Malissa Mulkey
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View article: Delirium prevalence and delirium literacy across Italian hospital wards: a secondary analysis of data from the World Delirium Awareness Day 2023
Delirium prevalence and delirium literacy across Italian hospital wards: a secondary analysis of data from the World Delirium Awareness Day 2023 Open
Purpose Delirium, a common medical emergency among hospitalized patients, requires effective detection and management protocols. This study aims to evaluate the delirium point prevalence and its management across Italian hospitals, categor…
View article: impact of depression on non-pharmacological cognitive interventions in patients undergoing cardiac surgery: A systematic review
impact of depression on non-pharmacological cognitive interventions in patients undergoing cardiac surgery: A systematic review Open
Background
Depression is associated with cardiac-related events and cognitive dysfunction contributing to poorer health outcomes and quality of life. Specifically, after cardiac surgery, broad cognitive domains are negatively affec…
View article: Assessing Patients With Altered Level of Consciousness
Assessing Patients With Altered Level of Consciousness Open
Patients with alterations in level of consciousness are among the most difficult to assess, so knowledge of how to assess these patients is important for tracking trends and identifying changes. This article discusses methods used to asses…
View article: Relationship between in-hospital angiotensin converting enzyme inhibitors and Angiotensin receptor blockers administration and delirium in the cardiac ICU
Relationship between in-hospital angiotensin converting enzyme inhibitors and Angiotensin receptor blockers administration and delirium in the cardiac ICU Open
While ACEIs and ARBs have been shown to slow the progression of memory loss for patients with Alzheimer's disease, we did not observe a difference in time to delirium onset.
View article: Supervised deep learning with vision transformer predicts delirium using limited lead EEG
Supervised deep learning with vision transformer predicts delirium using limited lead EEG Open
As many as 80% of critically ill patients develop delirium increasing the need for institutionalization and higher morbidity and mortality. Clinicians detect less than 40% of delirium when using a validated screening tool. EEG is the crite…
View article: Patient Safety: Cognitive Assessment at Intensive Care Unit Discharge
Patient Safety: Cognitive Assessment at Intensive Care Unit Discharge Open
Topic Assessing functional cognition is a critical need for intensive care unit survivors transitioning to another level of care. Clinical Relevance Up to 62% of patients discharged from an intensive care unit have significant cognitive im…
View article: Relationship between angiotensin‐converting enzyme inhibitors and angiotensin receptor blockers prescribing and delirium in the <scp>ICU‐A</scp> secondary analysis
Relationship between angiotensin‐converting enzyme inhibitors and angiotensin receptor blockers prescribing and delirium in the <span>ICU‐A</span> secondary analysis Open
Background Studies suggest Angiotensin‐Converting Enzyme inhibitors (ACEI) and Angiotensin Receptor Blockers (ARB) may slow the decline of memory function in individuals with mild to moderate Alzheimer's disease by regulating migroglial ac…
View article: Association between Serum Biomarkers of Inflammation One Week after ICU Admission and Post-Discharge Mortality in Critically Ill Patients
Association between Serum Biomarkers of Inflammation One Week after ICU Admission and Post-Discharge Mortality in Critically Ill Patients Open
Background: Delirium occurs among up to 80% of critically ill patients and is associated with poor patient outcomes. Levels of serum biomarkers of inflammation and astrocytic and glial activation measured at ICU admission are associated wi…
View article: Angiotensin-Converting Enzyme Inhibitor and Angiotensin Receptor Blocker Use and ICU Delirium Incidence
Angiotensin-Converting Enzyme Inhibitor and Angiotensin Receptor Blocker Use and ICU Delirium Incidence Open
Background: Delirium is a form of acute brain dysfunction which is associated with longer hospital stays, cognitive decline, and increased risk of mortality. Angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blockers…
View article: Relationship Among Clinically Obtained Biomarkers of Inflammation, Hypercoagulability, and Macrophage Activation, and Delirium in Critically Ill Patients With COVID-19
Relationship Among Clinically Obtained Biomarkers of Inflammation, Hypercoagulability, and Macrophage Activation, and Delirium in Critically Ill Patients With COVID-19 Open
OBJECTIVES: Critically ill patients with COVID-19 experience high rates of delirium and coma. Whether delirium occurs through novel mechanisms in COVID-19 is not known. We analyzed the relationship among biomarkers of inflammation (C-react…
View article: Vision Transformer Prediction of Delirium
Vision Transformer Prediction of Delirium Open
As many as 80% of critically ill patients develop delirium increasing the need for institutionalization and higher morbidity and mortality. Clinicians detect less than 40% of delirium when using a validated screening tool. EEG is the crite…
View article: Delirium detection using GAMMA wave and machine learning: A pilot study
