Digital Commons Network^™

Improving Postpartum Depression Education Within The Microsystem, Mackenzie A. Sturdevant

Master's Theses and Capstones

BACKGROUND: Postpartum depression (PPD) is a significant mental health issue affecting a substantial percentage of new mothers, ranging from "baby blues" to severe forms like postpartum psychosis. Maternity nurses play a crucial role in early detection and education due to the gap in postpartum care follow-up appointments, which can delay necessary interventions.

LOCAL PROBLEM: Despite the critical role of maternity nurses, there is variability in their preparedness to educate and support patients regarding PPD during the immediate postpartum period. This study aims to enhance maternity nurses' knowledge and confidence in providing PPD education through a quality improvement (QI) project within …

Improving Patient Handoff In The Emergency Department Microsystem, Alahna V. Kinney-Sandefur

Master's Theses and Capstones

Abstract

Background: Gaps in communication in the patient handoff process have been directly linked to patient safety errors and unwanted patient outcomes. The reviewed literature highlights multiple factors impacting the handoff process and unanimously conclude that a standardized handoff process is necessary in maintaining a high standard of patient safety and a minimization of safety errors.

Methods: This intervention took place in an 86-bed, acute care facility, a level III trauma center macrosystem with implementation of this project taking place in the emergency department and medical/surgical microsystems. Utilizing the Plan, Do, Study, Act framework over a total of eight weeks, …

Sensory Modulation Training To Reduce Restrictive Interventions On An Acute Inpatient Psychiatric Unit At A Secure Psychiatric State Hospital: A Clinical Nurse Leader Quality Improvement Project, Fionna Norman

Master's Theses and Capstones

Abstract

Background: Symptoms of severe mental illnesses can result in Personal Safety Emergencies (PSE’s) in the acute in-patient psychiatric setting. As part of treatment of PSE’s, restrictive interventions such as seclusion are utilized in current practice to maintain the safety of the patient, peers, staff, and the environment. Evidence-based research has shown restrictive interventions can cause physical and psychological harm to both patients and staff. Reducing restrictive interventions continues to be a priority to create the most therapeutic environment possible. Evidence-based research has shown that sensory modulation is a non-restrictive intervention that can reduce the use of restrictive interventions, decrease …

Using The Stop5 Debriefing Model To Increase Utilization Of Debriefing Practice In The Emergency Department: A Quality Improvement Project, Hallie Chancey

Master's Theses and Capstones

Abstract Background: The practice of debriefing has been an important process in critical care settings to promote team unity as well as best care practices. Literature has shown that debriefing can not only influence quality care and improved operations, but the process can also influence the emotional support staff receive. These implications are particularly important for nurses that work in critical care settings as the job can often be stressful and lead to moral distress as well as the need for evidence-based care practices is crucial when a patient’s life is on the line. Literature supports that any form of …

Improve Dysphagia Screening In Patients With Neurological Conditions Through Education: A Quality Improvement Project, Kendra Mcintosh

Master's Theses and Capstones

Background: A macrosystem in Southern Massachusetts faces challenges in patients with neurological conditions recieveing a dysphagia screening prior to anything enter the patients mouth in the Emergency Room.

Local Problem: The educational gap identified in Registered Nurses regarding the frequency of screening being completed and the knowledge of the indications for a dysphagia screening.

Methods: Using the Plan-Do-Study-Act model, an educational intervention was implemented. An educational poster was displayed in the microsystem. Data was collected pre-and post-intervention through a survey to measure change.

Interventions: The educational poster was displayed in high-traffic areas of the microsystem. This educational poster included …

Using Education To Improve Glycemic Management Within An Emergency Department, Rebecca Olson

Master's Theses and Capstones

Background: Patients with diabetes mellitus (DM) frequently visit acute care facilities for a variety of reasons. Proper management of this comorbidity increases patient safety, satisfaction, and quality care. Patients with persistent dysglycemic events in acute care facilities have an increased risk of complications and death during their stay. Lack of education can contribute to gaps in proper management within this population and therefore must be improved for better patient outcomes.

