Improving Treatment Speed for Status Epilepticus in Children Using a Quality Improvement Program

What this Trial Is About

Researchers are evaluating a stepped-wedge cluster randomized effectiveness-implementation hybrid study to improve the treatment time for Status Epilepticus SE in hospitalized, non-critically ill children. The study aims to reduce the time between SE diagnosis and the first dose of a benzodiazepine BZD, potentially lowering risks of complications and death. This design allows assessment of both the clinical impact and how well the intervention can be applied across multiple hospitals. Seven hospital centers will take part, each starting the quality improvement QI bundle intervention at different times in a staggered manner. The QI bundle includes standardizing the use of intranasal or buccal midazolam, targeting BZD treatment within 10 minutes of seizure onset, reorganizing medication supplies, using basic seizure first aid, creating SE-specific electronic health record documentation, and forming multidisciplinary QI teams. The study involves phases of routine care, adoption of the bundle, and sustained implementation with or without central support. Participants will be monitored during hospitalization to measure the time to first BZD dose as the primary outcome. Secondary outcomes include rates of ICU transfer, hospitalization costs, and changes in neurological function scores over 30 days. Data collection will include focus groups, process mapping, and simulations, alongside continuous feedback and support for sustaining the interventions. The study expects to provide valuable insights into both clinical effectiveness and practical implementation over its duration.

Improving Status Epilepticus Treatment Times