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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
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2
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Santilli N, Dewar S, Guerra C, Misra SN, Rabinowicz AL, Carrazana E. Use of intranasal rescue therapy for seizure clusters in students with epilepsy: Nurses' knowledge, perceptions, and practice. Epilepsy Behav Rep 2023; 22:100604. [PMID: 37448486 PMCID: PMC10337358 DOI: 10.1016/j.ebr.2023.100604] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 07/15/2023] Open
Abstract
School nurses play a crucial role in the prompt, appropriate response to epilepsy-related seizure emergencies among students in the school setting. Two intranasal benzodiazepine rescue therapies are now approved and offer potential benefits of being easy to use and socially acceptable. In July 2021, a survey was sent to 49,314 US school nurses to assess knowledge, perceptions, and practice with seizure rescue therapy. Responses were received from 866 (1.8% response rate). Of respondents, 45.7% had used rectal diazepam gel; 9.3%, midazolam nasal spray; and 6.0%, diazepam nasal spray. The majority (58.7%) had not delegated authority to administer rescue therapy, with state/local regulations and lack of willingness of school personnel being the most common barriers to delegation (37.7% and 20.1%, respectively). Additional training of nurses and school staff and progress on delegation policies may help optimize appropriate use of intranasal rescue therapy for seizures and enhance care of students with epilepsy in schools.
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Affiliation(s)
- Nancy Santilli
- Human Care Systems, 720-84 State St, Boston, MA 02109, United States
| | - Sandra Dewar
- Department of Neurology, Virginia Commonwealth University School of Medicine, 1101 E Marshall St, Richmond, VA 23298-0599, United States
| | - Cynthia Guerra
- Neurelis, Inc., 300-3430 Carmel Mountain Rd, San Diego, CA 92121, United States
| | - Sunita N Misra
- Neurelis, Inc., 300-3430 Carmel Mountain Rd, San Diego, CA 92121, United States
| | - Adrian L Rabinowicz
- Neurelis, Inc., 300-3430 Carmel Mountain Rd, San Diego, CA 92121, United States
| | - Enrique Carrazana
- Neurelis, Inc., 300-3430 Carmel Mountain Rd, San Diego, CA 92121, United States
- John A. Burns School of Medicine, University of Hawaii, 651 Ilalo St, Honolulu, HI 96813, United States
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3
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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.
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Affiliation(s)
- Rebecca J Schultz
- Texas Woman's University, United States; Baylor College of Medicine and Texas Children's Hospital, United States.
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4
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Patel AD, Becker DA. Introduction to use of an acute seizure action plan for seizure clusters and guidance for implementation. Epilepsia 2022; 63 Suppl 1:S25-S33. [PMID: 35999175 DOI: 10.1111/epi.17344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 06/08/2022] [Accepted: 06/08/2022] [Indexed: 11/29/2022]
Abstract
It is important for patients with epilepsy and their caregivers, including care partners, to understand the patient's seizure clusters and what to do when they occur. In many instances, seizure clusters are unique to each patient. The knowledge gained from understanding a patient's seizure cluster or seizure pattern provides a foundation for taking prompt action to prevent worsening to prolonged seizures, status epilepticus, and potentially death. Seizure action plans (SAPs), which are similar to the disease-related treatment action plans for other conditions, can be developed by a health care provider (HCP) in conjunction with the patient with epilepsy and/or caregivers, and SAPs are specifically customized for the individual patient and his or her seizure management. However, the current literature lacks unified guidance on how to design SAPs that will help prepare patients and caregivers for rapidly determining and initiating appropriate treatment of acute seizure emergencies in the community and at home. Here, we examine the current usage and value of SAPs for pediatric and adult patients with epilepsy, and we introduce the concept of the acute SAP (ASAP) for use specifically during seizure emergencies, such as seizure clusters. This type of standardized, simplified, and customized plan can rapidly and concisely provide patients and caregivers with a practical protocol to treat a seizure cluster consistently, appropriately, and in a timely manner. Details on potential content and formats of ASAPs are provided. Following this is a discussion of barriers to ASAP use that may affect HCPs or patients and caregivers, including lack of standardization, relevance, and personalization and pitfalls associated with technology. This leads into a discussion of guidance for developing, implementing, and updating ASAPs that suggests ways to address the barriers and ensure that the ASAP is best suited to the patient's needs.
