Digital Commons Network^™

The Impacts Of Social Media On Teacher Environment Perceptions, Victoria Puglia

Doctoral Dissertations

Social media significantly influences teachers’ perceptions of their professional environment, shaping job satisfaction, respect, autonomy, and professional support. This dissertation, split into three articles, investigates how exposure to positive, negative, or mixed social media posts impact these perceptions, addressing concerns surrounding teacher well-being and attrition in K-12 education. The study began with a literature review in Article 1 to establish a theoretical framework, followed by a series of validation steps to refine a survey instrument aligned with teaching perception constructs in Article 2. The final survey was administered to 406 K-12 teachers across the United States in Article 3, using …

Developing An Evidence-Based Culture Through Journal Club: A Pilot Study, Allison Davidson

DNP Scholarly Projects

Evidence-based practice is essential for improving patient outcomes and reducing healthcare costs, yet its implementation in nursing remains limited due to persistent barriers such as lack of knowledge, leadership support, time, and resources. Despite these challenges, nurses generally hold positive attitudes toward EBP, indicating a strong foundation for future initiatives aimed at enhancing education, training, and organizational commitment. To fully integrate evidence-based practice into nursing care, healthcare systems must address these barriers and invest in sustained support, ensuring that clinical decisions are consistently guided by the best available evidence. A pilot nursing journal club, led by an evidence-based practice mentor …

Optimizing Compression In Venous Leg Ulcers To Improve Wound Healing Rates Through Wound Care Nurse Support: A Quality Improvement Project, Temilola Obisesan

DNP Scholarly Projects

BACKGROUND: Venous leg ulcers (VLUs) are the most common lower extremity ulcers, accounting for 75% of chronic leg wounds and affect up to 2% of the population in developing countries. Generally, it has a 1-year recurrence rate of 40-70%. VLUs costs about $11B in the USA and other developed countries annually. Patients with VLUs spend about $7,000 more annually. Compression therapy along with local wound care is the best approach for VLU management, with compression therapy as the gold standard. Currently, compression therapy is underutilized in VLU care. The goal of this QI project is to provide wound nurses who …

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 …

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 …

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 …

Implementation Of Outpatient Cervical Ripening In The Community Hospital Setting: A Quality Improvement Process, April St Hilaire

DNP Scholarly Projects

Background: Cervical ripening is a critical component of labor induction. Outpatient cervical ripening using mechanical dilators offers a safe patient- centered alternative to inpatient management, with potential benefits in efficiency and patient satisfaction and cost savings.

Local Problem: At a community hospital setting with increasing induction rates, prolonged admission-to-delivery times and prolonged patient stays were observed in patients undergoing inpatient cervical ripening, prompting a need for more efficient, patient centered approaches.

Methods: Using the Plan-Do-Study-Act (PDSA) framework, an outpatient cervical ripening protocol was implemented over a 15-week period to compare inpatient versus outpatient cervical ripening using mechanical …

Improving The Process Of Performing Stroke Assessments Within The Emergency Department: A Quality Improvement Initiative, Michael Ferrone

DNP Scholarly Projects

Background: An acute stroke is a potentially life-threatening medical condition that may lead to significant morbidity and mortality. It is imperative that patients seek emergent medical attention as several of the known interventions are time-limited based upon the time of symptom onset. Once patients present for evaluation, it is of equal importance for medical professionals to recognize that someone may be experiencing an acute stroke and to escalate their care appropriately. Among the various evidence-based stroke assessments, the National Institute of Health Stroke Scale (NIHSS) is often implemented given its ability to detect acute neurological abnormalities and estimate stroke severity. …

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 …

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 …

A Quality Improvement Project To Enhance Chronic-Condition And Self-Care Knowledge In Adolescents With Spina Bifida, Ann Paris

DNP Scholarly Projects

Background: Spina Bifida is the most common central nervous system disorder in the United States (CDC, 2024). Even with early surgical repair, patients may have chronic, disabling, multisystem needs (Phillips et al., 2017). Adequate care of Spina Bifida requires a multidisciplinary approach. As such, patients with spina bifida require multiple specialty providers, clinic appointments, care-tasks, and interventions (CDC, 2024, Phillips, et al., 2017). Synthesizing information from multiple care providers can be daunting, especially for adolescents as they grow more autonomous in their care, and especially as they enter the age of pediatric-to-adult transition (Psihogios et al., 2015).

