a seizure care pathway in the emergency department preliminary quality and safety improvements癫痫护理路径在急诊科初步质量和安全改进.pdfVIP

Hindawi Publishing Corporation Epilepsy Research and Treatment Volume 2012, Article ID 273175, 7 pages doi:10.1155/2012/273175 Clinical Study A Seizure Care Pathway in the Emergency Department: Preliminary Quality and Safety Improvements Parameswaran M. Iyer,1 Patricia H. McNamara,1 Margaret Fitzgerald,1 Liam Smyth,2 Christopher Dardis,2 Tania Jawad,1 Patrick K. Plunkett,2, 3 and Colin P. Doherty1, 2 1 Department of Neurology, St James’s Hospital, Dublin 8, Ireland 2 School of Medicine, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland 3 Department of Emergency Medicine, St James’s Hospital, Dublin 8, Ireland Correspondence should be addressed to Colin P. Doherty, cpdoherty@stjames.ie Received 1 December 2011; Accepted 23 January 2012 Academic Editor: Martin J. Brodie 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. 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 i