References

Abad C, Fearday A, Safdar N. Adverse effects of isolation in hospitalised patients: a systematic review. J Hosp Infect. 2010; 76:(2)97-102 https://doi.org/10.1016/j.jhin.2010.04.027

Alzyood M, Jackson D, Aveyard H, Brooke J. COVID-19 reinforces the importance of handwashing. J Clin Nurs. 2020; 29:(15-16)2760-2761 https://doi.org/10.1111/jocn.15313

Barton J, Rogerson M. The importance of greenspace for mental health. BJPsych Int. 2017; 14:(4)79-81 https://doi.org/10.1192/S2056474000002051

Black JRM, Bailey C, Przewrocka J, Dijkstra KK, Swanton C. COVID-19: the case for health-care worker screening to prevent hospital transmission. Lancet. 2020; 395:(10234)1418-1420 https://doi.org/10.1016/S0140-6736(20)30917-X

Brown C, Ruck Keene A, Hooper CR, O'Brien A. Isolation of patients in psychiatric hospitals in the context of the COVID-19 pandemic: an ethical, legal, and practical challenge. Int J Law Psychiatry. 2020; 71 https://doi.org/10.1016/j.ijlp.2020.101572

Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. Hierarchy of controls. 2015. https://www.cdc.gov/niosh/topics/hierarchy/default.html (accessed 26 April 2022)

De Hert M, Cohen D, Bobes J Physical illness in patients with severe mental disorders. II. Barriers to care, monitoring and treatment guidelines, plus recommendations at the system and individual level. World Psychiatry. 2011; 10:(2)138-51 https://doi.org/10.1002/j.2051-5545.2011.tb00036.x

de Man P, Paltansing S, Ong DSY, Vaessen N, van Nielen G, Koeleman JGM. Outbreak of coronavirus disease 2019 (COVID-19) in a nursing home associated with aerosol transmission as a result of inadequate ventilation. Clin Infect Dis. 2021; 73:(1)170-171 https://doi.org/10.1093/cid/ciaa1270

Department of Health. Health building note 00-09: Infection control in the built environment. 2013. https://tinyurl.com/ya46e4xm (accessed 26 April 2022)

Edgar R, Sharp C, Bellis K, Bass P. A dedicated program to enhance shared patient equipment cleaning and use of personal protective equipment: role in control of a CPE outbreak. Infect Dis Health. 2019; 24:(1) https://doi.org/10.1016/j.idh.2019.09.023

Evans HL, Shaffer MM, Hughes MG Contact isolation in surgical patients: A barrier to care?. Surgery. 2003; 134:(2)180-188 https://doi.org/10.1067/msy.2003.222

Fernandes Agreli H, Murphy M, Creedon S Patient involvement in the implementation of infection prevention and control guidelines and associated interventions: a scoping review. BMJ Open. 2019; 9:(3) https://doi.org/10.1136/bmjopen-2018-025824

Gaspard P, Mosnier A, Gunther D Influenza outbreaks management in a French psychiatric hospital from 2004 to 2012. Gen Hosp Psychiatry. 2014; 36:(1)46-52 https://doi.org/10.1016/j.genhosppsych.2013.01.009

Gould DJ, Drey NS, Chudleigh J, King MF, Wigglesworth N, Purssell E. Isolating infectious patients: organizational, clinical, and ethical issues. Am J Infect Control. 2018; 46:(8)e65-e69 https://doi.org/10.1016/j.ajic.2018.05.024

Health and Safety Executive. Hierarchy of risk reduction measures. 2021a. https://www.hse.gov.uk/rubber/risk-reduction.htm (accessed 26 April 2022)

Health and Safety Executive. HSE information sheet. Falls from windows or balconies in health and social care. 2021b. https://www.hse.gov.uk/pubns/hsis5.pdf (accessed 26 April 2022)

Loveday HP, Wilson JA, Pratt RJ epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. J Hosp Infect. 2014; 86:(1)S1-S70 https://doi.org/10.1016/S0195-6701(13)60012-2

National Services Scotland. Standard Infection control precautions and transmission based precautions literature review: management of care equipment. Version 1.0. 2021. https://tinyurl.com/yc88hweh (accessed 26 April 2022)

NHS England/NHS Improvement. Minimising nosocomial infections in the NHS. 2020a. https://tinyurl.com/s44hhpmf (accessed 26 April 2022)

NHS England/NHS Improvement. Healthcare associated COVID-19 infections—further action. 2020b. https://tinyurl.com/4xa6dkvv (accessed 26 April 2022)

NHS England/NHS Improvement. Health technical memorandum 03-01. Specialised ventilation for healthcare premises. Part A: the concept, design, specification, installation and acceptance testing of healthcare ventilation systems. 2021a. https://tinyurl.com/4tj6vx58 (accessed 26 April 2022)

NHS England/NHS Improvement. Legal guidance for services supporting people of all ages during the coronavirus pandemic: mental health, learning disability and autism, specialised commissioning. 2021b. https://tinyurl.com/6ph9u7bt (accessed 26 April 2022)

NHS England/NHS Improvement. National standards of healthcare cleanliness 2021. 2021c. https://tinyurl.com/hpcte2j9 (accessed 26 April 2022)

Office for National Statistics. Deaths involving COVID-19 by local area and socioeconomic deprivation. 2020. https://tinyurl.com/2tw9zbnv (accessed 26 April 2022)

Public Health England. Communicable disease outbreak management, Operational guidance. 2014. https://tinyurl.com/2jzh2z7v (accessed 26 April 2022)

