Evaluation of seizure observation and documentation.

Abstract

This study evaluated seizure documentation after participants observed videotaped seizures to determine how their background (educational level, employment position, years of experience, practice frequency, and familiarity with epilepsy and seizures) and attributes of the seizures themselves affected their skill. Observer variables did not show significant differences when mean seizure rating scores of 348 documented seizures for 58 participants were compared. Combinations of variables were significant; certified nursing assistants (CNAs) with clinical seizure experience had significantly higher mean seizure rating scores than those without experience (p < .01). There were significant differences in the mean percentile scores for each seizure observed (p < .001). Seizures with excess motor activity had the highest scores. Most common observations for any seizure observed were location and description of movement. Participants had significantly higher scores when observing a seizure a second time (p < .001). Differences in education, employment position, and years of employment are not limiting factors in performing seizure observation and documentation for persons who have been trained and certified in the skill. Opportunities to periodically view seizures improved seizure observation and documentation. Because motor movement observations predominate seizure documents, seizure observation instruction should not only emphasize key observational details but also highlight less frequent observations, such as responsiveness, that may play a key role in seizure classification. Using videotaped seizures and a scoring tool are useful for initial training and certification as well as periodic retraining to maintain quality in the skill.