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EMU Caring: Safety in the Epilepsy Monitoring Unit


Original Release Date: August 1, 2013; 
Original Expiration Date: July 31, 2015
Review Date: August 30, 2018; Release Date: October 15, 2018
Renewal Date: December 31, 2021

Expiration Date: December 31, 2024

NEEDS STATEMENT
EMU Caring is a web-based program designed for health care professionals who care for people being evaluated in Epilepsy Monitoring Units (EMU). Upon completion of this program, the participant will understand the steps required to implement a culture of safety within the EMU. Anticipatory evaluation of patients, individualized care plans, and care team interactions and communication will be emphasized. The overall goal of this program is to enhance the professional’s and facility’s ability to care for patients admitted to the EMU.

The program consists of seven modules addressing the following topics:

  • Introduction to Safety in the EMU (Culture of Safety and Overview of EMU Safety)
  • Enhancing Safety Prior to Admission:
    • - Professional Education and Communication
      - Assessment and Education of Patient and Family
  • Seizure Observation
  • Environment and Activity
  • Seizure Provocation
  • Managing Seizures and Comorbidities
  • Preparing for Transition to Outpatient Care
Summaries of content for each module are provided in the appendix.

TARGET AUDIENCE
Neurologists, epileptologists, nurses, electroneurodiagnostic technologists and other healthcare professionals providing care to patients admitted to EMUs.

LEARNING OBJECTIVES
As a result of participation in this activity, learners will be able to:
  • Recognize safety risks and co-morbidities in patients being admitted to an EMU.
  • Counsel patients and families regarding goals, expectations and safety practices for an EMU admission. 
  • Develop strategies to enhance patient safety and team communication
  • Define criteria for surveillance techniques for seizure observation.
  • Develop a safety plan for seizure observation and activity incorporating patient-specific risks, environmental and system issues, and human and technological resources.
  • Identify environmental risks based on assessment of patient specific needs.
  • Establish plan of care for activity based on specific patient assessment and safety precautions.
  • Establish role specific responses for seizure provocation.
  • Identify personal training needs regarding monitoring, response to seizures, and identification of risks.
  • Establish patient specific seizure response protocols.
  • Identify role in handoffs and team communications. 
  • Implement teaching plans for patients upon discharge using knowledge of potential risks.

ACCREDITATION
Physicians: This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Epilepsy Society (AES) and the National Association of Epilepsy Centers (NAEC). The AES is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation
The American Epilepsy Society designates this enduring activity for a maximum of 3.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Continuing Education for Nurses:
In support of improving patient care, this activity is planned and implemented by the National Center for Interprofessional Practice and Education’s Office of Interprofessional Continuing Professional Development (OICPD) and the AES. The OICPD is accredited by the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.
The OICPD approves this knowledge-based activity for 3.5 contact hours (.35 CEUs).

Disclaimer:
Accreditation refers to educational content only and does not imply endorsement of products or services by PSNA, ANCC, CBRN, or AES.

Resolution of Conflicts of Interest
It is the policy of the American Epilepsy Society to ensure balance, independence, objectivity and scientific rigor. All persons involved in the selection, development and presentation of content are required to disclose any real or apparent conflicts of interest. In accordance with the ACCME Standards of Integrity and Independence in Accredited Continuing Education, the AES implemented the mechanisms of prospective peer review of this CME activity, to identify and resolve any conflicts. Additionally, the content of this activity is based on the best available evidence.

Planning Committee, Faculty Reviewers’ Disclosures of Financial Relationships
In accordance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education, the AES requires that any person who is in a position to control content of a CME activity must disclose all relevant financial relationships that they have with an ineligible company. Unless otherwise indicated (*), none of the planners or faculty of this activity have any financial relationships to disclose. All relevant financial relationships with ineligible companies have been mitigated. The following individuals contributed to this activity’s content.

Faculty
Patricia O. Shafer, R.N., M.N., Content Chair, Beth Israel Deaconess Medical Center, Boston, MA
Disclosure: Ms. Shafer has nothing to disclose.

Demaris Sanchez Monzon-Aguirre, RN, Miami Children’s Hospital, Miami, FL
Disclosure: Ms. Monzon-Aguirre has nothing to disclose.

Susan Agostini, R.EEG.T, Phoenix, AZ
Disclosure: Ms. Agostini has nothing to disclose.

