Inclusivity Of In Vitro Fertilization Clinic Websites, Erin Donahue

Honors Theses and Capstones

In the world, many people cannot naturally conceive children. They may be infertile, lack an intimate partner, or be in a same-sex relationship. Artificial reproductive technologies (ARTs) are catered to the aforementioned population. ARTs are fertility treatments that assist people with the fertilization of gametes and/or implantation of embryos. One of the most popular ARTs is in-vitro fertilization (IVF). IVF is a medical procedure in which an egg is fertilized by sperm in a lab so it can develop into an embryo. That embryo can then be implanted directly into the uterus. This quality improvement project aims to determine the …

Student Perspectives On The Adequacy Of Mental Health Curriculum Within The College Of Health And Human Services At Unh, Brianna Lee Meyer

Honors Theses and Capstones

This study aims to understand the confidence students in future healthcare oriented majors feel in regards to treating or interacting with individuals with mental health conditions. It also aims to understand the effect of students' in-major education, outside-major education, and lived experience on this confidence level. Students within the College of Health and Human Services at UNH were the participants who completed a short Qualtrics survey online. The survey collected data from Likert scales and short-answer questions. The Likert scales were then analyzed with a regression and descriptive statistics, while the short-answer questions were analyzed with thematic analysis. The study …

The Expansion Of Language Interpretation Services Post-Executive Order 13166: Effects On Maternal And Fetal Outcomes Of Non-English-Speaking Patients, Lilly Annabelle Smith

Honors Theses and Capstones

Over 69 million people older than the age of 5 in the U.S. speak a language other than English at home (U.S. Census, 2022). Of this population, around 38% report speaking English less than "very well" or limited English proficiency, “LEP”. Research has shown patient-provider communication quality in healthcare settings to be directly linked to the provider's ability to deliver safe and suitable care for LEP patients (Au et al., 2009). Executive Order (EO) 13166, signed into law in 2000, requires all federal agencies to implement and document language interpretation services in their establishments (Basu et al., 2017). LEP mothers …

Distribution Of Tick Species On Free-Ranging Ungulates In Northern New England, Karisa Graham

Honors Theses and Capstones

In Northern New England, ungulates are often parasitized by ticks, which is one of the leading causes for the decline in population. Ungulates are a good host for ticks, specifically deer ticks and winter ticks, and these ticks cause many tick-borne diseases in humans as well. The purpose of this study was to assess passive sampling from harvested animals as a means of tick surveillance in Vermont and New Hampshire. Ticks were collected from deer and moose and mapped throughout the two states by ArcGIS to visualize the trends in distribution. Relative abundance was greater in southeastern Vermont, with no …

Nursing Education And Comfort Level In Caring For Patients With Eating Disorders, Jaylyn E. Jewell

Honors Theses and Capstones

Nurses are integral to providing care to patients with eating disorders, who often present to the generalized hospital setting related to physical complications from their disorder. Despite the vital role nurses play, a lack of education is cited. This project sought to assess knowledge on eating disorders of nurses at a local hospital through dissemination of a survey. A total of n=18 responses were gathered. Results supported the fact that many nurses have received inadequate education on eating disorders, and consequently have low knowledge and competency in the care of these patients. This project seeks to identify this lack of …

Investigation Of The Causative Agent Of Canine Leproid Granuloma Infection Cases In The Northeastern United States, Nicole J. Marcotte

Honors Theses and Capstones

Canine leproid granuloma syndrome (CLGS) is a form of disease in dogs of many breeds that is characterized by a skin infection in the subcutis and/or dermis. The granulomas that form as a result of infection are typically non pruritic, alopecic, raised, and firm. These mass-like granulomas can ulcerate, causing further infection beneath the skin surface, and are present in areas of the body such as the ears, head, neck, and extremities. CLGS has been known to infect dogs of different breeds and ages, but has most commonly been reported to infect shorthaired, large sized breeds. This disease is suspected …

Understanding Hospital-Based Nurse End-Of-Life Care, Knowledge, And Comfort: A Quality Improvement Project, Emma Doran

Honors Theses and Capstones

Providing physical, emotional, and spiritual care to patients at the end of life (EOL) can relieve their suffering and the pain experienced by loved ones in their presence. As death approaches, patients’ symptoms may require increased comfort measures, and it is imperative that all nurses be properly trained and prepared to provide this care. In this quality improvement (QI) project, the End-of-Life Professional Caregiver Survey (EPCS) and demographic and experiential questions were administered in the form of a Qualtrics survey to nurses working on an acute care inpatient unit at a healthcare organization in New England. 18 survey responses were …

