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DNP IRB Proposal Effects of Implementing Seizure Education Among Hospital Based Nursing Staff

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Anecdotal evidence of lack of training for actively seizing patients.  Seizure is a low-frequency high-risk event. Status Epilepticus ( Hauntus , 2016) Nurses lack experience or education for managing actively seizing patients (Lee & Sim, 2020).

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How do nurses feel about seizure management? What is their experience related to management of actively seizing patients? What is baseline nursing knowledge regarding seizure and its etiology? What do they understand about status epilepticus and its management?

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• 2016 to 2021
• English were included.
• Qualitative or uantitative research articles,
evidence-baseå guidelines from authoritative
sources, systemätic reviews, and case study
review.
• Goo le Scholar Pub Cinahl, and the
Cochane Database of Systematic were
searched with keywords initially included
seizure, seizure management, status
epilepticus, nurse and70r nursing & training
and/or education.
• IWenty articles were acceDted for the final
review and inclusion based on their abstracts
and content.

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Articles related to the problem. Paucity of high-quality literature related to nursing related to seizure management.   Two articles related to lack of knowledge, lack of self-efficacy, and lack of self-confidence.  Lee & Sim (2020); Holland et al.,(2017) Two articles that gave guidance to how nurses led teams can improve patient outcomes.  Pranboon  et al.,(2020); Jones et al., (2016) Articles related to seizure and seizure management Five articles for seizure identification were selected.  Foster et al., (2018);  Charkraborty  &  Hocker  (2019);  Hantus  (2016); Pack, (2019); Bergy (2016) Four  articles are included with seizure management and SE as their focus.  Nelson &  Varelas  (2018);  Nas  et al.,(2020),; Tidwell et al., (2018); Jones et al.(2016)  Articles related to training  Lee et al., (2019); Cullen & Auberry et al., (2016);  LItzinger  at al., (2019); Lewis et al., (2019); Fisher et al. (2019)  Articles related to validated measurement and project structure Buckwalter et al., (2017).  Sternaer  et al., (2020).

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How does implementation of a standardized evidence-based guideline on active seizure management with standardized training compare with current training in bedside nurses at a large Tampa Bay hospital regarding efficacy and confidence, as measured by the perceived ability to provide care in acute situation (PAPCAS) instrument in management of actively seizing adults over two months?

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How does standardized seizure training affect the confidence of nurses in the management of actively seizing patients as measured by PAPCS?  How do nurses feel more empowered, educated, informed, and confident when dealing with seizing patients as measured by the PAPCS? How does increase knowledge effect confidence in seizure management?

One big red drawing pin in front of many smaller black drawing pins

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Active seizure management training developed using evidence-based guidelines for bedside nurses in a large Tampa Bay hospital will increase self-efficacy and confidence as measured by the PAPCAS.

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The Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care

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Development of a standardized evidence-based training for seizure management 30 minutes Pathophysiology, recognition of seizure, management of actively sizing patients, documentation in the electronic medical record Anonymous pre-post test survey

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Bedside adult acute care nurses No intensive care unit, dialysis, emergency department nurses Delivered at existing unit meeting

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Voluntary participation by nurses Will provide food at the meeting No personally identifying information such as names will be collected. Forms collected in individual anonymous envelopes

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Bergey  G. K. (2016). Management of a first seizure.  Continuum, 22(1) , 38–50. https:// doi.org /10.1212/CON.0000000000000271 Buckwalter, K. C., Cullen, L., Hanrahan, K.,  Kleiber , C., McCarthy, A. M.,  Rakel , B., Steelman, V., Tripp, R. T., & Tucker, S. (2017). Iowa Model of Evidence-Based Practice: Revisions and Validation.  Worldviews on Evidence-Based Nursing, 14(3),  175–182. https:// doi.org /10.1111/wvn.12223 Chakraborty, T., &  Hocker , S. (2019). The clinical spectrum of new-onset status epilepticus.  Critical Care Medicine, 47(7),  970–974. https:// doi.org  /10.1097/CCM.0000000000003776 Cullen, D., & Auberry, K. (2016). Implementation of an evidence-based seizure algorithm in intellectual disability nursing: A pilot study.  Journal of Intellectual Disabilities ,  20(1),  55–61. https://doi.org/10.1177/1744629515598216 Fisher Kenny, E., Martin, M., McClain, A., Stanley, R., Saunders, J., Lo, C., & Cohen, D. M. (2019). Nurse-Driven simulations to prepare and educate for a clinical trial.  Clinical Simulation in Nursing, 28 , 35–38. https://doi.org/10.1016/j.ecns.2018.12.005 Foster, E.,  Holper , S., Chen, Z., & Kwan, P. (2018). Presentation and management of community-onset vs hospital-onset first seizures.  Neurology. Clinical Practice , 8(5), 421–428. https://doi.org/10.1212/CPJ.0000000000000524 Hantus  S. (2016). Epilepsy Emergencies.  Continuum, 22(1),  173–190. https:// doi.org /10.1212/CON.0000000000000285 Holland, C., Edward, K. L., &  Giandinoto , J. A. (2017). Nursing and focal dyscognitive seizures: A clinical update when managing risk using advanced nursing skills.  The Journal of Neuroscience Nursing : Journal of the American Association of Neuroscience Nurses, 49(3 ), 164–168. https:// doi.org /10.1097/JNN.0000000000000276

