Approaching A Companion Document For Business: Applications Of The Framework In Business Information Literacy, Lumarie Guth, Ilana Stonebraker, G. Arave, Patricia Condon, Grace Liu, Wendy G. Pothier

Faculty Publications

Business librarians have yet to create a companion document to the ACRL Framework for Information Literacy for Higher Education but instead have developed a rich resource bank of instructional materials with examples of how the Framework can be practically applied in business librarianship.1 With the absence of a formal companion document, the authors of this chapter took a wide view to better understand how the Framework has been used by business librarians since its inception. In addition to the Framework, business librarians have sought to align their work with discipline-specific documents including the Association to Advance Collegiate Schools of Business …

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 …

Research Report: Cold-Hardy Hydrangeas For Landscape And Cut Flowers, Rebecca G. Sideman, Kaitlyn Orde, Ella Lukacz, Cathy Neal

Faculty Publications

This research report describes the performance of several cold-hard “panicle” (H. paniculata), “smooth” (H. arborescens), and “oakleaf” (H. quercifolia) hydrangea as landscape plants and for cut flower production in Durham, NH. We established a replicated planting of sixteen newer hydrangea cultivars at Woodman Farm in summer 2020. Preliminary data from these young shrubs indicates that there are wide differences in flower production, stem quality, flowering time and duration, and postharvest floral quality – among other traits.

Skills Evaluation Of Adjunct Nursing Faculty: A Quality Improvement Project, Ada Dimino Luong

DNP Scholarly Projects

Abstract

BACKGROUND: With rising student enrollment, colleges and universities are relying more on adjunct clinical nursing faculty as Clinical Nurse Educators (CNEs). Recruiting and retaining qualified CNEs is essential to high-quality clinical education. Although clinically proficient, CNEs may face challenges with teaching methods, instructional strategies, and formative feedback. This quality improvement (QI) project evaluated CNE’s competencies and developed a sustainable multimedia educational tool to enhance feedback skills in clinical education.

METHODS: The Academic Clinical Nurse Educator Skill Acquisition Tool (ACNESAT), a validated 40-item Likert-scale instrument created by Shellenbarger and Sebach, was used to assess CNE competencies. Pre and post intervention …

Improving Transitions In Care: The Post-Discharge Follow-Up Process For Va Hospitalizations, Kristina Huntoon

DNP Scholarly Projects

BACKGROUND: Transitions in care from hospitalization to home are a high-risk period for patients. Without care coordination during these transitions in care, patients are left trying to manage their care without any support. The VA has a mandated two-day post-discharge contact process that requires a member of the patient’s primary care team to contact the patient within two business days of a VA discharge.

METHODS: The Plan-Do-Study-Act method of quality improvement was used for this project. Baseline assessment included review of patient medical records for 15 months before the intervention, which included 27 discharges from unit 78C. The patient medical …

A Care Expansion Initiative: Providing Awareness And Access To Resources For Patients With Celiac Disease: A Quality Improvement Project, Jennifer Kumin

DNP Scholarly Projects

Background: Celiac disease (CD) is projected to be the most common genetic autoimmune disease in the world with 1% or 3 million people effected in the United States. It is estimated that as many as 70% of those effected are not aware. Diagnosis routinely takes 10-12 years from the initial onset of symptoms, exposing patients and the healthcare system to significant cost and stress through excess testing and misdiagnosis. One area that is often referenced in barriers around celiac disease is the lack of awareness and education specifically with patients, healthcare providers, and the community at large.

Methods: In this …

Critical Incident Debriefing: Impact On Oncology Nurses And The Infusion-Related Reaction Care Bundle, Megan A. Corbett

DNP Scholarly Projects

Background: A critical incident is a sudden, unexpected, emotionally distressing event commonly experienced by oncology nurses. Debriefing is an evidence-based best practice that facilitates communication, reflection, and learning to identify quality improvement opportunities to enhance clinical practice, patient safety, and quality of care. However, debriefing within oncology care settings is inconsistent despite the demonstrated benefit and availability of frameworks. Infusion-related reaction management follows an algorithm that directs care delivery, aligning with a care bundle approach. Care bundles, when consistently and reliably applied, help identify connections between the critical incident (i.e., infusion-related reaction) and opportunities for improvement to ensure clinicians follow …

An Integrated Approach To Patient Safety In The Medical Device Industry: A Quality Improvement Project, Kaylee Boisvert

DNP Scholarly Projects

Background: The currently established product surveillance process at Boston Scientific is a reactive one which presents compliance risks, patient safety risks, and quality risks. Evolution to a proactive process is necessary to protect public health, allow for commercialization of devices that have a robust safety, reliability, and efficacy profile, and to identify and react to risk before or at the early stages of a problem.

Methods: A pre-implementation survey of baseline opinions associated with decision-making, efficiency, effectivity, and safety of the current product surveillance system was performed. A baseline time study was performed associated with the process, which was separated …

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 …

Effective Measurement-Based Care For Depression Within Va Health Systems: A Quality Improvement Initiative, Amie L. Doyle

DNP Scholarly Projects

Background: Depression is highly common among U.S. veterans, surpassing civilian rates. Measurement-Based Care (MBC), including the Patient Health Questionnaire-9 (PHQ-9), facilitates systematic symptom monitoring and treatment enhancement. At Manchester VA Medical Center (VAMC), PHQ-9 completion in primary care was low (18.93% in May 2025) due to workflow inefficiencies, provider workload, and dependence on Mental Health Service Line (MHSL) referrals.

