1
|
Becker DA. The ECHO Was Heard Throughout the School. Epilepsy Curr 2023; 23:296-297. [PMID: 37901788 PMCID: PMC10601032 DOI: 10.1177/15357597231181888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023] Open
Abstract
Project ECHO Telementoring Program in Epilepsy for School Nurses Schultz RJ, Shafer PO, Owens S, Kakacek J, Farrell K. Epilepsy Behav . 2023:140. doi:10.1016/j.yebeh.2023.109114 Objectives: Many children with epilepsy experience seizures at school. School nurses must have the clinical expertise to deliver high-quality, safe care for students with epilepsy. However, in some regions of the U.S. access to interactive, epilepsy evidence-based education programs are limited. The objective of this project was to assess the feasibility of adapting the Epilepsy Foundation’s (EFs) school nurse education program to the ECHO model and evaluate its impact on school nurse knowledge and self-efficacy in managing epilepsy in students with seizures and program satisfaction. Methods: The EFs educational program for school nurses was adapted to the ECHO model and delivered by a team of interdisciplinary epilepsy specialists via videoconferencing. Retrospective post-program surveys were administered at program completion. Data from 32 participants with complete post-program surveys were used for the analysis of knowledge and confidence. Descriptive statistics and the sign test were conducted. Results: Participants were 166 school nurses from 13 states. The majority had >15 years of school nurse experience and served schools in suburban or rural areas. Improvements in knowledge and confidence were reported on most survey items. The highest improvements in self-reported knowledge and confidence were in psychosocial aspects of care, comorbidities, and recognition of nonepileptic events. Program satisfaction was rated as high by over 90% of participants. Conclusions: Telementoring using the ECHO methodology is a feasible modality to educate and link epilepsy specialists and providers with school nurses nationwide. Findings suggest that attending the MSS ECHO provided an educational and meaningful learning experience. The gains in knowledge and confidence in psychosocial aspects of epilepsy care and comorbidities highlight the importance of the inclusion of this content in educational programs
Collapse
|
2
|
Schultz RJ, Shafer PO, Owens S, Kakacek J, Farrell K. Project ECHO telementoring program in epilepsy for school nurses. Epilepsy Behav 2023; 140:109114. [PMID: 36780774 DOI: 10.1016/j.yebeh.2023.109114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 01/24/2023] [Accepted: 01/25/2023] [Indexed: 02/13/2023]
Abstract
OBJECTIVES Many children with epilepsy experience seizures at school. School nurses must have the clinical expertise to deliver high-quality, safe care for students with epilepsy. However, in some regions of the U.S. access to interactive, epilepsy evidence-based education programs is limited. The objective of this project was to assess the feasibility of adapting the Epilepsy Foundation's (EFs) school nurse education program to the ECHO model and evaluate its impact on school nurse knowledge and self-efficacy in managing epilepsy in students with seizures and program satisfaction. METHODS The EFs educational program for school nurses was adapted to the ECHO model and delivered by a team of interdisciplinary epilepsy specialists via videoconferencing. Retrospective post-program surveys were administered at program completion. Data from 32 participants with complete post-program surveys were used for the analysis of knowledge and confidence. Descriptive statistics and the sign test were conducted. RESULTS Participants were 166 school nurses from 13 states. The majority had > 15 years of school nurse experience and served schools in suburban or rural areas. Improvements in knowledge and confidence were reported on most survey items. The highest improvements in self-reported knowledge and confidence were in psychosocial aspects of care, comorbidities, and recognition of nonepileptic events. Program satisfaction was rated as high by over 90% of participants. CONCLUSIONS Telementoring using the ECHO methodology is a feasible modality to educate and link epilepsy specialists and providers with school nurses nationwide. Findings suggest that attending the MSS ECHO provided an educational and meaningful learning experience. The gains in knowledge and confidence in psychosocial aspects of epilepsy care and comorbidities highlight the importance of the inclusion of this content in educational programs.