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Jones, D.,  DeVita , M., &  Warrillow , S. (2016). Ten clinical indicators suggesting the need for ICU admission after Rapid Response Team review. Intensive Care Medicine, 42(2), 261–263. https:// doi.edu /10.1007/s00134-015-3828-8 Lee, J. H., Ju, H. O., & Lee, Y. J. (2019). Effects of an algorithm-based education program on nursing care for children with epilepsy by hospital nurses. Child Health Nursing Research, 25(3), 324-332. https://doi.org/10.4094/chnr.2019.25.3.324 Lee, J.E., & Sim, I.O. (2020) Gap between college education and clinical practice: Experience of newly graduated nurses. Nursing Open. 2020;7 :449–456. https:// doi.org /10.1002/nop2.409 Litzinger , T. L., Cohen, T. N., Cabrera, J. S., Captain, K. A., Fabian, M. A., Miles, S. G.,  Shappell , S. A., &  Boquet , A. J. (2019). A data-driven approach to team training for nurses in a level II trauma center. Journal of Trauma Nursing, 26(3), 134–140. https://doi.org/10.1097/JTN.0000000000000438 Lewis, K. A., Ricks, T. N.,  Rowin , A., Ndlovu, C., Goldstein, L., &  McElvogue , C. (2019). Does simulation training for acute care nurses improve patient safety outcomes: A systematic review to inform evidence‐based practice. Worldviews on Evidence-Based Nursing, 16(5), 389–396. https://doi.org/10.1111/wvn.12396 Mainali , S., Stutzman, S., Sengupta, S.,  Dirickson , A.,  Riise , L., Jones, D., Yang, J., & Olson, D. M. (2017). Feasibility and efficacy of nurse-driven acute stroke care. Journal of Stroke & Cerebrovascular Diseases, 26(5), 987–991. https:// doi.org /10.1016/j.jstrokecerebrovasdis.2016.11.007 Nass, R. D.,  Meiling , S.,  Andrié , R. P.,  Elger , C. E., & Surges, R. (2017). Laboratory markers of cardiac and metabolic complications after generalized tonic-clonic seizures. BMC Neurology, 17, 1–11. https://doi.org/10.1186/s12883-017-0965-4

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Nelson, S. E., &  Varelas , P. N. (2018). Status epilepticus, refractory status epilepticus, and super-refractory status Epilepticus.  Continuum, 24(6),  1683–1707. https://doi.org/10.1212/CON.0000000000000668 Pack A. M. (2019). Epilepsy overview and revised classification of seizures and epilepsies.  Continuum, 25(2) , 306–321. https://doi.org/10.1212/CON.0000000000000707 Pranboon , S.,  Tiamkao , S.,  Chainirun , N.,  Sawanyawisuth , K., & Integrated Epilepsy Research Group (2020). A fast-track care by a nursing case management concept improved status epilepticus outcomes.  The Journal of Neuroscience Nursing : Journal of the American Association of Neuroscience Nurses, 52(4) , 200–204. https:// doi.org /10.1097/JNN.0000000000000522 Sterner, A.,  Säfström , E.,  Palmér , L.,  Ramstrand , N., & Hagiwara, M. A. (2020). Development and initial validation of an instrument to measure novice nurses’ perceived ability to provide care in acute situations – PCAS.  BMC Nursing, 19(1),  1–9. https:// doi.org  /10.1186/s12912-020-0406-3 Tidwell, W. P., Thomas, T. L.,  Pouliot , J. D.,  Canonico , A. E., & Webber, A. J. (2018). Treatment of alcohol withdrawal syndrome: Phenobarbital vs CIWA- Ar  protocol.  American Journal of Critical Care, 27(6) , 454–460. https:// doi.org /10.4037/ajcc2018745

DNP IRB Proposal Effects of Implementing Seizure Education Among Hospital Based Nursing Staff

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