Nursing Checklist for ECT patients
(P, X, R (refused) or N/A))Patient’s Name: / Prefers to be called:
SESSION: / 1 / 2 / 3 / 4 / 5 / 6
ward / ECT / ward / ECT / ward / ECT / ward / ECT / ward / ECT / ward / ECT
DATE:
1. Correct patient is identified
Identify wristband attached
2. Has the patient experienced any problems since the last treatment (e.g. confusion/memory loss, changes to physical health)?
3. Does patient have any concerns regarding the treatment that they wish to discuss?
4. Has patient smoked this morning? If so how much?
5. Does the patient have any objections to a medical/nursing student being present?
6. (a) BP
(b) Temperature
(c) Pulse
(d) Respiration
7. Record of BM (as appropriate if patient diabetic)
8. Relevant investigation results in case notes (ECG, bloods, etc.)?
9. Any new investigation results since last treatment?
10. When did patient last eat or drink?
11. When did patient last pass urine?
12. Has patient taken any medication/protective medication this morning? If so state time.
Nursing Checklist for ECT patients
(P, X, R (refused) or N/A))Patient’s Name: / Prefers to be called:
SESSION: / 1 / 2 / 3 / 4 / 5 / 6
ward / ECT / ward / ECT / ward / ECT / ward / ECT / ward / ECT / ward / ECT
DATE:
13. Is the Patient Wearing
(a) Make Up
(b) Nail Varnish
(c) Hair Lacquer / Gel
(d) Jewellery / Hairpins
(e) Piercings
(f) Hearing Aid
(g) Contact Lens
All to be removed as appropriate
14. (a)Have dentures been removed?
(b) does the patient have any crowns or loose teeth
15. Is the patient an out-patient or patient going on leave within the next 24 hours? If yes: (a) has the post anaesthetic information for patients receiving ECT guidelines been discussed with the patient and their 'responsible adult' (1st treatment)?
(b) have these guidelines' been signed by patient and filed in their notes (copy given to patient)?
16. If out-patient – is a responsible adult to collect?
17. Has patient any allergies?
18. Has capacity been checked and documented within the last 24 hours
19. Check presentation concurs with recorded capacity assessment
Comments:
Signature:
2
Northumberland, Tyne and Wear NHS Foundation Trust
Appendix 8 – Nursing checklist for ECT Patients – V03 – Issue 1 – Issued Apr 16
Part of ECT-PGN-01-Integrated care pathway for source Electro-Convulsive Therapy -NTW(C)51-ECT Policy