Collapse
Affiliation(s)
- Rebecca J Schultz
- Texas Woman's University, United States; Baylor College of Medicine and Texas Children's Hospital, United States.
| | | | | | | | | |
Collapse
|
3
|
Boyd TM, Moyer SM, Lambert D. Interdisciplinary Collaboration to Care for Students Diagnosed with PANDAS: An Education and Referral Intervention. J Sch Nurs 2022:10598405221129553. [PMID: 36177527 DOI: 10.1177/10598405221129553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is an autoimmune disorder associated with sudden onset of behavior changes. The prevalence of PANDAS is increasing in schools and interdisciplinary collaboration, knowledge, and the use of referrals to the school nurse are important for supporting students. This project sought to provide education on PANDAS to the interdisciplinary school team and implement a referral process for students exhibiting behavior changes. A self-directed online educational intervention was employed. A pretest-posttest design was utilized to assess knowledge before, immediately after, and six-weeks after the educational intervention. A referral log was implemented to track the number of referrals to the school nurse. The final sample size included 19 participants. Mean scores increased from pretest to posttest, and the implementation of a referral system produced 12 new school nurse referrals. Further strategies are needed to enhance interdisciplinary collaboration and support students experiencing health-related issues.
Collapse
Affiliation(s)
- Tiffany M Boyd
- Department of Nursing, 5482Millersville University, Millersville, PA, USA
| | - Susan M Moyer
- Department of Nursing, 5482Millersville University, Millersville, PA, USA
| | - Dawn Lambert
- Department of Nursing, 5482Millersville University, Millersville, PA, USA
| |
Collapse
|
4
|
Samanta D, Elumalai V, Hoyt ML, Modi AC, Sajatovic M. A qualitative study of epilepsy self-management barriers and facilitators in Black children and caregivers in Arkansas. Epilepsy Behav 2022; 126:108491. [PMID: 34929473 PMCID: PMC8764703 DOI: 10.1016/j.yebeh.2021.108491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To identify facilitators and barriers of epilepsy self-management practices among Black children and caregivers. METHODS Qualitative semi-structured in-depth interviews were conducted with 11 child-caregiver dyads (11 children with epilepsy and 11 caregivers). A deductive-inductive analysis was undertaken to describe the range of barriers and facilitators significant to participants. RESULTS The barriers and facilitators were classified into 3 management themes: epilepsy-specific knowledge and information, treatment, and lifestyle. Within these themes, several important subthemes were identified. Two subthemes related to knowledge barriers emerged: children and caregivers' limited understanding and retention of complex written and spoken information and variable training and confidence in seizure first-aid. In contrast, facilitators for introducing and encouraging access to epilepsy self-management concepts were participants' eagerness to learn about this topic and a keen interest in using educational materials enriched with visual aids on a phone platform as an adjunct to in-person education. The second theme revealed various practical barriers to optimum treatment adherence, including mistrust of the healthcare system. In comparison, caregivers' collaborative approach and innovative strategies were identified as facilitators for treatment adherence. Finally, the lifestyle management barriers included a lack of defined processes to adopt healthy behaviors and challenges with disclosing epilepsy. Facilitators of this theme were comprised of building a team around the child to foster wellbeing and making healthy habits a fun and joyful experience for children. DISCUSSION Qualitative evidence in this study highlights caregivers' mistrust in the healthcare system and the lack of community support. Culturally competent interventions may improve access to and quality and utilization of self-management programs in Black children and families while reducing disparities.
