Table 2 Skill items before and after the test, n (%)
From: Treatment of status epilepticus in pediatrics: curriculum learning combined with in-situ simulations
Skill | Pre-training | Post-training | P (pre-post) |
|---|---|---|---|
Evaluating the patient (before the patient has witnessed a seizure) | |||
  Obtains a concise history (from RN/ED team/family members) (must ask all three to get credit) | 2 (20%) | 9 (90%) |  < 0.001 |
  States out loud the patient's level of alertness | 2 (20%) | 10 (100%) |  < 0.001 |
  Examines eyes | 5 (50%) | 9 (90%) | 0.02 |
  Examine for any focal weakness | 6 (60%) | 10 (100%) | 0.02 |
Evaluating and stabilizing the patient (after witnessed seizure noted) | |||
  States that the patient is having a seizure | 5 (50%) | 10 (100%) | 0.01 |
  States out loud time of seizure onset | 1 (10%) | 10 (100%) |  < 0.001 |
  Calls for help | 8 (80%) | 10 (100%) | 0.53 |
  Reposition patient on to the side | 4 (40%) | 9 (90%) | 0.01 |
  Evaluates patient's airway: suction patient | 3 (30%) | 10 (100%) |  < 0.001 |
  Places pulse oximeter | 9 (90%) | 10 (100%) | 0.62 |
  Asks RN to provide oxygen if the patient is hypoxic | 8 (80%) | 9 (90%) | 0.58 |
  Asks RN to check blood pressure | 9 (90%) | 10 (100%) | 0.62 |
  Asks RN to initiate telemonitoring (EKG) and ensures that this gets done by RN | 6 (60%) | 10 (100%) | 0.02 |
  Performs a brief neurological exam: must check or ask RN if any eye deviation | 2 (20%) | 10 (100%) |  < 0.001 |
Management | |||
  Ensures that the patient has a working IV access | 4 (40%) | 10 (100%) | 0.01 |
  Orders 1st-line ASD (must be given within 5 min of seizure onset) | 10 (100%) | 10 (100%) |  > 0.999 |
  Asks RN to check finger stick blood glucose | 5 (50%) | 10 (100%) | 0.01 |
  Orders labs | 9 (90%) | 100 (100%) |  > 0.999 |
  Order a second ASD (needs to be ordered within 5 min from ordering first ASD) | 2 (20%) | 9 (90%) |  < 0.001 |
  Calls pharmacy or asks RN to call the pharmacy to communicate the emergent need for ASDs | 3 (30%) | 10 (100%) |  < 0.001 |
  Orders a stat head CT | 5 (50%) | 10 (100%) | 0.01 |
  Communicates with attending physician/fellow on-call to staff the case | 3 (30%) | 10 (100%) |  < 0.001 |
  States out loud the concern for nonconvulsive status | 3 (30%) | 10 (100%) |  < 0.001 |
Re-evaluating the case | |||
  Orders a postload ASD level | 0 | 8 (80%) |  < 0.001 |
  Orders an emergent EEG and call the on-call fellow to ask for a stat EEG | 3 (30%) | 10 (100%) |  < 0.001 |
  Makes appropriate decision regarding disposition/level of care (ICU) and communicates this decision to the nurse | 4 (40%) | 10 (100%) | 0.01 |