Abstracts

Educational Intervention for the Management of Pediatric Convulsive Status Epilepticus

Abstract number : 2.345
Submission category : 13. Health Services (Delivery of Care, Access to Care, Health Care Models)
Year : 2022
Submission ID : 2204214
Source : www.aesnet.org
Presentation date : 12/4/2022 12:00:00 PM
Published date : Nov 22, 2022, 05:23 AM

Authors :
Hend Abulsayen, MD – SUNY Downstate Medical Center; Theodora Andriotis, DO – SUNY Downstate Medical Center; Susanna O'Kula, MD – SUNY Downstate Medical Center; Geetha Chari, MD – SUNY Downstate Medical Center

Rationale: Convulsive Status Epilepticus (CSE) is a common pediatric neurological emergency and any lag or variation in management can lead to significant morbidity and mortality. Non-neurologists are often the first to treat CSE. Our goal was to implement an educational intervention to teach pediatric residents CSE management and assess their understanding, as well as comfort level in CSE treatment.

Methods: Using quality improvement methodology, we conducted an educational intervention to teach the pediatric residents at our institution how to manage CSE based on a recently instituted, evidence-based protocol. The educational intervention consisted of a virtual lecture due to the pandemic social distancing requirements.  The lecture consisted of a step-by-step discussion of the protocol. Multiple lectures were required to reach all pediatric residents; lecture recordings were also provided. The residents were given an eight-question assessment regarding timing, choice, and dosages of medications in CSE management pre- and post-educational intervention.  Additional items (Likert scale) evaluated residents’ perceived confidence in treating CSE.  Pre- and post- intervention average scores were compared (percentages).

Results: A total of 47 participants were included in the pre-intervention test analysis and 23 participants in the post-intervention analysis. 44% of the pre-test participants were PGY1s, 29% PGY2s and 27% PGY3s, with similar distribution in both pre- and post-test groups. 49% of participants in the pre-intervention group completed the post-intervention assessment (data collection is ongoing). Pre-intervention residents scored 60.9% of questions correctly compared post-intervention (77.1% average score) (Figure 1). Prior to the educational intervention, 38% of residents felt “somewhat uncomfortable”) in CSE management; however, in the post- education survey, only 4% reported feeling “somewhat uncomfortable” and the majority (52%) reported they were now “somewhat comfortable" with CSE management (Figure 2).  

Conclusions: A virtual lecture is insufficient to adequately educate residents on the management of pediatric CSE, although average scores pre- and post-intervention increased by 10% and residents’ perceived comfort level improved. We encountered significant barriers to implementation, namely poor attendance and lack of participation in post- test assessment. In future improvement cycles, we will adapt the lecture to include case-based simulation and distribute a CSE pocket card guide. 

Funding: Not available
Health Services (Delivery of Care, Access to Care, Health Care Models)