Abstracts

Rationale: The Epilepsy Monitoring Unit Quality and Safety (Q&S) committee meets monthly and consists of patient care managers, nurse clinical specialists, staff nurses, physicians and administrators. Through the development of this committee and the discussion of individual reports, patient satisfaction survey, face to face discussions, adverse events and collaboration with other areas, our committee identified that our institution did not have a true standard of care for patients with epilepsy. Methods: After reviewing the current "culture of care" for our adult EMU, the group identified that it was non-specific and lacking in more necessary guidelines. Falls are always a concern and discussed routinely after quarterly data collection. The quality and safety developed safeguards to prevent patient falls and established more specific guidelines. A retrospective audit was also performed to assess responses to patients experiencing an event in our adult and pediatric EMU. This was based on time to the patient, initial safety response and patient testing during the seizure or event. The nursing staff on the adult EMU along with the Q&S and the Nursing Staff Development for neurosciences developed a competency checklist for all nursing staff working in the adult EMU that will be required annually. Additionally, a training course has become part of orientation for all new nursing nursing hires to the Kentucky Childrens Hospital (KCH) and to inpatient neurosciences . . Results: The adult EMU has not reported any true falls or injuries since we initiated our safety guidelines. The adult EMU staff completed their check-off for the first time as of 5/31/14. After feedback, we will make changes as needed, assess changes in the unit culture and use this checklist as our springboard for a hospital wide assessment tool, eventually developing a web-based training competency required for all hospital nursing staff. As of 6/1/14, in the past 1 year, approximately 150 new nursing hires to pediatrics and neurosciences as well as approximately 200 KCH staff have completed epilepsy care training as part of their orientation or ongoing education. The nursing staff are responding to and engaging the patients in the adult EMU more satisfactorily and consistently. The ability to accurately assess this is challenging due to multiple variabilities, but the response times have been improved and the testing and safety response have as well. More data will be available at the time of this presentation. Conclusions: The quality and safety committee will undoubtedly find endless opportunities for improvement. We will remain dedicated to improving the culture of safety in our institution for all people, but specifically, people with epilepsy. Engaging staff to understand seizures and epilepsy, to identify seizures and to feel empowered in caring for and counseling these patients will lead to better patient outcomes and a higher satisfaction for the patients and the healthcare team.