Marjorie Funk

Distinguished Alumnae/i Award 1994

Class of 1984

Professor Funk has been on the faculty at the Yale School of Nursing since 1984. She received a BA in religion from Wheaton College in Massachusetts, a BSN from Cornell University - New York Hospital School of Nursing, a MSN in Medical-Surgical Nursing with a clinical specialty in cardiovascular nursing from the Yale School of Nursing, and a PhD in Chronic Disease Epidemiology from Yale University.

Her teaching responsibilities include statistics, research, electrocardiography, and clinical supervision in cardiac critical care.

The focus of Marge’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. 

In 2008, Marge received a $3.9 million grant 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, 16-site randomized clinical trial evaluating the effect of implementing American Heart Association practice standards for ECG monitoring on nurses’ knowledge, quality of care, and patient outcomes. The intervention consists of an online ECG monitoring education program and strategies to implement and sustain change in practice.  The PULSE Trial is an example of translational research in which the effectiveness of an intervention in real-world clinical practice is being tested.

Marge’s research has provided an opportunity for her to mentor both students and hospital nurses.  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 has a clinical association with the Cardiac ICU.

Marge is active in the American Heart Association, the American Association of Critical-Care Nursing, and the Eastern Nursing Research Society.

Research Interests
The wise use of technology in the care of critically ill patients with heart disease, especially ECG monitoring 

Clinical Affiliation
Cardiac ICU, Yale-New Haven Hospital 

Selected Publications
Lever, N. M., Nystrom, K. V., Schindler, J., Halliday, J., Wira, C., & Funk, M. (in press). Missed opportunities for recognition of ischemic stroke in the emergency department. Journal of Emergency Nursing.

Lopes, R. D., Li, L., Granger, C. B., Wang, T. Y., Foody, J. M., Funk, M., … Alexander, K. P. (in press). Atrial fibrillation and acute myocardial infarction: Antithrombotic therapy and outcomes. American Journal of Medicine.

Miller, A. L., Dib, C., Li, L., Chen, A. Y., Amsterdam, E., Funk, M., … Wang, T. Y. (in press). Left ventricular ejection fraction assessment among patients with acute myocardial infarction and its association with hospital quality of care and evidence-based therapy use. Circulation: Cardiovascular Quality and Outcomes.

Funk, M. & Cassidy, G. (2014). 20 things you didn’t know about electrocardiography. Journal of Cardiovascular Nursing, 29, 8-9.

Funk, M., May, J.L., Stephens, K., Fennie, K.P., Chang, P., Winkler, C., Feder, S.L., Drew, B.J., and the PULSE Site investigators. (2013). An interactive online education program improves knowledge of ECG monitoring: Findings from the PULSE Trial. Circulation, 128, A18317. 

Funk, M., Fennie, K.P., May, J.L., Stephens, K., Feder, S.L., Chang, P., Drew, B.J., and the PULSE Site investigators. Improved electrocardiographic monitoring practices in the Practical Use of the Latest Standards of Electrocardiography (PULSE) Trial. Circulation, 128, A14151.

Feder, S. & Funk, M. (2013). Over-monitoring and alarm fatigue: For whom do the bells toll? Heart & Lung, 42, 395-396.

Winkler, C., Funk, M., Schindler, D.M., Zegre Hemsey, J., Lampert, R., & Drew, B.J. (2013). Arrhythmias in patients with acute coronary syndrome in the first 24 hours of hospitalization. Heart & Lung, 42, 422-427.

Guzman, L. A., Li, S., Wang, T. Y., Daviglus, M. L., Exaire, J., Rodriguez, C. J., Torres, V. I., Funk, M., Saucedo, J., Granger, C. B., Piña, I. L., & Cohen, M. G. (2012). Differences in treatment patterns and outcomes between Hispanics and non-Hispanic whites treated for ST-segment elevation myocardial infarction: Results from NCDR ACTION Registry-GWTG. Journal of the American College of Cardiology, 59, 630-631.

Morse, E., & Funk, M. (2012). Pre-participation screening and prevention of sudden cardiac death in athletes: Implications for primary care. Journal of the American Academy of Nurse Practitioners, 24, 63-69.

Pickham, D., Helfenbein, E., Shinn, J. A., Chan, G., Funk, M., Weinacker, A., … & Drew, B. J. (2012). High prevalence of corrected QT interval prolongation in acutely ill patients is associated with mortality: Results of the QT in Practice (QTIP) study.Critical Care Medicine, 40, 394-399.

Pickham, D., Shinn, J. A., Chan, G., Funk, M., & Drew, B. J. (2012). Quasi-experimental study to improve nurses’ QT-interval monitoring: Results of QTIP study. American Journal of Critical Care, 21, 195-200.

