UK framework for basic epilepsy training and oromucosal midazolam administration.

Basic epilepsy training Community prevention of status Epilepsy safety Midazolam Rescue medication

Journal

Epilepsy & behavior : E&B
ISSN: 1525-5069
Titre abrégé: Epilepsy Behav
Pays: United States
ID NLM: 100892858

Informations de publication

Date de publication:
09 2021
Historique:
received: 18 04 2021
revised: 11 06 2021
accepted: 11 06 2021
pubmed: 13 7 2021
medline: 15 9 2021
entrez: 12 7 2021
Statut: ppublish

Résumé

UK wide Oromucosal Midazolam is used as an emergency treatment in community for seizures administered by family/carers with the right training. The Joint Epilepsy Council (JEC) UK which produced the training guidelines disbanded in 2016. Provide standards for basic epilepsy education and rescue medication (Midazolam) administration. The Epilepsy Nurses Association (ESNA), The International League against Epilepsy, British Chapter (ILAE) and the Royal college of Psychiatrists (RCPsych), used the Delphi process to update guidelines for the administration of oromucosal midazolam including developing a voluntary on-line test for carers. During 2017-2019 a facilitator worked with two ESNA committees to update the existing guidance and another to develop a question-bank. Both committee outputs were circulated to the ESNA membership, then ILAE and RCPsych for review. Patient-facing organizations and charities' opinions were solicited. All feedback was assimilated. A private provider was contracted to deliver the test. A consensus process involving two task and finish groups of 19 people each compared, reflected, debated, and engaged with stakeholders across three stages. The updated ratified guidelines were circulated nationally. The Delphi process highlighted many regions and individuals had local assessment tools and procedures in place, while others (around 50%) had no assessment provision. 278 carers with a 95% pass-rate and 100% positive feedback have undertaken the online test (10/2020). The UK-wide care provision gap in basic epilepsy-training and safe rescue medication administration is now addressed. A two-yearly update to the guidelines and test is planned.

Sections du résumé

BACKGROUND
UK wide Oromucosal Midazolam is used as an emergency treatment in community for seizures administered by family/carers with the right training. The Joint Epilepsy Council (JEC) UK which produced the training guidelines disbanded in 2016.
PURPOSE
Provide standards for basic epilepsy education and rescue medication (Midazolam) administration.
METHODS
The Epilepsy Nurses Association (ESNA), The International League against Epilepsy, British Chapter (ILAE) and the Royal college of Psychiatrists (RCPsych), used the Delphi process to update guidelines for the administration of oromucosal midazolam including developing a voluntary on-line test for carers. During 2017-2019 a facilitator worked with two ESNA committees to update the existing guidance and another to develop a question-bank. Both committee outputs were circulated to the ESNA membership, then ILAE and RCPsych for review. Patient-facing organizations and charities' opinions were solicited. All feedback was assimilated. A private provider was contracted to deliver the test.
RESULTS
A consensus process involving two task and finish groups of 19 people each compared, reflected, debated, and engaged with stakeholders across three stages. The updated ratified guidelines were circulated nationally. The Delphi process highlighted many regions and individuals had local assessment tools and procedures in place, while others (around 50%) had no assessment provision. 278 carers with a 95% pass-rate and 100% positive feedback have undertaken the online test (10/2020).
CONCLUSION
The UK-wide care provision gap in basic epilepsy-training and safe rescue medication administration is now addressed. A two-yearly update to the guidelines and test is planned.

Identifiants

pubmed: 34252835
pii: S1525-5050(21)00440-6
doi: 10.1016/j.yebeh.2021.108180
pii:
doi:

Substances chimiques

Midazolam R60L0SM5BC

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

108180

Informations de copyright

Copyright © 2021 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest All authors have the disclosure of being authors of the ESNA guidance which is referenced and used in this paper. It is free to download and use.

Auteurs

Phil Tittensor (P)

Royal Wolverhampton NHS Trust United Kingdom, United Kingdom; University of Wolverhampton United Kingdom, United Kingdom.

Sarah Tittensor (S)

University Hospitals Birmingham NHS Foundation Trust United Kingdom, United Kingdom.

Erica Chisanga (E)

Cambridge University Hospital NHS Foundation Hospital Trust United Kingdom, United Kingdom.

Manny Bagary (M)

Birmingham and Solihull Mental Health Foundation Trust, United Kingdom.

Caryn Jory (C)

Cornwall Partnership NHS Foundation Trust United Kingdom, United Kingdom.

Rohit Shankar (R)

Cornwall Partnership NHS Foundation Trust United Kingdom, United Kingdom; Cornwall Institute of Intellectual Disability Equity Research (CIDER), Peninsula School of Medicine, University of Plymouth, United Kingdom. Electronic address: Rohit.shankar@nhs.net.

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