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Affiliation(s)
- Anup D Patel
- Division of Neurology, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Danielle A Becker
- Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
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5
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Penovich P, Glauser T, Becker D, Patel AD, Sirven J, Long L, Stern J, Dixon-Salazar T, Carrazana E, Rabinowicz AL. Recommendations for development of acute seizure action plans (ASAPs) from an expert panel. Epilepsy Behav 2021; 123:108264. [PMID: 34482230 DOI: 10.1016/j.yebeh.2021.108264] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE OF REVIEW Disease-related treatment action plans for acute exacerbations providing information that may be helpful for self-management for patients and caregivers are commonly used for chronic conditions such as asthma and diabetes. However, among patients with epilepsy, a review of the literature suggested that the majority did not have an action plan in place for acute seizure treatment. RECENT FINDINGS Currently, there is a lack of unified guidance on seizure action plans (SAPs) in the literature. In the authors' opinion, available formats have limitations for practical use and may not be easily customizable to individual patients, and they are not often designed to provide simple-to-follow steps for rapid immediate steps to determine and initiate appropriate treatment of seizure emergencies. Our group reviewed current examples of SAPs and provided guidance on the development of acute seizure action plans (ASAPs) designed to facilitate rapid, appropriate acute care in the community and to be as useful as possible for a wide range of care partners, including those with limited experience. SUMMARY This paper provides agreed upon expert opinion recommendations and considerations for goals, development process, types of content, and format for an ASAP.
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Affiliation(s)
| | - Tracy Glauser
- Comprehensive Epilepsy Center, Cincinnati Children's Hospital, Cincinnati, OH, USA
| | - Danielle Becker
- Case Western Reserve University School of Medicine and MetroHealth System, Cleveland, OH, USA
| | - Anup D Patel
- Neurology, Nationwide Children's Hospital, Columbus, OH, USA
| | - Joseph Sirven
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Lucretia Long
- Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - John Stern
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
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Dean P, O'Hara K, Brooks L, Shinnar R, Bougher G, Santilli N. Managing Acute Seizures: New Rescue Delivery Option and Resources to Assist School Nurses. NASN Sch Nurse 2021; 36:346-354. [PMID: 34189971 PMCID: PMC8586177 DOI: 10.1177/1942602x211026333] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Approximately 470,000 children and adolescents in the United States have epilepsy, 30% of whom experience seizures despite antiseizure drug regimens. School nurses, teachers, caregivers, and parents play integral roles in implementing a care plan that avoids triggers, recognizes signs, and provides supportive care—ideally, guided by a patient-specific seizure action plan, which may include the use of rescue medication. Benzodiazepines are the mainstay of seizure rescue medication; for decades, rectally administered diazepam was the only approved rescue medication for seizure clusters outside the hospital setting. However, rectal administration has limitations that could delay treatment (e.g., social acceptability, removal of clothing, positioning). More recently, intranasal midazolam (for patients ≥12 years) and intranasal diazepam (for patients ≥6 years) were approved for this indication. Training and education regarding newer forms of rescue medication should improve confidence in the ability to treat seizures in school with the goal of increasing the safety of students with epilepsy.
