Intervention time and adverse events in a canadian epilepsy monitoring unit: An updated audit

Abstract

BackgroundOptimizing patient safety in the epilepsy monitoring unit (EMU) has become a topic of increasing interest. We performed an audit of our center's new single-floor EMU, assessing intervention rate (IR), intervention time (IT), and adverse events (AEs). MethodsA prospective study was conducted on all clinical seizures of patients admitted over a one-year period at our Canadian academic tertiary care center's new single-floor EMU. This single-floor EMU was supervised by EEG technologists during daytime (similar to the old set-up) and beneficiary attendants during nighttime/weekends (versus live video feed to the central nursing station on the neurology ward previously). Among 153 admissions, 79 were analyzed, and a total of 537 seizures were reviewed to assess IR, IT, and AEs. Univariate comparisons were performed with our double-floor EMU, which we reported in a previous publication. ResultsIn our new single-floor EMU, the IR was 61.1 % and overall median IT was 29.0s (19.0s–45.9s). The AE rate was 4.8 %. Compared to previously reported numbers for our old double-floor EMU (IR = 27.8 %; IT = 21.0s; AE = 1.2 %), the IR was significantly higher ((p < 0.001) but unexpectedly, the median IT was higher (p < 0.001) as well as the AE rate (p < 0.001). ConclusionThis prospective evaluation revealed a small but non-negligible rate of complications in our EMU, higher than our prior retrospective audit. Heightened levels of supervision in our new single-floor EMU led to higher IR. This may have led to artificially longer ITs.