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Expediting Treatment of Seizures in the Intensive Care Nursery

Katelin Kramer1,2, Arpi Bekmezian3,2, Kendall Nash3,4,2

  • 1Departments of Pediatrics katelin.kramer@ucsf.edu.

Pediatrics
|August 12, 2021
PubMed

Insights

This quality improvement project successfully reduced the time to seizure treatment in neonates by 48%. The new seizure rescue process expedited medication delivery in the intensive care nursery (ICN), improving outcomes for newborns with seizures.

Area of Science:

  • Neonatal neurology
  • Quality improvement science
  • Pediatric intensive care

Background:

  • Prolonged neonatal seizures are linked to adverse neurodevelopmental outcomes.
  • Timely medical intervention is crucial for improving seizure management in neonates.
  • Current treatment delays necessitate innovative solutions in the intensive care nursery (ICN).

Purpose of the Study:

  • To decrease the time to medical treatment for neonatal seizures by 45% within 15 months.
  • To implement and evaluate a novel seizure rescue process in an academic children's hospital's ICN.
  • To improve neurodevelopmental outcomes by accelerating seizure management.

Main Methods:

  • A multidisciplinary team developed key drivers for timely seizure treatment.
  • Interventions included an optimized seizure rescue process with bedside pharmacist delivery and educational sessions.
  • Data were collected via monthly chart review and analyzed using statistical process control charts.

Main Results:

  • Time to seizure treatment decreased by 48%, from 27 minutes to 14 minutes.
  • This significant improvement was sustained from January 2016 to March 2020.
  • The seizure rescue process was effectively utilized without an increase in unnecessary activations.

Conclusions:

  • An innovative seizure rescue process, combined with education, expedited antiseizure therapy in the ICN.
  • This quality improvement initiative successfully reduced treatment times without requiring emergency code resources.
  • The findings support the adoption of similar strategies to improve neonatal seizure management.
Abstract

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