Digital Commons Network^™

Using Education To Confidently Identify And Report Concerns Of Child Abuse And Neglect: A Qualitative Improvement Initiative Through Staff Development, Sarah E. Neilson

Master's Theses and Capstones

BACKGROUND: Pre-licensure education on child abuse and neglect is crucial for nurses in the healthcare field. It helps to equip them with the knowledge and skills necessary to effectively identify, report, and intervene in cases of child abuse and neglect. Having this education available and understanding the signs and effects of child abuse and neglect, empowers nurses to take quick and decisive action in early intervention and prevention. Within the microsystem of a local Operating Room (OR), this quality improvement (QI) project will determine the muchneeded addition to the healthcare curriculum.

METHODS: The Plan, Do, Study, Act (PDSA) framework was …

Enhancing Postpartum Depression Screening Tools To Improve Maternal Mental Health Outcomes: A Quality Improvement Initiative, Jillian Squires

Master's Theses and Capstones

Abstract

BACKGROUND:

Postpartum depression (PPD) is a prevalent and serious condition affecting new mothers, often underdiagnosed due to challenges in traditional screening methods. Early detection and intervention are crucial for improving maternal and infant health outcomes.

LOCAL PROBLEM:

On the maternity unit, existing PPD screening processes were insufficient, with significant barriers including patient reluctance to disclose mental health concerns, leading to missed or inadequately addressed PPD cases.

METHODS:

This quality improvement (QI) project utilized the Plan-Do-Study-Act (PDSA) framework. Pre-intervention surveys were conducted to identify current challenges and perceptions. An at-home PPD screening tool using the Edinburgh Postnatal Depression Scale (EPDS) …

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 …

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 …

Re-Educating Proper Blood Culture Collection With Emphasis On Initial Blood Waste To Decrease Contamination Rates: A Quality Improvement Project, Samantha A. Dickinson

Master's Theses and Capstones

Background: A critical access hospital in New England experienced an increase in blood culture contamination rates within the Emergency Department (ED). There was a disconnect between the current standardized collection protocol within the ED and the action of staff collecting which has led to an increase of blood contamination (BCC) rates.

Local Problem: The disconnect between the current collection standard and staff collecting caused the Emergency Department to rise above 3.0% in blood cultures contaminations. This rise in contamination rates contributes to longer patients stays and unnecessary treatments.

Methods: Using the Plan-Do-Study-Act model, an educational flyer was implemented to remind …

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 …

Wellness In Motion: A Quality Improvement Initiative To Support Resident Mobility And Reduce Falls., San N. Pham

Master's Theses and Capstones

Background: Falls are a significant concern in community living centers for older adult veterans. Promoting physical activity and resident engagement is crucial for reducing fall risk among this population.

Local Problem: A specific microsystem within this setting has a fall rate of 3 falls per month. This discrepancy underscores the need for targeted interventions to effectively address this issue.

Methods: This study measured key metrics related to falls and resident engagement in mobility programs both before and after the implementation of an exercise program within the microsystem.

Intervention: The "GIMME 10" exercise program, grounded in evidence-based practices and emphasizing resident-centric …

Incorporating Educational Interventions To Improve Nursing Adoption Of Electronic Medical Record Technology: A Quality Improvement Project, Andrew Oratovsky

Master's Theses and Capstones

Background: Use of Electronic Medical Records (EMRs) has become the standard for medical information management and exchange amongst acute care hospitals in the United States. The Epic® electronic medical record has been identified as a popular EMR software for adoption by many healthcare organizations. Associated with the adoption of this technology is a large investment in training medical professionals on its specific processes.

Local Problem: In the outpatient, primary care setting of a hospital in New England, the adoption of Epic® has come with much fear and resistance regarding the ability of nursing staff to efficiently learn and …

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, …

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

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 …

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 …

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 …

Annual Reports Of The Town Of Seabrook, New Hampshire For Year Ending December 31, 2023 As Compiled By Town Officers., Seabrook Town Representatives

Seabrook, NH Annual Reports

This is an annual report containing vital statistics for a town/city in the state of New Hampshire.

Floating Offshore Wind Turbine Analysis And Discovery, Payton Maddaloni

Honors Theses and Capstones

No abstract provided.

Imputation Strategies For Different Categories Of Missing Data, Karthik Chalumuri

Honors Theses and Capstones

Addressing missing data in research is crucial for ensuring the reliability and validity of study findings, yet it remains a significant challenge. This study investigates the impact of missing data on research outcomes and explores the underutilization of existing tools for managing missingness, potentially leading to gaps in critical information with tangible implications for decision-making processes (Dziura et al.).

