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, …

Improving The Postpartum Depression Discharge Education To Increase Quality And Safety Of Care: A Quality Improvement Initiative, Amanda Lucia

Master's Theses and Capstones

Background: Postpartum depression (PPD) is the most prevalent psychological condition to affect mothers following childbirth which can have detrimental consequences on the physical and mental health of the mother, child, and spouse (Wang et al., 2021). Globally, postpartum depression affects 17.2% of the world population, and in the United States 1 in 8 women who recently gave birth reported symptoms of PPD, and 1 in 10 women reported experiencing a major depressive episode within a year following delivery (CDC, 2023). Patients’ spouses and family members are in a unique position to identify early manifestations of PPD which can lead to …

A Quality Improvement Initiative To Redefine The Process Of Instrument Decontamination From The Surgical Field In The Operating Room To The Sterile Processing Department., Nicole Dannett Denton

Master's Theses and Capstones

Background: The Operating Room (OR) faces a significant challenge with the increasing presence of bioburdens on instruments. Research-based on evidence has demonstrated the critical role of precleaning at the point of care with sterile water in reducing bioburden incidence. While current practices recommend the use of an enzymatic solution post-procedure to spray instruments, it is clear that a more comprehensive approach is needed to effectively manage bioburdens and reduce the risk of Surgical Site Infections (SSI).

Methods: Utilizing the Plan-Do-Study-Act (PDSA) model to create a Quality Improvement (QI) solution, the project leader recommended using sterile water at the point of …

Improving Quality Of Documentation In Perianesthesia Care Units To Increase Nurse Satisfaction And Patient Safety: A Quality Improvement Project, Anja Novcic

Master's Theses and Capstones

Abstract

Background: Quality documentation in healthcare settings is essential to ensure nurse satisfaction and patient safety. Documentation templates for patient charting should be in a format that follows best practice nursing care and captures all necessary assessments and interventions ordered by providers for patient care. A quality improvement was conducted in a PACU to evaluate the nurse satisfaction with the use of a new and revised documentation template for pain block procedures.

Local Problem: Within the perianesthesia care unit (PACU) of a Same Day Surgery center, a problem was identified regarding the nurse dissatisfaction with the template in place for …

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: …

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 …

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 …

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: …

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 …

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 …

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, …

Challenging The Criminalization Of Undocumented Drivers Through A Health-Justice Framework, Jason A. Cade

Scholarly Works

States increasingly use driver’s license laws to further policy objectives unrelated to road safety. This symposium contribution employs a health justice lens to focus on one manifestation of this trend—state schemes that prohibit noncitizen residents from accessing driver’s licenses and then impose criminal sanctions for driving without authorization. Status-based no-license laws not only facilitate legally questionable enforcement of local immigration priorities but also impose structural inequities with long-term health consequences for immigrants and their family members, including US citizen children. Safe, reliable transportation is a significant social determinant of health for individuals, families, and communities. Applying a health justice lens …

Chevron And Stare Decisis, Kent H. Barnett, Christopher J. Walker

Scholarly Works

In our contribution to this Chevron on Trial Symposium, we argue that the Supreme Court should not overrule Chevron in Loper Bright Enterprises v. Raimondo and its companion case Relentless v. Department of Commerce. We based our argument largely on statutory stare decisis. In particular, Chevron deference is a bedrock precedent in administrative law, relied on by the Supreme Court and the lower federal courts thousands of times since Chevron was decided in 1984. Congress, federal agencies, and the regulated public have also structured their affairs around the precedent. Conversely, the constitutional arguments against Chevron are unpersuasive, and the debate …

Can State Legislatures Strip Federal Courts Of Jurisdiction To Review State Laws?, Matthew I. Hall, Eliza K. Hall

Scholarly Works

For more than a century, federal courts have relied on the Ex parte Young doctrine to provide authority to protect individual constitutional rights against state infringement. Ex parte Young provides the primary mechanism for federal judicial review of allegedly unconstitutional state laws, permitting persons whose federal rights are affected by state law to seek an injunction in federal court against the state officials charged with enforcing the law. By some accounts, the Ex parte Young doctrine is an exception to sovereign immunity; by others, it is merely an example of the “traditional tool of equity” known as the anti-suit injunction. …

They're Cops, Too, Shanée Brown

Scholarly Works

Caseworkers or child protective workers are government officials tasked with investigating allegedly endangered children and their parents or guardians. They work for state agencies and exercise police power, but this kind of police power intrusively interferes with the life of an individual more than police power wielded by other law enforcement agencies. The Fourth Amendment provides individuals with protections against illegal searches and seizures of bodies and private spaces by the government, and police officers, as well as caseworkers, are required to respect these constitutional protections. Caseworkers, who are state actors, are dedicated to public safety in that they have …

Brokered Abuse, Thomas E. Kadri

Scholarly Works

This chapter examines how data brokers, companies that collect, sell, and trade personal information, enable and intensify interpersonal abuse. The article analyzes the data brokerage industry’s role in undermining personal obscurity, the relative safety that comes from being difficult to find or understand, and explores how current laws not only fail to address these harms but can make them worse. The chapter argues that existing privacy regimes, particularly those requiring victims to request data removal from individual brokers, impose psychological burdens and can retraumatize victims.

