|
XII. POST TREATMENT A. Return to the Ward The ward staff person who accompanied the patient to the ECT suite will return the patient to the ward. Upon return to the unit the ward nurse will assess the patient, and document these findings along with the patient's vital signs on the Post ECT Progress Note (621 C LIPC side two). The Treating Psychiatrist will also evaluate the patient after the ECT treatment. The evaluation should include a mental status exam, including assessment of orientation and memory, and a general assessment of the patient's physical status. This evaluation should be recorded on the Post ECT Progress Note (621 C LIPC Side two) Cognitive assessments, either by objective measures, ( e.g.MMSE testing) or subjective patient reports should be monitored no less than weekly during a course of ECT. If there is evidence of substantial Cognitive deterioration during the course of ECT, the treating psychiatrist must alert the Director of ECT so that modification of the ECT procedure can be considered. If these effects remain present following completion of the ECT course, a plan should be made for post-ECT follow-up assessment. B. Evaluation of Outcome PILGRIM PSYCHIATRIC CENTER Issue Date: 10/1/97 1 Revision Date: 2/20/2001 Facility Policy Reviewed Date:2/20/2001 I Page 25 of 58 Subject: ELECTROCONVULSIVE THERAPY (ECT) Issuing Office: Clinical Services 1. Each patient's treatment plan should indicate ECT as a specific treatment method/modality. 2. Clinical assessments regarding the patient's overall response to treatment and /or the occurrence of adverse events should be performed by the treating psychiatrist. The severity of the patient's symptoms for which ECT was prescribed should be rated weekly on the ECT Target Symptom Sheet (621 D LIPC). In additon, the Treating Psychiatrist, will summarize the patient's overall response to ECT weekly ( monthly for patients receiving continuation/maintenance treatment) in a progress note to be filed in the ECT section of the medical record. 3. The AMD will also review the patient's progress with treating psychiatrist at least weekly (monthly for continuation/maintenance treatment). This will be documented on the Post ECT Progress Note (621 C LIPQ, by the Treating Psychiatrist. The AMD should also maintain an ongoing dialogue with the Director of ECT re: the efficacy of the treatment during an acute course of ECT. 4. Any sudden onset of new risk factors, or worsening of those present prior to ECT, should be conveyed to the Director of ECT by the Treating Psychiatrist. The risk/benefit of ECT should be evaluated, and appropriate interventions will be made prior to giving the next ECT treatment. |
| home |