Focusing on the different categories of missing data—Missing Completely At Random (MCAR), Missing At Random (MAR), and Missing Not At Random (MNAR)—this research examines various imputation strategies tailored to each category. Specifically, we compare the efficacy of several model-based imputation methods, …

Fluorotelomer Carboxylic Acid Degradation: Implications For Septic Systems, Alexis Marie Eaton

Honors Theses and Capstones

Per- and polyfluoroalkyl substances, or PFAS, are a group of manmade organic chemicals that have been widely used since the 1940’s due to their resistance to heat, water, and oil. These compounds are associated with negative health outcomes including poor thyroid function, reproductive toxicity, and carcinogenicity. Because products with PFAS are widely used in residential settings, and because many PFAS do not completely degrade during wastewater treatment/handling, septic systems may be an important non-point source of PFAS to groundwater. Many homes that have septic systems, which discharge wastewater effluent to the subsurface, also use groundwater as a drinking water source; …

A Free-Boundary Successive Over-Relaxation Grad-Shafranov Equation Solver, Alec J. Damsell

Honors Theses and Capstones

Fusion has long been considered the “Holy Grail” of renewable energy, but has not yet seen viability as a commercial power source. With tokamaks like SPARC, NSTX-U, and ITER coming online over the next ten years, there is growing investment in fusion technology by both the public and private sector. If these tokamaks reach or exceed their scientific aims, further investment in fusion and new tokamak designs are expected. The first step in designing a tokamak is choosing a good plasma equilibrium, which is described by the Grad-Shafranov equation. This work presents a successive over-relaxation routine to solve the Grad-Shafranov …

The Future Of Building: The Potential Impacts Of 3d Printing Within The Construction Industry, Alyssa Morrison

Honors Theses and Capstones

This research investigates the expanding practice of 3D printing in construction, focusing on its potential impacts and challenges it will face within the industry. Emphasizing both its sustainability and cost-saving benefits, this paper examines how 3D printing could potentially revolutionize traditional building methods. The ability to decrease greenhouse gas emissions, address the global housing shortage, and reduce material waste are addressed. Through interviews with industry professionals, as well as a thorough literature review, the research explores the factors driving interest and investment in 3D printing technology. Additionally, it analyzes common misconceptions regarding 3D printed structures and pinpoints areas for further …

Floating Offshore Wind Turbine Analysis And Discovery, Payton Summer Maddaloni

Honors Theses and Capstones

This poster encompasses yearlong literary research into floating offshore wind turbines. Limitations created by society are discussed, these have prohibited large leaps to get the turbines out of the design phase. Traditional platform designs are displayed to show the potential the industry has to offer as the next renewable energy source. The maintenance phase seeks optimization. A case study by the University of Cincinnati used production losses as a consideration to lower the total cost of traditionally expensive maintenance. Finally, the end-of-life scenarios are currently being overlooked by developers. This opens the door to multiple options for disposal. Mimicking the …

Assessment Of Open Top Chambers To Simulate Effects Of Climate Change On Soil Temperature And Cover Crop Response In Agricultural Systems, Gretchen Bahmueller

Honors Theses and Capstones

Climate change is expected to yield warmer winters that have the potential to place additional stress on our already stressed agricultural systems. Understanding how agricultural systems may respond to these changes is essential to creating crop and land management plans that ensure food security for future generations. To better understand how warming winters can/will affect air and soil temperatures and cover crop performance, open top chambers (OTCs) were deployed post cover crop seeding in a field experiment at the UNH Kingman Research Farm in Madbury, NH. The experiment consisted of four cover crop treatments sown into or after corn: an …

Student Perspectives On The Adequacy Of Mental Health Curriculum Within The College Of Health And Human Services At Unh, Brianna Lee Meyer

Honors Theses and Capstones

This study aims to understand the confidence students in future healthcare oriented majors feel in regards to treating or interacting with individuals with mental health conditions. It also aims to understand the effect of students' in-major education, outside-major education, and lived experience on this confidence level. Students within the College of Health and Human Services at UNH were the participants who completed a short Qualtrics survey online. The survey collected data from Likert scales and short-answer questions. The Likert scales were then analyzed with a regression and descriptive statistics, while the short-answer questions were analyzed with thematic analysis. The study …