Improving Efficiency In The Intensive Care Unit Through Reduction Of Nurse Burnout: A Quality Improvement Initiative, Johanna Grace Koroma

Master's Theses and Capstones

Abstract

Background: Intensive care unit (ICU) nursing is prone to high levels of burnout, which poses concern for staff wellbeing, patient safety, and microsystem strain (Kerlin et al., 2020). Educational interventions may serve as a means of increasing awareness on the issue and reducing the effects of burnout, through promotion of evidence-based management strategies.

Local Problem: One ICU microsystem identified several key contributing factors to nurse burnout, including staffing shortages, limited resources, competing responsibilities within the macrosystem, and insufficient organizational support (Zhang et al., 2025). Baseline survey data of the population observed a prevalence of 50% “high” burnout profiles among …

Increasing Patient Feedback Survey Completions Through Patient-Centered Nursing Communication: A Quality Improvement Project, Lindsey E. Pawlowski

Master's Theses and Capstones

Background: Patient feedback is essential to providing the best possible nursing care. Positive patient experiences can impact overall patient satisfaction, loyalty, and trust.

Local Problem: On a pediatric unit at a New England hospital, an assessment of the microsystem revealed that there was a low number of monthly patient feedback survey completions, which limited insight into patient experiences.

Aim Statement: The primary aim of this project was to increase the number of monthly National Research Corporation (NRC) surveys to ten by June 30, 2026.

Methods: This quality improvement project was guided by the Plan-Do-Study-Act (PDSA) model. The first stage of …

Increasing Nursing Perceptions On Advanced Directives Through Education To Promote Patient Centered Care, Michelle Strong

Master's Theses and Capstones

No abstract provided.

Improved Daily Communication To Reduce On-Time First Case Start (Fcots) Delays In The Operating Room: A Quality Improvement Project, Autumn Tourangeau

Master's Theses and Capstones

BACKGROUND: First Case On-Time Starts (FCOTS) are a key indicator of perioperative efficiency and influence operating room (OR) utilization, staff productivity, patient satisfaction, and healthcare costs. Baseline data from an ambulatory perioperative unit demonstrated persistent variability in FCOTS performance and inconsistent interdisciplinary communication regarding surgical delays.

Local Problem: Inconsistent communication and documentation of first-case delays limited interdisciplinary awareness of workflow barriers and contributed to ongoing variability in FCOTS performance.

Intervention: A standardized, HIPAA-compliant daily communication process was implemented, consisting of an end-of-day email summarizing FCOTS delays and the documented reasons for delays. Educational materials and standardized documentation tools were introduced …

Improving Equipment Safety And Operational Efficiency In The Labor And Delivery Setting Using A Standardized Bedside Equipment Checklist: A Quality Improvement Project, Clara E. Lane

Master's Theses and Capstones

Background: Timely and effective neonatal resuscitation depends on the immediate availability and functionality of emergency equipment. Within labor and delivery settings, equipment failures or delays in obtaining necessary supplies and equipment can be detrimental to neonatal health outcomes. Standardized equipment verification processes have been recommended to improve equipment readiness and reduce preventable delays in care provision during neonatal emergencies.

Local Problem: Baseline observational data within the labor and delivery microsystem identified inconsistencies in equipment verification processes, resulting in variable equipment readiness across the microsystem. Staff reported variations in room preparation, safety checks, and concerns related to missing or malfunctioning equipment …

Incorporating Structured Safety Huddles To Improve Nursing Communication And Reduce Medical-Surgical Inpatient Fall Rates: A Quality Improvement Project, Alexia K. Leonard

Master's Theses and Capstones

BACKGROUND: Patient falls are a significant concern for patient safety in the acute care setting and are typically connected to inadequate communication during shift transitions. Bedside shift report is considered the standard of care, however, barriers are still present when shifting patient care responsibilities among nursing staff. A literature review identified standardized safety huddles as an evidence-based practice to improve areas of communication, teamwork, situational awareness, and patient safety. This quality improvement (QI) project concentrated on the implementation of a standardized evening safety huddle in order to improve nursing communication and reduce patient falls on an inpatient medical-surgical/telemetry unit. METHODS: …

Improving Telemetry Alarm Fatigue By Reducing Perception Of Noise Through Education: A Quality Improvement Project, Emma Bergeron

Master's Theses and Capstones

Background: The perception of excess telemetry noise has a negative impact on nursing staff workflow, emotional stress, physical stress, and alarm fatigue. This can create a distressing workplace, interrupt the ability to answer telemetry alarms in an appropriate amount of time, and further worsen alarm fatigue in nursing staff.