Peer Support To Enhance Safe Alcohol Use In University Students: A Quality Improvement Project, Kerri Reynolds

DNP Scholarly Projects

BACKGROUND: College is a period of transition to adulthood where many students experiment with alcohol consumption. Peer educators can bring access to evidence-based alcohol consumption education through student-centric strategies. This quality improvement project aimed to implement an evidence-based training program for college peer educators followed by the delivery of campus alcohol education in a six week period. Feasible ideas for sustainable college peer educator training were generated at this medium-sized public university. The impact of training on six peer educators’ self-reported professional leadership skills, knowledge, and confidence was measured.

METHODS: The Certified Peer Educator (CPE) training program (NASPA) was used …

Integrating Behavioral Health Into Family Medicine: Improving Access To Specialty Care Using A Collaborative Care Model, Christina Stephens

DNP Scholarly Projects

Primary care, an extensive of family medicine remains a key access point for patients entering the healthcare system. Accessing medical care and specialty psychiatric services is limited in rural communities. Patients often find exhaustive wait times, untimely referrals, and reliance on emergency services for crisis management. The primary care provider is able to help their community improve access to behavioral health care by using a collaborative approach. This quality improvement initiative used the framework produced by the AIMS Center at the University of Washington and adopted for use creating an 8-week intensive program in a family medical practice located in …

Evaluating The Impact Of Simulation On Perceived Knowledge And Confidence Of New Graduate Nurses (Ngns) In Maternal-Newborn Care, Disa Seymour

DNP Scholarly Projects

Abstract

Background: Nursing education worldwide varies in duration and training process, with nurses often facing rapid immersion into patient care complexities when entering the workforce. While new nurses contribute significantly to the nursing community with contemporary knowledge, their transition to practice can be daunting, necessitating support for both competence and retention. As specialty care settings integrate more new graduate nurses (NGNs) to address workforce shortages, collaboration between leaders and educators becomes crucial. Simulation emerges as a vital tool in building confidence while learning, offering a safe space for skill development and growth of confidence.

Purpose: This project’s objective was to …

Scares: A Clinician Guide To Spinal Cord Awareness, Response, And Emergency Support Creation And Implantation Of Scares Protocol Among Hospitalist Advanced Practice Providers, Brittany Biega

DNP Scholarly Projects

While they are more common in patients with oncological disease and trauma, SCE still exist among patients without these comorbidities. Less has been established regarding care protocols in this population. The absence of standardized procedures has been linked to preventable, adverse patient outcomes, including cases of permanent damage due to delayed treatment. This project employs Lean Six Sigma methodologies and Johns Hopkins Evidence- Based Practice to devise a robust SCE protocol, aimed at standardizing care and improving patient outcomes. A multidisciplinary team including general medicine, neurology, neurosurgery, and neuroradiology developed “Spinal Emergency Management Guidelines” protocol, which was implemented within the …

Optimizing The Assisted Living Experience: Integration Of Value-Based Care To Foster Augmented Resident-Centered Quality, Jennette Pietrzak

DNP Scholarly Projects

Background: Fee-for-Service models are quantity-focused reactive approaches and have historically been at the forefront of healthcare. Value-based models focus on proactive, resident-centered care that is aimed at quality care over quantity. Implementation of ValueBased Care models can positively impact healthcare and fiscal outcomes

Purpose: The quality improvement project aimed to develop, integrate, and implement a valuebased model in Memory Care as an alternative to traditional Fee-for-Service models. The project aimed to improve key performance indicators by reducing hospitalizations, emergency room visits, and falls following the implementation of Value-Based Care (VBC) models.

Method: Data metrics for hospitalizations, emergency room visits, and …

Empowering Nurse Leaders To Achieve Harmony: Fostering Work-Life Balance, Gilberto Gamba

DNP Scholarly Projects

BACKGROUND: Balancing professional and personal life demands has become a focal point in today’s healthcare organizational culture. Despite the technological advances in providing better and faster healthcare, team members often struggle to achieve work-life harmony while meeting the demands of a growing population of healthcare clients. The evidence highlights nurse leaders as one group for which the identification and implementation of work-life balance interventions is crucial.

