Abstracts

Rationale: An epilepsy monitoring unit (EMU) is used to evaluate and treat seizures. However, adverse events occur in up to 10% of EMU patients.¹ 1:1 staff may provide the highest level of safety, but staffing shortages and cost limit the availability. EHealth remote monitoring systems can assist with patient monitoring. We aim to assess attitudes of EMU staff after implementing EHealth in our EMU.


Methods: A cross-sectional electronic survey was administered in June 2024 at a county hospital in New York, Westchester Medical Center, around 18 months after an adult EMU was established, and 9 months after EHealth implementation. EHealth’s audiovisual intercom ESitter technology in patient rooms allows remote staff to instantly speak to patients after push button activation, clear erraneous push buttons, or escalate to a floor alarm for nursing response. A volunteer sample of EMU EEG technicians, nurses, epileptologists, and EHealth staff completed the survey. The survey collected participants’ experience levels and used a Likert scale (strongly disagree to strongly agree) to explore EMU experience and attitudes towards the EHealth system from different care perspectives. Experience was defined by the position, not solely in an EMU. Responses indicating no EMU patient experience were excluded.


Results:
10 EEG technicians, averaging 6 years of experience, 5 nurses, averaging 9 years of experience, 5 epileptologists, averaging 14 years of experience, and 11 EHealth members, averaging 2.9 years of experience participated. 4/5 epileptologists, 9/11 EHealth, 4/10 technicians, and 2/5 nurses reported EHealth in the EMU improves patient safety.EHealth reported an average 2.9 push button alarms per shift, technicians 3.2, epileptologists 3, and nurses 1.6. 5/5 nurses, but only 2/5 epileptologists and 4/10 technicians felt if EHealth sounds the alarm, a patient is seizing. Only 1/5 nurses and 1/5 epileptologists felt the push button alarm system would be more effective directly at the nurses’ station, without EHealth. 4/5 epileptologists felt EHealth saved nurses’ time, however only 1/5 nurses felt it saved them time. 4/10 technicians felt a barrier to capturing a seizure was having time to monitor. 100% of EHealth said they would alert nursing if concerned for seizure, even without push button activation.




Conclusions: While safety was felt to be improved only by the majority of epileptologists and EHealth, nursing did feel if EHealth alerted nursing, it was for a seizure and required a rapid response. Nurses also reported half the number of push buttons as other groups, suggesting EHealth may cut their required response time in half. EHealth can serve as a second set of eyes for seizure monitoring, even without push buttons. Our preliminary results suggest EHealth could improve EMU monitoring and patient safety, potentially alleviating staff and financial burden.

References:

1. 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