Determining the role and responsibilities of the community epilepsy nurse in the management of epilepsy

Abstract

Aims and Objectives:The aim of this study is to enhance the understanding of the core elements and influencing factors on the community-based epilepsy nurse's role and responsibilities.Background: Internationally, epilepsy nurse specialists play a key role in providing person-centred care and management of epilepsy but there is a gap in understanding of their role in the community.Design: A national three-stage, mixed-method study was conducted.Methods: One-on-one, in-depth semi-structured qualitative interviews were conducted online with 12 community-based epilepsy nurses (Stage 1); retrospective analysis of data collected from the National Epilepsy Line, a nurse-led community helpline (Stage 2); and focus group conducted with four epilepsy nurses, to delve further into emerging findings (Stage 3). A thematic analysis was conducted in Stages 1 and 3, and a descriptive statistical analysis of Stage 2 data. Consolidated Criteria for Reporting Qualitative studies checklist was followed for reporting. Results:Three key themes emerged: (1) The epilepsy nurse career trajectory highlighted a lack of standardised qualifications, competencies, and career opportunities. ( 2)The key components of the epilepsy nurse role explored role diversity, responsibilities, and models of practice in the management of living with epilepsy, and experiences navigating complex fragmented systems and practices. ( 3) Shifting work practices detailed the adapting work practices, impacted by changing service demands, including COVID-19 pandemic experiences, role boundaries, funding, and resource availability. Conclusion: Community epilepsy nurses play a pivotal role in providing holistic, person-centred epilepsy management They contribute to identifying and addressing service gaps through innovating and implementing change in service design and delivery. Relevance to Clinical Practice: Epilepsy nurses' person-centred approach to epilepsy management is influenced by the limited investment in epilepsy-specific integrated care initiatives, and their perceived value is impacted by the lack of national standardisation of their role and scope of practice. No Patient or Public Contribution: Only epilepsy nurses' perspectives were sought.

Implementation of consensus-based perioperative care pathways to reduce clinical variation for elective surgery in an Australian private hospital: a mixed-methods pre–post study protocol

“…Qualitative data pertaining to the implementation of the perioperative clinical pathways will use the concept of theoretical saturation to determine the observation and interview sample size 38. Based on prior studies, we anticipate conducting 30 interviews and 15–20 meeting observations 39 40. Staff will be recruited using convenience time-frame sampling which removes opportunistic recruitment of staff and patients, and any researcher or hospital selection bias.…”

“… 38 Based on prior studies, we anticipate conducting 30 interviews and 15–20 meeting observations. 39 40 Staff will be recruited using convenience time-frame sampling which removes opportunistic recruitment of staff and patients, and any researcher or hospital selection bias.…”

Integrated Care in Epilepsy Management: A Scoping Review of the Models and Components of Health and Social Care Delivery

“…Although ENs were emphasised as central to facilitating person-and-family-centred care [23,43], they were underutilised in both implemented and recommended models of care. The role scope of ENs both within MDTs and within models of care has not been clearly defined, potentially explaining the under-inclusion of ENs within integrated models of care [52].…”

Healthcare leaders navigating complexity: a scoping review of key trends in future roles and competencies

“…Leadership has been identified as a key shaping influence on organizational culture [ 11 ], including workplace commitment to safety [ 12 ], and on preventing workforce burnout [ 13 , 14 ]. The increased need for multidisciplinary and integrated care models has shed growing light on the leadership roles of clinicians, including physicians, nurses, and allied health practitioners [ 15 – 17 ]. Individuals with both clinical and leadership expertise have been considered vital in complex healthcare landscapes because of their ability to balance administrative needs while prioritizing safety and high-quality care provision [ 18 – 22 ].…”

“…This is becoming increasingly recognized; CanMEDS is due to be updated in 2025 to incorporate competencies related to complexity [ 38 ]. Meanwhile, on the front lines, lack of role clarity and ambiguity about tasks and responsibilities presents a significant barrier for healthcare leaders [ 1 , 15 ]. In complex and unpredictable systems like healthcare, leaders spend substantial time ‘sense-making’, understanding, prioritizing and responding adaptively according to the needs of the situation [ 39 , 40 ].…”