Optimizing Pediatric Patient Safety in the Emergency Care Setting.

This is a revision of the previous American Academy of Pediatrics policy statement titled "Patient Safety in the Emergency Care Setting" and is the first joint policy statement by the American Academy of Pediatrics, the American College of Emergency Physicians, and the Emergency Nurses Association to address pediatric patient safety in the emergency care setting. Caring for children in the emergency setting can be prone to medical errors because of a number of environmental and human factors. The emergency department has frequent workflow interruptions, multiple care transitions, and barriers to effective communication.

Optimizing Pediatric Patient Safety in the Emergency Care Setting.

Patient safety is the foundation of high-quality health care and remains a critical priority for all clinicians caring for children. There are numerous aspects of pediatric care that increase the risk of patient harm, including but not limited to risk from medication errors attributable to weight-dependent dosing and need for appropriate equipment and training. Of note, the majority of children who are ill and injured are brought to community hospital emergency departments.

Enhancing the wellness of caregivers of individuals with epilepsy: The effects of a brief stress management course.

Purpose: To determine whether a brief stress management video can improve the quality of life of caregivers of persons with epilepsy (PWE).

Methods: Thirty-three adult caregivers of PWE who scored 5 or higher on the Caregiver Self-Assessment Questionnaire (CSAQ) completed a 30-min stress management video. This was preceded by a pre-intervention assessment, followed by post-intervention assessment at 1 month, and a delayed post-intervention assessment evaluation 3 months after video was viewed.

The effects of a brief memory enhancement course on individuals with epilepsy.

Purpose: The purpose of the study was to determine whether a brief memory enhancement course in persons with epilepsy (PWE) can improve cognitive abilities, quality of life, self-management, and seizure severity.

Methods: Thirty-nine PWE completed a 1-hour memory enhancement course. This was preceded by a baseline/preintervention assessment (BA/PRE), followed by postintervention assessment (POST) at 1 & 1/2 to 3 months, and a delayed postintervention assessment evaluation (DPOST) at 4 & 1/2 to 6 months after course completion.

Understanding the self-management skills of persons with epilepsy.

Purpose: To determine whether the self-management skills of persons with epilepsy (PWE) vary across the different domains of the Epilepsy Self-Management Scale (ESMS).

Methods: 172 PWE completed a survey questionnaire as well as the ESMS.

Results: Using ANOVA with pairwise comparison, the mean item scores of the medication, seizure, and safety management subscales of the ESMS were significantly higher than the lifestyle and information management subscales (p<0.

Factors associated with increased felt stigma among individuals with epilepsy.

Purpose: The aim of the study is to determine whether certain demographic, clinical, and psychosocial traits are associated with higher levels of felt stigma among persons with epilepsy (PWE) patients followed at a level 4 epilepsy center.

Methods: We performed a direct survey of 182 consenting patients that included the Epilepsy Stigma Scale.

Results: On univariate analysis, higher levels of perceived stigma were associated with age, marital status, race, driving, work status, seizure etiology, Quality of Life in Epilepsy-10 (QOLIE-10) scores, and health literacy.

In focus: The everyday lives of families of adult individuals with epilepsy.

Epilepsy is a multifaceted chronic neurological disorder with diverse effects on a patient's psychosocial well-being. The impact on quality of life has been well documented, and many studies have addressed the detrimental influences epilepsy has on an individual. However, the emotional impact and the influence of the condition on family members have not been well studied.

Factors associated with superior self-management skills among individuals with epilepsy.

Purpose: This study aimed to determine whether the self-management skills of patients with epilepsy are associated with certain demographic, clinical, and psychosocial variables.

Methods: A direct survey of 182 patients, including the Epilepsy Self-Management Scale, was conducted.

Results: On univariate analysis, higher age, the occurrence of convulsions, and the use of religion as a coping mechanism were associated with higher self-management scores.

The societal integration of individuals with epilepsy: perspectives for the 21st century.

Epilepsy is a common neurologic disorder seen throughout the world. Advances in therapy have made it possible for persons with epilepsy (PWEs) to have improved seizure control and a better quality of life. However, it is not entirely clear whether this has resulted in their successful integration into society.

Racial differences in coping strategies among individuals with epilepsy.

Purpose: The purpose of this study was to determine whether racial differences exist in the coping styles of individuals with epilepsy.

Methods: This study utilized a survey of patients with epilepsy, including the Brief-COPE.

Results: One hundred thirteen Caucasians and 70 African-Americans comprised the study population.

Analyzing depression coping strategies of patients with epilepsy: a preliminary study.

Purpose: To determine whether individuals with epilepsy who are depressed have different coping reactions, such as increased use of disengagement-type coping reactions, compared to those who are not.

Methods: We surveyed 200 patients with epilepsy and obtained demographic and clinical information. We used the Neurological Institute Disorders Depression Inventory for Epilepsy (NIDDI-E) to determine those patients who had a major depression (NIDDI-E score >15) and administered the Quality of Life in Epilepsy-10 Inventory (QOLIE-10), Beliefs About Medicines Questionnaire-Specific, Sheehan Disability Scale, a screening question for health literacy ("How confident are you filling out medical forms by yourself?"), and the Brief Coping with Problems Experienced (Brief-COPE).

Determining the coping strategies of individuals with epilepsy.

Purpose: The purpose of the present study was to determine whether the coping styles of patients with epilepsy are associated with certain demographic, clinical, and psychosocial variables.

Methods: A survey of 200 patients using several tests including the Brief-COPE was conducted.

Results: Nine subscales of the Brief-COPE achieved acceptable internal consistency and were employed in study analysis.

Effects of antiepileptic drug characteristics on medication adherence.

Purpose: To determine whether antiepileptic drug (AED) characteristics are associated with medication adherence.

Methods: We reviewed pharmacy and clinical records of 108 patients with epilepsy from the indigent care program at Shands-Jacksonville. We calculated the mean medication possession ratio (MMPR) for each AED.

Health disparities in medication adherence between African-Americans and Caucasians with epilepsy.

Objective: The goal of this study was to determine whether racial disparities exist with respect to adherence to antiepileptic drugs (AEDs) in patients with epilepsy.

Method: We reviewed the pharmacy and clinical records of 108 patients with epilepsy who were part of the indigent care program at Shands-Jacksonville. We determined the medication possession ratio (MPR) for each patient and obtained other demographic and clinical variables.

Factors associated with poor seizure control and increased side effects after switching to generic antiepileptic drugs.

Objective: To determine those factors associated with increased seizures and side effects after switching from brand name to generic antiepileptic drugs (AEDs).

Methods: We surveyed adult epilepsy patients and obtained demographic, clinical, and psychosocial data. We inquired whether they switched from brand name to generic AEDs, and whether they experienced poorer seizure control and increased side effects.

Detecting health disparities among Caucasians and African-Americans with epilepsy.

Objective: The aim of the study was to determine whether African-Americans and Caucasians who receive care at a tertiary epilepsy center can be distinguished on a variety of demographic, clinical, and psychosocial variables.

Methods: We surveyed 111 consecutive patients followed at a tertiary epilepsy center.

Results: On univariate analysis, African-Americans had significantly more seizures (P=0.

Seizure severity is associated with quality of life independent of seizure frequency.

Objective: The goal of the work described here was to determine whether seizure severity is associated with quality of life and if this association exists independent of seizure frequency.

Methods: We administered a survey questionnaire to patients followed at the Comprehensive Epilepsy Program, University of Florida Health Sciences Center/Jacksonville.

Results: The study population comprised 142 subjects.