Abstracts

Rationale: Accurate classification of symptoms is essential for patients experiencing intractable seizures. To improve the assessment and treatment of unremitting seizures, a tertiary care hospital in the Southwest established an Epilepsy Monitoring Unit (EMU) in the early 1980’s. In 2006, the EMU tripled in size from 5 to 15 beds, accompanied by an increase in number of nursing staff. To address these changes, a pilot project was designed to determine nurses’ baseline knowledge of seizure symptoms and to serve as the basis for education planning.Methods: 20 Staff nurses on a neuroscience unit were given a 2-part test to determine their experience, confidence and knowledge in identifying seizure types. In Part A, nurses were asked to classify 23 listed characteristics as either non-epileptic or epileptic seizures. In part B, nurses were asked to watch 6 seizure videos and identify the seizure type as a simple partial, complex partial, generalized or non-epileptic seizure. Results: Descriptive data indicated that mean nursing experience was 9.74 years (range=0.0-35.00) with 4.61 years (range=0.42-16.00) experience in neuroscience nursing. The average number of shifts worked in the EMU was 2.91 per week. Seizure type was correctly classified in 65.05% of the videos, while the 23 characteristics were identified correctly 78.48% of the time. The results were further divided by years of neuroscience nursing experience: 0-1 years, 1-5 years, 6-10 years, and 10+ years. The nurses with 0-1 years experience scored 78.26% on Part A and 53.33% on Part B. Nurses with 1-5 years experience scored 71.98% on Part A and 68.52% on Part B. The next category of nurses with 6-10 years experience scored 88.04% on Part A and 79.16% on Part B. Finally, the nurses with 10+ years of nursing experience scored 89.13% on Part A and 50.00% on Part B. When measuring the confidence level of nurses in identifying seizure types, nurses with 0-1 years experience scored 1.66 on a range of 0-10. Nurses with 1-5 years experience scored 5.18 while those with 6-10 years experience scored 3.06. Finally, nurses with 10+ years scored 7.50 on a range of 0-10. Conclusions: Although the number of years experience is related to nurses’ abilities to accurately classify seizure types by characteristics, as listed in Part A, there is no relationship between years of experience and the ability to identify a seizure type by watching the videos. When measuring the confidence level of nurses in identifying seizure types, nurses with 10+ years of experience were more confident, those with less than 1 year experience were less confident, and those with 1-5 years and 6-10 years were neither confident nor unconfident. Although all nurses scored greater than 71% on Part A, even the most experienced nurses were only able to correctly identify the seizure types 50% of the time on Part B. As a result of the findings and because accurate seizure classification is essential to the delivery of quality patient care, an educational plan will be developed. EMU nurses of all experience levels will receive further education and be reassessed at a later date.