Abstracts

Rationale: Children with epilepsy, like children without, spend a considerable amount of time learning and socializing in the school environment. An online survey of elementary school teachers cited the internet as the primary source of information about epilepsy while most responders suggested school nurses 74% and Physicians 73% as preferred sources for information (Mott J et al. 2013). We therefore recognized the need for school nurses to have direct access to Pediatric Epilepsy Programs and the need for Epilepsy Educators to act as a link that transcends the Hospital and reach out to the PCP, Nurses and in-turn the parent and child. We propose that this will foster better awareness, earlier identification, improved management and reduced Hospitalization. Apart from the possibility of improving quality of life for these children, by reducing seizures, it may be beneficial to create a questionnaire to identify knowledge, or lack thereof, about epilepsy and its management.Methods: Knowledge was accessed by distributing a 20 item questionnaire to school nurses (75) within one school district. The purpose of this assessment was to identify knowledge gaps around the treatment and management of seizures. Responder rates were 92% on 16 questions and 69.3% on 4 questions. Questions pertained to demographics, seizure knowledge and management and an adolescent specific issue, driving guidelines for their state. Statistical analysis was completed a needs assessment devised and active intervention implemented.Results: The majority surveyed had been school nurses for between 2-10 years (58.66%) and (57.33%) support the elementary level, most feeding into a limited number of middle schools and even less high schools. The majority had 2-5 visits from children for seizures during a school year (41.33%), followed by 0-1 visits (36%). Nurses identified they had no school visits from physicians or epilepsy educators in the past year and 62% never discussed seizures or epilepsy over the phone with a health care professional. Diastat (<7%) and oral seizure medications (15%) were seldom given in schools. Somewhat surprising 20% stated that they had children with VNS in their care. 81% had some knowledge of epilepsy before becoming a school nurse. Most nurses knew when to give diastat. They also knew that nothing should be placed in the mouths of seizing individuals, however most called EMS regardless if seizure stopped with diastat. Most thought epilepsy prevalence was approximately 1/1000 children and also thought that seizures occurred while fully awake and revealed GTC. 2/3rd thought that illness would not precipitate seizures while 87% perceived most children with Epilepsy to be normal. Only 33% knew the legal driving laws regarding persons with Epilepsy in their state. 48% thought surgery should never be explored in Epilepsy and 35% thought they required failure of more than 5 meds.Conclusions: The results reflect the need for greater collaboration and educational efforts between Epilepsy Educators and school nurses. This in turn will provide better care, social understanding and quality of life to children with Epilepsy.