Objective:

To evaluate the discrepancy between knowledge of AAN guidelines for status epilepticus and their implementation among ER physicians and to determine the effectiveness of focused educational interventions and performance metrics in improving guideline adherence.

Background:

Effective management of status epilepticus is critical for patient outcomes, and while ER physicians are often well-versed in the American Academy of Neurology (AAN) guidelines, consistent application in clinical practice is lacking. Addressing this gap is essential for enhancing care quality and patient safety.

Design/Methods:

In this study conducted at a high-volume emergency department, phase one involved assessing ER physicians' familiarity with and application of AAN guidelines for status epilepticus. An intervention program, comprising targeted education sessions and the introduction of adherence metrics via focused power plan in the EMR, was then implemented. Data on compliance, treatment times, and patient outcomes were collected pre- and post-intervention.

Results:

The preliminary analysis highlighted a significant gap between the physicians' knowledge of the AAN guidelines and their practical application during status epilepticus incidents. 82% of ER physicians had knowledge regarding identification and management of status epilepticus in theory. Pre and post intervention program revealed improvement of total lorazepam usage 3mg vs 6.4mg, decreased time in between abortive medications 65 minutes vs 22 minutes, and improved percentage of using first medication as abortive 35% vs 71% of the time, respectively. 

Conclusions:

The study demonstrates a prevalent gap between knowledge and implementation of the AAN guidelines for status epilepticus in the emergency room setting. It confirms that structured educational programs and the establishment of clear metrics are effective in enhancing guideline adherence, which is pivotal for improving patient care in emergency scenarios.