Methods: The Plan-Do-Check-Act design from the A3 Problem Solving model was used to guide a quality improvement project which focused on improving staff education and confidence surrounding glycemic management. The …

The Benefits Of Prenatal Education Via Virtual And Mobile Applications Before, During, And After Pregnancy: A Quality Improvement Project, Lindsay Farland

Master's Theses and Capstones

Background: The advancements of technology has led to a substantial increase in the use of pregnancy applications among expecting parents. Studies indicate that a majority of pregnant individuals utilize virtual education platforms for various purposes, including accessing information on nutrition, exercise, baby development, and pregnancy symptoms. Despite the potential benefits, participation in these platforms remains low, emphasizing a need for enhanced resources and engagement strategies. Research shows that engagement with antenatal education through mobile applications can lead to improved maternal and fetal outcomes, such as reduced rates of caesarean births and fewer complications related to hypertension or preeclampsia.

Methods: …

Enhancing Communication Efficiency In An Emergency Department By Employing A Visual Communication System For Lab Results Tracking: A Quality Improvement Project, Julie Burr

Master's Theses and Capstones

Abstract

Background: A Critical Access Hospital in New England faces communication challenges in its Emergency Department, impacting patient flow and safety. The current paper charting system leads to delays and inefficiencies.

Local Problem: The communication gap between ordering laboratory tests and providers reviewing results at the patient’s bedside averages 130 minutes, contributing to delays and potential patient safety issues.

Methods: Using the Plan-Do-Study-Act model, a visual communication system was implemented. Laminated labels indicating pending lab, CT, and radiology reports were affixed to patient folders. Data was collected pre- and post-intervention to measure time from lab order to provider review.

Interventions: …

Acuity-Based Models Of Care: Improving Wait Times And Efficiency In An Outpatient Infusion Center, Jordan Lavallee

Master's Theses and Capstones

Background: Timeliness is a crucial aspect of high-quality care, yet remains a common issue faced by many outpatient infusion settings leading to patient dissatisfaction and potential negative outcomes.

Local Problem: At a 28-chair community infusion center, results from patient satisfaction surveys as well as chart audits highlighted suboptimal wait times and efficiency. 32% of patients were dissatisfied with wait times ranging from 23 to 40 minutes based on the therapy received.

Methods: A quality improvement project was conducted aiming to decrease the average wait time of patients receiving short therapies while increasing patient satisfaction. After a thorough review of the …

Increasing Patient Awareness About Fall Risk Through Patient Education Pamphlets On A Medical-Surgical Floor: A Quality Improvement Project, Nicole Madden

Master's Theses and Capstones

Introduction At a nonprofit hospital located in New Hampshire, a thorough 5P Assessment was executed to identify the root cause behind an increase in falls occurring on a medical-surgical floor. Subsequently, a comprehensive quality improvement initiative was launched with the dual goals of minimizing falls and enhancing patients' awareness regarding their susceptibility to experiencing a fall during their length of stay. Patient falls are the most common adverse events reported in hospitals and are considered a sentinel event (LeLaurin & Shorr, 2019). Hospitals need to adopt a multifaceted approach to minimize the risk of patients experiencing falls during their inpatient …

Promoting Inpatient Mobility To Improve Patient Outcomes: A Quality Improvement Project In A Rural Critical Access Hospital, Chantal Laplante

Master's Theses and Capstones

Background: Although beneficial to patient outcomes, inpatient ambulation is not a prioritized care intervention, and a task often deferred to physical therapy. Patient immobility is a complex problem that requires a multifaceted approach.

Local Problem: In a rural, critical access hospital, on an 18-bed medical surgical unit, nursing staff lacked ownership of patient mobility. There was no standardized process to document ambulation and mobility tasks were not scheduled, falling to the end of the nursing work list. Many patients did not have activity orders upon admission and nurses lacked resources for ambulation assessment and daily goal setting. There was no …

Implementing Of An Informative Poster To Improve Nurse Job Satisfaction In A Medical Surgical Microsystem: A Quality Improvement Project, Stephanie E. Mahoney

Master's Theses and Capstones

Background: Nurse job satisfaction is important since the quality of patient care directly depends on the staff and their willingness to continue working. Traditional approaches used in yearly surveys may cover only some aspects that upset nurses, such as workload and training. This project was designed to overcome these limitations by presenting a more extensive and often-used procedure to assess and solve issues regarding the satisfaction level of registered nurses.