Collapse
Affiliation(s)
- Debopam Samanta
- Neurology Division, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
| | - Vimala Elumalai
- Division of Neurology, Arkansas Children’s Hospital, United States of America
| | - Megan Leigh Hoyt
- Division of Neurology, Arkansas Children’s Hospital, United States of America
| | - Avani C. Modi
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Martha Sajatovic
- Neurological and Behavioral Outcomes Center, Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center, Cleveland, Ohio,Department of Psychiatry, Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center, Cleveland, Ohio
| |
Collapse
|
5
|
Mattey B. Power of the Past, Celebrate the Present, Force of the Future Part 4: 50 Years of School Nursing Practice-From Then Until Now. NASN Sch Nurse 2019; 34:44-54. [PMID: 30799700 DOI: 10.1177/1942602x18815443] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article is the fourth in the series examining 50 years of NASN's history. It looks at the needs of our students and the practice of school nursing from 1968 through 2018 using the structure provided by NASN Framework for 21st Century School Nursing Practice™. The article examines the destiny of school nursing practice as determined by the needs of our students, the strength and resolve of school nurses, and the education and resources provided by NASN.
Collapse
|
6
|
Herring C, Brown SK, Morgan BT, Thompson J, Kullmar A, Blood-Siegfried J. Virtual Orientation of Volunteer Short-Term International Health Teams to Increase Self-Confidence and Cultural and Global Health Competence. J Contin Educ Nurs 2019; 50:35-40. [PMID: 30645657 DOI: 10.3928/00220124-20190102-08] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 08/17/2018] [Indexed: 11/20/2022]
Abstract
International health team volunteers frequently arrive at service sites with considerable lack of confidence and knowledge gaps because of poor preparation. Preservice orientation has been shown to improve knowledge, confidence, and competence, but current practices fall short of meeting most needs. This health care improvement project was aimed to improve self-confidence and cultural and global health competence using a virtual preservice orientation format. The virtual innovation significantly narrowed the difference in confidence between new and experienced team members. Significant increases were observed in knowledge of global health and health equities for new and experienced team members. Following the orientation, a significant difference in global health skills for the entire team also was observed. Many Americans leave the United States annually attempting to help those in need. This effort is hindered by poor preparation and unreal expectations. Improving health team member confidence and competence is one way to address this concern. [J Contin Educ Nurs. 2019;50(1):35-40.].
Collapse
|
7
|
Lepkowski AM, Maughan ED. Introducing NASN's New Evidence-based Clinical Guideline: Students With Seizures and Epilepsy. NASN Sch Nurse 2018; 33:345-350. [PMID: 30295151 DOI: 10.1177/1942602x18806824] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
|
8
|
Brackney DE, Brooks JL. Complementary and Alternative Medicine: The Mozart Effect on Childhood Epilepsy—A Systematic Review. J Sch Nurs 2017; 34:28-37. [DOI: 10.1177/1059840517740940] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This systematic review examines the effectiveness of Mozart’s music in decreasing seizures in children with epilepsy (Mozart Effect) using the Johns Hopkins Nursing Evidence-Based Practice rating scale©. A search for articles with “Mozart Effect,” “child*,” and “epilepsy” was conducted in CINAHL Complete, Science Direct, Cochrane, and PubMed databases. Eight studies were selected based on the exclusion and inclusion criteria after removal of duplicates ( n = 17) and others ( n = 46). Studies included were English language, peer reviewed, published between April 2010 and February 2017, and available in full text with an abstract. Quasi-experimental studies demonstrate that the Mozart Effect May reduce epileptiform discharges or seizures in children and has potential as an adjunct to medical management of seizure activity or alone when medication or surgery is not accepted. A causal relationship between the music of Mozart and decreased seizure activity has yet to be demonstrated.
