Resources: New guidance and assessment tool supporting community epilepsy care

The Epilepsy Nurses Association (ESNA) is this month launching new, best practice training guidelines for professional carers administering buccal (ormomucosal) midazolam for epilepsy patients in the community.

The guidelines will support best practice when training carers who are overseeing the use of buccal midazolam for the treatment of prolonged and / or clusters of epileptic seizures. The guidelines replace the Joint Epilepsy Council (JEC) guidelines on the use of buccal midazolam.

Launched this week, the guidelines are being introduced alongside an easy-to-use online assessment tool to ensure a standardised knowledge check can be undertaken effectively, following recommended training for professionals who are caring for epilepsy patients in healthcare and private care settings.

ESNA is an organisation principally formed by nurses with an interest in epilepsy. Most ESNA members support or complete training for buccal midazolam to ensure core competencies are up to date and patient safety is protected. ESNA’s latest guidelines, produced in collaboration with the International League Against Epilepsy (ILAE) and the Royal College of Psychiatrists (RCPsych), outline important safety standards for first aid intervention while demonstrating the need for awareness, training and consistent review of epilepsy knowledge and protocol.

To support the implementation of the guidelines, the Virtual College have created an online assessment tool to ensure to best practice is maintained in social care organisations when administering buccal midazolam.

Phil Tittensor, Consultant Nurse for the Epilepsies based at the Royal Wolverhampton NHS Trust, said that with one in every 103 people affected by epilepsy in the UK, a prevalence that is expected to rise and concerns over incorrectly administered medication such as buccal midazolam, the need to keep staff from healthcare assistants to support workers up to date with best practice is essential.

“Epilepsy is a serious neurological condition that can affect anyone, at any age and from any walk of life so management is absolutely key – not only in healthcare professionals but in non-professional carers who may be found working in social settings, residential homes and working with those experiencing learning difficulties,” he explained.

“The new ESNA guidelines are intended to address individual training needs for the safe administration of buccal midazolam and to be used by employing organisations to benchmark their services and ensure quality. Combined with the unique online assessment programme, we have a toolkit which boosts treatment knowledge, particularly around the care protocols of administering emergency medication.”

He added: “These resources ensure everyone in the country who is caring for and working with people who experience seizures and epilepsy has the same basic required standard of knowledge. We’re urging anyone running, managing or supervising people in this setting to download the guidelines and make this easy-to-use assessment tool available to staff. That way they can feel confident that their teams are operating with the most up-to-date information, based on the latest epilepsy guidelines.”

Dr Rohit Shankar Consultant Psychiatrist, and Hon. Associate Clinical Professor at Exeter Medical School, says the latest guidelines and assessment tool have the potential to save lives by upskilling and informing those caring for and training carers of people with epilepsy.

He added: “Epilepsy for some, is a lifelong condition and inherent to it is the risk of ‘Status Epilepticus’ ie when seizures do not stop or one seizure follows another without the person recovering in between and lasting longer than usual. This is one of the leading causes of not only epilepsy-related deaths but also on-going ill health.

“There is also the cost burden to the NHS, particularly in emergency care. Simple solutions to manage deterioration and reduce the ‘slide to status’ do exist which are both clinically and cost effective. However, the lack of up-to-date structured guidance in this area for the last few years has increased concerns of vulnerable people with epilepsy being failed and the potential increased risk of treatment-related harm delivered by poorly experienced trainers. Guidance such as these released by ESNA will save lives.”

The ESNA best practice guidelines can be accessed via the Virtual College website The online epilepsy assessment tool takes approximately 15 minutes to complete and costs just £5 + VAT per person. Users are required to refresh by retaking the programme every two years.

For more information about the new guidelines and online assessment tool, contact: [email protected]