Improving Interdisciplinary Communication And Collaboration With The Standardization Of Doula Care Through An Informatics Tool, Shela Le

Master's Projects and Capstones

Objective: The 22-bed Labor and Delivery (L&D) unit lacks a standardized model to introduce doulas, clarify their scope of practice, or communicate the value of the services they provide. To address this gap, the team implemented a standardized doula awareness poster that included each doula’s name, photo, years of experience, and personal interests. Aim: The goal is to enhance visibility and promote integration of doula support to strengthen team collaboration and patient engagement. Methods: A pre- and post-implementation survey was distributed exclusively to the volunteer doulas. After the doula awareness poster was displayed for a month, a post-survey assessed these …

Optimizing Electronic Health Record Workflow To Improve Flu Vaccinations In A Primary Health Clinic, Xzalyn Arianah Hernandez

Master's Projects and Capstones

Among the Latinx population influenza vaccination rates remain disproportionately low due to vaccine hesitancy, misinformation, limited access to healthcare, and socioeconomic barriers. Influenza related hospitalizations and deaths have risen in recent years as rates continue to drop across all age groups, as a result of this issue. This quality improvement project aims to increase staff satisfaction and flu vaccination rates among Latinx patients by the implementation of a more efficient workflow process. Different interventions were designed to address workflow inefficiencies and medical assistant dissatisfaction. These interventions included 1) integrating the Immunization Clinic function in EPIC to streamline flu vaccine documentation …

Reducing Hospital-Acquired Pressure Injuries Through Targeted Nurse Education On The Braden Scale And Skins Bundle, Sarah Nicole Farkas

Master's Projects and Capstones

Objective: Hospital-acquired pressure injuries (HAPIs) continue to rise nationally despite overall reductions in other hospital-acquired conditions. This project sought to address gaps in nurse knowledge, inconsistent prevention practices, and workflow barriers contributing to HAPI development on a Trauma Medical-Surgical Unit (Unit A). Aim: This project aims to decrease the number of HAPIs on the Trauma Medical Surgical Unit by 11%, from nine HAPIs to eight HAPIs, following implementation of nurse education on the proper use of the Braden Scale and the SKINS Bundle from October 6, 2025, to November 14, 2025. Methods: A pre-intervention survey was administered to identify baseline …

A Quality Improvement Initiative To Streamline Flu Vaccine Documentation And Increase Staff Engagement, Carla E. Giron

Master's Projects and Capstones

Objective: This quality improvement project was implemented in an urban community health clinic primarily serving low-income and Latinx patients. Factors such as demographics, socioeconomic status, health, and transportation contribute to low U.S. influenza vaccination rates (Chen et al., 2020), while EHR training can improve provider satisfaction and efficiency (DiAngi et al., 2019). This microsystem faced inconsistent workflow processes, limited EHR training, and documentation errors that contributed to low staff satisfaction rates and influenza vaccination rates. An average of 11.4% of patients received a flu vaccine in October 2023 and 2024. Medical assistants (MAs) completed a pre-intervention survey indicating that 35% …

Bridging Gaps In Safety: A Team-Based Approach To Reducing Falls Among Older Adults, Enzali Min

Master's Projects and Capstones

A skilled nursing facility in the San Francisco Bay Area is experiencing fall rates surpassing the national average throughout the year. Falls among elderly residents lead to multi-level complications, from minor bruising to major injuries such as fractures, head injuries and hospital transfer, and in the most severe cases, higher mortality rates. To address the issue of high fall rates at the nursing facility, the post-fall huddle protocol was developed on the unit. The team intends to reduce the facility's fall rate by 25% over the next five weeks, from October 1 through November 5, 2025, along with improving the …

The Pressure Is On: A Quality Improvement Project To Educate Nurses On Hospital Acquired Pressure Injuries, Lance Ward

Master's Projects and Capstones

Objective Hospital acquired pressure injuries (HAPIs) are injuries developed by admitted patients, from treatment interventions that they encounter during their hospital stay. If a patient acquires a HAPI during their stay, the hospital is required to cover all expenses related to the injury. An in-patient trauma unit at a large medical center wishes to improve patient care by educating nursing staff on preventive measures of HAPIs. A review of relevant literature on HAPIs from the past five years was conducted to identify HAPI preventions tools, such as the Braden Scale and SKINS bundle, as well as the best methods to …