Local Problem: The local problem identified was the perception of telemetry noise and alarm fatigue. The purpose of this study was to assess the extent of alarm fatigue and perception of telemetry noise on the unit.

Methods: The study consisted of an assessment of the microsystem itself and the observed impact …

Improving Nurse Well-Being And Patient Safety Through A Structured Break Buddy System: A Quality Improvement Project, Elizabeth Harrington

Master's Theses and Capstones

Abstract

Background: Nursing burnout has become an increasing concern due to heavy workloads, staffing shortages, and the inability of nurses to consistently take uninterrupted rest breaks during their shifts. Missed breaks contribute to fatigue, emotional exhaustion, decreased job satisfaction, and an increased risk of patient safety events. Evidence suggests that structured break interventions may improve opportunities for recovery during the workday.

Methods: A quality improvement (QI) project was conducted on a respiratory care unit at a midsized hospital in central New Hampshire using the Plan-Do-Study-Act (PDSA) framework. A microsystem assessment identified inconsistent break-taking as a significant gap. A five-question anonymous …

Introducing Education For Sensory Approaches In Mental Health-Related Emergency Department Visits: A Quality Improvement Project To Enhance Patient-Centered Care, Jesse O'Neill

Master's Theses and Capstones

Background: Barriers to specialty care access have resulted in emergency departments (ED) operating as temporary psychiatric hold facilities for their communities. Patients boarding in the ED are demonstrated to use a disproportionate percentage of facility resources with minimal benefit to the patient. The Institute for Healthcare Improvement identifies the impact of the healthcare environment on patient outcomes and suggests staff training to foster trauma-informed practice culture (Schall et al., 2020).

Local Problem: High-stress healthcare environments can escalate maladaptive patient behaviors and the use of restrictive interventions. Traditional use of restrictive interventions lacks supportive evidence and contradicts person-centered care goals (Molloy …

Implementing A Standardized Patient Report Sheet To Improve Timeliness And Efficiency Of Patient Handoff Reports: A Quality Improvement Project, Brian F. Mclaughlin

Master's Theses and Capstones

Abstract

Background: A successful patient handoff report is a foundational element of nursing care, it encompasses the patient's medical history, current treatment plan, patient-centered goals, and notes of consideration. Blazin et. al. (2020) identified unsuccessful patient handoff reports as the root cause of many medical errors. Improving the patient handoff report process provides opportunities for increased registered nurse job satisfaction, reduced medical errors, and increased time efficiency.

Local Problem: Anecdotal discussions with nursing staff on an adult medical-surgical unit  revealed frustration with the patient handoff reporting process. Nursing staff cited interruptions, lengthy patient handoff report times, and the need to …

Cheshire Advisory Council Agenda & Minutes 2026, Carl Majewski

Advisory Council

No abstract provided.

Strafford County Extension - Advisory Council Meeting Minutes 2026, Rebecca Hull

Advisory Council

No abstract provided.

Bmal1 Mediates Sex-Specific Circadian Regulation Of Cardiac Ion Channels And Temporal Arrhythmia Vulnerability, Brian P. Delisle, Ezekiel Rozmus, Abhilash Prabhat, Spencer B. Procopio, Xiping Zhang, Emilia Entcheva, Karyn A. Esser, Elizabeth Schroder

Physiology Faculty Publications

No abstract provided.

C/Ebpα Is Essential For Gonadal But Not Inguinal White Adipose Tissue Formation In Mice, Krista Y. Hu, Yu-Lin Ma, Esme A. Dodge, Olivia A. B. Maguire, Caio V. Matias, Ryan K. Barney, Hector S. Himede, Juliana Gomez Pardo, Miriam Cepeda, Scott M. Gordon, Robert C. Bauer

Physiology Faculty Publications

Objective: The distribution of excess white adipose tissue (WAT) in obesity correlates with risk for comorbidities. Thus, understanding depot-specific WAT developmental mechanisms is translationally relevant. SNPs near the gene CEBPA associate with waist to hip ratio, and while C/EBPα is a recognized regulator of adipogenesis, there is no previously known role for C/EBPα in regulating adipose distribution.

Methods: We crossed Cebpa floxed mice to the AdipoQ-Cre transgenic mouse strain, generating mice with adipocyte-specific knockout of Cebpa (Cebpa_ASKO). Mice were phenotyped on a chow diet and after prolonged high-fat diet (HFD) feeding.

