Improving Intensive Care Unit Nurses' Knowledge And Confidence In Performing Effective Spontaneous Awakening Trials: A Quality Improvement Project, Sophia T. Merry-Carreiro

Master's Theses and Capstones

Abstract

BACKGROUND

Mechanically ventilated ICU patents often require sedation for comfort and ventilator compliance. However, oversedation is linked to negative outcomes such as delirium, prolonged ventilation, and increased duration of ICU stay. Current best practices now support the use of daily sedation interruptions such as Spontaneous Awakening Trials (SATs). Despite these recommendations, implementation of SATs remain inconsistent and suboptimal.

LOCAL PROBLEM:

Within the ICU in a northern new England hospital, there was a need to improve nurse confidence and knowledge in SATs practices through staff education.

METHODS:

Using the Plan-Do-Study-Act (PDSA) model, a quality improvement project was developed to improve …

Prioritizing Safety Through Evidence-Based Fall Prevention Signage: A Medical-Surgical Quality Improvement Project, Sonila Murati

Master's Theses and Capstones

Background: Falls in the inpatient setting can result in prolonged hospitalization, injury, and increased healthcare costs. Older adult patients are particularly vulnerable due to age-related physiological decline and comorbidities, underscoring the need for effective fall prevention strategies.

Local Problem: In a medical-surgical telemetry unit at a New Hampshire hospital, monthly patient falls continued to be a persistent concern. Leadership identified inconsistent adherence to fall precautions as a key contributing factor, particularly concerning a predominantly older adult population with high fall risk. This project aimed to reduce preventable falls by reinforcing staff awareness through visual reminders.

Methods: Guided by the Plan-Do-Study-Act …

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. …

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 …

Enhancing Patient Outcomes And Safety By Reinforcing Nursing Staff Education About Fall Risks And Prevention In The Orthopedic Unit: A Quality Improvement Project, Sarah S. Walsh

Master's Theses and Capstones

Abstract

Background: Inpatient falls remain a significant concern for orthopedic units, especially among elderly post-surgical patients. Despite existing protocols, fall incidents persist due to various modifiable and non-modifiable risk factors. Nursing staff play a critical role in fall prevention, and targeted education is essential to reinforce best practices.

Local Problem: The orthopedic microsystem reported 13 falls during the 2023–2024 fiscal year, with contributing factors including post-operative weakness, patient confusion, and inconsistent communication. Staff surveys revealed gaps in education, awareness, and communication related to fall incidents.

Methods: A quality improvement initiative using the Define, Measure, Analyze, Improve, Control (DMAIC) model was …

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 …

Optimizing Surgical Count Accuracy And Efficiency Through Enhanced Operating Room Communication To Promote Patient Safety: A Quality Improvement Project, Jessica L. Limbocker

Master's Theses and Capstones

Abstract

Background: Retained surgical items (RSIs) are classified as “never events” because they are preventable and pose significant risks to patient safety. This quality improvement (QI) project aimed to reduce the risk of RSIs, particularly during Cesarean sections by identifying gaps in surgical count practices and implementing targeted interventions.

Local Problem: At the project site, baseline assessments revealed gaps in surgical count practices. These included inconsistent documentation, absence of formal education on count procedures, and communication barriers among the intraoperative team—all contributing to increased risk of RSIs.

Methods: This QI project implemented a multi-faceted intervention to enhance …

Enhancing Patient-Centered Suicide Prevention: A Quality Improvement Project Addressing Educational Gaps In Staff Caring For Veterans, Shayla Craigue

Master's Theses and Capstones

Veterans are at significantly higher risk for suicidal ideation (SI) than the general population and often encounter barriers to care such as stigma, trauma, and distrust in healthcare systems. This quality improvement project, conducted at a Veterans Affairs (VA) Urgent Care Clinic, aimed to enhance trauma-informed care by addressing educational gaps among clinical staff. Using the Plan-Do-Study-Act (PDSA) model, the intervention included a pre-intervention survey to assess baseline knowledge, a targeted educational poster informed by survey findings, and a post-intervention survey to measure changes in staff confidence, resource awareness, and understanding of the role of the mental health response team, …

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 …

Enhancing Patient Safety And Nursing Satisfaction In The Operating Room By Implementing Standardized Handoff Communication Sheets: A Quality Improvement Project, Hayleigh Mcneil

Master's Theses and Capstones

Background: Communication is essential to workflow in the operating room. In this microsystem, circulating nurses required relief nurses when necessary breaks were needed. Written communication allows for nurses to quickly access information when they are giving handoff reports.

Local Problem: An operating room in a trauma level two hospital in New England had a verbal handoff that was inconsistent and left relief nurses with incomplete reports. This issue caused a decrease in nursing satisfaction with a potential decrease in patient safety.

Methods: Using the Plan-Do-Study-Act model, a written standardized communication sheet was created and implemented. Data was …

Introducing Education On Modified Bedside Nursing Handoff To Reinforce Patient Safety Across High-Risk Populations: A Quality Improvement Project., Sydney P. Hodgdon

Master's Theses and Capstones

BACKGROUND:

The Modified Bedside Nursing Handoff (mBNH) is a process where nurses exchange patient information and responsibility at shift change, ideally at the bedside. A PRISMA-based literature review showed that mBNH may help improve communication, protect patient privacy, and enhance safety when done thoughtfully—sometimes at the bedside, sometimes just outside the room. This quality improvement project was launched on a busy unit that cares for high-acuity patients from across northern New England, including those recovering from strokes, motor vehicle accidents, and serious falls. The goal was to increase both frequency and how standardization that nurses reported using mBNH by at …