EMU Seizure Assessment: An Interactive Video

1. EMU Seizure Assessment: An Interactive Video Cathleen Solecki MSN, RN, CCRN, CNRN Beaumont Hospital, Grosse Pointe

2. OBJECTIVES Summarize the steps in producing an interactive video for educational purposes. Demonstrate how to respond and correctly assess a seizure patient after watching the interactive video. Describe the role of the nurse and EEG Technician in assessing a seizure patient in an Epilepsy Monitoring Unit. Compare and contrast the benefits of using an interactive video.

3. Purpose of Video • We identified that nurses were not always comfortable in their assessment skills when responding to and assessing a seizing patient. • Evident by reviewing seizure assessments performed by nursing staff via patient video monitoring. • A video was produced to improve the EMU nurses knowledge, proficiency, and increase comfort level for nurses performing an assessment of a seizure patient.

4. Goal of the Video • The goal of the video was to provide an educational resource for the nurses to illustrate what to avoid during a seizure assessment and then demonstrate the proper way to perform a seizure assessment. • A process was developed to educate the nurses that is reproducible, educationally and financially sound.

5. Steps in Video Production • Script production with staff feedback • AV production • Final Edits • Distribution • Implementation and Evaluation

6. Watch Video

7. Seizure Management • Management of the patient with seizures focuses on: • 1. Controlling the seizure as quickly as possible • 2. Preventing recurrence • 3. Maintaining patient safety • 4. Identifying the underlying cause.

8. Role of the Nurse and EEG Tech • The Person doing the assessment needs to describe out loud what activity the patient is doing during the event, in case movements are not being seen well on camera. • If the patient answers questions, you need to repeat what the patient says, often patient may speak quietly and their response in not picked up on camera. • If patient has no verbal response, state that as well.

9. Role of the Nurse • Event Guidelines • RESPOND • A. Turn on room lights • B. Pull back covers so patient can be seen. • C. Turn the patient to the side • D. Note start and end times of event • E. Do Not block camera view • 2. EVENT ASSESSMENT • A. Check Eyes • 1. Deviation direction • 2. Open/Closed • 3. Fluttering • 4. Pupils dilated/reactive to light • B. Pt Movements • 1. Describe type of movement (twitching, jerking, fumbling • 2. Unilateral/Bilateral • 3. Mouth movements: lip smacking/chewing • 4. Teeth: grinding/clenched • 5. Head deviation

10. Role of the Nurse • C. Level of Consciousness • 1. Oriented to self: Ask patient what their name is • 2. Oriented to place: Ask patient where they are • 3. Oriented to time: Ask patient the month and year • D. Motor Tasks • 1. Squeeze hand • 2. Point to the ceiling • 3. Move head right/left/up/down • 4. Lift legs • 5. Touch their nose • E. Memory tasks • 1. Give pt words to remember • 2. Name item or person in front of them • 3. Count to 10 • 4. Recite alphabet

11. Role of the EEG Tech • Whether it’s in the EEG lab or in the EMU setting, the tech functions as the eyes and ears for the neurologist. • Proper assessment and documentation is crucial to the interpretation of data. • The tech describes patient movements and behaviors on the EEG record. • If a patient experiences an event during the EEG, the tech must assess the patient so that the electroencephalographer is able to identify clinical symptoms or changes in mental status.

12. Role of the EEG Tech • The function of an EMU technologist may vary depending on the facility • An EMU tech works as a team with a specialized EMU RN • The technologist responds to clinical behaviors and/or EEG changes. The tech alerts the RN. Through camera adjustments and use of the intercom unit the tech monitors the event and keeps the nurse informed of the EEG changes and length of the episode. • At times, the tech will assist the nurse in the room

13. Benefits of Interactive Video • Pros • Used as an educational resource for nurses and EEG Technicians • Reproducible, educationally and financially sound • Videos can foster critical skills such as problem solving, critical thinking, and collaboration • It ensures that everyone gets the same information at the same time

14. Benefits of Interactive Video • Pros • Videos can also be created by training consultants for the specific needs of the particular organization or individual departments • It is a personal, face-to-face type of training as opposed to computer-based training (Training today, 2013). • They make training more fun and enjoyable • YouTube hosts more than 800 million unique visitors every month and more than 3 billion videos are viewed every day (Global Thinkers, 2013).

15. Benefits of Interactive Video • Cons • Requires computer equipment • Difficult to modify • Lengthy development time

16. EMU Staff

17. SUMMARY • Key points • Management consists on controlling the seizure as quickly as possible • Preventing recurrence • Maintaining patient safety • Identifying the underlying cause

18. References • Retrieved from http://trainingtoday.blr.com/employee-training-resources/How-to-Choose-the-Most-Effective-Training-Techniques • Retrieved from http://globalthinkers.com/2012/02/video-marketing-pros-cons/

19. QUESTIONS? THANK YOU!