Ehealth Esitter Implementation in the Epilepsy Monitoring Unit
Abstract number :
2.114
Submission category :
3. Neurophysiology / 3A. Video EEG Epilepsy-Monitoring
Year :
2024
Submission ID :
455
Source :
www.aesnet.org
Presentation date :
12/8/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Terry Park, MD – Westchester Medical Center
Cheryl Cafone, RN, MSN – Westchester Medical Center
Colleen Malvey, RN – Westchester Medical Center
Lucy Cheevers, RN, MSN, CCRN, CNRN, SCRN – Westchester Medical Center
Demetrius Simmons, AA, REEGT – Westchester Medical Center
Kelly Fisher, BA – New York Medical College
Harli Weber, MD – New York Medical College
Manisha Holmes, MD – 3. Westchester Medical Center Health Network, New York Medical College
Rationale: Epilepsy Monitoring Units (EMUs) allow for seizure assessment in a specialized unit. Despite careful monitoring, adverse events have occurred in up to 10% of EMU patients, including death1. Improving seizure recognition is crucial to increase safety and decrease the cost involved with extended monitoring.
One way may be through the improved screening of push button events (PBs), where patients, caretakers, or staff may press the button, notifying trained staff of potential imminent seizure activity. As PBs traditionally require designated personnel at a nursing station to respond, this can divert medical staff from other duties. An innovative EHealth ESitter program was implemented in our EMU to screen push button events, using an already-existing ESitter system, which was previously being utilized to monitor fall-risk patients with close video monitoring.
Methods: Using EMU reports, EHealth logs, and EEG Tech notes, we completed a retrospective study of EMU patient visits from 8/2023 through 12/2023, ages 18 or older, from a single center. Primary end point was to determine if EHealth could respond to push buttons and appropriately clear alarm or activate nursing response when needed; alleviating the need for additional personnel at the nursing station. Secondary goals included evaluating if this could lead to less additional personnel time.
Results: 13 adults, during this timeframe were assigned to EHealth: 12 male and 1 female, with age ranging from 20 to 62, averaging 36.5 years. EHealth responded to 37 PBs: 17 (45.9%) were cleared, and 20 were escalated to nursing (54%). There were 38 events documented in the EMU reports corresponding to push buttons: 20 (52.6%) were escalated by EHealth, and 18 (47.4%) were missing documentation from EHealth. Of the total events documented in the EMU reports, 33 (73.7%) corresponded to electrographic seizures and 7 (2.98%) did not have electrographic correlate. Of the 20 PBs escalated by EHealth, 100% corresponded to electrographic seizures in the EMU report.
Conclusions: EHealth screening of PBs in EMUs via video and intercom communication can be a resource to screen multiple patients, alleviating nursing load, potentially decreasing staff burden while increasing patient safety with appropriate escalation. Further analysis will need to be done to quality check PBs seen without EHealth response.
Sauro, KM, et al. Quality and safety in adult epilepsy monitoring units: A systematic review and meta-analysis. Epilepsia. 2016; 57(11), 1754-1770
Funding: None
Neurophysiology