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Auditing electroconvulsive therapy

The third cycle

Published online by Cambridge University Press:  03 January 2018

Richard Duffet  and
Paul Lelliott
Richard Duffet*
Affiliation:
Royal College of Psychiatrists' Research Unit, London
Paul Lelliott
Affiliation:
Royal College of Psychiatrists' Research Unit, London
*
Richard Duffett, Royal College of Psychiatrists' Research Unit, 11 Grosvenor Crescent. London SWIX 7EE
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Abstract

Background

This is the third large-scale audit in the past 20 years and compares the practice of electroconvulsive therapy (ECT) in England and Wales with the standards derived from the Royal College of Psychiatrists' 2nd ECT handbook.

Method

Facilities, equipment, practice, personnel and training were systematically evaluated during visits to all ECT clinics in the former North East Thames and East Anglia regions and Wales. All other English ECT clinics were surveyed with a postal questionnaire. Information was obtained for 184 (84%) of the 220 ECT clinics identified.

Results

Although some aspects of ECT administration had improved since the last audit in 1991, overall only one-third of clinics were rated as meeting College standards. Only 16% of responsible consultants attended their ECT clinic weekly and only 6% had sessional time for ECT duties. Fifty-nine per cent of all clinics had machines of the type recommended by the College and 7% were still using machines considered outdated in 1989. Only about one-third of clinics had clear policies to help guide junior doctors to administer ECT effectively.

Conclusions

Twenty years of activity by the Royal College of Psychiatrists and three large-scale audits have been associated with only modest improvement in local practice.

Type
Papers
Information
The British Journal of Psychiatry , Volume 172 , Issue 5 , May 1998 , pp. 401 - 405
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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References

American Psychiatric Association (1990) The Practice of Electroconvulsive Therapy: Recommendations for Treatment, Training and Privileging. Washington. DC: APA.Google Scholar
Duffett, R. & Lelliott, P. (1997) Junior doctors training in the theory and practice of electroconvulsive therapy. Psychiatric Bulletin, 21, 563–565.Google Scholar
Grimshaw, J. M. & Russell, I. T. (1993) Effect of clinical guidelines on medical practice: a systematic review of rigorous evaluations. Lancet. 342, 1317–1322.CrossRefGoogle Scholar
Grol, R. (1992) Implementing guidelines in general practice care. Quality Health, 1, 184–191.Google Scholar
Lock, T. (1994) Advances in the practice of electroconvulsive therapy. Advances in Psychiatric Treatment, 1, 47–56.Google Scholar
Lomas, J. (1993) Diffusion, dissemination, and implementation: who should do what? Annals of New York Academy of Science, 703, 226–235.Google Scholar
Pippard, J. (1992) Audit of electroconvulsive treatment in two national health service regions. British Journal of Psychiatry, 160, 621–637.CrossRefGoogle ScholarPubMed
Pippard, J. & Eltam, L. (1981) Electroconvulsive treatment in Great Britain: a report to the college. British Journal of Psychiatry, 139, 563–568.Google Scholar
Robertson, C. & Ferguson, G. (1996) Electroconvulsive therapy machines. Advances in Psychiatric Treatment, 2, 24–31.Google Scholar
Royal College of Psychiatrists (1977) The Royal College of Psychiatrists' memorandum on the use of electroconvulsive therapy. British Journal of Psychiatry, 131, 261–272.CrossRefGoogle Scholar
Royal College of Psychiatrists (1989) The Practical Administration of Electroconvulsive Therapy, London: Gaskell.Google Scholar
Royal College of Psychiatrists (1995) The ECT Handbook. The 2nd Report of the Royal College of Psychiatrists' Special Committee on ECT. Council Report CR39. London: Royal College of Psychiatrists.Google Scholar
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