Browsing by Author "Everhart, D. Erik"

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    Minimizing Post–Intensive Care Syndrome to Improve Outcomes for Intensive Care Unit Survivors
    (American Association of Critical-Care Nurses, 2022) Mulkey, Malissa A.; Beacham, Pamela; McCormick, Megan A.; Everhart, D. Erik; Khan, Babar; Medicine, School of Medicine
    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 disturbances/insomnia, cognitive dysfunction, posttraumatic stress disorder, other mental health conditions, and a lack of effective coping strategies. Clinical relevance: To minimize the risk of a patient developing post-intensive care syndrome, intensive care unit nurses must adopt practices that reduce the severity of disability and optimize patient outcomes. They must also advocate for patients who need additional expert care. Purpose: To describe interventions that critical care nurses can implement to minimize a patient's risk for post-intensive care syndrome. Content covered: This article describes patients who have a high risk of developing post-intensive care syndrome and interventions that are within nurses' purview.
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    Rapid Hand-held Continuous EEG has the Potential to Detect Delirium in Older Adults
    (Wolters Kluwer, 2022) Mulkey, Malissa A.; Gantt, Laura T.; Hardin, Sonya R.; Munro, Cindy L.; Everhart, D. Erik; Kim, Sunghan; Schoeman, Alexander M.; Roberson, Donna W.; McAuliffe, Maura; Olson, DaiWai M.; School of Nursing
    Background: Delirium-related biochemical derangements lead to electrical changes that can be detected in electroencephalographic (EEG) patterns followed by behavioral signs and symptoms. Studies using limited lead EEG show a large difference between patients with and without delirium while discriminating delirium from other causes. Handheld rapid EEG devices may be capable of detecting delirium before symptom onset, thus providing an objective physiological method to detect delirium when it is most amenable to interventions. Objective: The aim of this study was to explore the potential for rapid EEG to detect waveform pattern changes consistent with delirium status. Methods: This prospective exploratory pilot study used a correlational design and mixed models to explore the relationships between handheld portable EEG data and delirium status. Results: While being under powered minimized opportunities to detect statistical differences in EEG-derived ratios using spectral density analysis, sleep-to-wake ratios tended to be higher in patients with delirium. Conclusions: Limited lead EEG may be useful in predicting adverse outcomes and risk for delirium in older critically ill patients. Although this population is at the highest risk for mortality, delirium is not easily identified by current clinical assessments. Therefore, further investigation of limited lead EEG for delirium detection is warranted.
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    The impact of depression on non-pharmacological cognitive interventions in patients undergoing cardiac surgery: A systematic review
    (WFCCN, 2023) Mulkey, Malissa A.; Sorrell, Anne; Savransky, Anya; Everhart, D. Erik; Wierenga, Kelly L.; School of Nursing
    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 affected. To address cognitive dysfunction following cardiac surgery, researchers have tested non-pharmacological interventions with varied success. Depression is associated with worse cardiac and cognitive health outcomes yet depression’s potential contribution to interventions mitigating cognitive dysfunction following cardiac surgery is poorly understood. Aims This review aims to examine the impact of depression on the effectiveness of non-pharmacological interventions designed to minimize cognitive dysfunction associated with cardiac surgery. Methods A systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Peer-reviewed articles between January 2011 to February 2022 obtained from PubMed, MEDLINE, EMBASE, Psych INFO, CINAHL, and the Web of Science databases were screened for inclusion based on predetermined criteria. Each article was screened, and data was abstracted by two authors. Results Of 8128 articles screened, 442 were assessed for eligibility and 4 met inclusion criteria. Three of the studies did not report associated depression scale scores. The other study reported depression symptoms as mild to severe. Conclusion These findings suggest limited information exists regarding the relationship between depression and cognitive function among cardiac surgery patients who undergo non-pharmacologic interventions. Future studies should carefully examine symptoms of depression in relation to cognitive impairment post-cardiac surgery; such studies may further guide clinical interventions.