Strategies for Reducing Respiratory Virus in Inpatient Behavioral Health Settings

COVID-19

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In a behavioral health unit (BH), patients can move around and engage in communal activities and meals. However, this environment poses a higher risk of COVID-19 exposure for the patient population.

An infection prevention department in New Haven, Connecticut, developed an internal operating procedure to guide the identification and management of COVID-19 cases among patients in the BH units. This procedure was based on literature findings about how COVID-19 spreads.

In her poster presentation, “Behaving with Respiratory Viruses: Education and Training for Staff in a Behavioral Health Setting,” Jacqueline Fredrick, MSN, BS, RN, CIC, Infection Preventionist, Yale-New Haven Health, New Haven, Connecticut, explained how the procedure was created. The poster was at the Association for Professionals in Infection Control and Epidemiology (APIC) 2023 Annual Conference and Exhibition, held in Orlando, Florida, June 26 to 28, 2023.

From her poster, Fredrick identified these 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,” and “discuss strategies for respiratory virus mitigation in an inpatient behavioral health setting.

The infection prevention department created various guidelines to ensure the safety and well-being of patients. These guidelines covered testing requirements, managing the unit, patient cohorts, staff safety, and notifications to key staff and stakeholders.

In addition, a literature search was conducted to gather relevant information on respiratory virus transmission, while interviews with medical and nursing leadership were undertaken to discuss essential patient care practices.

Despite recommendations for universal mask-wearing, some patients may need help to comply. A COVID-19 testing program for new patients was implemented to identify potential carriers and allow for swift isolation. COVID-19 can be highly contagious, preventing widespread exposure in communal settings like behavioral health units is imperative. However, transferring patients to a medical ward may compromise their behavioral health plan of care. The guidelines aim to maintain patient safety, staff safety, and effective patient care practices. This guidance outlines considerations for a timely response to newly identified COVID-19 cases while meeting the balance of medical and behavioral health needs in the setting of a potential COVID-19 outbreak. This identical guidance could also be applied to cases of influenza and other highly transmissible respiratory viruses.