UK framework for basic epilepsy training and oromucosal midazolam administration.

Area of Science:

• Neurology
• Medical Education
• Public Health

Background:

• Oromucosal Midazolam is a vital emergency seizure treatment in the UK, administered by trained family members.
• The Joint Epilepsy Council (JEC) UK, previously responsible for training guidelines, disbanded in 2016, creating a training gap.
• This left a need for updated standards in basic epilepsy education and rescue medication administration.

Purpose of the Study:

• To provide updated standards for basic epilepsy education.
• To establish guidelines for the administration of rescue medication (Midazolam).
• To develop a voluntary online assessment for carers administering Midazolam.

Main Methods:

• The Delphi process was employed by the Epilepsy Nurses Association (ESNA), International League against Epilepsy (ILAE), and Royal College of Psychiatrists (RCPsych).
• Guidance was updated and a question bank developed through committee work (2017-2019), with feedback from professional bodies and patient organizations.
• A consensus process involved stakeholder engagement, leading to national circulation of ratified guidelines.

Main Results:

• A consensus was reached through a multi-stage process involving two task and finish groups.
• Updated guidelines were circulated nationally, revealing inconsistent local assessment tools and procedures.
• An online test was developed, with 278 carers completing it (as of Oct 2020) achieving a 95% pass rate and 100% positive feedback.

Conclusions:

• The UK-wide gap in basic epilepsy training and safe rescue medication administration has been addressed.
• The updated guidelines and online test provide standardized training for carers.
• A plan for biennial updates to guidelines and the test is in place to ensure ongoing quality of care.