METHODS: An original tool based on available evidence was developed and used with a group of nurse leaders participating in an educational activity to engage them in behaviors supporting work-life harmony. A post-educational survey …

Exploring Lexical Stress Perception: An Investigation Across Varied Listener Experience With Prosody, Olivia J. Pride

Honors Theses and Capstones

Prosody is a characteristic of speech that allows others to understand emotion, emphasis, and meaning of language more deeply. Perceptual accuracy by speech-language pathologists is critical to diagnosing speech disorders. This study examined perceptual abilities of three different groups in identifying lexical stress across groups. Four SLPs, 6 SLP graduate students, and 6 untrained listeners listened to 396 audio files elicited in a prior study using the lexical stress tasks from the Prosodic Profiling Elements of Prosody in Speech-Communication (PEPS-C) and the naturalistic lexical stress (NLS) tasks. Listeners were asked if syllable stress was on the first syllable, second syllable, …

Increasing Education And Staff Knowledge Of Delirium Care: An Evidence-Based Quality Improvement Project, Serena Martinath

Master's Theses and Capstones

Introduction At a small, community hospital in Massachusetts a gap analysis was conducted leading to a quality improvement project to increase staff education and knowledge regarding delirium and evidence-based best practices for delirium care. Delirium is a growing, often under recognized medical condition that occurs in hospitalized patients (Loftus & Wiesenfeld, 2017). Delirium is characterized by acute changes in congnition, level of consciousness, and attention (Loftus & Wiesenfeld, 2017). A better understanding of this condition is expected to result in improved patient care.

Methods The clinical microsystem studied in this gap analysis project was assessed by using the AHRQ Gap …

Non-Invasive Monitoring Device For Early Detection Of Breast Cancer Related Lymphedema, Amy Prendergast

Honors Theses and Capstones

Breast Cancer Related Lymphedema (BCRL) is a common co-morbidity in cancer survivors following neoadjuvant therapies such as chemotherapy, radiation, and/or surgery. It is brought about by the disruption in the lymphatic system (think lymph node biopsy) that leads to a buildup of lymphatic fluid in the arm. Current diagnostic strategies for this condition are merely retroactive, and fairly limited in the parameters that are examined to ensure patient well-being long term. We hypothesize that with an approach that mimics bioimpedance spectroscopy analysis, we will be able to provide a clinical support tool that would better determine early stages of lymphedema …

Heparin Vs. Saline: Evaluating Evidence-Based Best Practice For Maintaining Patency Of Implanted Ports, Shannon D. Murdock

Master's Theses and Capstones

Background Implanted ports are frequently used for central venous access in the adult oncology population. Maintaining patency of these ports is important for continuing uninterrupted treatment and supportive care for oncologic patients. Historically, heparin solution has been used as a locking solution for implanted ports to prevent occlusion. However, evidence shows that 0.9% sodium chloride (normal saline or NS) as a lock solution is equally effective as heparin solution at maintaining implanted port patency and poses less risk to patients.

Local Problem In an ambulatory adult oncology clinic serving Seacoast New Hampshire, a gap was identified between clinical practice where …

Promoting Safety Of Medication Administration And Reducing Medication Errors Using Photographic Patient Identification In An Inpatient Psychiatric Setting: A Quality Improvement Initiative, Kyla Kelly

Master's Theses and Capstones

Abstract

Background: Medication errors pertaining to patient wristband workarounds in a behavioral and mental health inpatient unit can affect patient outcomes, safety and can even be fatal. The proper verification of the five rights of medication administration, patient acuity, diagnosis, and unit staffing can impact the need for patient wristband workarounds to occur. Improving staff and patient education and reducing the need for wristband workarounds through the utilization of patient photographic identification significantly reduces the number of medication errors relating to wristband workarounds during the medication administration process. Additionally, a significant reduction in the time it takes to administer medications …

Using Education To Improve Nurse Perceptions On Rounding To Increase Patient Safety And Efficiency Of Care On A Behavioral Health Unit: A Quality Improvement Project, Shannon Alty

Master's Theses and Capstones

Abstract

Background: Hourly rounding completed by nursing staff are routinely completed on most inpatient hospital units. Evidence suggests that hourly rounding can improve patient outcomes, patient satisfaction rates, communication, minimize patient requests and improve the nurse patient relationship (Halm, 2009). Additional evidence suggests that inpatient psychiatric patients often feel disconnected from their nurse and hourly rounding is recommended to build the nurse-patient relationship (DaSilva, 2017). However, for successful implementation, nurse perceptions of rounding must be obtained.

