A consensus-based approach to patient safety in epilepsy monitoring units: Recommendations for preferred practices

Patricia O. Shafer, Janice M. Buelow, Katherine Noe, Ruth Shinnar, Sandra Dewar, Paul M. Levisohn, Patricia Dean, David Ficker, Mary Jo Pugh, Gregory L. Barkley

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Patients in an epilepsy monitoring unit (EMU) with video-EEG telemetry have a risk for seizure emergencies, injuries and adverse events, which emphasizes the need for strategies to prevent avoidable harm. An expert consensus process was used to establish recommendations for patient safety in EMUs. Workgroups analyzed literature and expert opinion regarding seizure observation, seizure provocation, acute seizures, and activity/environment. A Delphi methodology was used to establish consensus for items submitted by these workgroups. Fifty-three items reached consensus and were organized into 30 recommendations. High levels of agreement were noted for items pertaining to orientation, training, communication, seizure precautions, individualized plans, and patient/family education. It was agreed that seizure observation should include direct observation or use of closed-circuit camera. The use of continuous observation was strongest in patients with invasive electrodes, at high risk for injury, or undergoing AED withdrawal. This process provides a first step in establishing EMU safety practices.

Original languageEnglish (US)
Pages (from-to)449-456
Number of pages8
JournalEpilepsy and Behavior
Volume25
Issue number3
DOIs
StatePublished - Nov 2012

Fingerprint

Patient Safety
Epilepsy
Consensus
Seizures
Observation
Telemetry
Wounds and Injuries
Expert Testimony
Patient Education
Electroencephalography
Electrodes
Emergencies
Communication
Safety

Keywords

  • Delphi methodology
  • Epilepsy
  • Epilepsy monitoring units
  • Expert consensus
  • Patient safety
  • Seizure observation
  • Seizure precautions
  • Video-EEG telemetry

ASJC Scopus subject areas

  • Clinical Neurology
  • Behavioral Neuroscience
  • Neurology

Cite this

Shafer, P. O., Buelow, J. M., Noe, K., Shinnar, R., Dewar, S., Levisohn, P. M., ... Barkley, G. L. (2012). A consensus-based approach to patient safety in epilepsy monitoring units: Recommendations for preferred practices. Epilepsy and Behavior, 25(3), 449-456. https://doi.org/10.1016/j.yebeh.2012.07.014

A consensus-based approach to patient safety in epilepsy monitoring units : Recommendations for preferred practices. / Shafer, Patricia O.; Buelow, Janice M.; Noe, Katherine; Shinnar, Ruth; Dewar, Sandra; Levisohn, Paul M.; Dean, Patricia; Ficker, David; Pugh, Mary Jo; Barkley, Gregory L.

In: Epilepsy and Behavior, Vol. 25, No. 3, 11.2012, p. 449-456.

Research output: Contribution to journalArticle

Shafer, PO, Buelow, JM, Noe, K, Shinnar, R, Dewar, S, Levisohn, PM, Dean, P, Ficker, D, Pugh, MJ & Barkley, GL 2012, 'A consensus-based approach to patient safety in epilepsy monitoring units: Recommendations for preferred practices', Epilepsy and Behavior, vol. 25, no. 3, pp. 449-456. https://doi.org/10.1016/j.yebeh.2012.07.014
Shafer, Patricia O. ; Buelow, Janice M. ; Noe, Katherine ; Shinnar, Ruth ; Dewar, Sandra ; Levisohn, Paul M. ; Dean, Patricia ; Ficker, David ; Pugh, Mary Jo ; Barkley, Gregory L. / A consensus-based approach to patient safety in epilepsy monitoring units : Recommendations for preferred practices. In: Epilepsy and Behavior. 2012 ; Vol. 25, No. 3. pp. 449-456.
@article{bbd6d58da9844b228595d093ecada47b,
title = "A consensus-based approach to patient safety in epilepsy monitoring units: Recommendations for preferred practices",
abstract = "Patients in an epilepsy monitoring unit (EMU) with video-EEG telemetry have a risk for seizure emergencies, injuries and adverse events, which emphasizes the need for strategies to prevent avoidable harm. An expert consensus process was used to establish recommendations for patient safety in EMUs. Workgroups analyzed literature and expert opinion regarding seizure observation, seizure provocation, acute seizures, and activity/environment. A Delphi methodology was used to establish consensus for items submitted by these workgroups. Fifty-three items reached consensus and were organized into 30 recommendations. High levels of agreement were noted for items pertaining to orientation, training, communication, seizure precautions, individualized plans, and patient/family education. It was agreed that seizure observation should include direct observation or use of closed-circuit camera. The use of continuous observation was strongest in patients with invasive electrodes, at high risk for injury, or undergoing AED withdrawal. This process provides a first step in establishing EMU safety practices.",
keywords = "Delphi methodology, Epilepsy, Epilepsy monitoring units, Expert consensus, Patient safety, Seizure observation, Seizure precautions, Video-EEG telemetry",
author = "Shafer, {Patricia O.} and Buelow, {Janice M.} and Katherine Noe and Ruth Shinnar and Sandra Dewar and Levisohn, {Paul M.} and Patricia Dean and David Ficker and Pugh, {Mary Jo} and Barkley, {Gregory L.}",
year = "2012",
month = "11",
doi = "10.1016/j.yebeh.2012.07.014",
language = "English (US)",
volume = "25",
pages = "449--456",
journal = "Epilepsy and Behavior",
issn = "1525-5050",
publisher = "Academic Press Inc.",
number = "3",

