ECT Treatment Considerations Checklist: Fresh support for nurses
With the expanding role of psychiatric-mental health nurses concerning electroconvulsive therapy (ECT) including managing treatment, advocating for patients, and educating the public, APNA has a new resource to support nurses: the Electroconvulsive Therapy (ECT) Considerations Checklist. Created by the APNA Neuromodulation Task Force, the checklist supports PMH nurses providing individualized care for patients receiving electroconvulsive therapy by outlining considerations. (It is not intended to be all-inclusive.)
According to the American Psychiatric Association (APA), ECT has a response rate of 80-90% for patients receiving it as a first-line treatment and 50-60% for patients who have had multiple trials of medications and treatments without effect (APA, 2001, p.10).
Development of the checklist
The chairs of the APNA Neuromodulation Task Force, Paula Bolton, MS, CNP, ANP-BC and Donna Ecklesdafer, RN, MSN share how this resource came to be, how the task force arrived at these considerations and what they hope nurses will be able to accomplish with the checklist.
APNA: How did APNA ECT Treatment Considerations Checklist become a resource? What led the task force to work on this?
Bolton and Ecklesdafer: Nurses are very involved at all levels of care for patients considering or receiving ECT treatment. Over the years, we both have received many inquiries from nurses around the country (and internationally) related to ECT treatment and nursing role in providing treatment and caring for patients receiving ECT. We thought that our own psychiatric nursing association would be a good place to refer these nurses to look at evidenced-based practice considerations. Inspired by the work of Mary Rosedale, who was instrumental in the APNA position paper related to ECT, we asked the APNA Board of Directors to consider forming a task force to develop the ECT Checklist for nursing considerations.
“We are hopeful that as nurses work with patients contemplating or receiving ECT, they will use this evidence-based checklist to educate patients, advocate for patients…, dispel stigma that is often associated with ECT, and help normalize this procedure as a useful treatment option.”
APNA: How did you and the APNA’s Neuromodulation Task Force work to arrive at these considerations?
Bolton and Ecklesdafer: We began our work by revising the APNA ECT Position Paper and having those revisions approved by the Board. Our Steering Committee then tackled a literature review of ECT, and specifically, nursing care considerations related to ECT. Utilizing a template used to develop the APNA Ketamine Infusion Therapy Treatment Considerations, we drew upon the expertise of the members of our Steering Committee to draft the ECT Checklist, verifying the considerations with the evidence. Once complete, the draft was sent to the APNA Neuromodulation Task Force Advisory for input and the final document was sent to the APNA Board of Directors for approval.
APNA: What do you hope psychiatric-mental health nurses will be able to accomplish with this resource?
Bolton and Ecklesdafer: We are very excited to have this reference for psychiatric-mental health nurses and advanced practice nurses and have already referred multiple nurses to check out the document. We have promoted this within other professional organizations who treat patients with ECT. It is a useful tool for nurses to validate practice and to assist in setting up services. We are hopeful that as nurses work with patients contemplating or receiving ECT, they will use this evidence-based checklist to educate patients, advocate for patients who need this treatment, dispel stigma that is often associated with ECT, and help normalize this procedure as a useful treatment option.
Published July 2024
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About APNA: The American Psychiatric Nurses Association is a national professional membership organization committed to the practice of psychiatric-mental health nursing and wellness promotion, prevention of mental health problems, and the care and treatment of persons with psychiatric disorders. APNA’s membership is inclusive of all psychiatric-mental health registered nurses including associate degree, baccalaureate, advanced practice (comprised of clinical nurse specialists and psychiatric nurse practitioners), and nurse scientists and academicians (PhD). APNA serves as a resource for psychiatric-mental health nurses to engage in networking, education, and the dissemination of evidence. The American Psychiatric Nurses Association is accredited as a provider of continuing nursing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.
