A Quality Improvement Project: Enhancing Nursing Knowledge And Patient Safety In The Prevention Of Hospital-Acquired Pressure Injuries (Hapis) In A Medical-Surgical Unit, Kristen Vartabedian

Master's Theses and Capstones

Background: Hospital-acquired pressure injuries (HAPIs) are a significant quality indicator within the hospital system. HAPIs increase hospitalization, morbidity, and associated healthcare costs. The current evidence suggests that ongoing nursing education can improve pressure injury prevention and help in the early identification.

Local Problem: Nurses within a medical-surgical unit demonstrated a gap in knowledge in the identification of hospital acquired pressure injuries and lack of accuracy when charting skin findings. Thus, contributing to a delay in recognition and treatment of HAPIs.

Methods: This quality improvement project utilized the Plan-Do-Study-Act (PDSA) framework to guide implementation of educational flipbooks. Materials contained standardized wound …

Implementing A Nurse Re-Education Program To Promote Timely Use Of The Jada® System In The Postpartum Hemorrhage Cascade: A Quality Improvement Project, Maegan E. Doody

Master's Theses and Capstones

Background: Postpartum hemorrhage (PPH), defined as blood loss greater than 1,000 mL after delivery, is a leading cause of maternal morbidity in the United States. Identification of risk factors and timely intervention are critical to improving maternal outcomes after delivery. First-line interventions include manual uterine massage, uterotonic medications, and antifibrinolytic medications; however, when bleeding is not well controlled, the Jada® System (Jada) is a newer vacuum-induced hemorrhage control device with a high efficacy and safety profile, particularly when implemented earlier in the hemorrhage cascade.

Local Problem: In 2025, the annual rate of PPH within the microsystem was 7.29%, …

Reducing Readmissions For Copd Through Improved Education: A Gap Analysis, Raphael Gaughan

Master's Theses and Capstones

No abstract provided.

Promoting Equitable Access To Postpartum Hemorrhage Education: A Quality Improvement Project Using Educational Interventions For Night Shift Nurses, Michelle Stella

Master's Theses and Capstones

Abstract

Background: Postpartum hemorrhage (PPH) is a serious condition that can lead to maternal morbidity or mortality following the birth of their child. It is important for nurses to be properly educated to manage this condition quickly and efficiently. Night shift nurses often face barriers to accessing educational opportunities during their shift because most education is tailored to daytime hours.

Local Problem: At the project site facility, night shift nurses perceived inconsistent access to education compared to day shift nurses. This gap highlighted the need for more flexible educational modalities to meet the needs of night shift nurses.

Methods: This …

Enhancing Patient Safety And Team Communication Via Standardized Unit Handoff Tools In Inpatient Rehabilitation, Julia Rae Before

Master's Theses and Capstones

Abstract

Background: Interdisciplinary safety huddles in healthcare are used to facilitate staff communication, voice patient safety concerns and identify high acuity patients, as well as identify current unit issues that need resolution. Using characteristics of safety huddles, revising patient report sheets to include pertinent safety information often shared during huddles may lead to an increase in staff perception of communication as well as awareness to patient safety concerns. Within an in-patient rehabilitation hospital, anonymous staff reports indicated dissatisfaction with interprofessional communication and microsystem data revealed increased events of adverse patient outcomes and safety concerns. Baseline data indicated inconsistent patient handoff …

A Patient-Centered Approach To Improving Patient And Family Education On Perioperative Processes To Reduce Anxiety: A Quality Improvement Initiative, Ashley Lauren Doherty

Master's Theses and Capstones

Background: Perioperative anxiety is common among surgical patients and their family members. Anxiety may be increased by uncertainty and limited understanding of the surgical experience. Improving perioperative education may enhance understanding, reduce anxiety, and support a more patient and family centered surgical experience.

Local Problem: A Post-Anesthesia Care Unit (PACU) identified knowledge gaps in patient and family education about the perioperative process. The existing waiting room bulletin board was outdated and provided limited information. PACU nurses observed anxiety-related behaviors and confusion among patients and family members about the perioperative process. Patient satisfaction surveys routinely collected by the hospital also demonstrated …

Enhancing Safety And Efficiency In Cardiac Admission Handoffs Through Implementation Of An I-Pass Checklist: A Quality Improvement Project, Soraia D. Barros

Master's Theses and Capstones

Abstract

Background: Effective care handoff is a necessary step for maintaining patient safety during hospitalizations. The goal of this quality improvement project was to improve the completeness of information, particularly cardiac-related, provided by the ED staff to the CSSU nurses. The implementation involved the creation of a cardiac checklist and applying it to the pre-existing I-PASS forms used during asynchronous handoff.

Local Problem: The macrosystem implemented an updated system for handoffs between the ED and CSSU by substituting an over-the-phone report with a faxed I-PASS sheet. The result, as identified by the CSSU staff, is that reports contain undetailed patient …

Improving Effective Completion Of Catheter Care Using A Reminder System To Minimize Incidence Of Catheter-Associated Urinary Tract Infections: A Quality Improvement Project, Morgan K. Leonard

Master's Theses and Capstones

BACKGROUND: CAUTI rates can be decreased by implementing a care cluster for RNs for CAUTI care into morning assessments and medication administration to ensure it is being done regularly with reminders through cards at the computers in patient rooms. LOCAL PROBLEM: The local problem in the microsystem were the catheter-associated urinary tract infection (CAUTI) rates at 1.199, while the national benchmark is 1.000 (Medicare, n.d.).

METHODS: Reminder cards were placed in patient rooms on the computers which are highly utilized by staY while providing patient care to serve as a reminder to complete catheter care in a high task burden …

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.

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 …

Navigating Nursing Professional Governance: Unveiling Its Significance, Part 2, Brennan Lewis, Christi Welter, Misty Daugherty

Podcasts

Learn about the fundamental principles and practices of NPG to elevate nursing practice, foster professionalgrowth, and enhance patient outcomes.

Revolutionizing Nursing Care: Implementing Acuity Based Staffingstrategies, Brennan Lewis, Christi Welter, Natalie Denson, Marshall Stephenson

Podcasts

On this episode, we are discussing an innovative approach to staffing based on tailoring nurse staffing to meet patient needs, and how this can lead to enhanced patient outcomes and nurse satisfaction.

Navigating Nursing Professional Governance: Unveiling Its Significance, Part 1, Brennan Lewis, Christi Welter, Tammy Webb

Podcasts

Children’s Health Chief Nurse Executive Tammy Webb discusses some of the key components of nursing professional governance or NPG and why we transitioned to this new model. Together, Tammy and Brennan laid the groundwork and spearheaded the strategy for NPG at Children's Health.