}

TY - JOUR

T1 - A consensus-based approach to patient safety in epilepsy monitoring units

T2 - Recommendations for preferred practices

AU - Shafer, Patricia O.

AU - Buelow, Janice M.

AU - Noe, Katherine

AU - Shinnar, Ruth

AU - Dewar, Sandra

AU - Levisohn, Paul M.

AU - Dean, Patricia

AU - Ficker, David

AU - Pugh, Mary Jo

AU - Barkley, Gregory L.

PY - 2012/11

Y1 - 2012/11

N2 - Patients in an epilepsy monitoring unit (EMU) with video-EEG telemetry have a risk for seizure emergencies, injuries and adverse events, which emphasizes the need for strategies to prevent avoidable harm. An expert consensus process was used to establish recommendations for patient safety in EMUs. Workgroups analyzed literature and expert opinion regarding seizure observation, seizure provocation, acute seizures, and activity/environment. A Delphi methodology was used to establish consensus for items submitted by these workgroups. Fifty-three items reached consensus and were organized into 30 recommendations. High levels of agreement were noted for items pertaining to orientation, training, communication, seizure precautions, individualized plans, and patient/family education. It was agreed that seizure observation should include direct observation or use of closed-circuit camera. The use of continuous observation was strongest in patients with invasive electrodes, at high risk for injury, or undergoing AED withdrawal. This process provides a first step in establishing EMU safety practices.

AB - Patients in an epilepsy monitoring unit (EMU) with video-EEG telemetry have a risk for seizure emergencies, injuries and adverse events, which emphasizes the need for strategies to prevent avoidable harm. An expert consensus process was used to establish recommendations for patient safety in EMUs. Workgroups analyzed literature and expert opinion regarding seizure observation, seizure provocation, acute seizures, and activity/environment. A Delphi methodology was used to establish consensus for items submitted by these workgroups. Fifty-three items reached consensus and were organized into 30 recommendations. High levels of agreement were noted for items pertaining to orientation, training, communication, seizure precautions, individualized plans, and patient/family education. It was agreed that seizure observation should include direct observation or use of closed-circuit camera. The use of continuous observation was strongest in patients with invasive electrodes, at high risk for injury, or undergoing AED withdrawal. This process provides a first step in establishing EMU safety practices.

KW - Delphi methodology

KW - Epilepsy

KW - Epilepsy monitoring units

KW - Expert consensus

KW - Patient safety

KW - Seizure observation

KW - Seizure precautions

KW - Video-EEG telemetry

UR - http://www.scopus.com/inward/record.url?scp=84868690288&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84868690288&partnerID=8YFLogxK

U2 - 10.1016/j.yebeh.2012.07.014

DO - 10.1016/j.yebeh.2012.07.014

M3 - Article

C2 - 22999858

AN - SCOPUS:84868690288

VL - 25

SP - 449

EP - 456

JO - Epilepsy and Behavior

JF - Epilepsy and Behavior

SN - 1525-5050

IS - 3

ER -