Local Problem: Hourly rounding is a standard of practice, however, was not being consistently completed. Assessing the nurse perceptions regarding rounding, was imperative understand …

Assessing And Improving Pediatric Nurses' Documentation Of Childhood Immunization Status Using The Electronic Health Record, Katherine Engalichev

Master's Theses and Capstones

BACKGROUND: Adherence to the standardized childhood immunization schedule put forth by the American Academy of Pediatrics is the gold standard for decreasing vaccine-preventable disease morbidity. The first step to improving adherence with the recommended immunization schedule is identifying children who are under-immunized. The inpatient setting offers an opportunity to screen pediatric patients for immunization status. A survey was administered to nurses working on an inpatient pediatric unit to gauge nurse self-report of Cerner™ Electronic Health Record (EHR) use for immunization documentation, their perceptions regarding EHR ease of use for documenting pediatric immunization status, attitudes towards documenting immunization status, and perceived …

Improving Communication Between The Emergency Department And Prehospital Emergency Medical Services Through The Use Of A Secure Messaging Application: A Quality Improvement Project, Jacob G. Petlon

Master's Theses and Capstones

Background: Communication between emergency medical services (EMS) and the emergency department (ED) is a key part of treating patients being transported by ambulance. This communication is moving away from traditional radio and cell phone calls to the use of secure text-based apps. These apps can generate metrics and provide real time location information that is not available using traditional methods. Increased use of these apps can improve communication between EMS and receiving EDs.

Local Problem: Wildcat hospital introduced the EMS communication app Twiage in May of 2023. There is low utilization of the app and some EMS and ED …

Incorporating Non-Pharmacological Labor Coping Methods To Improve Nursing Care And Reduce Primary Cesarean Section Rates: A Quality Improvement Project, Cait Maccabe

Master's Theses and Capstones

Abstract

BACKGROUND: Cesarean sections (c-sections), while life-saving in some circumstances, carry a significantly higher risk of morbidity and mortality than vaginal birth for birthing patients and neonates alike. Despite this, rates of c-section have continued to rise in the US and around the world. As primary cesarean births are highly likely to lead to repeat cesarean births, concerted efforts are being made to reduce them both broadly and within the setting of this quality improvement (QI) project: a labor and delivery unit located within a Level II trauma center in New Hampshire. A literature review provided evidence supporting the use …

Using Education To Improve Timeliness And Efficiency Of Medication Administration In An Inpatient Hospital Setting: A Quality Improvement Project, Kevin Christopher Lane

Master's Theses and Capstones

Background: Timeliness of medication administration is important for optimal patient care. Technology, interdepartmental communication, and nursing workflow influence on-time delivery of medications. Improving knowledge through PowerPoint™ education and visual aids such as medication alert placards improves interdepartmental communication and positively influences nursing workflow leading to improved medication delivery times.

Local Problem: Nurses spend considerable time looking for and administering medications to patients on the unit. A goal was established to reduce the amount of time nurses spent looking for medications by 5% after implementing PowerPoint™ education to improve workflow.

Methods: This project used the Plan-Do-Study-Act (PDSA) strategy for implementation. …

Evidence-Based Suicide Assessment And Managment Training For Mental Health Professionals, Clara Abit

DNP Scholarly Projects

Background: Suicide is a significant public health concern both nationally and globally. While the suicide rate has been decreasing in recent years, evidence shows that the rate of suicide among teenagers and adolescents has been on the rise. Teenage suicide accounts for 14% of all deaths by suicide in the United States, calling for effective interventions in various settings. However, inadequate knowledge of the potential signs and risk factors of suicide hinders mental healthcare professionals' ability to recognize at-risk patients.