Method: In the quality improvement project, data on job satisfaction using the Acute Care Nurses Job Satisfaction Scale (ACNJSS) was collected on job interest, colleague support, recognition, workload, …

Educational Interventions To Improve Icu Nurses’ Knowledge And Confidence Related To Pressure Injuries: A Quality Improvement Initiative, Benjamin R. Maltais

Master's Theses and Capstones

Background: The prevalence of pressure injuries (PI) in critical care is highest amongst inpatient units, and are associated with significant complications, decreased quality of life, increased cost of hospitalization, and poor patient care (Agency for Healthcare Research and Quality, 2019; Cox et al., 2022; Gorecki et al., 2014; Mervis & Phillips, 2019). Similarly, many PI are considered to be avoidable (Pittman et al., 2019). Despite an increase in focus on PI awareness and prevention, there still remains a challenge for patients in critical care units. In addition, research has indicated that nurses’ lack of basic knowledge of PI (risk assessment, …

United States V. Sioux Nation Of Indians: A History Of Indigenous Diplomacy In The Black Hills, Elliott Lelaure

Master's Theses and Capstones

This thesis traces the history of Sioux-American competition for the Black Hills region of South Dakota from the Lakota’s discovery of the mountains in 1776 to the aftermath of United States v. Sioux Nation of Indians, a landmark 1980 Supreme Court case that awarded financial compensation to the tribes for the unconstitutional seizure of sacred lands. It argues that treaty negotiations in the nineteenth century – and attempts to resolve treaty-based disputes in the twentieth – testify to an international quality in the Sioux-American relationship. Far from passive victims of American expansion, it shows that Lakotas have consistently developed, debated, …

The Loss Of An Enemy: Brooklyn Nine-Nine And The Five Stages Of Grief, Anna Drabik

Comm-entary

This essay examines how sitcom Brooklyn Nine-Nine explores what it means to grieve the loss of someone who wasn’t necessarily a friend or a foe through the theoretical lens of The Five Stages of Grief. It begins with a brief explanation of what the Five Stages Theory is, followed by an outline of the tumultuous history between Captain Raymond Holt and Acting Commissioner Madeline Wuntch, describing their rivalry and placing it into the larger context of the show. Then, the piece follows Holt through each of the five stages after Wuntch’s unexpected death in season 7, episode 7, titled “Ding …

Tap Taps And Fist Bumps: Embodied Movements In Skateboarding Sessions, Paige O’Neil

Comm-entary

No abstract provided.

Sexism, Racism, And Classism In Netflix’S Docuseries Formula 1: Drive To Survive, Grace Cushing

Comm-entary

This essay critically analyzes Netflix’s sports docuseries Formula 1: Drive to Survive. Netflix’s docuseries dramatizes Formula One, which is arguably the highest level of international motorsport. Through strategic portrayals of events in and surrounding the sport, Netflix creates an entertaining but incomplete narrative of different Formula One seasons. This analysis examines the sexism, racism, and classism that are not only present in Formula One, but which also undermine the docuseries. Formula One is known to be a male-dominated, primarily white, and economically elite sport. This essay evaluates the various features of Formula 1: Drive to Survive that perpetuate these traits …

The Power Of Action, Giavanna Fioretti

Comm-entary

This essay analyzes a constructive conversation me and my roommate Kaylee had with a friend of ours, Teddy. This conversation presented itself after Kaylee and I witnessing a form of a microaggression. It was not intended with harm, but the conversation was one that we felt we needed to discuss. This essay emphasizes the impact of action and how it can be put to very good use. It also discusses how Teddy felt after the conversation, as opposed to how Kaylee and I felt after discussing this issue with him. This conversation was handled with kindness, as well as attempting …

American Express: Small Business Saturday, Sean Surrick

Comm-entary

This essay discusses the public relations campaign Small Business Saturday. Originating in 2010 as a response to economic downturns and aimed at spotlighting local businesses, this annual event has transcended its corporate origins to become a celebrated national holiday. This essay delves into the evolution and significance of Small Business Saturday, tracing its trajectory from inception to its current status as a cultural fixture. It also examines how American Express has teamed up with many other businesses to promote the holiday and give resources to small businesses. The event has become so well known that the United States Senate has …

Artificial Intelligence And Human Creativity: A Delicate Balance, Grace Bell

Comm-entary

This essay discusses the ways that virtues, as well as their meanings and their applications, are changing as technology develops. It also describes the debate among creatives and artists regarding the use of artificial intelligence (AI) in creative work, and the nuances that come with defining something as broad as 'creativity'. Artificial intelligence is new and frightening to many, and artists are unsure if this technology will make creative projects more accessible, or if it will take over human-designed creative projects entirely. Using Chat GPT as a tool and a creative partner, this essay investigates the ways that AI can …

The Cause And Effect Of Contemporary Science Communication, Dina Rathke

Comm-entary

No abstract provided.

