Seizure Rescue Medication: Caregiver Education in a Simulation Setting

Boston Children's Hospital

Status: Completed

Conditions: Status Epilepticus

Treatments: Other: Video Educational Intervention; Other: Verbal Instructions Educational Intervention; Other: Mannequin Educational Intervention

Study type: Interventional

Funder types: Other

Identifiers

NCT03562351

P00027241

Details and patient eligibility

About

1. Design an educational quality improvement program to assess the most effective educational approach on caregiver seizure RM application. The investigators hypothesize that this educational program will improve caregiver comfort, knowledge of emergent seizure care, and time to medication application.

Specifically, the aims include:

1. Create an educational video reviewing RM administration
2. Develop and validate a simulation training model/mannequin for rectal diazepam administration
3. Expand training to other seizure RMs (e.g. intranasal midazolam, buccal lorazepam) and transition the most effective educational model back to the clinics/bedside to standardize caregiver teaching throughout the department/hospital

Full description

The investigators will implement an intervention jointly with a simulation program to determine the most effective training model: verbal instructions, instructional video, or use of a mannequin. Caregivers will undergo a training curriculum, and 60 caregivers (20 assigned to each educational model) will be matched into three groups and assigned to participate in one of three educational models in the SIM Center. Pre-and post-training questionnaires will be distributed to assess provider knowledge and comfort level. Scoring of caregiver technique administering rectal diazepam to a mannequin and time to RM administration will be obtained to compare between the three educational arms of the study. Thirty additional patients (10 per group) will not receive an assessment of caregiver technique administering RM to the mannequin prior to the educational intervention to control for exposure to the mannequin. Ultimately, the most effective educational method in this simulation pilot study will be expanded to other RM types (e.g. intranasal midazolam, buccal lorazepam), standardized, and brought back to the clinics/bedside throughout the hospital.

Enrollment: 17 patients

Sex: All

Ages: 2 to 80 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

1. Adult caregivers of patients with epilepsy followed at BCH with the following:

   1. At least one seizure >5 minutes
   2. Prescription for rectal diazepam rescue medication
   3. Admission for seizure/neurologic problem or neurology/epilepsy clinic visit during the enrollment period

2. Adult caregivers of patients without epilepsy

Exclusion criteria

1. Adult caregivers of epilepsy patients without a rectal diazepam prescription
2. Non-English-speaking caregivers

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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17 participants in 3 patient groups

Verbal Instructions on use of RM

Experimental group

Description:

Caregivers will undergo an educational intervention with typical training with verbal instructions and use of a rectal diazepam trainer.

Treatment:

Other: Verbal Instructions Educational Intervention

Video on use of RM

Experimental group

Description:

Caregivers will undergo an educational intervention with training by watching an instructional video regarding rescue medication administration

Treatment:

Other: Video Educational Intervention

Mannequin on use of RM

Experimental group

Description:

Caregivers will undergo an educational intervention with training by use of a mannequin to practice administering the rescue medication

Treatment:

Other: Mannequin Educational Intervention