Abstracts

Rationale: The Blue Bird Circle Clinic for Pediatric Neurology at Texas Children's Hospital cares for approximately 4,400 children with seizures each year. Seizure education provided in our clinic varies, which may lead to caregiver uncertainty in when and how to respond to a change in baseline seizure activity. The purpose of this quality improvement project was to create and implement a standardized seizure education tool with a goal of teaching children and caregivers about their seizure diagnosis, daily management, and seizure first aid/treatment of status epilepticus. Methods: The Seizure Stoplight Tool was created by a multidisciplinary team including members of nursing, pharmacy, neurologists, and a nurse practitioner. The design was based on the concept of the asthma action plan, which is known for using the "green, yellow, and red" stoplight model for managing a chronic medical condition. The green zone encompasses baseline seizure management, including daily medications, seizure triggers, and home pharmacy. The yellow zone includes factors that may increase seizure activity as well as pediatrician contact information. The red zone helps guide the caregiver in decision-making during an emergency. The plan is available in hard copy and in our electronic medical record in English and Spanish. Nurses were designated to provide this education to families after the completion of a clinic visit. These nurses attended a 3-hour continuing education course given by the principal nurse practitioner in the Epilepsy Program. The program was piloted by two nurses, who met with families to create and customize their Seizure Stoplight Tool based on the individualized medical recommendations of the provider and used the tool as a guide to educate the family. Results: Since the creation of the Seizure Stoplight Tool, over 50 patients have been educated and provided with a copy of the tool to take home after their office visit. Verbal feedback from families and providers has been positive, with several caregivers reporting ease of understanding their child's medical plan outlined on the tool. One family requested several copies of the plan, both to hang on the refrigerator and to give to the child's multiple caregivers "to help everyone stay on the same page about what to do." One nurse reported, "I like that it gave us CEU's but more importantly I felt like I learned a lot" and another said the training "Definitely helped my confidence." After the initial pilot, all clinic nurses were assigned a weekly time slot to educate families using the tool. Barriers to implementing use of the tool included lack of provider awareness/willingness to utilize nurses, time, and inadequate nursing staff. Conclusions: Standardizing our approach to seizure education was instrumental in improving delivery of individualized seizure education to patient and caregivers. Future goals of this project include continuing to expand the number of patients educated and assessing patient's improved knowledge by giving a pre- and post- education test. Funding: N/A