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SETPEG AUDIT OF EPILEPSY CLINICS

This audit conducted by SETPEG members reviewed epilepsy clinics to assess service quality in South Thames East. The findings aim to contribute to the national Epilepsy 12 audit, with objectives including multi-axial seizure classification, diagnostic uncertainty, patient information, AE of AED, developmental progress, care plan, and access to epilepsy nurse specialists.

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SETPEG AUDIT OF EPILEPSY CLINICS

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  1. SETPEG AUDIT OF EPILEPSY CLINICS Somnath Banerjee 28 September 2010

  2. Background • NICE, SIGN and the BPNA have all made recommendations that paediatric epilepsy services should undergo regular audit. • SETPEG did an audit of epilepsy clinics run by it’s members at various sites. • The proposal & data capture were reviewed and approved by the SETPEG working group committee.

  3. Aims • The audit was to gain an initial snapshot of some aspects of service quality across South Thames East with the hope that the findings will be able to contribute positively to the national Epilepsy 12 audit.

  4. Objectives • Multi-axial seizure classification of ILAE. • Corrected QT interval is calculated in diagnostic uncertainty and EEG is arranged in a convulsive episode. • Patients and carers are given the information leaflets or directed to appropriate website. • Information provided about AE of AED. • Developmental/academic progress is documented. • Written care plan. • Access to epilepsy nurse specialist.

  5. Inclusion • Patients must have been diagnosed after 2nd January 2005. • Attending follow ups for at least 12 months at the time of data capture. • Monday 1st February 2010 to Friday 26th March 2010 (eight weeks). • Aged 17 years or under at the time of referral.

  6. Design & Setting • Paediatric clinics by SETPEG members at various sites in South East Thames .

  7. Data Protection and Caldicott Principles • The sharing of information for this audit did not breach Data Protection or the Caldicott Principles. The information collected in the audit was confined to such data as should be shared between multi-disciplinary agencies working within the NHS. • The epilepsy database, which was set up for this audit, did not contain any patient identifiers.

  8. Demography • Audited notes- 156 from eight Trusts’ sites (1. East Kent Hospitals, 2. Conquest Hospital Hastings, 3. Brighton & Hove, 4. Evelina Children Centre, 5. Princess Royal Bromley, 6. South Downs, 7. Lewisham Hospital & 8. Queen Elizabeth Hospital London).

  9. Clinic Distribution

  10. Gender

  11. Age Range

  12. Standard IA Seizure classification

  13. Standard IBSyndromic diagnosis

  14. Standard IIAIs the diagnosis clear?

  15. Standard II BcQT interval calculated

  16. Standard II CEEG done

  17. Standard IIIAE of AED communicated

  18. Standard IVLeaflet/ website address

  19. Standard VDev / academic progress

  20. Standard VIAWritten care-plan

  21. Standard VI Bcopy letter to parents

  22. Standard VI CCopy letter to school health

  23. Standard VIIAccess to epilepsy nurse

  24. Conclusions • Audit met some standards, although not 100% (1A- seizure classification, 2A- diagnosis, 2C- EEG, 6B- copy letters to parents/carers). • More stress on syndromic diagnosis. • cQT interval calculated in diagnostic uncertainty. • AE of AEDs needs to communicated. • Info leaflets / appropriate website addresses should be given to parents / carers.

  25. Conclusions • Dev/academic progress needs to be documented. • Written care plan if indicated. • Copy of the clinic letter to school health. • Access to specialist epilepsy nurse.

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