Delirium detection using GAMMA wave and machine learning: A pilot study Open
Delirium occurs in as many as 80% of critically ill older adults and is associated with increased long‐term cognitive impairment, institutionalization, and mortality. Less than half of delirium cases are identified using currently availabl…
View article: Nonpharmacological Cognitive Impairment Prevention Interventions in Older Adults Undergoing Cardiac Surgery
Nonpharmacological Cognitive Impairment Prevention Interventions in Older Adults Undergoing Cardiac Surgery Open
Background More than 1 million individuals undergo cardiothoracic surgery for coronary artery bypass graft or valve repair/replacement annually in the United States. There is an increased risk of developing serious cognitive impairment pos…
View article: Minimizing Post–Intensive Care Syndrome to Improve Outcomes for Intensive Care Unit Survivors
Minimizing Post–Intensive Care Syndrome to Improve Outcomes for Intensive Care Unit Survivors Open
Topic Post–intensive care syndrome is a collection of symptoms that more than half of patients who survive a critical illness, and their family caregivers, experience after the illness. Those symptoms include weakness/ fatigue, sleep distu…
View article: Understanding Disorders of Consciousness: Opportunities for Critical Care Nurses
Understanding Disorders of Consciousness: Opportunities for Critical Care Nurses Open
Background Disorders of consciousness are powerful predictors of outcomes including mortality among critically ill patients. Encephalopathy, delirium, and coma are disorders of consciousness frequently encountered by critical care nurses b…
View article: Increasing the Effectiveness of Targeted Temperature Management
Increasing the Effectiveness of Targeted Temperature Management Open
Topic Targeted temperature management and therapeutic hypothermia are essential components of the multimodal approach to caring for compromised patients after cardiac arrest and severe traumatic brain injury. Clinical Relevance The continu…
View article: Hospital value–based purchasing: How acute care advanced practice nurses demonstrate value
Hospital value–based purchasing: How acute care advanced practice nurses demonstrate value Open
Hospital value–based purchasing (HVBP) is a budget neutral initiative from the Centers for Medicare & Medicaid Services designed to adjust the hospital payment system based on health care quality data. Hospital value–based purchasing is de…
View article: Engaging Bedside Nurse in Research and Quality Improvement
Engaging Bedside Nurse in Research and Quality Improvement Open
Nurses are expected to participate in research and scholarly inquiry; despite ongoing attempts, the practice–research gap continues to be fraught with significant barriers. System strategies have not addressed concerns at the individual nu…
View article: Delirium Screening of Patients on a Neuroscience Step-Down Unit
Delirium Screening of Patients on a Neuroscience Step-Down Unit Open
This project aimed to identify patients who had experienced a stroke and were at risk for delirium earlier, and implement evidence-based protocols to reduce overall length of stay and mortality. Nurses were motivated to perform screening a…
View article: Using a Behavioral Response Team on Non-Psychiatric Nursing Units
Using a Behavioral Response Team on Non-Psychiatric Nursing Units Open
Negative behaviors often are directed toward nursing staff in verbal or physical assaults. Nursing staff on non-psychiatric units may not be prepared to manage such situations and need additional support. Behavioral Emergency Response Team…
View article: Calming the Agitated Patient: Providing Strategies to Support Clinicians
Calming the Agitated Patient: Providing Strategies to Support Clinicians Open
Agitation is a symptom of many medical and psychiatric disorders that can manifest along a spectrum of severity. Agitation often delays treatment onset, potentially impacting morbidity and mortality, and may require emergency interventions…
View article: A Review of Neuronal Pathways Associated With Consciousness
A Review of Neuronal Pathways Associated With Consciousness Open
INTRODUCTION: Accurate communication of information regarding fluctuations in level of consciousness is critical. It is, important for nurses to understand terms related to consciousness to appropriately assess and implement plans of care.…
View article: Distinguishing Delirium from Dementia
Distinguishing Delirium from Dementia Open
Distinguishing between delirium and dementia is essential for understanding the underlying mechanisms which direct a nurse to the best interventions. However, delirium and dementia are conditions that are at times difficult to differentiat…
View article: Distinguishing Delirium from Dementia
Distinguishing Delirium from Dementia Open
Distinguishing between delirium and dementia is essential for understanding the underlying mechanisms which direct a nurse to the best interventions. However, delirium and dementia are conditions that are at times difficult to differentiat…
View article: Considering Causes for Hypoactive Delirium
Considering Causes for Hypoactive Delirium Open
Delirium is defined as a mental disorder characterized by an abnormal state of cognition and awareness. Delirium is associated with an annual cost of $350 billion between the United States and Europe. Approximately 80% of delirium cases ar…