Title

Implement cEEG Monitoring in the ICU to Detect Sub-Clinical Seizures: A Program to Reduce Neurologic Deficit

Document Type

Presentation

Publication Date

11-17-2016

Comments

Advisor:

MR Cooper Jefferson College of Population Health, Thomas Jefferson University

Abstract

Neurologists have expressed an interest in performing cEEG monitoring in the ICU to identify non-convulsive seizures (NCSzs) to make appropriate treatment recommendations that may reduce the risk of permanent neurologic deficit. We will study the effects implementing cEEG monitoring as a diagnostic indicator has on making decisions that alter care, affect length of stay, and its financial implications. Employing methods to determine efficacy entail review of literature, statistics, and quantitative review of specific diagnoses that may benefit. We explored availability of technologists and neurologists to perform and interpret procedures and opportunities to involve outsourcing agencies. While literature provides support that implementing cEEG monitoring adds value as a diagnostic tool, it also confirms our concerns regarding a shortage of qualified technologists and neurologists to perform, review data, and interpret procedures on a 24/7 schedule. We studied staffing options and made recommendations for programming. Stakeholders include directors, managers, and clinical coordinators from Neuroscience and Sleep medicine departments, Neurologists, ICU nurse managers, ICU nurses, trauma nurses, administrators, and information technology. Because this program is new and patient volume low, implementing change management principles involve organizational alignment. We identified significant overlap in skill sets between sleep medicine and neuroscience staff. The potential benefits of introducing a cross training program to enhance skill sets will enable us to utilize current staff to provide cEEG monitoring system wide with the capability to remote in to various sites reducing the need to hire additional staff. A system wide approach allows us to implement cEEG monitoring standardize processes, utilize resources, build competencies and monitor growth for future enhancements of neuroscience programs.

Presentation: 39:43