Purpose: The project's objective was to evaluate the effects of the intervention on mental health workers' knowledge, skills, and screening …

Meta-Analytic Connectivity Modelling Of Healthy Swallowing, Chris R. Tilton

Honors Theses and Capstones

A quantitative, voxel-wise meta-analysis was performed to investigate the brain regions involved in healthy human swallowing. Studies included in the meta-analysis (1) examined water swallowing, saliva swallowing, or both, (2) included healthy, normal subjects, and (3) reported stereotaxic brain activation coordinates in standard space. Following these criteria, a systematic literature review identified 8 studies that met the criteria. An activation likelihood estimation (ALE) meta-analysis and meta-analytic connectivity modelling (MACM) analysis were performed with BrainMap software. Ten clusters with high activation likelihood were found in the bilateral precentral gyri, right insula, left declive, right medial frontal gyrus, right dorsal nucleus of …

Cardiorespiratory And Metabolic Responses To Low-Intensity Blood-Flow Restricted Running, Violet E. Sullivan, Amanda P. Ares, Summer B. Cook Ph.D.

Honors Theses and Capstones

Low-intensity (LI) aerobic exercise with blood-flow restriction (BFR) increases heart rate (HR), oxygen consumption (VO₂), and ratings of perceived exertion (RPE), sometimes to similar levels as high-intensity (HI) exercise. Distance runners may benefit from LI-BFR running in periods of reduced volume or intensity, possibly due to injury. PURPOSE: To compare HR, VO₂, blood lactate (BLa), and RPE during LI-BFR running and HI running without BFR. METHODS: Fifteen female distance runners (age 23+4yrs, height 1.67+0.50m, body mass 57.6+5.7kg, VO₂max 51.0+4.5mL•kg^-1•min^-1) completed three randomized 12-minute running conditions: LI control (40% VO_{2 …}

Taxonomic Classification Of Viral And Bacterial Dna Following 2021 Avian Mass Mortality Event, Tessa Baillargeon

Honors Theses and Capstones

From May through July 2021, an unusual mortality event occurred along the eastern coast and Midwest of the United States. Thousands of birds, mostly from the order Passeriformes, were part of the die-off including blue jays (Cyanocitta cristata), common grackles (Quiscalus quiscula), European starlings (Sturnus vulgaris), American robins (Turdus migratorius). Clinical signs included crusted eyes, swollen conjunctiva, otitis, seizures, and ataxia.

The New Hampshire Veterinary Diagnostic Laboratory (NHVDL) received over 100 affected birds from various collaborators throughout the United States including Washington DC, NJ, CT, MD, and OH. Given the timing and geologic …

Behavioral Markers And Endophenotypes Underlying Individual Differences In Ethanol Use, Haily R. Knapp

Honors Theses and Capstones

The main concern of this study is to evaluate the neurobiology of ethanol self-administration and cue-induced reinstatement in rats and its implications for Alcohol Use Disorder (AUD) prevention and treatment. The purpose of this study is to use a pre-clinical model of ethanol use to understand the individual effects at the neurobiological level. The study utilized economic demand and negative consequence testing to evaluate the rats' motivation to consume ethanol and their ability to relapse after periods of abstinence. The results showed individual and sex differences in ethanol consumption, with rats who placed a higher value on ethanol being more …

Implementing Universal Suicidality Screening In A Critical-Access Emergency Department, Delaney M. Kjendal, Kerry Nolte, Sara Robinson, Kimberly Force

Honors Theses and Capstones

Background: Implementation of a universal suicidality screening is considered best practice as it is associated with improved the detection of occult, or latent, suicide risk and can reduce subsequent risk. This quality improvement (QI) project evaluates the implementation of the Columbia-Suicide Severity Rating Scale (C-SSRS) to screen patients over the age of twelve at a regional healthcare system.

Methods: The QI project was conducted at Littleton Regional Healthcare (LRH) emergency department, a critical-access hospital in Littleton, New Hampshire that serves about 206 patients per week. Implementation of suicidality screening was of interest to LRH to promote mental health in the …

The Clinical Observations Of Nursing Students And Recent Graduates Caring For Lgbtq+ People, Emily E. Roy

Honors Theses and Capstones

Objective: The next generation of nurses have increased educational preparation to provide affirming care to lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people, but an evaluation of the effectiveness of this teaching has not been performed. The purpose of this study was to identify nursing student and recent nursing graduate observations of affirming and non-affirming care of LGBTQ+ people in healthcare settings during clinical experiences. We also sought to understand how those experiences affect their ability and willingness to provide affirming health care to LGBTQ+ people.

Methods: Participants filled out a mixed methods Qualtrics survey that was distributed through school …