Timing And Temperature Of Newborn Baths: A Qualitative Improvement Initiative Through Nursing Staff Development, Eileen Harwood

Master's Theses and Capstones

Abstract

BACKGROUND: Newborn bathing is a common task performed in a labor and delivery unit of a hospital, a newborn’s bath temperature, timing and how long it is performed, are important metrics to consider. Due to a newborn’s immature thermoregulation, there are multiple implications that come with receiving a bath that is not an optimal temperature or that is too soon after birth. As newborn bathing is often overlooked task due to its quotidian nature, a literature review of current evidence-based practice revealed the urgency to keep the optimal conditions at the forefront of considerations for both nurses and caregivers. …

A Quality Improvement Initiative To Enhance The Effectiveness Of Pre-Anesthesia Documentation And Nurse Satisfaction In The Pacu, Stephanie Colon

Master's Theses and Capstones

Background: Documentation is an essential component of healthcare delivery, especially in perianesthesia nursing. Electronic health records (EHR) have helped create high-quality documentation according to the standards of the American Nurses Association. However, EHRs have been found to be burdensome on nurses when they interfere with their workflow.

Local Problem: The documentation process for pre-operative anesthesia assessments within a nine bed PACU in Southern New Hampshire was found to be inefficient, increased chances of error or mistakes, and delayed patient data being accessible to the team.

Methods: Using the Plan-Do-Study-Act (PDSA) model, a quality improvement project was performed to update and …

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 …

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. …

Enhancing Triage Accuracy And Nursing Confidence Of The Emergency Severity Index To Improve The Effectiveness Of Triage Through Targeted Education: An Evidence-Based Quality Improvement Project, Mia K. Saucedo

Master's Theses and Capstones

Background: The Emergency Severity Index system is a standardized triage scoring guide used by emergency department nurses to efficiently assess patients based on severity and projected recourse needs. Studies have found that knowledge and confidence gaps among nurses may lead to improper triage score, leading to the misallocated spread of resources and longer wait times, increasing rates of morbidity and mortality. Early recognition of patient severity is vital for providing proficient patient care and improving patient outcomes and increased education is needed to improve this gap in nursing knowledge and confidence.

Local Problem: At a small, critical care access center …

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 …

Directing Patient Hand Hygiene Before Meals In The Icu: A Quality Improvement Project To Enhance Patient Safety, Nicholas Davini

Master's Theses and Capstones

BACKGROUND:

Hospital-acquired infections (HAIs) are a major problem in healthcare, increasing patient morbidity, mortality, and costs. While staff hand hygiene is a well-established infection control measure, less attention is paid to patient hand hygiene (PHH) despite CDC recommendations.

LOCAL PROBLEM:

An intensive care unit (ICU) in northeastern Massachusetts had no formal policy for patient hand hygiene, and hospital leadership expressed support for enhancing infection control practices.

METHODS:

Using the Plan-Do-Study-Act model, a quality improvement project was implemented to encourage PHH before meals. Baseline PHH rates were collected through observation. The intervention involved registered nurses (RNs) directing patients to use hand …

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 …

Improving The Effectiveness Of Post-Anesthesia Care Unit Transitions: A Quality Improvement Initiative Using A Standardized Nurse Handoff Report Sheet, Myra Mcauley

Master's Theses and Capstones

Background: Effective communication during patient handoff in the post-anesthesia care unit (PACU) is essential to ensuring patient safety and continuity of care. Unstructured or inconsistent handoff processes can lead to information omissions and care delays.

Methods: This quality improvement project implemented a structured nurse-to-nurse handoff report tool in the PACU. A pre- and post-intervention survey design was used to assess nurses’ perceptions of handoff clarity, completeness, and satisfaction. Educational sessions supported implementation.

Results: Pre-intervention survey data revealed dissatisfaction with the current handoff process, citing frequent information gaps. Following implementation of the structured tool, post-survey results showed improved communication clarity, increased …

A Quality Improvement Project: Increasing Pre-Term Infant Safety By Enhancing Skin-To-Skin Time In The Nicu, Maureen A. Cassidy

Master's Theses and Capstones

Background: Skin-to-skin (STS) contact, also known as kangaroo care, is a critical intervention for preterm infants, especially for those in the neonatal intensive care unit (NICU). It promotes neurodevelopmental outcomes, physiological stability, and parental bonding. However, STS often falls below recommended daily levels due to a variety of berries. Exploring aids like belly bands may help address these barriers and promote improved outcomes.

Local Problem: STS time in this NICU microsystem falls significantly below nationally recommended levels, with most preterm infants receiving less than one to two hours daily compared to the World Health Organization’s recommendation of 8-24 hours per …

A Quality Improvement Project Reinforcing Nursing Education On Support Resources For Families In The Icu, Emily Siel

Master's Theses and Capstones

BACKGROUND: The Intensive Care Unit (ICU) is often a source of psychological, physical, social, financial, and spiritual distress for families of patients. Multidisciplinary support resources are available but are often underutilized. Nurses are uniquely positioned to assess needs and integrate resources into care. Therefore, enhancing nurses' ability to guide families to appropriate support resources may alleviate distress and promote holistic well-being for patients and their families.