The Periphery Of Bankruptcy Law: The Importance Of Non-Bankruptcy Issues In Consumer Bankruptcy, Pamela Foohey

Scholarly Works

One in eleven Americans have filed bankruptcy at some point during their lives. Based on the number of consumer bankruptcy cases initiated during the past several decades, about one million individuals will file every year. This makes bankruptcy courts the leading federal courts with which people have contact. Embedded in people’s cases are a host of legal issues that do not directly implicate bankruptcy law, such as the interpretation of states’ exemptions laws and Article 9 of the Uniform Commercial Code, the avoidance of liens, and defenses to contract claims. Consumer bankruptcy law, via its process, is intertwined with the …

Reconstruction, And The Unfulfilled Promise Of Antitrust, Greg Day, Bennett Capers

Scholarly Works

Wealth inequality remains as wide, and as troubling, as it was a half-century ago. While scholars have offered various explanations, there is a contributor that has escaped serious scrutiny: state monopoly power. It is not just that there is a long history of states and municipalities using their monopoly power to protect dominant interests, from enacting Black Codes to shuttering Chinese laundries to barring women, immigrants, and minorities from certain professions. It is also that states continue to use their monopoly power in ways that entrench inequality, from zoning restrictions to eminent domain to regulations that, in effect, bar Black …

Taxing Dirty Luxuries, Victoria J. Haneman

Scholarly Works

Dirty luxuries are items that are pleasant or nice to have, not necessities, that absolutely bludgeon the environment. From the merely affluent to the ultra-rich, consumers enjoying dirty luxuries, such as luxury clothing, private jets, superyachts, SUVs, and vacation cruises, drive one of the most polluting types of consumption on the planet. This Article explores the climate costs of dirty luxuries, considers the current and proposed international efforts to address the climate impact of these luxuries, and proposes structures by which these luxuries may be taxed to either reduce consumption or compensate for negative externalities.

Electrophysiological And Clinical Fundamentals Of Qtc Prolongation Induced By Antipsychotic Medications, Zaid Naseer, Minaal Khan, Najeeb Manalai, Allison Foroobar, Patricia Harrison, Charles Scercy, Beth Yanoff, Partam Manalai

Department Surgery Faculty Publications

Patients with psychiatric disorders undergoing antipsychotic treatment are at an elevated risk for adverse cardiovascular events, including arrhythmias and sudden cardiac death. While the precise mechanisms linking cardiovascular diseases and psychiatric conditions remain unclear, QTc prolongation is suspected to be a contributing factor. The human ether-à-go-go-related gene (hERG, or KCNH2), which affects potassium channels, is implicated in the cardiotoxicity of various medications, including antipsychotics. This gene plays a critical role in determining whether a drug will be approved for market use. This paper elucidates the electrophysiological basis of QTc prolongation and reviews the evidence concerning which antipsychotics may exacerbate QTc …

Assessing A Potential Deviation In The Legislative Process: The Use Of Vehicle Bills In South Dakota, Neil Fulton, Sarah Kammer, Patrick M. Garry

South Dakota Law Review

No abstract provided.

Indian Country Lawyers: A South Dakota Survey, Bryce Drapeaux, Hannah Haksgaard

South Dakota Law Review

No abstract provided.

Assessing Learning Outcomes In Electrical Engineering Using Natural Language Processing: A Comparative Analysis Of Student And Employer Evaluations, Toka Khalil

Theses

The Co-op program is a graduation requirement for all majors in RIT Dubai. Just like any course, Co-op has also learning programs that is different from one major to another. The academic departments ensure that those learning programs are being achieved throughout the co-op duration that the student goes for to complete the requirement. By end of each co-op duration, the student completes a student evaluation form which consists of questions that are supposedly related to the learning outcomes of the academic program. At the same time, also the employer evaluation which needs to be filled by the employer, includes …

Using A "Moves To Innocence" Approach To Dissect And Debunk The Claim That Critical Race Theory Is Antisemitic, Diane Kemker

Lewis & Clark Law Review

In the United States, law and policy have most frequently reflected dominant white Christian majority interests. Critical Race Theory (CRT) offers powerful tools for understanding our history and situation, including that of American Jews, and how the social positions and interests of American Blacks and Jews, real and perceived, have intersected, sometimes aligning, sometimes diverging, and sometimes conflicting. And yet, among other charges leveled against it, Critical Race Theory is frequently accused of being antisemitic.

Intentionally or not, this charge delegitimizes and discredits CRT, and therefore advances the aims of all who oppose it for any reason, including white supremacists …