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Affiliation(s)
- Patricia Dean
- Epilepsy Program Specialist, Comprehensive Epilepsy Center, Nicklaus Children's Hospital, Miami, FL
| | - Kathryn O'Hara
- Clinical Research Nurse, Department of Neurology, Virginia Commonwealth University, Richmond, VA
| | - Lai Brooks
- Senior Director of the Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, TN
| | | | - Genei Bougher
- Vice President/Subinvestigator, Northwest Florida Clinical Research Group, LLC, Gulf Breeze, FL
| | - Nancy Santilli
- Global Managing Director, Human Care Systems, Boston, MA
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Engel ML, Shanley R, Scal PB, Kunin-Batson A. Anxiety and depressive symptoms in adolescents and young adults with epilepsy: The role of illness beliefs and social factors. Epilepsy Behav 2021; 116:107737. [PMID: 33493808 DOI: 10.1016/j.yebeh.2020.107737] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/15/2020] [Accepted: 12/20/2020] [Indexed: 01/08/2023]
Abstract
PURPOSE This study examined (1) the prevalence of anxiety and depressive symptoms among adolescents and young adults (AYA) with epilepsy and (2) demographic and medical characteristics, illness beliefs, and social factors associated with anxiety and depressive symptoms to guide intervention development. METHODS A community-based sample of AYA with epilepsy (n = 179, ages 13-24 years, 39% male) completed online questionnaires measuring anxiety symptoms (GAD-7), depressive symptoms (PHQ-9), illness beliefs (helplessness; acceptance; perceived benefits), and social factors (family functioning; social stigma; connectedness). Participants also reported medical information (epilepsy type; years since diagnosis; time since last seizure; current medications). RESULTS Prevalence of clinically significant symptoms of anxiety and depression, 36% and 35%, respectively, was high compared to population prevalence. In multivariable regression models, demographic and medical factors explained only 2% of the variance in depressive symptoms and 6% in anxiety symptoms. Illness beliefs and social factors accounted for a majority of the explanatory power of both models (partial R2 = 0.37 for anxiety; 0.44 for depression). Specifically, acceptance, family functioning, and social stigma accounted for the greatest variance (p's < 0.01). CONCLUSIONS This study found a high prevalence of anxiety and depressive symptoms among AYA with epilepsy. Epilepsy variables (seizure type, medications, and years since diagnosis) were not associated with these psychological symptoms. Rather, the majority of variance in symptoms was accounted for by potentially modifiable beliefs and social factors. Interventions that promote illness acceptance, enhance family functioning, and reduce social stigma may ameliorate psychological distress among AYA with epilepsy.
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Affiliation(s)
- Melissa L Engel
- Department of Psychology, Emory University, 36 Eagle Row, Atlanta, GA 30322, USA.
| | - Ryan Shanley
- Masonic Cancer Center Biostatistics Core, University of Minnesota, 717 Delaware Street SE, Minneapolis, MN 55455, USA
| | - Peter B Scal
- Department of Pediatrics, University of Minnesota, 717 Delaware Street SE, Minneapolis, MN 55455, USA
| | - Alicia Kunin-Batson
- Department of Pediatrics, University of Minnesota, 717 Delaware Street SE, Minneapolis, MN 55455, USA
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8
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Albert DVF, Moreland JJ, Salvator A, Moore-Clingenpeel M, Haridas B, Cole JW, Glynn P, Fults M, Dawson MZ, Moreland P, Patel AD. Seizure Action Plans for Pediatric Patients With Epilepsy: A Randomized Controlled Trial. J Child Neurol 2019; 34:666-673. [PMID: 31156013 DOI: 10.1177/0883073819846810] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Seizure action plans help patients and caregivers better self-manage their epilepsy. We hypothesized that providing pediatric patients and their caregivers with a seizure action plan would reduce unplanned health care utilization and decrease the impact of epilepsy. METHODS We developed a seizure action plan for use in pediatric epilepsy patients. A prospective cohort was randomly assigned to receive a seizure action plan in addition to standard epilepsy care or to standard epilepsy care alone. All caregivers were surveyed using the Modified Impact on Families (MIF) questionnaire at enrollment, 3 months, and 12 months. Health care utilization measures and Modified Impact on Families questionnaire scores were compared between the 2 groups. RESULTS Fifty-four patients received a seizure action plan and standard care, whereas 48 received standard care alone. The groups had similar demographics. There was a significantly higher proportion of overall clinic appointment no shows in the standard care group vs the seizure action plan group (P = .04); however, other significant differences in health care utilization were not found. Among patients with low seizure frequency (12 or fewer seizures per year), Seizure comfort scores on the Modified Impact on Families questionnaire were significantly higher at 12 months among the seizure action plan group compared to the standard care group. SIGNIFICANCE Caregivers for patients with epilepsy receiving a seizure action plan were more comfortable regarding seizure care and missed fewer appointments. However, differences in health care utilization were not present. The seizure action plan appears to have more impact in patients who experience lower seizure frequencies. Further studies evaluating the impact as well as assessing caregivers' perceptions of the seizure action plan using a larger sample are needed.