Public Health England. COVID-19: epidemiological definitions of outbreaks and clusters in particular settings (Withdrawn on 1 April 2022). 2020. https://tinyurl.com/39zkuxsh (accessed 26 April 2022)

COVID-19: guidance for maintaining services within health and care settings: infection prevention and control recommendations.London: PHE; 2021a

Public Health England. COVID-19: infection prevention and control for mental health and learning disability settings. 2021b. https://tinyurl.com/4uuct8rc (accessed 26 April 2022)

Public Health England. Ventilation of indoor spaces to stop the spread of coronavirus (COVID-19). 2021c. https://tinyurl.com/mwxnxubr (accessed 26 April 2022)

Purssell E, Gould D, Chudleigh J. Impact of isolation on hospitalised patients who are infectious: systematic review with meta-analysis. BMJ Open. 2020; 10:(2) https://doi.org/10.1136/bmjopen-2019-030371

Rodgers K, McAliskey S, McKinney P, Anderson K, McDonald C, Hanrahan M. Managing an outbreak of COVID-19 in a learning disability setting. Learning Disability Practice. 2021; 24:(1)12-18 https://doi.org/10.7748/ldp.2021.e2116

Rovers JJE, van de Linde LS, Kenters N Why psychiatry is different—challenges and difficulties in managing a nosocomial outbreak of coronavirus disease (COVID-19) in hospital care. Antimicrob Resist Infect Control. 2020; 9:(1) https://doi.org/10.1186/s13756-020-00853-z

Royal College of Nursing. RCN position on COVID-19. 2021. https://tinyurl.com/498fu5m5 (accessed 26 April 2022)

Royal College of Physicians. National Early Warning Score (NEWS) 2. 2017. https://tinyurl.com/ycyjd6v3 (accessed 26 April 2022)

Saint S, Higgins LA, Nallamothu BK, Chenoweth C. Do physicians examine patients in contact isolation less frequently? A brief report. Am J Infect Control. 2003; 31:(6)354-356 https://doi.org/10.1016/S0196-6553(02)48250-8

Guidelines for environmental infection control in health-care facilities: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC). Mortality and Morbidity Weekly Report. 2003:52(RR10). https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5210a1.htm (accessed 26 April 2022)

Taylor J, Rangaiah J, Narasimhan S, Clark J Nosocomial COVID-19: experience from a large acute NHS trust in south-west London. J Hosp Infect. 2020; 106:(3)621-625 https://doi.org/10.1016/j.jhin.2020.08.018

Williams R, Tweed J, Rebolledo L, Khalid O, Agyeman J, Pinto da Costa M. Patient adherence with infection control measures on a novel ‘COVID-19 triage’ psychiatric in-patient ward. BJPsych Open. 2021; 7:(4) https://doi.org/10.1192/bjo.2021.968

World Health Organization. Roadmap to improve and ensure good indoor ventilation in the context of COVID-19. 2021. https://tinyurl.com/327a87vu (accessed 26 April 2022)

World Health Organization. WHO save lives: clean your hands in the context of COVID-19. 2022. https://tinyurl.com/myac82xn (accessed 26 April 2022)

Worldometer. United Kingdom coronavirus: deaths. 2021. https://tinyurl.com/3a7w7zue (accessed 26 April 2022)

Xiang YT, Jin Y, Cheung T. Joint international collaboration to combat mental health challenges during the coronavirus disease 2019 pandemic. JAMA Psychiatry. 2020; 77:(10)989-990 https://doi.org/10.1001/jamapsychiatry.2020.1057

COVID-19

Infection Prevention

Mental Health

COVID-19 outbreak management in a mental healthcare setting

12 May 2022

Focus

02 May 2022

Volume 31 · Issue 9

ISSN (print): 0966-0461

ISSN (online): 2052-2819

Abstract

Since the beginning of the novel coronavirus disease pandemic (COVID-19), inadvertent exposure of hospitalised patients and healthcare workers has been a major concern. Patients in inpatient settings with mental illnesses have also been impacted by the restrictions the pandemic has caused, with many having experienced the confines and loss of liberties that COVID-19 has brought. This article identifies the infection prevention and control measures required in a mental health setting during an outbreak of COVID-19. The focus is on the challenges of working in a mental health setting and identifies the difficulties in containing the infection within this ill-designed built environment and includes the additional pressures of managing this complex and diverse group of patients. Current guidance on outbreak measures is given with particular attention applied to the patients, the practices and the environment.

In 2020, COVID-19, an infection caused by a novel coronavirus, transmitted significantly on NHS wards, exposing patients to a viral infection that could be fatal and which produced significant implications for patients and healthcare workers (HCWs). Outbreaks placed an additional burden on already stretched resources (Taylor et al, 2020). By early 2020, infection rates had soared in UK hospitals with data published by the Office for National Statistics (ONS) showing a significant increase in mentions of COVID-19 on death certificates in England and Wales (ONS, 2020). The UK had registered 73 621 coronavirus-related deaths before 2021 (Worldometer, 2021). Mental health settings were also severely affected by the fallout of the pandemic, with HCWs trying to control the transmission and suddenly dealing with challenging outbreaks of infections that had not been experienced before and having to treat patients suffering the effects of the virus in a confined environment that was ill-designed for treating patients with such a virus (Rodgers et al, 2021).

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Infection prevention and control

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Mental health setting

Hand hygiene

Healthcare workers