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APPENDIX II: STAFFING The ECT treatment team consists of a psychiatrist, and anesthetist privileged in the performance of clinical ECT-related duties by the organized medical staff of the facility. In addition the team includes an ECT and Recovery Nurse who will be credentialed by the department of Nursing for these duties. A . Responsibilities The Clinical Director will appoint a Director of ECT who is responsible for maintaining upto-date policies and procedures regarding ECT, for assuring that these policies and procedures are met, and for seeing that appropriate staffing equipment and supplies are available. The Director of ECT is in charge of all aspects of ECT services at PPC, including the oversight and supervision of all staff (psychiatrists, anesthetists, and nurses) involved in the administration of ECT. The ECT Psychiatrist has the overall responsibility for the proper administration of ECT treatment. The ECT Psychiatrist is the Clinical leader of the ECT team and is in charge of all treatment provided in the ECT suite. He or she should confirm that the pre-ECT evaluation has been satisfactorily completed and insure that the delivery of ECT is compatible with established policies and procedures. The ECT Psychiatrist will also check the readiness, availability and working conditions of the ECT device as well as the availability of a backup ECT treatment device. The Anesthetist is responsible for the maintenance of an airway and oxygenation; and, with the assistance of the ECT psychiatrist, the delivery of anesthetic, relaxant, and adjunctive agents and the management of emergent adverse reactions. The anesthetist should have current certification in advanced cardiac life support (ACLS) PILGRIM PSYCHIATRIC CENTER Issue Date: 10/1/97 Revision Date: 2/20/2001 Facility Policy Reviewed Date:2/20/2001 Page 37 of 58 7 Issuing Office: Clinical Services es Subject: ELECTROCONVULSIVE THERAPY (ECT) or its equivalent, and should be capable of managing foreseeable medical emergencies until other appropriate personnel are available. Prior to treatment administration, the anesthetist will check the readiness, availability and working conditions of the equipment used to monitor vital signs, provide suction, and deliver intermittent postive pressure oxygen. The ECT Treatment Nurse (Nurse 11 of ECT), is responsible for the provision of nursing services in the ECT suite. These tasks are delegated by the ECT Psychiatrist and/or Anesthetist. Such tasks may include education of patients and their families regarding ECT, assisting in the informed consent process, logistical coordination of treatments, readying the treatment area for the administration of ECT, assistance of patients to and from the treatment area, application of stimulus and monitoring electrodes, placement of bite-block, monitoring of vital signs, documentation of treatment-related data, and assuring that ECT-related supplies, including those necessary for handling medical emergencies, are kept in stock and relevant equipment is properly maintained. The Recovery Nurse: is responsible for monitoring the patient's vital signs and mental status during the acute postictal/postanesthetic period. The recovery nurse should also be capable of monitoring and adjusting the flow of intravenous fluids, administering oxygen per mask, suctioning oropharyngeal secretions, behaviorally managing postictal disorientation and agitation, and determining when intervention by the anesthetist or treating psychiatrist is indicated. |
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