TY - JOUR
T1 - Continuous electroencephalographic training for neuroscience intensive care unit nurses
T2 - A feasibility study
AU - Picinich, Christine
AU - Kennedy, Jeffrey
AU - Thind, Harjot
AU - Foreman, Christine
AU - Martin, Ryan M.
AU - Zimmermann, Lara L.
N1 - Funding Information:
Statistical analysis for this project was partially supported by the National Center for Advancing Translational Sciences, National Institutes of Health (NIH), through grant number UL1 TR001860. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - BACKGROUND: Use of continuous electroencephalographic (cEEG) monitoring has more than doubled at our institution for the last 4 years. Although intensive care unit cEEG is reviewed remotely by board-certified epileptologists every 4 to 6 hours, there are inherent delays between occurrence, recognition, and treatment of epileptiform activity. Neuroscience intensive care unit (NSICU) nurses are uniquely positioned to monitor cEEG in real time yet do not receive formal training. The purpose of this study was to evaluate the effectiveness of an education program to teach nurses to monitor cEEG, identify a burst suppression pattern, and measure the duration of suppression. METHODS: We performed a retrospective analysis of pretest and posttest data. All NSICU nurses (40) were invited to complete the pretest (PT-0), with 25 participating. Learning style/preference, demographics, comfort with cEEG, and knowledge of EEG fundamentals were assessed. A convenience cohort of NSICU nurses (13) were selected to undergo EEG training. Posttests evaluating EEG fundamental knowledge were completed immediately after training (PT-1), at 3 months (PT-3), and at 6 months (PT-6). The cohort also completed a burst suppression module after the training, which assessed ability to quantify the duration of suppression. RESULTS: Mean cohort test scores significantly improved after the training (P <.001). All nurses showed improvement in test scores, and 76.9% passed PT-1 (a score of 80% or higher). Reported mean comfort level with EEG also significantly improved after the training (P =.001). There was no significant difference between mean cohort scores between PT-1, PT-3, and PT-6 (all 88.6%; P = 1.000). Mean cohort score from the bust suppression module was 73%, with test scores ranging from 31% to 93%. CONCLUSIONS: NSICU nurses can be taught fundamentals of cEEG, to identify a burst suppression pattern, and to quantify the duration of suppression. Further research is needed to determine whether this knowledge can be translated into clinical competency and affect patient care.
AB - BACKGROUND: Use of continuous electroencephalographic (cEEG) monitoring has more than doubled at our institution for the last 4 years. Although intensive care unit cEEG is reviewed remotely by board-certified epileptologists every 4 to 6 hours, there are inherent delays between occurrence, recognition, and treatment of epileptiform activity. Neuroscience intensive care unit (NSICU) nurses are uniquely positioned to monitor cEEG in real time yet do not receive formal training. The purpose of this study was to evaluate the effectiveness of an education program to teach nurses to monitor cEEG, identify a burst suppression pattern, and measure the duration of suppression. METHODS: We performed a retrospective analysis of pretest and posttest data. All NSICU nurses (40) were invited to complete the pretest (PT-0), with 25 participating. Learning style/preference, demographics, comfort with cEEG, and knowledge of EEG fundamentals were assessed. A convenience cohort of NSICU nurses (13) were selected to undergo EEG training. Posttests evaluating EEG fundamental knowledge were completed immediately after training (PT-1), at 3 months (PT-3), and at 6 months (PT-6). The cohort also completed a burst suppression module after the training, which assessed ability to quantify the duration of suppression. RESULTS: Mean cohort test scores significantly improved after the training (P <.001). All nurses showed improvement in test scores, and 76.9% passed PT-1 (a score of 80% or higher). Reported mean comfort level with EEG also significantly improved after the training (P =.001). There was no significant difference between mean cohort scores between PT-1, PT-3, and PT-6 (all 88.6%; P = 1.000). Mean cohort score from the bust suppression module was 73%, with test scores ranging from 31% to 93%. CONCLUSIONS: NSICU nurses can be taught fundamentals of cEEG, to identify a burst suppression pattern, and to quantify the duration of suppression. Further research is needed to determine whether this knowledge can be translated into clinical competency and affect patient care.
KW - adult
KW - brain injuries
KW - brain injury, traumatic
KW - cEEG
KW - critical care nursing
KW - critical care/methods
KW - electroencephalography
KW - intensive care units
KW - intracranial hypertension
KW - monitoring, physiologic/nursing
KW - neurocritical care
KW - neuroscience nursing
KW - nursing evaluation research
KW - nursing staff, hospital/education
KW - status epilepticus
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U2 - 10.1097/JNN.0000000000000535
DO - 10.1097/JNN.0000000000000535
M3 - Article
C2 - 32740316
AN - SCOPUS:85090511333
VL - 52
SP - 245
EP - 250
JO - Journal of Neuroscience Nursing
JF - Journal of Neuroscience Nursing
SN - 0888-0395
IS - 5
ER -