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Affiliation(s)
- Dara V F Albert
- 1 Nationwide Children's Hospital/Ohio State University, Department of Pediatrics, Division of Child Neurology, Columbus, OH, USA
| | | | - Ann Salvator
- 2 Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | | | - Babitha Haridas
- 3 Oshei Children's Hospital/University at Buffalo, Department of Pediatric Neurology, Buffalo, NY, USA
| | - Justin W Cole
- 4 Cedarville University School of Pharmacy, Department of Pharmacy Practice, Cedarville, OH, USA
| | - Peter Glynn
- 2 Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Marci Fults
- 1 Nationwide Children's Hospital/Ohio State University, Department of Pediatrics, Division of Child Neurology, Columbus, OH, USA
| | | | - Patty Moreland
- 6 Nationwide Children's Hospital, Department of Information Services, Columbus, OH, USA
| | - Anup D Patel
- 1 Nationwide Children's Hospital/Ohio State University, Department of Pediatrics, Division of Child Neurology, Columbus, OH, USA
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9
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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]
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10
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Lineberry M, Whitney E, Noland M. The Role of School Nurses, Challenges, and Reactions to Delegation Legislation: A Qualitative Approach. J Sch Nurs 2017; 34:222-231. [DOI: 10.1177/1059840517741526] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Passage of new laws, national standards regarding delegation, and the recommendation for at least one full-time nurse in every school have provided more visibility to the role of school nurses. Recent legislative amendments in Kentucky presented an opportunity to examine how the role of the school nurse is changing. Aims were to describe the (1) role of school nurses in Kentucky, (2) impact of school nurses, (3) challenges faced by school nurses, and (4) impact of budget cuts and legislation. Three focus groups were conducted. School nurses faced challenges of limited time and resources, communication barriers, and multiple documentation requirements. Nurses’ greatest impacts were their availability, recognition of psychosocial problems and health concerns, and connection with resources. Nurses had not yet encountered many changes due to new legislation that expanded delegation of diabetes-related tasks to unlicensed school personnel, but some had concerns about possible negative effects while others expressed support.