Sangkachand, P., Cluff, M., & Funk, M. (2012). Detecting myocardial ischemia with continuous ST-segment monitoring: Two case studies. Heart & Lung, 41, 284-289.

Wiegand, D. L., & Funk, M. (2012). Consequences of clinical situations that cause critical care nurses to experience moral distress. Nursing Ethics, 19, 479-487.

Logan, A., Sangkachand, P., & Funk, M. (2011). Optimal management of shivering during therapeutic hypothermia after cardiac arrest. Critical Care Nurse, 31, e18-e30.

Stephens, K. E., Funk, M., Fennie, K. P., May, J. L., Herak, A., Makar, E. V., … Drew, B. J. (2011). Administrative data can be used to decrease medical record review burden while maintaining high sensitivity when assessing complex cardiac outcomes in hospitalized patients. Circulation: Cardiovascular Quality and Outcomes, 4, 6 Supplement AP29.

Funk, M. (2011). As healthcare technology advances: Benefits and risks. American Journal of Critical Care, 20, 285-291. 

Sangkachand, P., Sarosario, B., & Funk, M. (2011). Continuous ST-segment monitoring: Nurses’ attitudes, practices, and quality of patient care. American Journal of Critical Care, 20, 226-238. 

Slowikowski, G.C. & Funk, M. (2010). Factors associated with pressure ulcers in patients in a surgical intensive care unit. Journal of Wound, Ostomy and Continence Nursing, 37, 619-626.

Funk, M., Rose, L., & Fennie, K. (2010). Challenges of an internet-based education intervention in a randomized clinical trial in critical care. AACN Advanced Critical Care, 21, 376-379.

Pickham, D., Helfenbein, E., Shinn, J.A., Chan, G., Funk, M., & Drew, B.J. (2010). How many patients need QT interval monitoring in critical care units? Preliminary report of the QT in Practice study. Journal of Electrocardiology, 43, 572-576.

Funk, M., Winkler, C.G., May, J.L., Stephens, K., Fennie, K.P., Rose, L.L., Turkman, Y.E., & Drew, B.J. (2010). Unnecessary arrhythmia monitoring and underutilization of ischemia and QT interval monitoring in current clinical practice: Baseline results of the Practical Use of the Latest Standards for Electrocardiography (PULSE) Trial. Journal of Electrocardiology. 43, 542-547.

Drew, B.J., Ackerman, M.J., Funk, M., Gibler, W.B., Kligfield, P., Menon, V., Phillippedes, G.J., Roden, D.M., & Zereba, W. (2010). Prevention of torsade de pointes in hospital settings: A scientific statement from the American Heart Association and the American College of Cardiology Foundation. Circulation, 121, 1047-1060.

Aherns, T., Branson, R., Funk, M., & Frank, J. (2009). Clinical alarms: Where are we today? What more can be done? Initiatives in Safe Patient Care. http://www.initiatives-patientsafety.org/Initiatives2%20.pdf

Schlechte, E.A., Boramanand, N., & Funk, M. (2008). Supraventricular tachycardia in the pediatric primary care setting: Age-related presentation, diagnosis, and management. Journal of Pediatric Health Care, 22, 289-299.

Folan, L. & Funk, M. (2008). Measurement of thoracic fluid content in heart failure: The role of impedance cardiography. AACN Advanced Critical Care, 19, 47-55.

Jenerette, C.M., Funk, M., Ruff, C., Grey, M., Adderley-Kelly, B., & McCorkle, R. (2008). Models of inter-institutional collaboration to build research capacity for reducing health disparities. Nursing Outlook, 56, 16-24.

Kern, L.S., McRae, M.E., & Funk, M. (2007). ECG monitoring after cardiac surgery: Postoperative atrial fibrillation and the atrial electrogram. AACN Advanced Critical Care, 18, 294-304.

Funk, M., Wood, K., Valderrama, A.L., & Dunbar, S.B. (2007). Supraventricular dysrhythmias: Nursing research to improve health outcomes. Journal of Cardiovascular Nursing, 22, 196-217.

Drew, B.J. & Funk, M. (2006). Practice standards for ECG monitoring in hospital settings: Executive summary and guide for implementation. Critical Care Nursing Clinics of North America, 18,157-168.

Bourdeanu, L., Loseth, D.B., & Funk, M. (2005). Management of opioid-induced sedation in patients with cancer. Clinical Journal of Oncology Nursing, 9, 705-711.

Parkosewich, J., Funk, M., & Bradley, E.H. (2005). Applying five key success factors to optimize the quality of care for patients hospitalized with coronary artery disease. Progress in Cardiovascular Nursing, 20, 111-116.

