World Ethics Day Symposium

The NEURON ECT-EEG Algorithmic Rating Scale (NEARS) was introduced in the Electroconvulsive Therapy (ECT) guidelines by the Ministry of Health Malaysia published in 2021 to standardise ECT practices.However, limited data exist on its clinical application.This audit aimed to evaluate NEARS utilisation, scoring accuracy, its influence on stimulus dose adjustment, and preparation adequacy in ECT sessions conducted at Hospital Selayang.The audit was conducted over six months (November 2024-April 2025) and included all ECT sessions carried out by the Department of Psychiatry.The preintervention phase lasted one month (November 2024), followed by four months of interventions, including Continuing Medical Education (CME) sessions, reminder handouts, an educational video, and regular quizzes.A one-month post-intervention re-audit was then conducted.Data collected included NEARS scoring accuracy, stimulus dose decisions, and preparation indicators.Pre-and post-intervention data were compared to assess improvements.NEARS was applied in 100% of ECT sessions.Post-intervention, accurate NEARS scoring improved from 84.1% to 91.2%, while appropriate stimulus dose adjustments increased from 81.4% to 95.6%.Preparation adequacy also rose from 92.0% to 95.6%.Scoring errors were minimal and did not significantly impact patient outcomes.Structured education and consistent reminders led to improvements in NEARS scoring accuracy and stimulus dose decisions.This audit highlights that systematic training, proper documentation and clear protocols can enhance ECT quality.Ongoing training and quality assurance are essential, especially in high-turnover clinical settings.