Gregory L. Barkley, M.D., Henry Ford Hospital, Detroit, MI
Disclosure: Dr. Barkley has disclosed the following relevant financial relationship: Contracted researcher for Neuro Pace.

Maysaa Basha, MD, Wayne State University School of Medicine, Detroit, MI
Disclosure: Dr. Basha has nothing to disclose.

Andrew S. Blum, M.D., Ph.D., Brown Medical School/Rhode Island Hospital, Providence, RI
Disclosure: Dr. Blum has disclosed the following relevant financial relationships: Salary from The Neurology Foundation, Inc., Royalty from Springer Publishing, "The Clinical Neurophysiology Primer" and Contracted Researcher for UCB Pharma.

Janice M. Buelow, Ph.D., RN, FAAN, Indiana University School of Nursing, Indianapolis, IN
Disclosure: Dr. Buelow has nothing to disclose.

Jessica Charles, MSN, RN,Mayo Clinic, Phoenix, AZ
Disclosure: Ms. Charles has nothing to disclose.

Patricia Dean, ARNP, MSN - Miami Children's Hospital, Miami, FL
Disclosure: Ms. Dean has nothing to disclose.

Sandra Dewar, RN, M.S./CNS, Seizure Disorder Center, UCLA, Los Angeles, CA
Disclosure: Ms. Dewar has nothing to disclose.

Michael S. Duchowny, M.D., Miami Children's Hospital, Miami, FL
Disclosure: Dr. Duchowny has disclosed the following relevant financial relationship: Contracted Research for UCB and Eisai; travel reimbursement from Cyberonics.

Judy Ahn-Ewing, B.A.,R.EEG/EP T., CNIM, CLTM, St John Providence HealthSystems Novi, MI
Disclosure: Ms. Ewing has nothing to disclose.

Joyce Gerke, RN, Mayo Clinic, Phoenix, AZ
Disclosure: Ms. Gerke has nothing to disclose.

Ingrid Guerra, RN, Miami Children’s Hospital, Miami, FL
Disclosure: Ms. Guerra has nothing to disclose.

Susan T. Herman, M.D., Beth Israel Deaconess Medical Center, Boston, MA
Disclosure: Dr. Hermann has disclosed the following relevant financial relationship: Principal Investigator for UCB Pharma, Lundbeck Inc., Vertex Pharmaceuticals; no direct income.

Anuj Jayakar, M.D., Miami Children’s Hospital, Miami, FL
Disclosure: Dr. Jayakar has nothing to disclose.

Andres M. Kanner, M.D., University of Miami Miller School of Medicine,
Miami, FL
Disclosure: Dr. Kanner has nothing to disclose.

Brandon Korman, Psy.D., Miami Children’s Hospital, Miami, FL
Disclosure: Dr. Korman has nothing to disclose.

Dona E.C. Locke, Ph.D., ABPP, Mayo Clinic, Phoenix, AZ
Disclosure: Ms. Locke has nothing to disclose.

Rohit Marawar, MD, FAES, Wayne State University School of Medicine, Detroit, MI
Disclosure: Dr. Marawar has nothing to disclose. 

Kevin McGinnis, EEG Tech,Beth Israel Deaconess Medical Center, Boston, MA
Disclosure: Mr. McGinnis has nothing to disclose.

Elizabeth Nachman, B.S.N., RN, Mayo Clinic, Phoenix, AZ
Disclosure: Ms. Nachman has nothing to disclose.

Katherine Noe, M.D., Ph.D., Mayo Clinic, Phoenix, AZ
Disclosure: Dr. Noe has nothing to disclose.

Alison M. Pack, M.D., M.P.H., Columbia Presbyterian Medical Center, NY, NY
Disclosure: Dr. Pack has nothing to disclose.

Nigel Pederson, M.D., Beth Israel Deaconess Medical Center, Boston, MA
Disclosure: Dr. Pederson has nothing to disclose.

Madona D. Plueger, APRN, ACNS-BC, Barrow Neurological Institute, Phoenix, AZ
Disclosure: Ms. Plueger has nothing to disclose.

Jennifer Ponder, CLS, Miami Children’s Hospital, Miami, FL
Disclosure: Ms. Ponder has nothing to disclose.