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Affiliation(s)
| | - Elizabeth Whitney
- Department of Kinesiology and Health Promotion, College of Education, University of Kentucky, Lexington, KY, USA
| | - Melody Noland
- Department of Kinesiology and Health Promotion, College of Education, University of Kentucky, Lexington, KY, USA
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11
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Jansen P, Neininger MP, Bernhard MK, Kiess W, Merkenschlager A, Bertsche T, Bertsche A. Knowledge and attitudes about epilepsy: A survey of high school students in Germany. Seizure 2017; 51:139-144. [DOI: 10.1016/j.seizure.2017.08.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 08/15/2017] [Accepted: 08/17/2017] [Indexed: 11/30/2022] Open
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12
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Terry D, Patel AD, Cohen DM, Scherzer D, Kline J. Barriers to Seizure Management in Schools: Perceptions of School Nurses. J Child Neurol 2016; 31:1602-1606. [PMID: 27625012 DOI: 10.1177/0883073816666738] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 07/11/2016] [Accepted: 07/29/2016] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to assess school nurses' perceptions of barriers to optimal management of seizures in schools. Eighty-three school nurses completed an electronic survey. Most agreed they felt confident they could identify a seizure (97.6%), give rectal diazepam (83.8%), and handle cluster seizures (67.1%), but fewer were confident they could give intranasal midazolam (63.3%), had specific information about a student's seizures (56.6%), or could swipe a vagus nerve stimulator magnet (47.4%). Nurses were more likely to be available at the time of a seizure in rural (17/20) (85%) versus suburban (21/34) (62%) or urban (8/25) (32%) schools (P = .001). School nurses are comfortable managing seizures in the school setting. However, a specific seizure plan for each child and education on intranasal midazolam and vagus nerve stimulator magnet use are needed. A barrier in urban schools is decreased availability of a nurse to identify seizures and administer treatment.
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Affiliation(s)
- Debbie Terry
- Division of Neurology, Nationwide Children's Hospital, Columbus, OH, USA
| | - Anup D Patel
- Division of Neurology, Nationwide Children's Hospital, Columbus, OH, USA.,Department of Pediatrics, Ohio State University College of Medicine, Columbus, OH, USA
| | - Daniel M Cohen
- Department of Pediatrics, Ohio State University College of Medicine, Columbus, OH, USA.,Division of Emergency Medicine, Nationwide Children's Hospital, Columbus, OH, USA
| | - Daniel Scherzer
- Department of Pediatrics, Ohio State University College of Medicine, Columbus, OH, USA.,Division of Emergency Medicine, Nationwide Children's Hospital, Columbus, OH, USA
| | - Jennifer Kline
- Department of Pediatrics, Ohio State University College of Medicine, Columbus, OH, USA.,Division of Emergency Medicine, Nationwide Children's Hospital, Columbus, OH, USA
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13
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Wei HS, Hwa HL, Shen ACT, Feng JY, Hsieh YP, Huang SCY. Physical Conditions and Special Needs as Risk Factors of Peer Victimization Among School Children in Taiwan. J Sch Nurs 2016; 33:223-231. [PMID: 27216248 DOI: 10.1177/1059840516649237] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Students with physical symptoms and diseases may be at an increased risk of peer victimization. This study examined the associations of several medical conditions (obesity, asthma, allergy, epilepsy, and diabetes) with experience of physical, verbal, and relational victimization among children. A sample of 6,233 fourth-grade students from 314 elementary schools in Taiwan was recruited for the analysis. The mean age of the sample was 10.5, with an even distribution of gender (50.3% male and 49.7% female). Children with asthma, allergy, and epilepsy reported higher frequencies of peer victimization. Those who took daily medications or received treatment were also at a higher risk of being victimized. Diabetes and obesity were not found to be associated with peer victimization. The findings highlighted that children with physical conditions suffer maltreatment from peers. Sensitivity training should be provided to school health professionals, so they can evaluate the risk of victimization among students with special needs during assessment.
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Affiliation(s)
- Hsi-Sheng Wei
- 1 Department of Social Work, College of Social Sciences, National Taipei University, New Taipei City, Taiwan
| | - Hsiao-Lin Hwa
- 2 Department and Graduate Institute of Forensic Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.,3 National Taiwan University Children and Family Research Center, National Taiwan University, Taipei, Taiwan
| | | | - Jui-Ying Feng
- 5 Department of Nursing and Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Ping Hsieh
- 6 Department of Social Work, College of Nursing and Professional Disciplines, University of North Dakota, Grand Forks, ND, USA
| | - Soar Ching-Yu Huang
- 7 California School of Professional Psychology, Alliant International University, San Diego, CA, USA
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