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Quality and Regulatory Outcome 1

Quality and Regulatory Outcome

Applying the PICOT (Patient/Problem, Intervention, Comparison, Outcome and Time)

Question Tool in order to evaluate human systems, I was able to evaluate the system of care for a

patient with intractable epilepsy and the care plan that leads to the best seizure control. The

PICOT Tool uses evidence-based research to support the findings and evidence is the best

method to demonstrate that quality and regulatory outcomes are being met.

The comparison for this plan of care was between treatment for a patient with intractable

epilepsy with a ketogenic diet and anti-epileptic drugs versus treatment with anti-epileptic drugs

only. I found through my literature research that the ketogenic diet in the treatment of intractable

epilepsy has been in use since the 1920s and has undergone some modifications based on further

research and evidence. This diet with a fat to carbohydrate and protein ratio of 3:1 or 4:1, has

shown through evidence in randomized control trials of its effectiveness. Within these trials, to

ensure patient safety, specific guidelines and regulations had to be in place and followed by both

the trial participants and the researchers. For the trial participants, this included reporting pre-

existing conditions and behavioral problems in the provided questionnaires, reporting to follow

up appointments and diligent recording of seizure activity. For the researchers, this included

reporting all side effects identified, regardless of the number of participants that experienced

them and following guidelines as to when to discontinue the diet. Ensuring that quality

improvement and regulatory systems are in place requires the participation of all members of the

health care team and the patient as well. I saw that as nurses, we must ensure that an

understanding is in place for patients and their family so that they can better participate in their

own care.
Quality and Regulatory Outcome 2

In finding the answer to my PICOT Question, which was that treatment with antiepileptic

drugs and a ketogenic diet led to positive outcomes and improved seizure control in pediatric

patients with intractable epilepsy compared to treatment with AEDs only, I was able to identify

the regulatory systems in place to ensure patient safety. Once patient safety in ensured, quality

improvement systems can be implemented based on evidence-based research.