Results: Cebpa_ASKO mice almost entirely lack gonadal …

Dim Light At Night Worsens Cardiac Autonomic Dysregulation In Female Diabetic Mice, Abhilash Prabhat, Shrishti Naidu, Isabel G. Stumpf, Tanya S. Seward, Elizabeth A. Schroder, Brian P. Delisle

Physiology Faculty Publications

Cardiovascular autonomic neuropathy (CAN) is a common complication of diabetes mellitus. CAN is characterized by impaired cardiovascular autonomic control and is associated with increased mortality, especially among women with type 2 diabetes. Identifying environmental factors that exacerbate the CAN-associated phenotype may reveal modifiable strategies to reduce cardiovascular risk.

Nighttime light exposure is a novel cardiovascular risk factor. Among ∼90,000 individuals, greater nighttime light exposure correlated with increased atrial fibrillation and heart failure risk. Light at night disrupts sympathovagal balance and elevates nocturnal heart rate in humans. Dim light at night similarly disrupts autonomic regulation of heart rate in mice. We …

Early Microglial Response To Amyloid Plaques Drives Sleep Loss In Alzheimer’S Disease, Nicholas J. Constantino, Riley E. Irmen, Matthew J. Lanning, Sierra M. Turner, Clair C. Ashley, Caitlin M. Carroll, Evan M. Neary, Dave Rubinow, J. Andy Snipes, Shannon L. Macauley

Physiology Faculty Publications

Introduction: Sleep disruption is an early feature of Alzheimer's disease (AD), but the cellular mechanisms linking amyloid pathology to sleep loss remain unclear.

Methods: Electroencephalography/electromyography (EEG/EMG) recordings, quantitative EEG analysis, and sleep deprivation were performed in APPswe/PSEN1dE9 (APP/PS1) mice at different stages of pathology relative to normal aging. Amyloid burden and microglial density were quantified with whole-brain light-sheet microscopy. CSF1R-mediated microglial depletion explored effects of microglia on sleep loss.

Results: Amyloid plaques caused non–rapid eye movement (NREM) sleep loss that did not worsen with increased plaque burden. Aging reduced REM sleep and eliminated sleep rebound. Amyloid pathology was associated with …

Dennd5b Disruption Results In Reduced Body Fat And Increased Intestinal Fatty Acid Oxidation By Activation Of Autophagy, Khaga R. Neupane, Alexander Karakashian, Maura Mobilia, Olivia Hage, Patrick Tso, Min Liu, Laurent Vergnes, Karen Reue, Scott M. Gordon

Physiology Faculty Publications

Intestinal absorption of dietary lipid is essential for systemic lipid homeostasis; however, elevated postprandial plasma lipid levels are associated with obesity and increased risk for atherosclerotic cardiovascular disease. In humans and rodents, biological sex impacts dietary triglyceride absorption, and males tend to have higher postprandial triglyceride levels compared to females, but the physiological basis for this is not well understood. Here, we show that the gene DENND5B is associated with body composition in humans and mice and that genetic deletion of Dennd5b in mice prevents postprandial plasma triglyceride elevations in both sexes. Our findings establish a role for this protein …

Evidence Of Interparticle Chylomicron “Bridging” In Mouse Mesenteric Lymph After A Lipid Bolus, Khaga Raj Neupane, Alexander Karakashian, Min Liu, Scott M. Gordon

Physiology Faculty Publications

No abstract provided.

Pediatric Chop Chemotherapy Acutely Disrupts Satellite-Cell Dynamics And Blunts Muscle Mass In A Sex-Specific Manner, Jainil Daredia, Marc A. Magaña, Carla M.C. Nascimento, Jaden M. Wells, Nicholas T. Thomas, Yuan Wen, Savannah V. Rauschendorfer, Cory M. Dungan, Michael P. Wiggs

Physiology Faculty Publications

Pediatric cancer survival now exceeds 85% owing, in part, to advances and the use of combination chemotherapy treatments such as CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone). Despite its efficacy, CHOP may cause off-target effects during critical pediatric development periods such as impairments of skeletal muscle. We evaluated the acute effects of a CHOP administered to C57Bl/6J mice from postnatal day 28 to 48. CHOP slowed body-weight gain and led to a smaller gastrocnemius fiber cross-sectional area by ~25% in both sexes (n ¼ 11 or 12 males; n ¼ 8 or 9 females). RNA sequencing detected 214 differentially expressed genes …

Skeletal Muscle Methylome-Transcriptome Disruptions During The Onset And Progression Of Colorectal Cancer-Induced Cachexia, Ana Regina Cabrera, Ronald G. Jones, Eleanor R. Shrems, Francielly Morena, Yuan Wen, Tyrone A. Washington, Kevin A. Murach, Nicholas P. Greene

