The safety of UK video telemetry units: Results of a national service evaluation

PURPOSE To assess patient safety during seizures occurring on UK video telemetry units and identify factors in unit infrastructure which may improve safety with the intention of producing national guidelines. METHODS A prospective multicentre national service evaluation of the occurrence of adverse events and level of nurse attendance during seizures occurring on video telemetry units was performed. Data from 272 seizures from 27 video telemetry units across the UK were analysed. RESULTS Adverse events occurred in 12% of seizures: 7% were physical events such as falls or respiratory compromise and 5% were unnoticed seizures. Nursing staff did not attend the patients in 44% of seizures and attendance was delayed beyond 30s in a further 29%. Only 27% of seizures were attended by a Healthcare Professional within half a minute. The most important factor shown to improve timely attendance of patients during seizures was the presence of a nurse dedicated to the telemetry bed(s). The site of the telemetry bed (bay or cubicle) and method of observation (direct or indirect) was less important. An optimal nurse-to-patient ratio was difficult to identify but the study suggests that a ratio of at least 1 nurse to 4 patients is appropriate. CONCLUSION The results provide an evidence base for the production of national standards and guidelines for surveillance of patients during video telemetry to improve patient safety.