Improving Status Epilepticus Treatment Times
Quality Improvement in Time to Treatment of Status Epilepticus
Nationwide Children's Hospital
450 participants
Feb 1, 2024
INTERVENTIONAL
Conditions
Summary
This is a stepped-wedge cluster randomized effectiveness-implementation hybrid study aimed at determining the effect of dissemination of a QI bundle on the time to treatment of SE among hospitalized, non-critically ill children. The primary study endpoint is to decrease the time from the SE diagnosis to treatment with the first dose of a benzodiazepine (BZD) as measured during hospitalization, which will decrease chances of morbidity and mortality.
Eligibility
Inclusion Criteria5
- SE episode occurs in a male or female child aged between \> 30 days to \< 19 years
- Seizures meeting AT LEAST ONE of the following criteria:
- continuous clinically apparent seizure lasting greater than 5 minutes
- continuous clinically apparent seizure of any duration receiving BZD
- repeated seizures without return to neurological baseline within 5 minutes
Exclusion Criteria2
- SE episode occurs in a child with infantile spasms
- SE episode occurs in a child with electrographic-only seizures without clinical signs other than encephalopathy
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Interventions
(1) standardizing BZD default to intranasal or buccal midazolam; (2) targeting initial BZD treatment within 10 minutes of seizure onset; (3) relocating and bundling all administration items needed to the hospital unit medication room; (4) utilizing basic seizure first aid in the initial patient assessment; (5) developing and implementing SE-specific EHR documentation; (6) multidisciplinary QI teams
Sites will implement both the standard QI bundle as well as site-specific PDSA cycles with central data and methods support.
Sites will implement both the standard QI bundle as well as site-specific PDSA cycles without central data or methods support.
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT06194747