Physiology Faculty Publications

Cancer cachexia is a wasting condition, primarily affecting skeletal muscle, impairing patients’ quality of life, prognosis, and survival. The molecular triggers are incompletely defined, but given prior evidence for epigenetic plasticity in muscle, we speculate that dysregulated DNA methylation plays a role in muscle transcriptional alterations mediating cachexia severity. We aimed to describe and integrate the cachexia methylome and transcriptome. We used a time course approach in a mild cachexia model (colon-26, C26) coupled with a severe cachexia genetic model (Apc^Min/+) in both biological sexes to assess the methylome across degrees of cachexia pathology. The muscle methylome and …

Cytoprotective Role Of Octacosanol In Lipopolysaccharide-Induced Inflammation, Jingrong Tang, Zhi Hong Yang, Wenling Li, Huaitian Liu, Diego Lucero, Denis Sviridov, Olivia White, Julia Kun, Yoh Suke Mukouyama, Alan T. Remaley

Physiology Faculty Publications

Inflammation and endothelial dysfunction are key steps in the pathogenesis of atherosclerosis. Octacosanol (C₂₈H₅₈O, OCT), a very-long-chain saturated aliphatic alcohol (VLCA) with 28 carbons, is the main component of policosanol, a nutraceutical mixture of VLCAs (C20-C34) extracted from plants. Polycosanol in animal models is known to reduce atherosclerosis, but its mechanism of action remains unclear. This study investigates the pathways by which OCT alleviates LPS-induced inflammation in primary human aortic endothelial cells (HAECs). After overnight pretreatment with purified OCT, inflammation in HAECs was induced by lipopolysaccharide (LPS) at 100 ng/ml. The effects of OCT on the …

From Lipoprotein Metabolism To Blood Clotting, Alexis N. Smith, Mirza A. Beg, Woosuk Steve Hur, David Ginsburg, Iftikhar J. Kullo, Sean S. Davies, Ira Tabas, Jesse W. Williams, Chieko Mineo, Bishuang Cai, Rana K. Gupta, Jaume Amengual, Anna Schwendeman, Gregory A. Graf, Mary Sorci Thomas, Ze Zheng

Physiology Faculty Publications

The biannual Fredrickson Lipid Research conference took place in person in Milwaukee, Wisconsin, from September 3–5, 2025. Each conference highlights the most advanced basic and translational research in lipids and lipoprotein metabolism. As with each Fredrickson Lipid Research conference, the overall theme is focused on “Lipid Metabolism, Lipoproteins, and Atherosclerosis,” and this year included a special scientific session exploring the connections between Blood Clotting and Lipid Metabolism. This session underscored ongoing research aimed at explaining the mechanisms by which dyslipidemia alters the coagulation system and drives thrombotic cardiovascular disease. Other scientific session themes at the conference included Biomarkers in Cardiovascular …

Agricultural Evidence Synthesis At A Critical Juncture: Quality Gaps And Implications For Evidence-Based Agriculture, Chao Cai, Jane Yatcilla, Justyna Czader, Sylvie Brouder, Jeffrey Volenec

Libraries Faculty and Staff Scholarship and Research

Systematic reviews and meta-analyses have become essential tools for synthesizing evidence to guide agricultural policy and practice, yet whether these syntheses are themselves conducted with sufficient rigor has rarely been systematically assessed. This study provides a field-wide assessment of reporting quality in agricultural evidence synthesis, examining whether existing reviews are conducted with sufficient transparency and rigor to support the policy and practice decisions they are meant to inform. We drew a random sample of 244 systematic reviews and meta-analyses from a bibliometric dataset of 1,709 articles published between 1997 and 2023, evaluating reporting quality using a 12-indicator rubric across four …

Let’S Modify Safety Valve To Value Family Ties, Laura Ginsberg Abelson

Faculty Journal Articles and Book Chapters

Federal sentencing law has long struggled to balance the breadth of drug conspiracy liability with the prin­ciple of proportional punishment. The statutory “safety valve” provision, codified at 18 U.S.C. § 3553(f) and mirrored in the U.S. Sentencing Guidelines, was designed to provide relief from mandatory minimum sentences for low- level, nonviolent offenders. Yet its requirement that defendants disclose all information concerning the offense sometimes places family-member codefendants in an untenable position: they may avoid harsh penalties only by incriminating loved ones. The requirement also conflicts with other provisions of the Guide­lines that provide guidelines reductions, but not relief from mandatory …

