Digital Commons Network^™

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: …

Comparing Treemap 2016 Forest Estimates To Two Field Sites In New Hampshire, Rue Teel

Master's Theses and Capstones

The goal of this study was to determine whether TreeMap 2016, a forest model created by Riley et al. (2022a), is appropriate for fine-scale forestry applications in the northeastern United States.The integration of remotely sensed data and forest inventories to create multi-source forest inventories has become standard practice in many countries around the world. Wall-to-wall models of terrestrial biomass are of particular interest in light of the role of forests in carbon sequestration. TreeMap 2016 makes tree-level predictions of forest conditions across the U.S. at a 30x30-meter pixel resolution using USFS Forest Inventory and Analysis data. TreeMap has been used …

Brooches And Identity In Early Medieval Burials In Britain, Elizabeth Christopher

Spectrum

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.

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.

Growing Organizational Marketing, Publicity, And Outreach Strategies With Intention, Elizabeth R. Fowler, Wendy G. Pothier, Donald Dow

Faculty Publications

Marketing is a necessary function of academic libraries but is frequently deprioritized in library job descriptions and organizational structures. This article serves as a case study of how one library worked to formalize marketing efforts by moving from ad hoc committee-based work to structured positions guided by an organizational marketing plan. Sharing examples over time to show the impact of marketing efforts, the authors detail the process of creating an outline for a marketing plan, as well as new initiatives that developed through the process.

A Collaborative Assessment Of Coastal Ocean Acidification Monitoring In Maine & Standard Operating Procedures And Best Practices For The Collection Of Continuous Ph Data In Coastal Marine Environments, Christopher W. Hunt, Curtis Bohlen, Mike Doan, Jeremy Miller

Faculty Publications

The ‘Sensor Squad’ of the Maine Ocean Climate Collaborative is the product of a 2023 Maine Coastal and Marine Climate Action Fund grant to conduct “A two-year pilot project designed to address and overcome technological barriers to ocean acidification data collection, develop protocols to elevate quality assurance and ensure comparable data, and meet regularly to discuss project results and data compilation”. The Squad consists of representatives from Friends of Casco Bay (FOCB), Wells National Estuarine Research Reserve (WNERR), and the University of New Hampshire (UNH). This report is a summary of their efforts to assess affordable, repeatable means of continuously …

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.

Viscosity Stratified Turbulence: Insights From Direct Numerical Simulations, Quasilinear Reduction And Resolvent Analysis, Pulkit Kumar Dubey

Doctoral Dissertations

This dissertation focuses on wall-bounded shear-driven turbulence with temperature-dependentviscosity. Direct numerical simulations and quasilinear reduction have been used to establish the asymmetric variation of turbulent statistics in the wall-normal direction. A comparison of energy spectra in the cold and hot halves of the channel reveals that large scale motions are amplified in the more viscous half while small scale motions are amplified in the less viscous half. Interestingly, the threshold wavenumber distinguishing these scales remains independent of stratification. This observation has been verified via a low-order reconstruction of the turbulent kinetic energy profile using resolvent analysis. Fourier modes that selectively …

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 …

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 …

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 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 …

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. …

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 …

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 …

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 …

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 …

Critical Analysis Of The “Mother, Daughter, And Doll” From Boushra Almutawakel’S, Samantha Dempsey

Comm-entary

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.

Clandestine Captains Of Culture: How Making Music For Your Community Can Influence Global Culture Explored Through The History And Legacy Of Dj Screw, Aristides Estevao

Comm-entary

No abstract provided.

A Feminist Critique Of Promising Young Woman, Farrell Hoffman

Comm-entary

No abstract provided.