METHODS: The Plan-Do-Study-Act (PDSA) model was used to guide this project. A pre-intervention survey assessed awareness, utilization, and perception of ownership. Following dissemination of the intervention, a post-survey evaluated improvements in knowledge and integration. …

ปัจจัยคัดสรรที่สัมพันธ์กับพฤติกรรมการใช้สารเสพติดของผู้ใช้สารเสพติด หลายชนิดร่วมกันในภาคใต้ของประเทศไทย, เตชินี สิทธิอำนวย

Chulalongkorn University Theses and Dissertations (Chula ETD)

การวิจัยครั้งนี้เป็นการวิจัยเชิงบรรยาย มีวัตถุประสงค์เพื่อศึกษา 1) สถานการณ์และรูปแบบการใช้สารเสพติดร่วมของผู้ใช้สารเสพติดที่รับการบำบัดสารเสพติดในโรงพยาบาลรัฐบาลในเขต ภาคใต้ และ 2) เพื่อศึกษาความสัมพันธ์ระหว่างปัจจัยคัดสรร ได้แก่ อายุ เพศ อาชีพ ระดับการศึกษา สถานภาพสมรส อายุที่เริ่มใช้สารเสพติด ระยะเวลาการใช้สารเสพติด การดื่มแอลกอฮอล์ การสูบบุหรี่ ภาวะซึมเศร้า ความวิตกกังวลขณะปัจจุบัน การวิตกกังวลประจำบุคคล การเผชิญความเครียดด้านการมุ่งแก้สาเหตุปัญหา การเผชิญความเครียดด้านการจัดการกับอารมณ์ และสัมพันธภาพในครอบครัว กับพฤติกรรมการใช้สารเสพติดของผู้ใช้สารเสพติดหลายชนิดร่วมกันในภาคใต้ กลุ่มตัวอย่างเพื่อตอบวัตถุประสงค์วิจัยข้อ 1 คือ ผู้ใช้สารเสพติด จำนวน 111 คน และกลุ่มตัวอย่างเพื่อตอบวัตถุประสงค์วิจัยข้อ 2 คือ ผู้ใช้สารเสพติดหลายชนิดร่วมกัน จำนวน 211 คน ทั้งเพศชายและหญิง ที่มีอายุ 20 – 59 ปี ที่ได้รับการคัดเลือกตามเกณฑ์คุณสมบัติที่กำหนดไว้ ซึ่งเข้ารับการบำบัดรักษายาเสพติดแบบผู้ป่วยนอก โรงพยาบาลรัฐบาลในเขตภาคใต้ ได้แก่ โรงพยาบาลธัญญารักษ์สงขลา โรงพยาบาลมหาราช นครศรีธรรมราช โรงพยาบาลสิชล และโรงพยาบาลพระพรหม จังหวัดนครศรีธรรมราช เครื่องมือที่ใช้ในการวิจัยมี 5 ชุด คือ 1) แบบสอบถามข้อมูลส่วนบุคคล 2) แบบสอบถามพฤติกรรมการใช้สารเสพติด 3) แบบประเมินภาวะซึมเศร้า 9Q 4) แบบวัดความวิตกกังวล STAI 5) แบบวัดการเผชิญความเครียต และ 6) แบบสอบถามสัมพันธภาพในครอบครัว สถิติที่ใช้ในการวิเคราะห์ ข้อมูลได้แก่ การแจกแจงความถี่ ร้อยละ ส่วนเบี่ยงเบนมาตรฐาน สถิติไคสแคว์ และค่าสัมประสิทธิ์สหสัมพันธ์เพียร์สันผลการวิจัยพบว่า 1. จากผลการศึกษาสถานการณ์และรูปแบบการใช้สารเสพติดในภาคใต้ พบว่า ผู้ใช้สารเสพติดเพียงชนิดเดียวมีเพียง 23 คน (ร้อยละ 20.7) และผู้ใช้สารเสพติดส่วนใหญ่มีพฤติกรรมการใช้สารเสพติดหลายชนิดร่วมกัน 88 คน (ร้อยละ 79.3) จำแนกเป็นใช้สารเสพติดสองชนิดร่วมกัน 76 คน (ร้อยละ 68.5) และใช้สารเสพติดสามชนิดร่วมกัน …

Community Health Worker-Delivered Tobacco Cessation In A Small Rural County, Ellen J. Hahn, Amanda Bucher, Amanda T. Wiggins, Kathy Rademacher, Whitney Beckett, Leeann Taylor, Audrey Darville, Jean Edward

BREATHE Faculty Publications

Purpose: We evaluated a Community Health Worker (CHW)-Tobacco Treatment Specialist (TTS) model for delivering tailored tobacco treatment counseling and support in a rural, low-resourced county.