Local Problem: Underutilization of the PHQ-9 in primary care hampers early detection and effective treatment of depression among veterans.

Methods: Four primary care teams received training on using the Behavioral Health Laboratory (BHL) software, which facilitates pre-visit electronic completion of the …

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 …

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 …

A Quality Improvement Initiative To Improve Nurse Reassessment And Documentation Of Administered Prn Pain Medication, Stacy L. Brady

DNP Scholarly Projects

BACKGROUND: Effective pain management remains a critical challenge both globally and with the United States, where more than 51 million adults suffer from pain. Veterans are particularly vulnerable due to the lasting impact of service-related injuries. “Pro re nata” (PRN or “as needed”) pain medications are frequently used to manage pain, but timely reassessment and documentation following a PRN pain medication administered is often missed or delayed. Reassessing and documenting the results after the administration of the PRN pain medication is required by The Joint Commission and the Veterans Affairs Providence Healthcare System’s (VAPHS) standard operating procedure (SOP) states reassessment …

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 …

Developing A Rural Family Health Curriculum To Promote Retention Of New Graduate Nurse Practitioners, Molly G. Boudreau

DNP Scholarly Projects

Background: There is a critical shortage of primary care providers (PCPs) in rural areas of the United States. Nurse Practitioners (NPs) are essential for addressing the primary care shortage especially in rural communities. However, significant barriers exist to the retention of NPs in rural communities, especially new graduate NPs in the first year of practice. Evidence in the literature suggests bolstering the focus on transition-to-practice for new graduate NPs to improve retention and turnover rates.

Purpose: The aim of this quality improvement project was to develop a structured, postgraduate, on-boarding curriculum at a rural outpatient family medicine clinic with the …

Promoting Rapid Identification Of Oncological Emergencies In The Emergency Department : A Quality Improvement Project, Christine Hart Brown

DNP Scholarly Projects

BACKGROUND: The American Cancer Society estimates 2,041.90 new cases of cancer in the U.S. (1 in 18 Americans) with a global projection of thirty-five million new cases annually by 2050. With this alarming increase, early recognition of oncological emergencies in the Emergency Departments is essential. Life-threatening conditions require rapid assessment, accurate diagnosis, and immediate interventions. Qualified emergency nurses must understand the effects that cancer and treatment have on the immune, metabolic, and hematologic systems. This quality improvement (QI) project focuses on assessing emergency nurses’ oncological knowledge of acute emergencies and providing a resource for rapid identification.

PROBLEM STATEMENT: …

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 …

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 …

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. …

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. …

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 …

Enhancing Patient Outcomes And Safety By Reinforcing Nursing Staff Education About Fall Risks And Prevention In The Orthopedic Unit: A Quality Improvement Project, Sarah S. Walsh

Master's Theses and Capstones

Abstract

Background: Inpatient falls remain a significant concern for orthopedic units, especially among elderly post-surgical patients. Despite existing protocols, fall incidents persist due to various modifiable and non-modifiable risk factors. Nursing staff play a critical role in fall prevention, and targeted education is essential to reinforce best practices.

Local Problem: The orthopedic microsystem reported 13 falls during the 2023–2024 fiscal year, with contributing factors including post-operative weakness, patient confusion, and inconsistent communication. Staff surveys revealed gaps in education, awareness, and communication related to fall incidents.

Methods: A quality improvement initiative using the Define, Measure, Analyze, Improve, Control (DMAIC) model was …

Educating Staff On Effective Ways To Improve Medication Discharge Instructions In Emergency Departments (Ed): A Quality Improvement Project, Isabelle L. Kuhn

Master's Theses and Capstones

Background: Emergency Departments (EDs) serve a vital role in treating acute conditions, yet they face challenges in ensuring patients understand discharge instructions, particularly those related to medications. Approximately 70% of ED patients demonstrate deficits in at least one discharge domain, including medication understanding. Limited health literacy, time constraints, and rushed environments contribute to these gaps. Improving discharge communication is critical to reduce medication errors and prevent avoidable readmissions.

Local Problem: In a Northern New England ED, an assessment of the microsystem highlighted that patients often struggled to understand medication discharge information, increasing the risk of non-adherence and readmission. …

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, …

Improving Nurse Knowledge And Attitudes Through Education On Integrative Pain Management In A Medical-Surgical Unit: A Quality Improvement Project, Samantha Hamilton

Master's Theses and Capstones

Abstract

Background: Pain management in medical-surgical microsystems is complex, with many patients experiencing acute and chronic pain that can be difficult to control. Nurses often receive limited continuing education on integrative and comprehensive pain management strategies, highlighting a need to improve their knowledge and attitudes toward evidence-based, multimodal approaches.

Local Problem: Nurses in this 38-bed medical-surgical microsystem identified a gap in education related to integrative pain management strategies. This may lead to a reliance on pharmacological interventions and missed opportunities for holistic, patient-centered care

Methods: A 25-day quality improvement project was conducted using an asynchronous educational PowerPoint on integrative …

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 …

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.