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A Seizure Care Pathway in the Emergency Department: Preliminary Quality and Safety Improvements
Aim. To evaluate the utility of a seizure care pathway for seizure presentations to the emergency department (ED) in order to safely avoid unnecessary admission and to provide early diagnostic and therapeutic guidance and minimize length of stay in those admitted. Methods. 3 studies were conducted,...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi Publishing Corporation
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3420717/ https://www.ncbi.nlm.nih.gov/pubmed/22953060 http://dx.doi.org/10.1155/2012/273175 |
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author | Iyer, Parameswaran M. McNamara, Patricia H. Fitzgerald, Margaret Smyth, Liam Dardis, Christopher Jawad, Tania Plunkett, Patrick K. Doherty, Colin P. |
author_facet | Iyer, Parameswaran M. McNamara, Patricia H. Fitzgerald, Margaret Smyth, Liam Dardis, Christopher Jawad, Tania Plunkett, Patrick K. Doherty, Colin P. |
author_sort | Iyer, Parameswaran M. |
collection | PubMed |
description | Aim. To evaluate the utility of a seizure care pathway for seizure presentations to the emergency department (ED) in order to safely avoid unnecessary admission and to provide early diagnostic and therapeutic guidance and minimize length of stay in those admitted. Methods. 3 studies were conducted, 2 baseline audits and a 12-month intervention study and prospective data was collected over a 12-month period (Nov 2008-09). Results. Use of the Pathway resulted in a reduction in the number of epilepsy related admissions from 341 in 2004 to 276 in 2009 (P = 0.0006); a reduction in the median length of stay of those admittedfrom 4-5 days in the baseline audits to 2 days in the intervention study (P ≤ 0.001); an improvement in time to diagnostic investigations such as CT brain, MRI brain and Electroencephalography (P ≤ 0.001, P ≤ 0.048, P ≤ 0.001); a reduction in readmission rates from 45.1% to 8.9% (P ≤ 0.001); and an improvement in follow-up times from a median of 16 weeks to 5 weeks (P < 0.001). From a safety perspective there were no deaths in the early discharged group after 12 months follow-up. Conclusion. The burden of seizure related admissions through the ED can be improved in a safe and effective manner by the provision of a seizure care pathway. |
format | Online Article Text |
id | pubmed-3420717 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | Hindawi Publishing Corporation |
record_format | MEDLINE/PubMed |
spelling | pubmed-34207172012-09-05 A Seizure Care Pathway in the Emergency Department: Preliminary Quality and Safety Improvements Iyer, Parameswaran M. McNamara, Patricia H. Fitzgerald, Margaret Smyth, Liam Dardis, Christopher Jawad, Tania Plunkett, Patrick K. Doherty, Colin P. Epilepsy Res Treat Clinical Study Aim. To evaluate the utility of a seizure care pathway for seizure presentations to the emergency department (ED) in order to safely avoid unnecessary admission and to provide early diagnostic and therapeutic guidance and minimize length of stay in those admitted. Methods. 3 studies were conducted, 2 baseline audits and a 12-month intervention study and prospective data was collected over a 12-month period (Nov 2008-09). Results. Use of the Pathway resulted in a reduction in the number of epilepsy related admissions from 341 in 2004 to 276 in 2009 (P = 0.0006); a reduction in the median length of stay of those admittedfrom 4-5 days in the baseline audits to 2 days in the intervention study (P ≤ 0.001); an improvement in time to diagnostic investigations such as CT brain, MRI brain and Electroencephalography (P ≤ 0.001, P ≤ 0.048, P ≤ 0.001); a reduction in readmission rates from 45.1% to 8.9% (P ≤ 0.001); and an improvement in follow-up times from a median of 16 weeks to 5 weeks (P < 0.001). From a safety perspective there were no deaths in the early discharged group after 12 months follow-up. Conclusion. The burden of seizure related admissions through the ED can be improved in a safe and effective manner by the provision of a seizure care pathway. Hindawi Publishing Corporation 2012 2012-05-29 /pmc/articles/PMC3420717/ /pubmed/22953060 http://dx.doi.org/10.1155/2012/273175 Text en Copyright © 2012 Parameswaran M. Iyer et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Study Iyer, Parameswaran M. McNamara, Patricia H. Fitzgerald, Margaret Smyth, Liam Dardis, Christopher Jawad, Tania Plunkett, Patrick K. Doherty, Colin P. A Seizure Care Pathway in the Emergency Department: Preliminary Quality and Safety Improvements |
title | A Seizure Care Pathway in the Emergency Department: Preliminary Quality and Safety Improvements |
title_full | A Seizure Care Pathway in the Emergency Department: Preliminary Quality and Safety Improvements |
title_fullStr | A Seizure Care Pathway in the Emergency Department: Preliminary Quality and Safety Improvements |
title_full_unstemmed | A Seizure Care Pathway in the Emergency Department: Preliminary Quality and Safety Improvements |
title_short | A Seizure Care Pathway in the Emergency Department: Preliminary Quality and Safety Improvements |
title_sort | seizure care pathway in the emergency department: preliminary quality and safety improvements |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3420717/ https://www.ncbi.nlm.nih.gov/pubmed/22953060 http://dx.doi.org/10.1155/2012/273175 |
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