Infection Preventionist Yale-New Haven Health New Haven, Connecticut, United States
Disclosure(s):
Jacqueline Fredrick, MSN, BS, RN, CIC: No financial relationships to disclose
Background: Patients in a behavioral health unit move about freely and participate in communal activities and meals. This type of environment can lead to an increased risk of Coronavirus Disease 2019 (COVID-19) exposure among the patient population. Despite national recommendations for universal mask wearing by all patients, many patients are unable or unwilling to comply. A COVID-19 testing program for new patients identifies individuals who may be incubating COVID-19 and allow for swift isolation from the group before widespread exposure occurs. COVID-19 can be a highly contagious respiratory illness, especially in a communal milieu such as Behavioral Health Units. Transfer of behavioral health patients to a medical ward may compromise the behavioral health plan of care.
Methods: A literature search was performed to gather information on the most relevant guidelines for respiratory virus transmission. Additionally, interviews with medical and nursing leadership were conducted on 8 adult behavioral health units within a hospital organization to discuss essential patient care practices.
Results: The Infection Prevention department created an internal standing operating procedure to provide guidance on identified cases of COVID-19 among the patient population on the Behavioral Health (BH) units. This was developed in accordance with literature findings on COVID-19 disease transmission.
Conclusions: Guidelines for care included patients' health and safety, testing requirements, managing the unit, notifications to key staff and stakeholders, staff safety, identifying patient cohorts, and when to open the unit to new admissions. This guidance serves to outline considerations for a timely response to newly identified COVID cases while meeting the balance of medical and behavioral health needs in the setting of a potential COVID-19 outbreak. This same guidance could also be applied for cases of influenza and other highly-transmissible respiratory viruses.
Learning Objectives:
Identify specific patient population risk factors for respiratory virus transmission in a congregate living setting.
Recognize behavioral health staff barriers to infection prevention practices during a respiratory virus outbreak.
Discuss strategies for respiratory virus mitigation in an inpatient behavioral health setting.