From Fear To Familiar: Reducing Technology-Induced Anxiety In Seniors, Justin Kyle V. Manalang

Master's Projects and Capstones

Abstract

This quality improvement project focuses on reducing the average technology-induced anxiety score among senior community members through 1:1 mentorship sessions. Aim During an eight-week period from September 10, 2025, to November 5, 2025, this project will reduce the severity of technology-induced anxiety by 25% from the established baseline. Methods: A 5P Microsystem assessment was conducted alongside an initial questionnaire to gauge the residents’ interests and concerns regarding technology use. From the results, focused mentorship sessions were conducted once a week and pertained to the chief complaint the resident had for eight weeks. The mentorship sessions were one-to-one and individualised …

Enhancing Psychotropic Medication Documentation Through Staff Education To Promote Increased Compliance Rates And Patient Safety, Matalyn F. Kirkes

Master's Projects and Capstones

Objective: Inappropriate psychotropic medication use and documentation poses a risk to patient safety and health as well as premature death while also leading to regulatory noncompliance (Bednarczyk et al., 2022). Improving nurse documentation can help patients maintain safe and adequate prescriptions and doses. Context: Baseline data collected within our microsystem revealed gaps in nurse comfort and knowledge around documentation requirements. The nursing staff (LVNs/RNs), who we received the baseline data from, are responsible for assessments, documentation, and patient monitoring, for which there is significant variability in understanding the required expectations. Interventions: The education for the skilled nursing staff as well …

Stop, Look, And Save A Spot! Implementing The Hapi Prevention Tool, A Visual Cuing System That Aims To Reduce Hospital-Acquired Pressure Injuries In Acute Care Units, Jada Baldoza

Master's Projects and Capstones

Objective: Hospital-acquired pressure injuries continue to be a major challenge in many healthcare settings as it poses increased risk in patient safety. Additionally, it creates a significant financial burden on hospitals as it increases operational costs that can increase strain on healthcare resource demands. Nurses play a major role in mitigating these injuries through practicing quality patient care and utilizing prevention strategies that have been proven effective. Aim: A quality improvement project was conducted by introducing a visual cueing system, the HAPI Prevention Tool to investigate its potential sustainability on reducing HAPI rates in the medical-surgical unit. Methods: The QI …

From Fear To Familiar: Alleviating Technology Anxiety In Older Adults Through A Community-Based Mentorship Program, Inyoung Jang

Master's Projects and Capstones

This quality improvement project was implemented in a senior residential facility in Richmond, California, catering to older low-income adults who frequently experience elevated levels of technology anxiety. Aim This project aims to reduce the mean modified technology-anxiety score among residents aged 65 and older by at least 25% from baseline by November 5, 2025. Methods The Abbreviated Technology Anxiety Scale (MTAS) was modified to consider the cognitive, linguistic, and experiential differences among target population. The original 11-item instrument, which was validated primarily within college-aged populations, used terms and repeated items irrelevant to older people. The adapted tool included five simplified …

Implementing A Standardized Doula Awareness Tool To Improve Team Collaboration And Patient Understanding, Stephanie Wong

Master's Projects and Capstones

Setting: 22-bed, Labor and Delivery (L&D) unit in the Bay Area serving diverse birthing patients. Problem & Context: The unit lacks a standardized model to introduce doulas, clarify their roles, or communicate their value. Evidence shows that doulas feel unseen by other hospital staff (Kett et al., 2022) and report that their role can be misunderstood, undervalued, or unrecognized, creating barriers to effective partnership (Louis-Jacques et al., 2024). Pre-survey: Only 19.2% of the participating volunteer doulas felt patients understood their role as a doula, and 11.5% felt patients were only slightly knowledgeable. In terms of collaboration, just 15.4% felt consistently …

Standardizing Care: Strengthening Dka Protocol Implementation Among Emergency Department Nurses, Toni Joy Angelique Biliran Miculob

Master's Projects and Capstones

Objective: The objective of this project was to address the inconsistent understanding and utilization of the Diabetic Ketoacidosis (DKA) protocol in a high-acuity emergency department within a large hospital system, where baseline survey results showed that 84% of nurses found the DKA order set confusing and only 15% felt “very comfortable” applying it.

