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.

中文翻译：

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实施标准化的缉获行动计划，以改善沟通和家长教育。

背景

质量措施强调了有效治疗癫痫持续状态的必要性。一种策略是通过个性化的癫痫发作行动计划来预防难治性癫痫持续状态。作为质量改进项目，我们实施了标准化的癫痫行动计划，以改进向癫痫儿童家庭提供关键信息。

方法

我们使用计划-执行-研究-行动循环实施了我们的标准化缉获行动计划。该计划已分发给在门诊神经病学诊所就诊的儿童（0 至 18 岁）的看护人。在每次访问开始时，家庭都会收到问卷，以评估他们对孩子的诊断、治疗和紧急癫痫管理舒适度的理解。随着时间的推移，对提供者利用率和问卷答复进行了分析，以评估行动计划的有效性。

结果

标准化缉获行动计划的提供者利用率从 0% 提高到 58.1%。在基线时，31.5% 的看护人表示他们不知道孩子的癫痫综合征或癫痫发作类型，29.6% 不知道孩子学校的应急方案，9.2% 不知道何时将癫痫发作视为紧急情况或如果他们孩子的癫痫发作已成为紧急情况，17.5% 的人不愿意使用救援药物。接受行动计划的看护人在后续访问中的反应有所改善（P  < 0.001），而没有接受标准化表格的看护人没有改善。

结论

在儿科神经病学诊所标准化提供癫痫发作行动计划可以改进有关癫痫诊断和癫痫发作紧急情况的护理人员教育的关键要素。