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An audit of children referred with suspected epilepsy
R Appleton1, F Besag, C Kennedy
1Epilepsy Audit Group, British Paediatric Neurology Association.
Insights
This national audit of childhood epilepsy care found that while most case notes met the audit standard, crucial details like epilepsy triggers and family communication were often missing. The study highlights a low response rate despite a simple audit form.
Area of Science:
- Neurology
- Pediatrics
- Public Health
Background:
- Epilepsy is a common neurological disorder in children.
- Effective management requires comprehensive data collection and communication.
- A national audit was initiated to assess the quality of care for children with suspected epilepsy.
Purpose of the Study:
- To evaluate the adherence to a pre-defined standard of care for children presenting with possible epilepsy.
- To identify areas of strength and weakness in the documentation of history, examination, investigation, treatment, and communication.
Main Methods:
- A national audit involving the British Paediatric Neurology Association.
- Retrospective review of 50 children's case notes from three participating centers.
- Data collection using a 30-question audit form based on an advisory group's standard.
Main Results:
- The majority of case notes met the audit standard across most sections.
- Only 64% of records documented epilepsy provoking factors.
- Communication regarding epilepsy support organizations was documented in 0-48% of cases, indicating a significant gap.
Conclusions:
- While the audit standard was largely met, significant deficiencies exist in documenting key historical details and family communication.
- The low response rate from participating centers suggests challenges in conducting national audits in pediatric neurology.
- Improvements in data recording and communication strategies are needed to enhance the care of children with epilepsy.
Abstract:
Members of the British Paediatric Neurology Association were invited to participate in a national audit of children presenting with a possible diagnosis of epilepsy. The audit was based on a 'standard' or set of pre-determined questions drawn up by an advisory audit group. The audit form comprised a total of 30 questions divided into four sections addressing history, examination, investigation, treatment and communication. Information for the audit was obtained retrospectively from the child's case notes. Each participating centre or consultant was asked to audit the case notes of 20 children. At the end of the 12-month recruitment period three centres responded, contributing audit forms on 50 children. The required information was provided for the majority of the questions in each of the four sections, thereby meeting the audit 'standard'. Within the history section, only 32 of the 50 (64%) case notes had recorded whether or not there was 'any obvious provoking factor or circumstance to the episodes'. Communication was the least satisfactorily completed section with between none and 48% of the case notes documenting that the child's family had been informed of the existence of a voluntary epilepsy organization. Despite the simplicity of the audit form, the response for this national audit was considerably lower than anticipated.