Majority of psychiatric inpatients are not compliant with COVID-19 infection control measures

King’s College London

A new article from researchers at King’s suggests that the majority of psychiatric inpatients within a ‘COVID-Triage’ ward model, particularly those with diagnoses of psychotic disorders, personality disorders, and substance-use disorders, are not compliant with COVID-19 infection control measures.

Graphic of healthcare workers in protective clothing

New research by clinical academics at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Imperial College London, and South London and Maudsley NHS Foundation Trust (SLaM) examines psychiatric inpatient compliance with COVID-19 infection control measures within a ‘COVID-Triage’ ward model.

The study, published in BJPsych Open, found that more than three quarters (78%) of inpatients were not compliant with infection control measures.

Since the COVID-19 pandemic began, there has been particular concern for intra-hospital transmission and the implications on mortality rates. Many psychiatric patients also have physical health comorbidities, leading to increased vulnerability to COVID-19. Despite this, there haven’t yet been any studies specifically examining transmission of COVID-19 within psychiatric inpatient facilities.

In an effort to reduce intra-hospital transmission within psychiatric inpatient facilities, a ‘COVID-Triage’ ward model has been implemented at SLaM, which ensures patients either test negative for COVID-19 or complete a 14-day isolation period before being admitted to the facility.

“We found that several patients who are generally non-adherent to wear a mask, are willing to comply and wear it when staff instruct patients to don face coverings. Staff training sessions may be helpful in facilitating this, by emphasising the importance of infection control measures and the role of staff in patients’ behaviour.” – Dr Mariana Pinto Da Costa, King’s IoPPN and SLaM

Observational data from 176 adult inpatients’ case notes were analysed. Overall, 78.4% of psychiatric inpatients in the ‘COVID-Triage’ wards were not compliant with COVID-19 infection control measures. However, compliance improved when patients were given direct instructions by staff.

Patients diagnosed with psychotic disorders, personality disorders, and substance use disorders showed significantly less compliance with infection control measures in the ‘COVID-Triage’ wards compared to those without these diagnoses.

The findings of this study highlight the importance of staff engagement in improving compliance with infection control measures and indicate an urgent need for more effective methods for improving compliance in acute care facilities.

Patient compliance with infection control measures on a novel ‘COVID-19 Triage’ psychiatric inpatient ward (DOI 10.1192/bjo.2021.968) (Ryan Williams, John Tweed, Laura Rebolledo, Osman Khalid, Josephine Agyeman, Mariana Pinto da Costa) was published in BJPsych Open.

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