OBJECTIVE: To determine whether a pocket card treatment algorithm improves the early treatment of status epilepticus and to assess its utilization and retention in clinical practice. METHODS: Multidisciplinary care teams participated in video-recorded status epilepticus simulation sessions from 2015 to 2019. In this longitudinal cohort study, we examined the sessions recorded before and after introducing an internally developed, guideline-derived pocket card to determine differences in the adequacy or timeliness of rescue benzodiazepine. Simulation participants were queried 9 months later for submission of a differentiating identification number on each card to assess ongoing availability and utilization. RESULTS: Forty-four teams were included (22 before and 22 after the introduction of the pocket card). The time to rescue therapy was shorter for teams with the pocket card available (84 seconds [64-132]) compared with teams before introduction (144 seconds [100-162]) (U = 94; median difference = -46.9, 95% confidence interval [CI]: -75.9 to -21.9). The adequate dosing did not differ with card availability (odds ratio 1.48, 95% CI: 0.43-5.1). At the 9-month follow-up, 32 participants (65%) completed the survey, with 26 (81%) self-reporting having the pocket card available and 11 (34%) confirming ready access with the identification number. All identification numbers submitted corresponded to the hard copy laminated pocket card, and none to the electronic version. CONCLUSIONS: A pocket card is a feasible, effective, and worthwhile educational tool to improve the implementation of updated guidelines for the treatment of status epilepticus.
OBJECTIVE: To determine whether a pocket card treatment algorithm improves the early treatment of status epilepticus and to assess its utilization and retention in clinical practice. METHODS: Multidisciplinary care teams participated in video-recorded status epilepticus simulation sessions from 2015 to 2019. In this longitudinal cohort study, we examined the sessions recorded before and after introducing an internally developed, guideline-derived pocket card to determine differences in the adequacy or timeliness of rescue benzodiazepine. Simulation participants were queried 9 months later for submission of a differentiating identification number on each card to assess ongoing availability and utilization. RESULTS: Forty-four teams were included (22 before and 22 after the introduction of the pocket card). The time to rescue therapy was shorter for teams with the pocket card available (84 seconds [64-132]) compared with teams before introduction (144 seconds [100-162]) (U = 94; median difference = -46.9, 95% confidence interval [CI]: -75.9 to -21.9). The adequate dosing did not differ with card availability (odds ratio 1.48, 95% CI: 0.43-5.1). At the 9-month follow-up, 32 participants (65%) completed the survey, with 26 (81%) self-reporting having the pocket card available and 11 (34%) confirming ready access with the identification number. All identification numbers submitted corresponded to the hard copy laminated pocket card, and none to the electronic version. CONCLUSIONS: A pocket card is a feasible, effective, and worthwhile educational tool to improve the implementation of updated guidelines for the treatment of status epilepticus.
Authors: Tracy Glauser; Shlomo Shinnar; David Gloss; Brian Alldredge; Ravindra Arya; Jacquelyn Bainbridge; Mary Bare; Thomas Bleck; W Edwin Dodson; Lisa Garrity; Andy Jagoda; Daniel Lowenstein; John Pellock; James Riviello; Edward Sloan; David M Treiman Journal: Epilepsy Curr Date: 2016 Jan-Feb Impact factor: 7.500
Authors: Marina Gaínza-Lein; Iván Sánchez Fernández; Michele Jackson; Nicholas S Abend; Ravindra Arya; J Nicholas Brenton; Jessica L Carpenter; Kevin E Chapman; William D Gaillard; Tracy A Glauser; Joshua L Goldstein; Howard P Goodkin; Kush Kapur; Mohamad A Mikati; Katrina Peariso; Robert C Tasker; Dmitry Tchapyjnikov; Alexis A Topjian; Mark S Wainwright; Angus Wilfong; Korwyn Williams; Tobias Loddenkemper Journal: JAMA Neurol Date: 2018-04-01 Impact factor: 18.302
Authors: Abhishek G Sathe; Holly Tillman; Lisa D Coles; Jordan J Elm; Robert Silbergleit; James Chamberlain; Jaideep Kapur; Hannah R Cock; Nathan B Fountain; Shlomo Shinnar; Daniel H Lowenstein; Robin A Conwit; Thomas P Bleck; James C Cloyd Journal: Acad Emerg Med Date: 2019-07-18 Impact factor: 5.221