Collapse
Affiliation(s)
- Dana E. Brackney
- Department of Nursing, Beaver College of Health Sciences, Appalachian State University, Boone, NC, USA
| | | |
Collapse
|
9
|
Wagner JL, Modi AC, Johnson EK, Shegog R, Escoffery C, Bamps Y, Austin JK, Schultz RJ, MapelLentz S, Smith G. Self-management interventions in pediatric epilepsy: What is the level of evidence? Epilepsia 2017; 58:743-754. [PMID: 28233908 DOI: 10.1111/epi.13711] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To respond to recommendations put forth by the Institute of Medicine to improve self-management resources for youth with epilepsy by conducting a systematic review of the self-management literature in pediatric epilepsy. METHODS Inclusion criteria: youth birth to 18 years with a seizure disorder or an epilepsy diagnosis and/or their caregivers, published 1985-2014 in English, and conducted in countries with a very high human development index. Abstract and keywords had to explicitly refer to "self-care" (pre-1996) and/or self-management (post-1996). The review was conducted in seven phases: (1) identification of bibliographical search criteria and databases; (2) abstract assessment; (3) full article review; (4) organization of final citations into instrument development, intervention, factors associated with self-management categories; (5) American Academy of Neurology level of evidence (LOE) assessment for intervention studies; (6) CONsolidated Standards of Reporting Trials (CONSORT) evaluation of LOE level III articles utilizing a control group; and (7) categorization of intervention outcomes across four self-management domains. RESULTS Of the 87 articles that met eligibility criteria, 24 were interventions and received LOE scores of level III or IV. Most studies (n = 20, 80%) were scored at level III; however, only eight had a control group and adhered to CONSORT guidelines. They largely neglected information on intervention components (e.g., implementation, treatment fidelity), randomization, participant flow, missing data, and effect size or confidence intervals. The 24 intervention studies reported significant impact in four domains: individual (n = 13), family (n = 6), health care system (n = 3), and community (n = 2). SIGNIFICANCE There are no level I or II studies. No study met full CONSORT guidelines. Outcomes were well described; however, the nature of self-management interventions (e.g., multiple foci, skills targeted) and the observed heterogeneity in outcomes complicates comparisons across studies. Randomized controlled trials (RCTs) that include large sample sizes, impact of the intervention, treatment fidelity, and power analyses are necessary to further this evidence base.
Collapse
Affiliation(s)
- Janelle L Wagner
- Department of Pediatrics, College of Nursing, Medical University of South Carolina, Charleston, South Carolina, U.S.A
| | - Avani C Modi
- Center for Treatment Adherence and Self-Management, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A
| | - Erica K Johnson
- Harborview Medical Center, University of Washington, Seattle, Washington, U.S.A
| | - Ross Shegog
- Prevention Research Center & School of Public Health, University of Texas, Houston, Texas, U.S.A
| | - Cam Escoffery
- Department of Behavioral Sciences & Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia, U.S.A
| | - Yvan Bamps
- Department of Behavioral Sciences & Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia, U.S.A
| | - Joan K Austin
- School of Nursing, Indiana University-Purdue University Indianapolis, Bloomington, Indiana, U.S.A
| | - Rebecca J Schultz
- Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, U.S.A
| | - Sarah MapelLentz
- Department of Pediatrics & Adolescent Health, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | - Gigi Smith
- Department of Pediatrics, College of Nursing, Medical University of South Carolina, Charleston, South Carolina, U.S.A
| |
Collapse
|
10
|
Price P, Kobau R, Buelow J, Austin J, Lowenberg K. Improving understanding, promoting social inclusion, and fostering empowerment related to epilepsy: Epilepsy Foundation public awareness campaigns--2001 through 2013. Epilepsy Behav 2015; 44:239-44. [PMID: 25726152 PMCID: PMC4580242 DOI: 10.1016/j.yebeh.2014.12.044] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 12/17/2014] [Indexed: 10/23/2022]
Abstract
It is a significant public health concern that epilepsy, the fourth most common neurological disorder in the United States, is generally poorly understood by both the public and those living with the condition. Lack of understanding may magnify the challenges faced by those with epilepsy, including limiting treatment opportunities, effective management of symptoms, and full participation in daily life activities. Insufficient awareness of epilepsy and appropriate seizure first aid among the public and professionals can result in insufficient treatment, inappropriate seizure response, physical restraint, social exclusion, or other negative consequences. To address the need for increased public education and awareness about epilepsy, the national Epilepsy Foundation, supported by the Centers for Disease Control and Prevention, has conducted yearly multifaceted public education and awareness campaigns designed to reach the broad population and targeted segments of the population including youth, young adults, racial/ethnic groups (i.e., African-, Hispanic-, and Asian-Americans), and people with epilepsy and their caregivers. Campaign channels have included traditional media, social media, and community opinion leaders and celebrity spokespersons. The key activities of these campaigns, conducted from 2001 to 2013, are summarized in this report.
