Abstracts

RATIONALE: Clinical Pathways have been utilized with increasing frequency in the clinical setting to assist providers in prioritizing and organizing the many activities necessary to provide efficient, effective care to patients. Patients are admitted to the Epilepsy Monitoring Unit (EMU) for video EEG monitoring to aid in detection and recording of possible epileptic events to facilitate diagnosis and treatment. The steps needed to ensure that this occurs in an effective manner can be complex and key elements could be overlooked. Video EEG monitoring takes place 24 hours a day over several days and involves multiple caregivers, making continuity of care a challenge. Utilizing the Clinical Pathway concept in the EMU would standardize care, potentially reduce errors, increase efficiency and quality of care, decrease costs and facilitate capturing valuable data about the patient's epileptic events. METHODS: An interdisciplinary team of Epileptologists, staff nurses, EEG technologists and Advanced Practice Nurses from the Minneapolis VA Medical Center (MVAMC) and Fairview-University Medical Center (FUMC) collaborated to develop three documents (an EMU standardized admit order form, the EMU Clinical Pathway and the EMU Seizure Flowsheet) for use in the EMU's at both facilities. RESULTS: The EMU Clinical Pathway, the EMU standardized admit order form and the EMU Seizure Flowsheet have been readily accepted by the nursing and medical staff, have decreased the time it takes to write admission orders to the EMU, have improved continuity of care and have simplified and standardized the data collection process during a seizure event. CONCLUSIONS: Clinical Pathways have improved the day-to-day operation of our EMU's. Our experience in utilizing these instruments may be of benefit to others with similar patient care issues.