DeVries-Rizzo Margo
Children's Hospital, London Health Sciences Centre, London, ON, Canada; Western University, London, ON, Canada.
Children's Hospital, London Health Sciences Centre, London, ON, Canada; Western University, London, ON, Canada.
Epilepsy Behav. 2016 Apr;57(Pt A):145-150. doi: 10.1016/j.yebeh.2016.02.012. Epub 2016 Mar 5.
The epilepsy monitoring unit (EMU) is a well-established resource for investigating patients' seizures but is known to be heterogeneous in organization and clinical practice. The purpose of this study was to gain a better understanding of similarities and differences in EMU characteristics across Canada, with specific emphasis on EMU organization and nursing resources, which were currently unknown. Results would be used to develop a consensus on best nursing practice guidelines in EMUs with the goal to improve patient care and safety during epilepsy monitoring admissions.
An 18-item survey was developed addressing EMU locations, types, nursing ratios, nursing roles, and other allied health resources. Surveys were distributed to lead nurses, physicians, and administrators in 29 EMUs across Canada. Results were tabulated and presented for each question in the survey.
All EMUs were located in urban, teaching centers and divided similarly by patient age. The survey demonstrated considerable variability in EMU bed location and organization with the majority of EMUs being smaller, open units embedded in wards rather than larger, closed units. Independent of patient acuity, variability also existed in nurse-to-patient ratios, nursing skill level, specialty nursing support, and EEG technician availability. These findings highlight that EMU heterogeneity contributes to the challenges in the development of standardized safe care practices and that nursing education and nursing best practice recommendations need to be developed with baseline EMU nursing competencies, skills, and knowledge in mind.
癫痫监测单元（EMU）是用于调查患者癫痫发作的成熟资源，但已知其在组织和临床实践方面存在异质性。本研究的目的是更好地了解加拿大各地EMU特征的异同，特别强调目前尚不清楚的EMU组织和护理资源。研究结果将用于就EMU最佳护理实践指南达成共识，目标是在癫痫监测住院期间改善患者护理和安全。
制定了一项包含18个条目的调查问卷，内容涉及EMU的地点、类型、护理比例、护理角色以及其他联合健康资源。调查问卷分发给了加拿大29个EMU的护士长、医生和管理人员。对调查结果进行了列表整理，并针对调查问卷中的每个问题进行了呈现。
所有EMU均位于城市教学中心，且按患者年龄进行了类似划分。调查显示，EMU床位设置和组织存在很大差异，大多数EMU规模较小，是嵌入病房的开放式单元，而非规模较大的封闭式单元。无论患者病情严重程度如何，护士与患者的比例、护理技能水平、专科护理支持以及脑电图技术人员的配备也存在差异。这些发现凸显出EMU的异质性给标准化安全护理实践的发展带来了挑战，并且在制定护理教育和护理最佳实践建议时需要考虑EMU护理的基本能力、技能和知识。
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