Aim: The aim was to improve nurse clarity, confidence, and consistency in using the DKA protocol to support timely, evidence-based management of this high-risk, time-sensitive condition.

Methods: The intervention consisted of brief, targeted education delivered during pre-shift huddles across day and night shifts, focusing …

California Water Reuse: State Of The Industry As Direct Potable Reuse Comes Online, Guy Gutterman

Master's Projects and Capstones

Since the early 1900’s, California has found ways to reuse its wastewater, and in 2023 the state added a new method, Direct Potable Reuse (DPR), to its toolkit. DPR allows for advanced treated wastewater to be sent directly to a drinking water system, without an environmental buffer. Through a synthesis of the literature and related government documents of the state's water reuse history, an analysis of regional water recycling trends, and a survey of water utility professionals, this paper aims to understand DPR's future role in securing California's water supply. Historically, public perception has delayed adoption and development of California's …

Improving Knowledge To Improve Care: Strengthening Nurse Expertise In The Emergency Management Of Diabetic Ketoacidosis, Minda Murphy

Master's Projects and Capstones

Abstract

Setting: A high acuity emergency department within a large hospital system. Problem: Nurses in the emergency department reported inconsistent understanding and utilization of the existing Diabetic Ketoacidosis (DKA) protocol. Pre-intervention survey results showed that 84% of nurses identified the DKA order set as confusing, and only 15% reported feeling “very comfortable” with the protocol. These knowledge gaps contributed to delays in glucose monitoring, inconsistent insulin administration, uncertainty about order-set responsibilities, and variable adherence to evidence-based management. Context: DKA is a time-sensitive, high-risk emergency that requires precise, protocol-driven actions to prevent complications such as electrolyte imbalance, cerebral edema, prolonged hospitalization, …

Lost In Translation: Navigating Cultural And Linguistic Barriers For Indian Learners In Tesol Classrooms, Shivam Jaynarayanbhai Gohel

Master's Projects and Capstones

ABSTRACT

This thesis examines the cultural, linguistic and emotional issues of the Indian multilingual students in the U.S. TESOL classroom and explains the value of decolonized and culturally responsive pedagogies to ameliorate foreign language anxiety and create equitable education. Based on the frameworks of Culturally Responsive/Sustaining Pedagogy and Affective Filter Theory, the study integrates existing and existing research to investigate the role of colonial heritage in influencing TESOL practice, the undermining effect of anxiety on academic achievement and the empowering effect of instructions that are inclusive and responsive. Chapter I presents the problem, including how multilingual and multicultural identities of …

Enhancing Fall Prevention Through Post-Fall Huddles In A Skilled Nursing Facility, Eliza R. Galimba

Master's Projects and Capstones

Objective: Falls in skilled nursing facilities increase the risk of injury, readmissions, and higher healthcare costs. This facility’s rates remained high due to inconsistent post-fall protocols, no standardized review process, and insufficient communication. Seventy-five falls were documented in the first eight months of 2025, exceeding the national benchmark of 3–5 per 1,000 patient-days (AHRQ, 2024). Aim: This quality improvement project will occur over a 5-week period from October 1, 2025, to November 5, 2025, and aims to decrease the fall rate by 25%, from 4.3 falls per 1,000 patient-days to 3.3 falls per 1,000 patient-days, through improved team communication and …

What We Can Learn From Comenius About Why We Educate, David I. Smith

University Faculty Publications and Creative Works

As we wrangle repeatedly over the purposes of schooling and who gets to define them, what might we gain by taking a moment to listen to a thoughtful voice from a place and time not defined by our own mix of prejudices? I invite you to listen to such a voice, one speaking from a different era amid different anxieties and in a different idiom yet addressing questions that remain pressing. It is a voice shaped by a lifetime of educational engagement and reflection in the constant shadow of violence, yet, to the last, invested in the pursuit of delight. …

