Abstracts

Rationale: Patient-centered care and improving the patient experience is a crucial component in delivering high quality healthcare. Little is known about patient experience in an Epilepsy Monitoring Unit (EMU). Inpatient continuous video-electroencephalography (EEG) monitoring constrains activity and privacy as patients wait for days for seizures to occur and for a diagnosis and/or treatment plan. This qualitative pilot study explored patient perceptions in the EMU. Understanding these perceptions will allow healthcare providers to better prepare their patients prior to EMU admission, improving overall patient experience and quality of care.Methods: Under an IRB approved protocol, patients in the EMU being monitored for diagnostic purposes were recruited to participate in semi-structured interviews. Interviews were conducted between 2 to 4 days after admission. The qualitative research study utilized a phenomenological design to explore perceptions of patients’ experiences while hospitalized in an EMU. Domains covered included expectations of the admission, concerns or worries, experiences of waiting, and perceptions of nursing care received. Inclusion criteria: Over 18 years of age Admitted for diagnostic monitoring in a 15 bed EMU Able to communicate in English No evidence of confusion or cognitive dysfunction that would compromise the interview process Interviews were audio recorded, transcribed verbatim, and analyzed using standard van Manen’s approach to qualitative data analysis. Descriptive statistics were used to analyze demographic data.Results: 12 patients participated in the study. The demographics were a cross-section of patients seen in the institution’s EMU. There were 7 female and 5 male participants whose ages ranged from 29 – 78 (mean age 55). Three participants had previous EMU experience. Patients expressed high praise for nursing care and described goals of the hospital experience that were consistent with researcher expectations. Patients’ responses to questions about experiences of waiting and fears yielded invaluable insights into the monitoring process. When asked globally about the experience of waiting for a seizure to occur, three important ideas arose: (1) Patients felt anxiety related to seizing, (2) pressure to have a seizure while on the unit, and (3) displacement from their usual environment. In particular, there was concern that the change in environment, as the unit tended to be more controlled, may decrease participants’ chance of experiencing a seizure. When asked directly about fears related to being admitted to the EMU, 5 of the 12 participants denied having fears. During interviews, however, the following fears were mentioned: losing emotional or psychological control during a seizure (one person specifically worried about “acting like a jerk”), and emotional discomfort resulting from constant presence of the camera.Conclusions: These results suggest potential in the replication of a patient’s usual environment and set of experiences, so as to both increase seizure likelihood while reducing concerns of unfamiliarity.