Abstracts

Rationale: Seizures in children are a common diagnosis the nursing staff is expected to manage at a Children’s Hospital. The level of comfort the nursing staff might have assessing patients with seizures and differentiating between psychogenic non epileptic seizures (PNES) versus epileptic seizure varies from unit to unit. This project was initiated to assess the comfort level of nurses in managing children presenting with seizures.Methods: A multiple choice questionnaire based test assessing nurse level of confidence in caring for a pediatric seizure patient as well as evaluating their knowledge of managing and caring for patients with seizures was administered pre and post review of an educational module which was created and placed for 6 weeks in the Health Stream Learning Connection which is a web based education site for nursing staff. The content addressed defining and identifying seizures versus epilepsy, identifying features of PNES, managing and caring for seizures. 79 nurses had completed the epilepsy education module including participation from varied specialty areas within the hospital.Results: Pre-test results indicate that only 30.38% (n=24) of nursing staff at Dayton Children’s Hospital (DCH) felt confident in their abilities when caring for epileptic patients as well as when seizures warranted rescue medication while in the post test the numbers improved to 62.3% and 73.91% respectively. Pre-test 45.57% (n=36) of nurses indicated that they were comfortable with seizure first aid which improved to 82.61%. All the nurses felt that the independent education module was an effective method of learning and 68.12% (n=47) felt the knowledge would change their practice. Nursing staff demonstrated satisfactory general knowledge of basic seizure first aid. Gaps in knowledge were identified in the pre- test in identifying the post ictal state and identifying characteristics of a non-epileptic seizure. There is also an identified gap in knowing when rescue medication is warranted and when to alert appropriate providers. Post education module test scores improved, suggesting that nurses were better able to distinguish a post ictal patient from an actively seizing patient as well as identify characteristics of a non-epileptic patient. There was little to no change in identifying at what time frame a rescue medication is warranted.Conclusions: The study performed identified a gap in nurses’ perceived knowledge and comfort level at a Children’s Hospital in caring for pediatric patients with epilepsy. An educational module administered as a voluntary independent study was effective in enhancing nurses’ perception of their knowledge and in boosting their confidence. However, further education may be needed with regards to knowing when a rescue medication is warranted as lack of this knowledge can create an unnecessary delay in treatment which places patient at risk of a seizure progressing to status epilepticus.