Abstract
Background
Quality measures have highlighted the need for efficient treatment of status epilepticus.
One strategy is prevention of refractory status epilepticus through individualized
seizure action plans. As a quality improvement project, we implemented a standardized
seizure action plan to improve the delivery of key information to families of children
with seizures.
Methods
We implemented our standardized seizure action plan using plan-do-study-act cycles.
The plans were distributed to caregivers of children (zero to 18 years) seen for seizures
in outpatient neurology clinics. Families were given questionnaires at the beginning
of each visit to gauge their understanding of their child’s diagnosis, treatment,
and comfort in emergency seizure management. Provider utilization rates and questionnaire
responses were analyzed over time to assess the effectiveness of the action plan.
Results
Provider utilization rates of the standardized seizure action plan improved from 0%
to 58.1%. At baseline, 31.5% caregivers indicated that they did not know their child’s
epilepsy syndrome or seizure type, 29.6% did not know the emergency protocol at their
child’s school, 9.2% did not know when to consider a seizure an emergency or what
to do if their child’s seizure had become an emergency, and 17.5% were not comfortable
administering rescue medication. Caregivers who received the action plan had improved
responses at subsequent visits (P < 0.001), whereas those who did not receive the standardized form did not improve.
Conclusions
Standardizing provision of seizure action plans in pediatric neurology clinic can
improve key elements of caregiver education regarding epilepsy diagnoses and seizure
emergencies.
Keywords
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References
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Article info
Publication history
Published online: April 16, 2020
Accepted:
April 4,
2020
Received:
December 2,
2019
Footnotes
Declarations of interest: None.
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
