Related Experiment Video

Updated: Apr 24, 2026

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
06:59

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

Published on: November 9, 2016

33.8K

Optimizing anticonvulsant administration for children before anesthesia: a quality improvement project

Charlotte T Jones1, Vidya T Raman2, Seth DeVries3

  • 1Division of Child Neurology, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio.

Pediatric Neurology
|September 7, 2014
PubMed

Insights

Children with epilepsy often miss anticonvulsant medications during hospital transitions, risking seizures. A quality improvement project successfully increased scheduled anticonvulsant administration before anesthesia procedures, improving patient safety.

Area of Science:

  • Pediatric Neurology
  • Quality Improvement in Healthcare
  • Medication Safety

Background:

  • Children with epilepsy face heightened risks of missed anticonvulsant doses during hospital transitions.
  • This medication gap can lead to lowered anticonvulsant levels and breakthrough seizures, particularly before procedures requiring anesthesia.

Purpose of the Study:

  • To implement an interdisciplinary quality improvement project aimed at increasing the administration rate of scheduled anticonvulsants for children with epilepsy before procedures requiring anesthesia.

Main Methods:

  • Utilized the Institute for Health Care Improvement methodology to form an interdisciplinary team.
  • Standardized medication administration protocols for patients with 'nothing per os' (NPO) status before anesthesia.
  • Developed a contingency plan for managing missed home anticonvulsant doses.

Main Results:

  • The percentage of children receiving scheduled anticonvulsants at home before anesthesia procedures rose from 76% to 90% (P = 0.002).
  • In-hospital administration of maintenance anticonvulsants before procedures increased significantly from 21% to 91% (P < 0.001).

Conclusions:

  • Quality improvement initiatives effectively enhanced the continuity of anticonvulsant medication during the home-to-hospital transition for pediatric epilepsy patients.
  • Sustaining these improvements necessitates ongoing efforts and active parental involvement in care transitions.
Abstract

Keywords:
anticonvulsantsepilepsyhospital careneurological disorderspediatricquality improvementtransitions

More Related Videos

Guidelines for Elective Pediatric Fiberoptic Intubation11:19

Guidelines for Elective Pediatric Fiberoptic Intubation

Published on: January 17, 2011

17.5K
Anesthesia and Intubation of Preadolescent Mouse Pups for Cardiothoracic Surgery09:47

Anesthesia and Intubation of Preadolescent Mouse Pups for Cardiothoracic Surgery

Published on: June 2, 2022

2.3K

Related Concept Videos

Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
1.0K
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
398
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
950
Factors Affecting Drug Response: Overview01:21

Factors Affecting Drug Response: Overview

When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
3.1K
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
403
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
543