A Zinc Chelate Of Lysine/Glutamic Acid Reduces Alcohol-Induced Ciliary Dysfunction, Emily Do, Daren L. Knoell, Christopher Bauer, Deanna Mosley, Deandra R. Smith, Derrick R. Samuelson, Todd A. Wyatt

Journal Articles: Environmental, Agricultural & Occupational Health

Alcohol misuse is a known risk factor for pneumonia, and up to 50% of individuals who misuse alcohol are zinc deficient. Chronic alcohol misuse can lead to alcohol-induced ciliary dysfunction (AICD), preventing effective mucociliary clearance and protection against lung infection. Because zinc salts fail to alter AICD, we hypothesized a form of zinc (Zinpro Zinc LG) with enhanced cell uptake would protect against AICD. Human and mouse airway epithelial cells were treated with 50 mM ethanol for 1-24 h followed by the ciliostimulatory agents. Cilia beat frequency (CBF) and cAMP-dependent protein kinase (PKA) activity were assayed. Cyclic AMP or beta …

Qubit Lattice Algorithm Simulations Of The Scattering Of A Bounded Two Dimensional Electromagnetic Pulse From The Infinite Planar Dielectric Interface, Min Soe, George Vahala, Linda Vahala, Efstratios Koukoutsis, Abhay K. Ram, Kyriakos Hizanidis

Electrical & Computer Engineering Faculty Publications

Qubit lattice algorithm (QLA) simulations are performed for a two-dimensional spatially bounded pulse propagating onto a plane interface between two dielectric slabs. QLA is an initial value scheme that consists of a sequence of unitary collision and streaming operators, with appropriate potential operators, that recover Maxwell equations in inhomogeneous dielectric media to the second order in the lattice discreteness. For the case of total internal reflection, there is transient energy transfer into the second medium due to the evanescent fields as the Poynting unit vector of the pulse is rotated from its incident to reflected direction. Because of the finite …

Recent Advances In Bioceramics, Fundamental Properties And Future Perspective In Biomedical Applications ‒ A Review, Ayesha Younas, Muhammad Umar Aslam Khan, Mohd Faizal Binte Abdullah, Lobat Tayebi, Shuanghu Wang, Abdalla Abdal-Hay, Yichi Xu

Electrical & Computer Engineering Faculty Publications

Bioceramics are important biomaterials in biomedical engineering because of their biocompatibility, bioactivity, osteoconductivity, and structural resemblance to actual bone tissue. In recent years, materials science and nanotechnology have enabled the use of bioceramics in bone regeneration, dental restoration, tissue engineering, drug delivery systems, and implantable medical devices. This comprehensive review covers advances in bioceramics, including calcium phosphates, hydroxyapatite (HAp), tricalcium phosphate, bioactive glasses, zirconia, alumina, and multifunctional ceramic nanocomposites. Priority is given to techniques such as additive manufacturing, 3D printing, sol-gel processing, electrospinning, and nanostructuring to improve mechanical strength, porosity, bioactivity, and cell interactions. Recent advances include ion doping, surface …

Comprehensive Analytical Investigation Of Tetrahydro-4h-Chromene And Dihydropyridine Derivatives, Ryan J. Burk

Chemistry & Biochemistry Dissertations

Novel calcium channel blockers (CCBs) with dihydropyridine (DHP) or tetrahydro-4H-chromene moieties are often chiral, so effective enantiomer separation methods are needed for continued drug development. The purpose of this dissertation is to outline a comprehensive method development model for the chiral separations of DHPs and tetrahydro-4H-chromene derivatives. The scope of this dissertation is to address analytical challenges during initial synthesis, chiral separations, and data analysis during post-processing for this class of chiral compounds. The first section focuses on the method development strategies for separations of DHPs in the sub/supercritical fluid (SFC) and normal phase modes with the 2-hydroxypropyl-β-cyclodextrin stationary phase. …

Novel Methods For Environmental Fluoride Measurement, Cable Warren

Chemistry & Biochemistry Dissertations

Fluoride analysis has been an important focus of analytical analysis for many years and will continue to be so going forward. Today, fluorinated compounds, specifically per/polyfluoroalkyl substances (PFAS), better known as “forever chemicals” have captured the moment and are the subject of vast research and regulation. Under this context, I have researched new methods of fluoride separation and concentration in complex media as well as a novel method of PFAS destruction and total organic fluorine analysis for screening of PFAS in aqueous samples. Through research and work on micro-scale detection methods, an understanding of the state of the art and …

Andante: Introduction, Ilaria Serra

Andante: An Introduction

Cover art: Dorothy Tennant (1855-1926), Al gioco