Ensuring compliance with COVID-19 infection control measures on hospital wards

A new article from researchers at King’s College London suggests that 78% of psychiatric inpatients within a ‘COVID-Triage’ ward model implemented at South London and Maudsley NHS Foundation Trust are not compliant with COVID-19 infection control measures such as wearing face coverings.

Clinical academics at the King’s College London Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Imperial College London, and South London and Maudsley NHS Foundation Trust, have examined 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.

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

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.

Dr Mariana Pinto Da Costa, King's College London IoPPN and South London and Maudsley NHS Foundation Trust, said:

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.

Observational data from 176 adult inpatients’ case notes were analysed. While many psychiatric inpatients in the ‘COVID-Triage’ wards were not compliant with COVID-19 infection control measures, 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.

To find out more visit the King’s College London website.

Read more about King’s Health Partners COVID-19 response.