics professionals. The study examines how seven proposed data literacy competencies align with workplace needs, how employees address the data literacy gap, and how librarians can support workforce readiness. Findings highlight opportunities for libraries to bridge the data literacy gap through instruction and resources development that integrate technical and non-technical data skills with information literacy.

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 …

Wellness Wheel Action Guide Fillable Form, Michele Kroll

UNH Cooperative Extension

No abstract provided.

Brewdog Case Study, Kate Daugherty-Miller

Comm-entary

No abstract provided.

Mythic Criticism Of Spider-Man: Across The Spider-Verse, Grace Cushing

Comm-entary

No abstract provided.

Nine Dragons, Bailey Fraser

Comm-entary

No abstract provided.

Public Health: The Ethical Potential For Applied Neuromarketing, Olivia Buzzell

Comm-entary

No abstract provided.

The Pussyhat And Performative Activism: What Happens When Protest Becomes Fashionable?, Layla Hanissian

Comm-entary

No abstract provided.

2025 Cheshire County Advisory Council Agenda & Minutes, Diane Dugray

Advisory Council

No abstract provided.

Strafford County Advisory Council 2025 Meeting Minutes, Cooperative Extension

Advisory Council

No abstract provided.