Methods: This was an exploratory, prospective study of people 18 years or older who used any tobacco product including e-cigarettes or vapes in the past 30 days. The CHW assessed tobacco use, secondhand smoke exposure, and quit history; and collected an expired breath carbon monoxide sample and a brief health history before providing 4–6 in-person or phone-based sessions involving tailored tobacco treatment counseling and support. The CHW connected participants to a prescriber at a federally …

Implementing And Evaluating A Pilot Interprofessional Training Program To Engage Health Care Teams In Cost Of Care Conversations, Jean Edward, Kimberly D. Northrip, Mary Kay Rayens, Julia Costich, Andrea Welker, Rachel O’Farrell, John A. D'Orazio

Nursing Faculty Publications

Introduction: This study evaluated the impact of Financial and Insurance Navigation Assistance-Training – a pilot interprofessional training program to facilitate cost of care (CoC) conversations and address health-harming social determinants of health in a pediatric hematology–oncology clinic.

Methods: A pre–post study design was used to evaluate the impact of Financial and Insurance Navigation Assistance-Training on an interprofessional health care team's (clinicians, social workers, financial navigator, and legal advocates) knowledge, attitudes, and behaviors related to CoC conversations and screening, referring, and collaborating with interprofessional team members. Data were collected …

Diet Quality Mediates The Relationship Between Chronic Stress And Inflammation In Patients With Metabolic Syndrome, Junghee Kang, Debra K. Moser, Terry A. Lennie, Misook L. Chung, D. Travis Thomas, Martha J. Biddle

Nursing Faculty Publications

Background 

Chronic stress is associated with promotion of inflammation and development of metabolic syndrome, as well as deterioration of diet quality. Inflammation can be modified by changes in dietary intake.

Objective 

The aim of this study was to test the hypothesis that diet quality mediates the relationship of chronic stress with inflammation in patients with metabolic syndrome.

Methods 

Participants with metabolic syndrome (n = 73, 62 ± 12 years old, 71% female) completed questionnaires on chronic stress (Perceived Stress Scale-10) and diet quality (Healthy Eating Index-2020). The Perceived Stress Scale-10 was dichotomized. The Healthy Eating Index-2020 score was used as …

Championing Reproductive And Perinatal Health With The Recovery Community: Improving Access To Healthcare And Health Promotion Resources To Support Recovery, Hartley C. Feld, Alex Elswick, Jeremy Byard, Whitney Beckett, Amanda Fallin-Bennett

Nursing Faculty Publications

Peer recovery support services are instrumental in the promotion of long-term recovery primarily by focusing on building the recovery capital of people with substance use disorders. Women may have specific health-related needs that are not generally part of recovery support staff training. Our team co-created a model by training people with lived experience as coaches to promote the health of women with SUD during the critical period of their reproductive years when mortality from overdose risk is high and can be compounded by issues surrounding pregnancy. We explored the outcomes of a small pilot test of this model to promote …

Evaluating Potential Determinants Of Health System Implementation Of A Virtual Oncology Financial And Legal Navigation Intervention To Address Cancer-Related Financial Toxicity, Jean Edward, Haafsah Fariduddin, Mackenzie Caldwell, Lori P Eisele, Joanna Doran, Monica Bryant, John A. D'Orazio, Anne E. Ray, Kimberly D. Northrip

Nursing Faculty Publications

Background

Integration of comprehensive oncology financial and legal navigation (OFLN) programs within health systems are needed to address cancer-related financial toxicity, however, implementation challenges exist.

Objectives

The aim of this study was to assess contextual factors that may influence implementation of a virtual OFLN intervention within a pediatric and adolescent and young adult oncology clinic and to inform necessary modifications to the proposed implementation strategies, pathways, and workflows.

Methods

We conducted 18 key informant interviews with healthcare team members, patients and caregivers. Data collection and analysis were guided by the Consolidated Framework for Implementation Research (CFIR) to provide a structured …

Degree Of Rurality Moderates The Association Of Sedentary Time With Cognitive Function In Rural Patients With Cardiac Diseases And Depressive Symptoms, Chin-Yen Lin, Jia-Rong Wu, Geunyeong Cha, Junghee Kang, Martha J. Biddle, Misook L. Chung, Ashmita Thapa, Mary Kay Rayens, Linda Gibson-Young, Debra K. Moser

Nursing Faculty Publications

Background: Prolonged sedentary time has been linked to impaired cognitive outcomes. However, the impact of sedentary time on cognitive function at different degrees of rurality is not yet well understood in patients with cardiac diseases and depressive symptoms.

Purpose: To determine whether degree of rurality moderates the relationship between sedentary time and cognitive function.

Methods: This study includes 135 coronary heart disease or heart failure patients, primarily residing in rural Kentucky, including Appalachian areas, United States. Sedentary time was measured by the average daily sedentary time (in minutes) using accelerometry (ActiGraph). Cognitive function was assessed using the Montreal Cognitive Assessment-Blind. …