Inpatient psychiatry unit devoted to COVID-19 patients

Abstract

The COVID-19 pandemic has significantly changed the mental health care. Treating psychiatric patients with COVID-19 poses multiple challenges in the inpatient psychiatric setting in terms of mitigating transmission of the virus. Gracie Square Hospital, a freestanding psychiatric hospital located in New York City, dedicated a unit for treating COVID-19 patients requiring inpatient psychiatric treatment. We faced different challenges including treatment refusal, difficulty complying with safety precautions due to psychosis, agitated behavior, and staff psychological well-being. We considered reformation of protocols, expansion of the use of technology, development of a supportive platform, and standardization of clinical practice. This paper describes our strategies to manage the challenges while providing acute psychiatric treatment to COVID-19 patients.

Recommendations for the safety of hospitalised patients in the context of the COVID-19 pandemic: a scoping review

“… 15–18 20–23 25 26 30–33 35 36 38 41 42 44–48 50–53 56–58 60–69 71 72 74–79 82–92 94 96–98 100–102 104–112 115 117 118 120–125 127–129 131–137 139 Forecasting and provision must be made for the supply of sufficient quantity and to avoid shortages. 21 24 25 39 42 67 72 99 101 108 112 115 119 125 …”

“…The reorganisation of the health services category addresses 17 recommendations related to the flow of patients, the management of human and material resources and the reorganisation of the hospital environment in order to prevent the transmission of COVID-19. It is recommended that all patients are considered suspects 47 70 80 90 91 101 128 and undergo risk stratification 20 21 23 23 47 or nasal swab 84 95 101 at admission screening, 21 22 36 39 49-51 53 69 95 108 133 in the preoperative period, 23 26 47 48 61 69 72 87 90 95 102 124 in Open access referrals 31 84 and before non-emergency procedures involving airway approaches. 66 79 95 Suspected and confirmed patients should be isolated, 20 115 134 In case of death, the body must be wrapped in a sheet soaked in a disinfectant solution and placed in the coffin.…”

“…15-18 20-23 139 Forecasting and provision must be made for the supply of sufficient quantity and to avoid shortages. 21 24 25 39 42 67 72 99 101 108 112 115 119 125 All workers must wear a surgical mask in the hospital environment. 23 ; waterproof shoes, boots or wellies 31 33 79 91 113-116 134 and disposable and waterproof protector for shoes, 16 31 43 47 56 70 72 86 111 in aerosol-generating procedures, 15 115 117 133 and in operating rooms.…”

Lessons Learned or Forgotten? Impacts of COVID-19 on the Future Direction of Global (e-)Mental Health Care

“…Due to the pandemic, only the most affected patients, i.e., suicidal, psychotic, or delirious, access public health facilities through emergency wards as the activity of many outpatient clinics was discontinued [ 4 ]. The pandemic led to a drastic reduction in levels of care in community mental health centers and general hospital psychiatric wards [ 8 ], including treatment refusal by the patients, difficulty complying with safety precautions due to psychosis, agitated behavior, and problems with staff psychological well-being [ 9 ]. Schizophrenia is a prototypical severe mental illness in which the insufficiency of the existing medical care system can be traced.…”

Prepare the psychiatric inpatient unit for COVID-19 pandemic

“…1 Patients with psychiatric disorders have been reported to be vulnerable to being infected with COVID-19 and to experience adverse outcomes 2 ; clinical recommendations and practical suggestions have been proposed in response to the evolving needs of psychiatric acute inpatients. [3][4][5] However, patients with COVID-19 who have severe mental illnesses with potential dangerousness to self or others do not meet the current CECC criteria for hospital/quarantine ward admission. Here, we share our experience in managing a cluster infection in a psychiatric inpatient unit (Yuanshan and Suao branches of Taipei Veterans General Hospital) and actions we took to care for COVID-19 patients requiring intensive psychiatric care and treatment.…”