Patient adherence with infection control measures on a novel ‘COVID-19 triage’ psychiatric in-patient ward

Abstract

Background Intra-hospital transmission of coronavirus disease 2019 (COVID-19) is a major concern. Psychiatric in-patient units pose unique challenges for the prevention of transmission. ‘COVID-triage’ wards with strict infection control procedures have been implemented to prevent the spread of infection, but little is known about the extent to which psychiatric in-patients adhere to these procedures. Aims To examine patient adherence with infection control measures on a novel ‘COVID-triage’ psychiatric in-patient ward in London, England. Method This was an observational study of adherence with infection control measures. The proportion of patients who were adherent with infection control measures was calculated. The association of adherence with demographic and clinical factors was examined. Results The majority of patients (n = 138/176, 78.4%) were not adherent with infection control measures. However, adherence did improve when patients who were non-adherent were given direct instructions by staff during clinical contact. Patients with diagnoses of psychotic disorders, personality disorders and substance use disorders were less likely to be adherent than those without these diagnoses. Conclusions Psychiatric in-patients show poor adherence with infection control measures. Proactive engagement by staff is key to improving patients’ adherence. Urgent efforts are needed to identify and implement other effective methods of improving adherence in acute settings.

Keywords

• COVID-19
• infection control
• in-patient treatment
• personality disorders
• psychotic disorders