A description of Canadian epilepsy monitoring units: An initial step toward developing nursing practice consensus guidelines

Margo DeVries-Rizzo; Canadian Epilepsy Nursing Group

doi:10.1016/j.yebeh.2016.02.012

A description of Canadian epilepsy monitoring units: An initial step toward developing nursing practice consensus guidelines

Epilepsy Behav. 2016 Apr;57(Pt A):145-150. doi: 10.1016/j.yebeh.2016.02.012. Epub 2016 Mar 5.

Authors

Margo DeVries-Rizzo¹; Canadian Epilepsy Nursing Group²

Affiliations

¹ Children's Hospital, London Health Sciences Centre, London, ON, Canada; Western University, London, ON, Canada. Electronic address: margo.devries-rizzo@lhsc.on.ca.
² Children's Hospital, London Health Sciences Centre, London, ON, Canada; Western University, London, ON, Canada.

PMID: 26953844
DOI: 10.1016/j.yebeh.2016.02.012

Abstract

Objective: The epilepsy monitoring unit (EMU) is a well-established resource for investigating patients' seizures but is known to be heterogeneous in organization and clinical practice. The purpose of this study was to gain a better understanding of similarities and differences in EMU characteristics across Canada, with specific emphasis on EMU organization and nursing resources, which were currently unknown. Results would be used to develop a consensus on best nursing practice guidelines in EMUs with the goal to improve patient care and safety during epilepsy monitoring admissions.

Methods: An 18-item survey was developed addressing EMU locations, types, nursing ratios, nursing roles, and other allied health resources. Surveys were distributed to lead nurses, physicians, and administrators in 29 EMUs across Canada. Results were tabulated and presented for each question in the survey.

Conclusion: All EMUs were located in urban, teaching centers and divided similarly by patient age. The survey demonstrated considerable variability in EMU bed location and organization with the majority of EMUs being smaller, open units embedded in wards rather than larger, closed units. Independent of patient acuity, variability also existed in nurse-to-patient ratios, nursing skill level, specialty nursing support, and EEG technician availability. These findings highlight that EMU heterogeneity contributes to the challenges in the development of standardized safe care practices and that nursing education and nursing best practice recommendations need to be developed with baseline EMU nursing competencies, skills, and knowledge in mind.

Keywords: Epilepsy monitoring unit; Nursing; Practice guidelines; Resources; Safety; Seizure.

MeSH terms

Adult
Canada
Consensus
Electroencephalography / methods*
Epilepsy / diagnosis*
Evidence-Based Medicine
Female
Health Care Surveys
Humans
Middle Aged
Monitoring, Physiologic / standards*
Nurses*
Patient Safety / standards*
Patient Safety / statistics & numerical data
Practice Guidelines as Topic*
Seizures / diagnosis
Surveys and Questionnaires