Date of Award

5-9-2020

Document Type

Capstone

Degree Name

Doctor of Nursing Practice (DNP)

School Name

Donna and Allan Lansing School of Nursing and Health Sciences

Department

Nursing

Major Advisor

Dr. Barbara Jackson

Second Advisor

Dr. Heather Owens

Third Advisor

Dr. Michael Oldham

Abstract

Pediatric refractory epilepsy affects approximately 30% of all children diagnosed with epilepsy. Childhood refractory epilepsy patients pose a challenge for traditional approaches to epilepsy management due to their complex and unique needs. Refractory epilepsy negatively impacts a patient’s ability to attend school or hold a job, and patients have a generally poor health status related to seizures as well as pharmaceutical side effects (Conway et al., 2016). The ketogenic diet (KD) is an alternative option for the treatment of pediatric refractory epilepsy due to established efficacy, manageable side effects, and reduced health care-associated costs due to reduced emergency department (ED) visits, and reduced inpatient admissions (Hallbook et al., 2015; Khoo et al., 2016; Lambrechts et al., 2017; Martin et al., 2016; Pasca et al., 2018; Whiting et al., 2017; Wijnen et al., 2017). When attempting to address the complex needs of a child with this chronic medical condition, interdisciplinary and multidisciplinary clinics have been shown to improve patient outcomes in various pediatric fields including refractory epilepsy, when compared to general, traditional clinics (Williams et al., 1995).

An interdisciplinary pediatric ketogenic diet clinic (KDC) was created in 2015 to provide a more coordinated approach to the management of pediatric refractory epilepsy patients on the KD. The clinic was staffed by a pediatric epileptologist, pediatric neurology nurse practitioner, registered dietician, and social worker. Through a retrospective design, data from pediatric KD patients were analyzed to determine the interdisciplinary KDC’s effects on seizure frequency, seizure related hospitalizations, number of seizure medications (AEDs), and adherence to the treatment regimen by both patients and providers when compared to the management of KD patients prior to implementation of the KDC, the traditional approach. The interdisciplinary approach to the KD yielded more seizure free patients, improved adherence to KD standards of care, reduced epilepsy related inpatient admissions, and demonstrated a greater number of patients experiencing a reduction in the number of AEDs when compared to the traditional approach.

Available for download on Tuesday, April 06, 2021

Share

COinS