How Can Clinicians Prevent the Spread of COVID-19 on Psychogeriatric Wards?

The coronavirus disease 2019 (COVID-19) has taken a particularly heavy toll on older adults, who are more prone to infection and poor outcomes. Patients with psychiatric disorders receiving inpatient care are another population that may be more exposed to COVID-19, and the secondary effects of the pandemic may detract from ongoing treatment, thus worsening overall mental health.

Patients in these overlapping populations require tailored measures to prevent the spread of disease. Researchers at the Fourth People’s Hospital of Chengdu, Chengdu City, Sichuan Province, China offered some key insights for the management of an inpatient psychogeriatric ward during the COVID-19 pandemic in a brief article published in the American Journal of Geriatric Psychiatry.

The researchers noted that distinguishing a common fever from COVID-19 related symptoms may be challenging. They recommended isolating patients with a body temperature over 37.3 ^oC and providing extensive tests, including blood tests, respiratory examinations, and computed tomography imaging. This isolation should continue until the patient is afebrile. If suspected of having COVID-19, patients should then be isolated for 14 days, and the remaining patients on the ward should have temperature checks 3 times per day.

To control the spread of COVID-19, the researchers advocated strict measures for admissions to the ward, and prevention measures such as nutritional support and respiratory interventions. They also warned that quarantine could result in fear, helplessness, anxiety, and depression over the long duration of the pandemic. In the psychogeriatric ward, providers should offer health education lectures for groups of 6 patients and individual psychological crisis interventions.

Lastly, the researchers advised family members of elderly patients to partake in online video chats, rather than in-person visits. They suggested that family members only enter the ward if a full history was provided and no symptoms were present. The researchers concluded by advising that infection identification occur “accurately and quickly,” transmission should be cut off, and nutrition and immunity need to be strengthened.

Reference

Wenjing Z, Wei J, Hongyi L. Preventing and controlling measures of 2019 coronavirus disease (COVID-19): practice in psychogeriatric ward [published online April 25, 2020]. Am J Geriatr Psychiatry. doi:10.1016/j.jagp.2020.04.020