Pedro Rubio, R.EEG.T, Miami Children’s Hospital, Miami, FL
Disclosure: Mr. Rubio has nothing to disclose.

Aileen Sanchez, RN, MSN, Miami Children’s Hospital, Miami, FL
Disclosure: Ms. Sanchez has nothing to disclose.

Andrew C. Schomer, M.D., Beth Israel Deaconess Medical Center, Boston, MA
Disclosure: Dr. Schomer has nothing to disclose.

Karen L. Secore, MS, APRN CNRN, Dartmouth Hitchcock Medical Center, Lebanon, NH
Disclosure: Ms. Secore is a member of the Nursing Advisory Board for Lundbeck, Inc.

Ann Hyslop Segeran, M.D., Miami Children's Hospital, Miami, FL
Disclosure: Dr. Hyslop Segeran has nothing to disclose.

Joseph I. Sirven, M.D., Mayo Clinic, Phoenix, AZ
Disclosure: Dr. Sirven has disclosed the following relevant financial relationship.
Consulting fees from UCB.

Lauren Sullivan, RN, BSN, Beth Israel Deaconess Medical Center, Boston, MA
Disclosure: Ms. Sullivan has nothing to disclose.

Lisa Tapsell, R.E.T., R.EEG.T., CLTM, Mayo Clinic, Phoenix, AZ
Disclosure: Ms. Tapsell has nothing to disclose.

Srijana Zarkou, M.D., Beth Israel Deaconess Medical Center, Boston, MA
Disclosure: Ms. Zarkou has nothing to disclose.

Planning Committee Members
Ruth C. Shinnar, RN, M.S.N., Project Chair, Montefiore Medical Center, NY, NY
Disclosure: Ms. Shinnar has nothing to disclose.

David M. Ficker, M.D., University of Cincinnati, Cincinnati, OH
Disclosure: Dr. Ficker has disclosed the following relevant financial relationship: Honoraria for Lundbeck. Consulting Fee for Best Doctors.

Mary Jo Pugh, Ph.D., RN, South Texas Veterans Health System, Helotes, TX
Disclosure: Dr. Pugh has disclosed the following relevant financial relationship.
Contracted research for Brain Sentinel.

Nathan B. Fountain, M.D., University of Virginia, Charlottesville, VA
Disclosure: Dr. Fountain has disclosed the following relevant financial relationship: Consultant for UCB, Inc; Contracted Researcher for UCB, Inc., Lundbeck, Vertex, Medtronic and Neuropace

Christianne N. Heck, M.D., University of Southern California, Los Angeles, CA
Disclosure: Dr. Heck has nothing to disclose.

Fred Lado, M.D., Ph.D., Montefiore Medical Center, NY, NY
Disclosure: Dr. Lado has nothing to disclose.

David Labiner, M.D., University of Arizona, Tucson, AZ
Disclosure: Dr. Labiner has disclosed the following relevant financial relationship: Primary Investigator on industry sponsored research grants for: Eisai Inc., SK Life Science, Inc., Sunovion, Upsher-Smith and Visualase.

CME Reviewers
Howard P. Goodkin, M.D., Ph.D. University of Virginia, Charlottesville, VA
Disclosure: Dr. Goodkin has disclosed the following relevant financial disclosure.
Received remuneration from Elsevier.

AES Medical Content Specialist
Paul M. Levisohn, M.D., Children’s Hospital Colorado, Aurora, CO
Disclosure: Dr. Levisohn has disclosed that he is a contracted researcher for Eisai Inc.

Technologists:
ASET - The Neurodiagnostic Society has granted ASET Continuing Education [ACE] credits for this program. Such crediting, however, should not be construed by program participants as an endorsement of any type of instruments or supplies mentioned or involved in these presentations.

INSTRUCTIONS FOR PARTICIPATION TO EARN CME/CE CREDIT
There are no fees for participating in or receiving credit for this online educational activity.
  1. Read the needs statement, target audience, learning objectives, and faculty disclosures. 
  2. Study the educational content online.
  3. You must satisfactorily complete all questions on the pre and post assessments
  4. Please complete the activity evaluation to provide feedback for future programming.

EMUCaring is a unique experience that will result in improved care and better outcomes for patients. The surveys being used will document those changes in clinical practice that will result from participation. This will allow us to determine the impact of EMUCaring as well as define future needs. 

Registration is required for this free activity.