The Countess Of Chester Hospital Whistle-Blower Case Study, Kaylie Efstratiou

Comm-entary

The following case examines whistle-blowing in the workplace and how it is treated in organizational culture, dealing with the varying ethical perspectives displayed when managerial staff are faced with a whistle-blower. In 2015, an alarming number of infants began to mysteriously pass away in the neonatal ward at the Countess of Chester Hospital. After a few staff members began to realize that one nurse, Lucy Letby, may have been a common denominator in the deaths, a report was made and brought to the attention of the unit manager. When nothing was done after several meetings, some of the staff took …

Epiphany After The Flood, Fiona Flaherty

Comm-entary

No abstract provided.

Evaluating ‘Professionalism’ In Modern Organizations, Ava Montalbano

Comm-entary

This case discusses organizational communication theories, such as professionalism, hegemony, disciplinary Power, and antiracism, and how they impact organizations and their members. Nadia Hernadez is a Mexican-American immigrant who experienced discrimination under the disguise of professionalism during her time working in various organizations.

How Mindfulness In Business Practices Can Enact Positive Change, Kali Couronis

Comm-entary

No abstract provided.

Shame In A Digital Age, Gianna Anzalone

Comm-entary

This essay dives into the nature of mediated shame, analyzing its implications in various contexts and genres of media. Beginning with an analysis of shame as a disciplinary mechanism, the essay highlights how online platforms perpetuate societal norms through the perception and judgment of others. Drawing examples from reality television, it explores how shame is commodified for entertainment, often at the expense of vulnerable participants. Using shows like "The Biggest Loser" as a case study, the essay examines how media narratives exploit and amplify shame, leading to a spoiled identity. This essay also acknowledges the role of shame as a …

Shades Of Humanity: Capturing Diversity Through Photography, Pat Hussey

Comm-entary

This essay evaluates the rhetorical devices present in Rachel Cobb’s, "At the Black Lives Matter Protests in NYC: A Photo Essay," which shows images taken during several protests in the initial wake of the Black Lives Matter movement. It shows us the diversity of those involved in supporting the fight for the rights of others. I choose to explore this further through the lens of Cobb and use several scholars to acknowledge the role that the photographer has in shaping our perception and understanding. Finally, I try to connect to larger social discourses concerning race and the access to equitable …

Implementing A Nurse-Driven Protocol To Reduce Routine Gastric Residual Monitoring: A Quality Improvement Project, Alondra N. Abreu Carlo

Master's Theses and Capstones

The American Society for Enteral and Parenteral Nutrition (ASPEN) and the Society for Critical Care Medicine (SCCM) updated the Adult Patient Enteral Nutrition Guidelines in 2016. These updates included discontinuing routine gastric residual monitoring due to its contribution to poor patient outcomes and mentioning the lack of evidence proving its relevance to gastric motility. Per ASPEN and SCCM, best practice suggests monitoring patients for intolerance symptoms and then checking gastric residual volume (GRV) if symptoms are present. If the GRV is greater than 500ml and intolerance symptoms are present, the recommendation is to perform further assessment, potentially leading to stopping …

Adventure’S Role On First-Year Rotc Cadet's Sense Of Belonging And Trust, John Robert Henkelman

Master's Theses and Capstones

In recent years, the United States military has fallen short of recruitment and retention goals. Belonging and trust may be beneficial in developing stronger peer-to-peer bonds in first-year college outdoor orientation programs, but no known study has explored the use of adventure in developing belonging and trust in ROTC orientation programs. Researchers surveyed traditional and adventure-based ROTC orientation programs and compared belonging and trust scores. ROTC programs were then compared to non-military-based outdoor orientation programs from across the United States. Using quantitative analysis, this exploratory study found that both national outdoor orientation programs and adventure-based ROTC orientation programs increase a …

Unh/Noaa Joint Hydrographic Center 2024 Performance And Progress Report Executive Summary, Larry A. Mayer

Center for Coastal and Ocean Mapping

Reporting Period: 01/01/2023–12/31/2023