Purpose: …

Development Of An Educational Toolkit For Washington State Nursing Professionals Regarding Climate-Related Impacts On Health, Margaret "Maggie" Pinson

DNP Scholarly Projects

BACKGROUND: Most healthcare professionals (HCPs) know that climate change poses a serious threat to human health, but few physicians and nurses actually discuss climate-related impacts on health with their patients. This knowledge-practice gap poses a risk to patient safety.

PROBLEM: Patients who are unaware of environmental threats to health may develop new illnesses, experience unnecessary exacerbations of underlying health problems and may die.

METHODS: A quality improvement intervention that addressed the educational needs of HCPs as described in the literature was developed and hosted on an online survey platform.

INTERVENTION: Preintervention survey questions captured baseline attitudes, beliefs, and knowledge. The …

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 …

Distribution Of Supplemental Educational On Pharmacology To Assist Mental Health Technicians On The Behavioral Health Unit In Leading Group Therapy Sessions: A Quality Improvement Project, Bree T. Mastromarino

Master's Theses and Capstones

Background

Staff within the microsystem strive to provide quality care to patients experiencing acute mental health crises in hopes of stabilizing their condition, allowing them to function safely and appropriately among others. This will hopefully lead to eventual rehabilitation back into society. The main technique used in this microsystem for the rehabilitation of patients is providing group therapy (GT) sessions. These sessions teach healthy coping mechanisms and encourage internal reflection on triggers that could be contributing to emotional instability.

Local Problem

Recently, the leadership team has made the decision that Mental Health Technicians (MHTs) and social workers will lead the …

Microstructural Changes, Damage Evolution And Failure Of Hcp Metals Titanium And Magnesium, Nicholas Mark Pitkin

Master's Theses and Capstones

This work presents three experimental investigations analyzing the microstructural evolution, void nucleation and growth, and failure in titanium and magnesium. The first study compares the void nucleation and growth of Grade 2 and Grade 4 commercially pure titanium during monotonic tensile testing and cyclic-bending-under-tension. Voids were characterized by X-ray computed tomography (XCT). It was shown that CBT (cyclic bending under tension) did not suppress the growth in void volume but allowed for further plastic deformation despite it. The second study investigates the relationship between microstructural evolution and void accumulation in high-purity titanium during interrupted tensile testing. The initial microstructure of …

Recognizing And Responding To Moral Distress: Using Transformational Leadership To Increase Nurse Leader Thriving, Miriam Dowling-Schmitt

DNP Scholarly Projects

Background: Moral distress, burnout, and compassion fatigue in acute care nurses has increased significantly since the Covid-19 pandemic and has been associated with high levels of nursing turnover and increased costs to healthcare systems. Nurse leaders at the study organization had never received education on recognizing and responding to moral distress. Nursing engagement scores were low at the study organization in the areas of leadership support and well-being investment in nurses.

Problem Description: Between 2017 and 2021 job satisfaction for nurses with direct patient care responsibilities decreased in 20 of 21 categories according to the Bureau of Health Workforce. High …

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 …

Design And Implementation Of A Nursing Peer Practice Case Review Program In An Academic Surgical/Trauma Icu, Natalie Tredway

DNP Scholarly Projects

Background: Peer review has been in use in healthcare for many years, primary by physicians. Recently, however, nursing has adopted a framework for peer review within the profession. According to the American Nurses Association (admin, 2011), organizations are required to maintain a systematic peer review process aimed at evaluating nursing care and nursing care providers to obtain/maintain Magnet designation. According to Foster (2015) nursing peer review (NPR) is “process by which practicing registered nurses systematically assess, monitor, and make judgments about the quality of nursing care provided by peers as measured against professional standards of practice”. The focus is on …

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 …

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: …

Analyzing Seasonal Wind Trends And Climate Change Impacts Along The East Coast Of The United States (1990-2022), Avery L. Wilson

