Enhancing Preadmission Communication of Postictal Agitation Risk in the Epilepsy Monitoring Unit: A Retrospective Quality Review

Abstract

Epilepsy Monitoring Units (EMUs) play a crucial role in helping patients with epilepsy understand the sequelae of seizures and adjust treatment plans to enhance their quality of life. In this retrospective quality improvement project medical records were reviewed from January 1, 2024, to December 31, 2024. The study assessed postictal confusion, agitation, and aggression in patients with documented preadmission evidence of these behaviors, compared with those without identified postictal risk. Records from 103 patients were examined for notes on confusion, agitation, and aggression. Safety reports were analyzed both for the total number and specifically within the EMU population. Police and security reports were also quantified, first for the entire unit and then for the EMU subgroup. Descriptive and inferential statistics were used to analyze correlations between patients with a known history of postictal behavioral risks and those without such risks. Although the data analysis did not reveal a statistically significant difference, episodes of aggression comprised 35% of safety reports, and police and security incidents accounted for 22.2% of unit events. These findings highlight the importance of recognizing behavioral risk, particularly aggression, in the EMU. Implementing a standardized epilepsy risk assessment tool and improving documentation continuity are recommended interventions to enhance patient safety.

Disciplines

Law Enforcement and Corrections | Nursing

Subject Area

Nursing; Law enforcement; Behavioral psychology; Health care management

Department

Nursing (NUR)

First Advisor

Stager, Sharon L.

Second Advisor

O'Connor, Kelly J

Date of Award

2025

Document Type

Dissertation

Degree Name

D.N.P.

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