Collapse
Affiliation(s)
- P. Price
- McKing and Associates, Atlanta, GA, USA
| | - R. Kobau
- Centers for Disease Control and Prevention, Division of Population Health, Epilepsy Program, USA,Corresponding author at: Centers for Disease Control and Prevention, Division of Population Health, Epilepsy Program, 4770 Buford Highway NE, MS F-78, Atlanta, GA 30341, USA. Tel.: +1 770 488 6087; fax: +1 770 488 5486., (R. Kobau)
| | - J. Buelow
- National Epilepsy Foundation, Landover, MD, USA
| | | | | |
Collapse
|
11
|
Brook HA, Hiltz CM, Kopplin VL, Lindeke LL. Increasing Epilepsy Awareness in Schools. J Sch Nurs 2015; 31:246-52. [DOI: 10.1177/1059840514563761] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A high prevalence of epilepsy diagnoses and seizure events among students was identified at a large Midwestern school district. In partnership with the Epilepsy Foundation of Minnesota (EFMN), a quality improvement project was conducted to provide education and resources to staff caring for school children with seizures. School nurses ( N = 26) were trained as seizure management educators and instructed staff in 21 schools on seizure awareness and response. School nurses utilized new seizure management resources, a procedural guideline, and care plan updates. The majority of school nurses rated the resources and training interventions as “very helpful.” School nurse confidence in managing students with seizures increased, seizure action plan use increased, and 88% of children’s records with new seizure diagnoses had completed documentation. School nurses played vital roles in increasing seizure awareness as educators and care managers. EFMN is using this project as an exemplar for expanding its Seizure Smart Schools program.
Collapse
Affiliation(s)
- Heather A. Brook
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
| | | | | | - Linda L. Lindeke
- School of Nursing and Center for Children with Special Health Care Needs, University of Minnesota, Minneapolis, MN, USA
| |
Collapse
|
12
|
Koh HK, Kobau R, Whittemore VH, Mann MY, Johnson JG, Hutter JD, Jones WK. Toward an integrated public health approach for epilepsy in the 21st century. Prev Chronic Dis 2014; 11:E146. [PMID: 25167091 PMCID: PMC4149320 DOI: 10.5888/pcd11.140270] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Epilepsy, a complex spectrum of disorders, merits enhanced public health action. In 2012, the Institute of Medicine (IOM) released a seminal report on the public health dimensions of the epilepsies, recommending actions in 7 domains. The report urged a more integrated and coordinated national approach for care centering on the whole patient, including heightened attention to comorbidities and quality of life; more timely referral and access to treatments; and improved community resources, education, stakeholder collaboration, and public communication. The US Department of Health and Human Services responded to this report by accelerating and integrating ongoing initiatives and beginning new ones. This article summarizes recent federally supported activities promoting an integrated public health approach for epilepsy, highlighting progress in response to the landmark 2012 IOM report and identifying opportunities for continued public health action.
Collapse
Affiliation(s)
- Howard K Koh
- , Office of the Assistant Secretary for Health, US Department of Health and Human Services, 200 Independence Ave SW, Washington, DC 20201
| | | | | | - Marie Y Mann
- US Department of Health and Human Services, Washington, DC
| | | | | | - Wanda K Jones
- US Department of Health and Human Services, Washington, DC
| |
Collapse
|