ABSTRACT
The coronavirus disease 2019 (COVID-19) pandemic presented unprecedented challenges to the provision of inpatient psychiatric care. The nature of the physical plant, programmatic constraints, and the patient population required a rapid and agile approach to problem-solving under conditions of uncertainty and stress. Flexibility in decision-making, excellent communication, an effective working relationship with infection prevention and control experts, and attention to staff morale and support were important elements of successful provision of care to our inpatients. We present our experience, lessons learned, and recommendations should a resurgence of the pandemic or a similar crisis occur.
Subject(s)
Attitude of Health Personnel , COVID-19 , Inpatients , Mental Disorders/therapy , Personnel, Hospital , Psychiatric Department, Hospital , Adult , COVID-19/prevention & control , Humans , Personnel, Hospital/psychology , Personnel, Hospital/standards , Psychiatric Department, Hospital/organization & administration , Psychiatric Department, Hospital/standardsABSTRACT
The COVID-19 pandemic has significantly changed the mental health care. Treating psychiatric patients with COVID-19 poses multiple challenges in the inpatient psychiatric setting in terms of mitigating transmission of the virus. Gracie Square Hospital, a freestanding psychiatric hospital located in New York City, dedicated a unit for treating COVID-19 patients requiring inpatient psychiatric treatment. We faced different challenges including treatment refusal, difficulty complying with safety precautions due to psychosis, agitated behavior, and staff psychological well-being. We considered reformation of protocols, expansion of the use of technology, development of a supportive platform, and standardization of clinical practice. This paper describes our strategies to manage the challenges while providing acute psychiatric treatment to COVID-19 patients.
Subject(s)
COVID-19 , Psychiatry , Humans , Inpatients , New York City , Pandemics , SARS-CoV-2ABSTRACT
The United States is currently experiencing an opioid epidemic, as drug overdose deaths have become a leading cause of death. According to the Centers for Disease Control, in 2017, opioids were responsible for 47,000 deaths, which involved both illicit and prescription opioids. A multifaceted public health approach that utilizes public health authorities, health care providers, local hospitals, and affected communities is required to effectively reduce opioid-related morbidity and mortality. The authors of this paper developed an inpatient program on the dual-diagnosis unit at Gracie Square Psychiatric Hospital in New York to target the opioid crisis. The purpose of this program was to train patients and their families on how to respond to an opioid overdose and administer naloxone spray. The paper describes the implementation of this program.
Subject(s)
Analgesics, Opioid/adverse effects , Inpatients , Naloxone/administration & dosage , Narcotic Antagonists/administration & dosage , Opiate Overdose/drug therapy , Opiate Overdose/prevention & control , Family , Humans , Nasal Sprays , New York City , Opiate Overdose/mortality , Opioid Epidemic , United StatesABSTRACT
Hourly rounds are becoming more popular on inpatient medical wards and are known to be beneficial to patients and nurses. However, there is little evidence about their impact in psychiatry and what hourly rounds would look like on inpatient mental health units. This article examines the introduction of hourly nurse rounds on inpatient mental health wards in an American hospital, and how they were adapted to the needs of psychiatric patients. The positive effects on patient care and staff are reported.