Funk, M., Chrostowski, V.M., Richards, S., & Serling, S.A. (2005). Feasibility of using ambulatory ECG monitors following discharge after cardiac surgery. Home Healthcare Nurse, 23, 441-451.

Drew, B.J., Califf, R.M., Funk, M., Kaufman, E.S., Krucoff, M.W., Laks, M.M., Macfarlane, P.W., Sommargren, C., Swiryn, S., & Van Hare, G.F. (2004). Practice standards for electrocardiographic monitoring in hospital settings: An American Heart Association Scientific Statement from the Councils on Cardiovascular Nursing, Clinical Cardiology, and Cardiovascular Disease in the Young.Circulation, 110, 2721-2746.

Dunbar, S.B., Funk, M., Wood, K., & Valderrama, A.L. (2004). Ventricular dysrhythmias: Nursing approaches to health outcomes.Journal of Cardiovascular Nursing, 19, 316-328.

Milner, K.A., Vaccarino, V., Arnold, A.L., Funk, M., & Goldberg, R.J. (2004). Gender and age differences in chief complaints of acute myocardial infarction (Worcester Heart Study). American Journal of Cardiology, 93, 606-608.

Funk, M., Richards, S.B., Desjardins, J., Bebon, C., & Wilcox, H. (2003). Incidence, timing, symptoms, and risk factors for atrial fibrillation after cardiac surgery.  American Journal of Critical Care, 12, 424-435.

Funk, M., Ostfeld, A.M., Chang, V.M., & Lee, F.A. (2002). Racial differences in the use of cardiac procedures in patients with acute myocardial infarction. Nursing Research, 51, 148-157.

Funk, M. & Richards, S. (2002). Using ambulatory electrocardiography during recovery from cardiac surgery.  Critical Care Nurse, 22(2), 115-121.

Milner, K.A., Funk, M., Arnold, A., & Vaccarino, V. (2002). Typical symptoms are predictive of acute coronary syndromes in women. American Heart Journal, 143, 283-288.

Funk, M., Naum, J.B., Milner, K.A., & Chyun, D. (2001). Presentation and symptom predictors of coronary heart disease in patients with and without diabetes. American Journal of Emergency Medicine, 19, 482-487.

Milner, K.A., Funk, M., Richards, S., Vaccarino, V., & Krumholz, H.M. (2001).  Symptom predictors of acute coronary syndromes in younger and older patients.  Nursing Research, 50, 233-241.

Patton, J.A., & Funk, M. (2001).  Survey of use of ST-segment monitoring in patients with acute coronary syndromes.  American Journal of Critical Care, 10, 23-34.

Richards, S.B., Funk, M, & Milner, K.A. (2000). Racial differences in presenting symptoms and delay in seeking care in patients with coronary heart disease. American Journal of Critical Care, 9, 237-244.

Selected Awards and Honors
Katharine A. Lembright Award, Council on Cardiovascular Nursing, American Heart Association, 2011 

Visiting Lecturer, Nursing Endowed Lectureship, University of Ottawa Heart Institute, 2011

Research Abstract Award for “An Interactive Online Education Program Improves Nurses Knowledge of ECG Monitoring: Early Findings of the PULSE Trial”, National Teaching Institute, American Association of Critical-Care Nurses, 2011

Distinguished Research Lecturer, American Association of Critical-Care Nurses, 2011

Cardiac Nursing Visiting Scholar, Massachusetts General Hospital, 2011

Research Abstract Award for “Substandard Quality of ECG Monitoring in Current Clinical Practice: Baseline Results of the PULSE Trial”, National Teaching Institute, American Association of Critical-Care Nurses, 2010

Dorothy Sexton Mentorship Award, Delta Mu Chapter of Sigma Theta Tau, 2005

Excellence in Research Award, American Association of Critical-Care Nurses, 2005

Inducted into the Bristol (CT) Sports Hall of Fame, 2003

Winner, Nursing Research Award, Heart Failure Society of America, 2003

Fellow, American Academy of Nursing, 2000

Fellow, Council on Cardiovascular Nursing, American Heart Association, 1999

Virginia Henderson Award for Outstanding Contributions to Nursing Research, Connecticut Nurses’ Association, 1995

New Investigator Award, American Heart Association Council on Cardiovascular Nursing, 1994

Distinguished Alumna Award, Yale University School of Nursing, 1994

Hewlett-Packard - American Association of Critical-Care Nurses Researcher, 1993 - 1994

Annie W. Goodrich Award for Excellence in Teaching, Presented by the Students of Yale University School of Nursing, 1990