ECT – current practical administration

Abstract

In the current climate of interest in audit (Standing Medical Advisory Committee, 1990) and a desire at our hospital to embark on criterion based projects, we set out to undertake a simple audit project surveying the practice of ECT. The aim was to audit the treatment facilities, the treatment procedure and the supervision and training. It was hoped that the full cycle of audit – setting goals, measuring activity, and then effecting change – would be achieved (Shaw & Costain, 1989)

Administration of ECT by trainee psychiatrists

“…Even so, still too many trainees are being supervised by their peers rather than by more senior psychiatrists, and the extent of even this level of supervision is limited. This is in common with findings from other units and training rotations (Hill-Smith & Lee, 1992;Ramsay & McPhillips, 1993;Henderson et al 1993) but, nevertheless, falls short of the recommendations of the Royal College of Psychiatrists (1989) that "All trainees should have the opportunity of seeing ECT administered on several occasions by an experi enced operator". This phrase has not been retained in the latest College guidelines (1995); and, although recommendations for supervision have received greater emphasis, they remain sparse and open to interpretation.…”

A re-audit of ECT training and practice

“…This is a mental health unit providing services to the London Borough of Sutton, staffed by four general consultant psychiatrists, a consultant for old age psychiatry, a rehabilitation psychiatrist and six senior house officers/registrars. A previous audit carried out at the same unit had prompted Immediate action, with improvements in several areas including decoration and comfort of the waiting room, training and supervision of junior doctors, giving information to patients for the purpose of obtaining consent and abandoning the routine administration of atropine (Hill-Smith & Lee. 1992).…”