Policy Library- 147 University Curriculum, Assessment, And Student Success Committees, Indiana State University, General Counsel

Policy Library

Policy 147 University Curriculum, Assessment, and Student Success Committees

Exploring The Association Between Nurse Characteristics And Intent To Leave Their Current Position In Counties With Rural Hospital Closures, Caroline A. King

2025 Fall Honors Capstones Projects - Archive

Increased rural hospital closures and nursing burnout may lead to greater morbidity/mortality for rural residents. Current literature fails to capture whether rural hospital closures influence nurses’ intent to leave their current position. In this cross-sectional study, descriptive and correlational statistical analyses were conducted on survey responses from a sample of nurses who lived in a rural county that experienced a hospital closure. 66% of nurses stated that, at one point, they had considered leaving their primary nursing position. Logistic regression model results revealed that nurse-reported age and gender were significant predictors of a nurse’s intention to leave their current position. …

How The Advisor-Advisee Relationship Contributes To Black Student Success At Pwis, Renata Denise Roberts

Theses and Dissertations

This qualitative study explores how the advisor-advisee relationship contributes to Black student success at Predominantly White Institutions (PWIs). Black student enrollment and retention at PWIs continue to decline, especially with national efforts to cut DEI measures. Previous research highlights that engagement and institutional support are critical to persistence and graduation; however, limited literature exists on how academic advising relationships can impede or contribute to Black student outcomes in these environments. Viewing from the lens of Black students’ perceptions, this study examines how the academic advising experience can foster trust and contribute to academic achievement for Black students or impede their …

Microbial Metabolism Amplified Warming In Three Phanerozoic Hyperthermal Events, Yuyang Wu, Haijun Song, Daoliang Chu, Ying Cui, Jacopo Dal Corso, Genming Luo, Huyue Song, Li Tian, Hanchen Song, Enhao Jia, Jinnan Tong

Department of Earth and Environmental Studies Faculty Scholarship and Creative Works

The ocean’s biological carbon pump (BCP) plays a crucial role in climate regulation by facilitating long-term removal of atmospheric CO2. However, BCP changes during past hyperthermals remain poorly understood. Here we use the vertical carbon isotope (δ13C) gradients between surface and mid-waters to trace the BCP changes during the Permian−Triassic, early Toarcian, and Palaeocene−Eocene hyperthermals, detecting a two- to three-fold increase in the vertical δ13C gradients. We found that enhanced organic matter remineralization, driven by increased microbial respiration under warming, are the primary trigger for increased vertical δ13C gradients. Warming-induced enhancements in microbial metabolism caused a two- to six-fold reduction …

Maria Vasquez-De Perez V. Attorney General United States Of America

2025 Decisions

Agency

Usa V. Rodolfo Beltre

2025 Decisions

USDC for the Middle District of Pennsylvania

A Geological And Geochemical Study Of The Philipsburg Mining District, Granite County, Montana, Celine M. Beaucamp

Graduate Theses & Non-Theses

The Philipsburg district, renowned for its rich mining history, has contributed significantly to Montana's mineral production, ranking as the state's second-most productive district. Active from 1865 to the 1980s, it yielded an impressive array of Ag (50-60 million oz), with notable outputs of Au, Zn, Pb, Cu, and battery-grade MnO2. The district features Cordilleran polymetallic veins, some of which are along bedding in Mississippian and Devonian limestone, and others are steeply dipping quartz veins in silicate-rich sedimentary rocks and in the Philipsburg batholith. The veins exhibit a district-wide mineral zonation, marked by Cu- and Ag-rich ores near granite porphyries, with …

Aqueous Geochemistry Drives Microbial Cu, Fe, And Zn Uptake Rates In Yellowstone, A Continental Hydrothermal System, Eva Carolina Andrade-Barahona

Graduate Theses & Non-Theses

Microbial uptake of trace metal cofactors such as copper (Cu), iron (Fe), and zinc (Zn) is governed by biogeochemical processes in hydrothermal systems where metal bioavailability varies widely. In situ microbial metal uptake rates were quantified by applying metal stable isotope probing (MSIP) in the Yellowstone hydrothermal system across diverse geochemical conditions in hydrothermal springs. The findings in these studies revealed that pH exerts a dominant influence on microbial copper uptake rate, also enhanced by increased Cu²⁺ ion availability and dissolved oxygen. Microbial iron uptake, in contrast, displayed a broad tolerance to environmental variability, occurring across a pH range of …

