ABSTRACT
COVID-19 is an infectious disease that has spread across the globe with a social, economic and psychological impact that will undoubtedly change the world in which we live. Those working in mental health services will have experienced major changes in working practices, including navigating the challenges of infection control, whilst caring for some of the most vulnerable members of our society. There have been a number of publications considering many of the practicalities of the COVID-19 challenges in mental health. However, deeper reflections of philosophical issues regarding our own shared experiences have not yet been well covered in the professional press. This commentary describes some experiences of working within a low secure forensic service at the beginning of the COVID-19 pandemic in the UK. It aims to explore some of the key themes arising from this unprecedented situation, proposing areas for reflection and shared learning within the mental health inpatient community. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
ABSTRACT
BACKGROUND: Restraint is widely practised within inpatient mental health services and is considered a higher-risk procedure for patients and staff. There is a sparsity of evidence in respect of the efficacy of personal protective equipment (PPE) used during restraint for reducing risk of infection. METHODS: A series of choreographed restraint episodes were used to simulate contact contamination in research participants playing the roles of staff members and a patient. For comparison, one episode of simulated recording of physical observations was taken. Ultraviolet (UV) fluorescent material was used to track the simulated contact contamination, with analysis undertaken using established image registration techniques of UV photographs. This was repeated for three separate sets of PPE. RESULTS: All three PPE sets showed similar performance in protecting against contamination transfer. For teams not utilising coveralls, this was dependent upon effective cleansing as part of doffing. There were similar patterns of contamination for restraint team members assigned to specific roles, with hands and upper torso appearing to be higher-risk areas. The restraint-related contamination was 23 times higher than that observed for physical observations. DISCUSSION: A second layer of clothing that can be removed showed efficacy in reducing contact contamination. PPE fit to individual is important. Post-restraint cleansing procedures are currently inadequate, with new procedures for face and neck cleansing required. These findings leave scope for staff to potentially improve their appearance when donning PPE and engaging with distressed patients.
Subject(s)
COVID-19/transmission , Health Personnel/education , Infection Control/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Personal Protective Equipment/standards , Restraint, Physical , Simulation Training , Behavior Control , Humans , Inpatients , SARS-CoV-2 , United Kingdom/epidemiologyABSTRACT
COVID-19 is an infectious disease that has spread across the globe with a social, economic and psychological impact that will undoubtedly change the world in which we live. Those working in mental health services will have experienced major changes in working practices, including navigating the challenges of infection control, whilst caring for some of the most vulnerable members of our society. There have been a number of publications considering many of the practicalities of the COVID-19 challenges in mental health. However, deeper reflections of philosophical issues regarding our own shared experiences have not yet been well covered in the professional press. This commentary describes some experiences of working within a low secure forensic service at the beginning of the COVID-19 pandemic in the UK. It aims to explore some of the key themes arising from this unprecedented situation, proposing areas for reflection and shared learning within the mental health inpatient community.