Duffett R, Lelliott P
Royal College of Psychiatrists' Research Unit, London.
Br J Psychiatry. 1998 May;172:401-5. doi: 10.1192/bjp.172.5.401.
This is the third large-scale audit in the past 20 years and compares the practice of electroconvulsive therapy (ECT) in England and Wales with the standards derived from the Royal College of Psychiatrists' 2nd ECT handbook.
Facilities, equipment practice, personnel and training were systematically evaluated during visits to all ECT clinics in the former North East Thames and East Anglia regions and Wales. All other English ECT clinics were surveyed with a postal questionnaire. Information was obtained for 184 (84%) of the 220 ECT clinics identified.
Although some aspects of ECT administration had improved since the last audit in 1991, overall only one-third of clinics were rated as meeting College standards. Only 16% of responsible consultants attended their ECT clinic weekly and only 6% had sessional time for ECT duties. Fifty-nine per cent of all clinics had machines of the type recommended by the College and 7% were still using machines considered outdated in 1989. Only about one-third of clinics had clear policies to help guide junior doctors to administer ECT effectively.
Twenty years of activity by the Royal College of Psychiatrists and three large-scale audits have been associated with only modest improvement in local practice.
这是过去20年里的第三次大规模审计，旨在比较英格兰和威尔士的电休克治疗（ECT）实践与皇家精神病学院第二版ECT手册所制定的标准。
在前东北泰晤士河、东安格利亚地区以及威尔士的所有ECT诊所进行访问期间，对设施、设备使用情况、人员及培训进行了系统评估。向英格兰的所有其他ECT诊所发放了邮政调查问卷。在确定的220家ECT诊所中，获取了184家（84%）的信息。
尽管自1991年上次审计以来，ECT治疗的某些方面有所改善，但总体而言，只有三分之一的诊所被评为符合学院标准。仅有16%的责任顾问每周到其ECT诊所出诊，只有6%的人有专门的ECT工作时间。所有诊所中有59%拥有学院推荐类型的设备，7%仍在使用1989年就被认为过时的设备。只有约三分之一的诊所制定了明确政策，以帮助指导初级医生有效实施ECT治疗。
皇家精神病学院开展了20年的活动以及三次大规模审计，仅使当地的实践有了适度改善。