Honors Theses and Capstones

This study investigates long-term trends in ocean wind intensity and variability along the U.S. East Coast between 1990 and 2022 using ECMWF ERA5 reanalysis data. Focusing on monthly maximum, mean, and standard deviation (STD) of wind speed at 10 meters above the surface, linear regressions were performed to analyze long-term trends. Results indicate a significant increase in wind intensity and variability in the northeastern region, particularly during winter months, which may forecast more frequent and intense cyclonic activity such as Nor’easters. Conversely, a weak decreasing trend was observed in the south. These shifts have implications for ocean-atmosphere dynamics, including vertical …

An Investigation Into Artificial Intelligence And Intellectual Property From An Economic Perspective, Jackson Benjamin Bram Girard Lasalle

Honors Theses and Capstones

This paper investigates the debate around recent developments in Artificial Intelligence and its impact on intellectual property laws from an economic perspective.

The Fate Of Coffee: A Socioeconomic Analysis Of Peruvian Coffee Management In The Face Of Usaid Withdrawal And Climate Change, Sophia E. Elliott

Honors Theses and Capstones

Coffee is one of the most widely traded commodities globally, with the market valued at over USD 223 billion in 2023. The cultivation and management of this crop are largely carried out by small-scale farmers, who make up approximately 80% of producers and rely heavily on coffee farming for their livelihood. Despite the relevance of this crop for producers and consumers alike, these producers often live in conditions of extreme poverty. Variability within climatic conditions has increased the vulnerability of coffee plants to pests and pathogens, in particular Coffee Leaf Rust (CLR) (Hemileia vastatrix). This, in turn, has led to …

Noaa Or&R Remote Sensing /Uas Workshop Report, Coastal Response Research Center

Coastal Response Research Center

NOAA’s DPP partnered with CRRC to plan and facilitate a hybrid workshop over two days at UNH’s Memorial Union Building (MUB) in Durham, NH. This workshop titled “NOAA OR&R Remote Sensing/UAS Workshop” identified overarching concepts, knowledge gaps, challenges, and research regarding the current capabilities of oil spill remote sensing of NOAA and its partners, including government and state agencies, and the private sector (e.g., OSROs, contractors). The resulting conversations explored state of the art technologies that could be deployed during a spill event and complications introduced to response and recovery efforts by data delivery timelines, data products, and remote sensing …

2024 U.S. Globe Partner Yearbook, Globe U.S. Coordination Office

Partner Yearbooks

No abstract provided.

Improving The Effectiveness Of Post-Anesthesia Care Unit Transitions: A Quality Improvement Initiative Using A Standardized Nurse Handoff Report Sheet, Myra Mcauley

Master's Theses and Capstones

Background: Effective communication during patient handoff in the post-anesthesia care unit (PACU) is essential to ensuring patient safety and continuity of care. Unstructured or inconsistent handoff processes can lead to information omissions and care delays.

Methods: This quality improvement project implemented a structured nurse-to-nurse handoff report tool in the PACU. A pre- and post-intervention survey design was used to assess nurses’ perceptions of handoff clarity, completeness, and satisfaction. Educational sessions supported implementation.

Results: Pre-intervention survey data revealed dissatisfaction with the current handoff process, citing frequent information gaps. Following implementation of the structured tool, post-survey results showed improved communication clarity, increased …

A Quality Improvement Project Reinforcing Nursing Education On Support Resources For Families In The Icu, Emily Siel

Master's Theses and Capstones

BACKGROUND: The Intensive Care Unit (ICU) is often a source of psychological, physical, social, financial, and spiritual distress for families of patients. Multidisciplinary support resources are available but are often underutilized. Nurses are uniquely positioned to assess needs and integrate resources into care. Therefore, enhancing nurses' ability to guide families to appropriate support resources may alleviate distress and promote holistic well-being for patients and their families.

METHODS: The Plan-Do-Study-Act (PDSA) model was used to guide this project. A pre-intervention survey assessed awareness, utilization, and perception of ownership. Following dissemination of the intervention, a post-survey evaluated improvements in knowledge and integration. …

Town Of Dummer, Nh Annual Report Of The Town Officers For The Year Ended December 31, 2024, Dummer Town Representatives

Dummer, NH Annual Reports

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

Town Of Lempster, New Hampshire, Incorporated 1767, Annual Reports For The Year Ending December 31, 2024, Lempster Town Representatives

Lempster, NH Annual Reports

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