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2011 Distinguished Research Lecturer
Marge Funk, professor at the Yale University School of Nursing, New Haven, Connecticut, has been awarded the 2011 AACN Distinguished Research Lectureship.
The focus of Dr. Funk’s research is the wise use of technology in the care of critically ill patients with heart disease. She has examined the appropriate and safe use of technology, its equitable distribution, and the human-machine interface. The use of a particular type of technology – electrocardiographic (ECG) monitoring – is a thread throughout her research career. Her emphasis has been on the clinical application of monitoring – how nurses use it and how patients might benefit.
Dr. Funk’s first experience with research demonstrated that simple, noninvasive, and inexpensive right precordial ECG leads were just as reliable in diagnosing right ventricular infarction as more complex, invasive, and costly tests. Her studies on the use of dedicated monitor watchers addressed the question of how much human surveillance of ECG monitors is necessary. Despite finding that clinically important arrhythmias were detected with significantly greater accuracy when a dedicated monitor watcher was present, the use of monitor watchers did not result in lower rates of most adverse outcomes.
In her study on atrial fibrillation (AF) after cardiac surgery, she found that AF is common and often occurs after discharge from the hospital and without accompanying symptoms. She concluded that outpatient monitoring may be warranted in patients with characteristics that place them at increased risk for AF.
Despite the prognostic value of continuous ischemia monitoring, a national random survey of nurse leaders in cardiac units (done with a master’s student) revealed that 46% did not use ST-segment monitoring for the detection of myocardial ischemia. One of the most common reasons given for not using ST-segment monitoring was that nurses perceived it to be difficult to use. Based on this finding, Dr. Funk and nurses in the cardiac ICU evaluated a new type of ischemia monitoring software (ST-Map) that was designed to make ischemia monitoring easier. They found that ST-Map was associated with more frequent use of ischemia monitoring, improved attitudes of nurses toward ischemia monitoring, and shorter time to the acquisition of a 12-lead ECG in response to symptoms or ST-segment changes.
In 2008, Dr. Funk received a grant for $3.9 million from the National Heart, Lung and Blood Institute for the Practical Use of the Latest Standards for Electrocardiography (PULSE) Trial. The PULSE Trial is a 5-year, 17-site randomized clinical trial evaluating the effect of implementing American Heart Association/AACN practice standards for ECG monitoring on nurses’ knowledge, quality of care, and patient outcomes. Baseline data revealed deficiencies in nurses’ knowledge and substandard practice related to ECG monitoring. The intervention, consisting of an online ECG monitoring education program and strategies to implement and sustain change in practice, was just completed in the experimental group hospitals. The PULSE study is an example of translational research in which the effectiveness of an intervention in real-world clinical practice is being tested
Dr. Funk’s research has provided an opportunity for her to mentor both hospital nurses and students. She is Co-Chair of the Nursing Research Committee at Yale-New Haven Hospital and helps hospital nurses through all phases of the research process, including presenting and publishing.
She received a BA from Wheaton College in Massachusetts, a BSN from Cornell University – New York Hospital School of Nursing, an MSN from the Yale University School of Nursing, and a PhD in Chronic Disease Epidemiology from Yale University.
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