Scaling Ai In Decision-Based Learning: A Data-Driven Evaluation For Resource Optimization, L. Ashley Schumacher

Instructional Psychology and Technology Graduate Student Projects

This project evaluated a AI Assistant built inside ChatGPT to support faculty in creating Decision-Based Learning (DBL) expert decision models in the Conate DBL software. The evaluation addressed a persistent training bottleneck: faculty experienced high cognitive load and significant time loss when navigating a documentation-heavy workflow that required repeated movement between training guides, ChatGPT, and the DBL platform, including extensive copy-and-paste steps. The AI Assistant was developed to replace much of the manual prompting process by providing structured protocols that guide model creation (e.g., exploring possible DBL models, creating paths, generating scenarios, and drafting learning modules) while faculty still build …

Enhancing Flu Vaccination Rates Through Improved Electronic Health Record User Workflow Training, Grace Sayre

Master's Projects and Capstones

A quality improvement project was implemented at an urban community health clinic primarily serving low-income, underinsured, and Latinx individuals. The site had a history of poorly organized flu vaccine rollout and low vaccination rates among the patient population. Seasonal influenza infects millions of people across the US each year, resulting in hundreds of thousands of deaths (Garza et al., 2023), and vaccination is the best prevention. Electronic health record training has been shown to reduce user burnout and improve efficiency (Gordon et al., 2022). The QI project aims to increase medical assistant satisfaction with the flu vaccine rollout by 15%, …

Charting The Course: Improving Psychotropic Medication Documentation Through Staff Education To Promote Patient Safety And Cms Compliance, Anne J. Bertram Rn

Master's Projects and Capstones

The University of San Francisco master’s level nursing program culminates with a clinical nurse leader (CNL) quality improvement project. The objective of this project is to reinforce the program’s didactic CNL classes by allowing students the opportunity to design, implement, and analyze a quality improvement project in a microsystem. SETTING: Skilled nursing facilities often prescribe psychotropic medications to help manage residents’ behavioral and psychological symptoms. Due to the possibility of side effects and increased sedation, there are concerns for patient safety and quality of life. Inadequate management of these patients and symptoms compromises patient safety and breaches state and federal …

Improving Chemotherapy Patients' Confidence And Preparedness Through Dual-Format Teaching, Jasmine Esther Aminpour, Harshpreet Kaur, Ana Ruvalcaba, Sarah Muwanas

Master's Projects and Capstones

Section I: Abstract

Objective

Chemotherapy initiation is widely recognized as a period of heightened anxiety and cognitive overload for oncology patients, often limiting their ability to retain essential information during traditional one-time, nurse-led education sessions (Gucuyener & Karabacak, 2025; Howell et al., 2020). This quality improvement (QI) project sought to address gaps in comprehension, preparedness, and digital engagement within an outpatient oncology infusion microsystem by integrating evidence-based digital chemotherapy education with structured follow-up support.

Aim

The project aimed to determine whether a nurse-guided walkthrough of a digital chemotherapy education platform, paired with standardized follow-up calls, would improve patient comprehension, confidence …

Enhancing Patient Safety In A Skilled Nursing Facility With A Post-Fall Huddle Protocol: A Quality Improvement Initiative, Evelin Yajaira Dominguez Dominguez

Master's Projects and Capstones

Objective To implement a post-fall huddle guide at a San Francisco Bay Area skilled nursing facility to address the 75 resident falls that occurred over an eight-month period. The literature emphasized the positive impact of huddles on staff communication, awareness, and collaboration which ultimately created a safe environment. Aim By November 4, 2025, the overall fall rates among patients in a San Francisco Bay Area SNF will decrease by 25%, from 4.8 falls per 1,000 patient days to 3.6 falls per 1,000 patient days. Methods Pre-implementation and post-implementation surveys were completed by LVNs and CNAs to assess knowledge of post-fall …