NALNECT / ECTAS ECT nurse competencies

ECTAS cannot issue a certificate of competency for the completion of the competencies document unless the ECTAS/NALNECT training days have been attended.

The role of the ECT nurse is to provide guidance, support and expertise relating to all aspects of patient care within the ECT service.

The competencies listed below relate specifically to the extended role of the ECT nurse so do not contain generic competencies.

Levels

1 = fully conversant

2 = working knowledge

3 = awareness

Verbally assessed

1 = is able to explain accurately to a standard that shows sufficient understanding to allow competent application of the knowledge.

2 = able to explain key features to a standard that shows understanding in common situations and access further information if necessary.

3 = is aware of the topic and knows where to get further information but not to a level that provides a working knowledge.

Observed

1 = is able to carry out the procedure to a standard that shows sufficient skill and understanding that would allow them to carry out the procedure competently and independently.

2 = is able to carry out the procedure to a standard that shows sufficient skill and understanding in common situations with either direct or indirect supervision.

3 = is aware of the topic and knows where to get further information but not to a level of working knowledge.

Competencies

1. Able to describe the theories of how ECT works.

2. Demonstrates a knowledge of guidelines and standards relating to ECT including:

• Royal College of Psychiatrists

• Royal College of Nursing

• ECT Accreditation Service

• NICE guidelines

• NMC Code of Conduct

3. Demonstrates a knowledge of local guidelines and policy with special reference to:

• Referral process

• Prescription

• Review process

• Escort nurses

4. Demonstrates an awareness of local policy relating to:

• Health and safety including incident reporting

• Infection control

• Decontamination

• Transporting of patients

• De-escalation and management of violence

5. Demonstrates a knowledge of consent to treatment requirements, including common law and Mental Health Act documentation and requirements.

6. Knowledge of the indications for ECT.

7. Able to describe the contra-indications of ECT.

8. Able to describe the possible side effects of ECT.

9. Able to describe the risks and benefits of ECT.

10. Able to describe the pre-treatment preparations required to be undertaken by the referring doctor and the rationale behind these.

11. Able to describe the procedure for the administration of ECT.

12. Able to describe the principle of stimulus dosing.

13. Able to describe what is meant by an inadequate seizure and the process of re-stimulation.

14. Able to describe what is meant by a prolonged seizure and is aware of the procedure to terminate a seizure.

15. Able to describe the procedure for outpatient ECT.

16. Demonstrates a basic knowledge of anaesthetic procedures.

17. Able to demonstrate knowledge of the drugs used in ECT.

18. Able to describe the observations and treatments necessary during the recovery period.

19. Able to describe procedures for the management of emergencies:

• Respiratory/cardiac arrest

• Suxemethonium apnoea

• Anaphylaxis

• Malignant hyperthermia

20. Demonstrates a knowledge of NICE guidance on:

• Continuation/maintenance ECT

• Discontinuation of ECT

• Unilateral/bilateral ECT

21. Able to correctly inform other professionals of the procedures involved in ECT including ward liaison.

22. Able to correctly and sensitively inform the patient and their carers of the procedures involved in ECT.

23. Able to demonstrate the use and maintenance of equipment in the ECT department.

24. Able to set up and organise the department in preparation for a treatment session.

25. Able to correctly prepare the patient for their treatment.

26. Correctly checks all patient documentation.

27. Able to apply monitoring equipment correctly.

28. Able to measure the patient’s vital signs and record accurately.

29. Able to apply EEG monitoring correctly if requested.

30. Assists the doctor in the administration of ECT.

31. Able to recognise and monitor a motor and EEG seizure.

32. Able to assist to put the patient in the recovery position.

33. Able to demonstrate competency in airway management including the use of suction and care of intravenous fluids (if required).

34. Able to remove an intravenous cannula.

35. Able to complete an orientation assessment.

36. Able to complete required ECT paperwork correctly.

Published with permission of Royal College of Psychiatrists.