Abstracts

Rationale: Abstract: Epilepsy occurs in one-third of individuals with intellectual disability (ID), and the rates increase as the severity of intellectual disability increases. When it occurs, epilepsy casts multiple, intense, chronic effects on the intellectually disabled person, their family and carers. Barriers to best care for this population are many, including innate skill limitations within the population and the limited preparation found in healthcare professionals' understanding of the heterogeneous needs of this vulnerable population. This capstone project reviewed the literature on intellectually disabled persons with epilepsy, assessed educational needs of healthcare professionals at a local clinical agency, developed a side-effect monitoring guide for anti-epilepsy drugs and discussed additional ways to advance nursing practice guidelines for this population. Methods: This DNP capstone project started with a review of the literature and proceeded to assessing educational needs of the professional clinical staff of a clinical agency in northwestern Wisconsin that supports frail elders and persons with disabilities in their homes and in the community as a managed care organization. Educational needs assessment surveys were sent to 183 professional practice staff members. Educational needs were addressed in an agency-wide presentation specific to care needs of individuals with intellectual disabilities and epilepsy. Results: The staff provided much front-line insight into the needs of healthcare professionals in providing best practice to intellectually disabled persons with epilepsy. Trends that were identified in the comments include: a need for improved, specific knowledge in this area, recognition that this is a highly complex practice area, a need for patient advocacy, difficulty identifying and classifying seizures, and treatment and management issues. An educational presentation, entitled, "Moving toward best practice in the care of intellectually disabled persons with epilepsy" was provided to professional clinical staff of this clinical agency. Pre-test and Post-tests demonstrated educational gains. Finally an anti-epilepsy drug adverse-effect monitoring guide was developed. Preliminary feedback from nurses who have tested the guide has been summarized and is favorable. Conclusions: The anti-epilepsy drug adverse-effect monitoring guide was developed specifically for monitoring adverse effects in the intellectually disabled population who cannot self-report. It is a beginning practice protocol that addresses one need of a complex and specific patient population. It is an ongoing, evolving process to attain best practice guidelines which pointed this writer in ways practice can be enhanced, and in directions for improving other areas of practice.