Universal COVID-19 testing and a three-space triage protocol is associated with a nine-fold decrease in possible...

Area of Science:

• Infectious Disease Epidemiology
• Healthcare Management
• Public Health Policy

Background:

• The Substance Abuse and Mental Health Service Administration (SAMSA) issued guidelines in May 2020 for psychiatric hospitals.
• Recommendations included universal COVID-19 testing and "three-space" triage for infection control.
• Westchester Behavioral Health Center (WBHC-NYP) implemented a protocol aligned with these guidelines in April 2020.

Purpose of the Study:

• To evaluate the effectiveness of a combined COVID-19 testing and space allocation protocol.
• To assess the impact on nosocomial infection rates in an inpatient psychiatric setting.
• To determine the statistical significance of changes in infection incidence.

Main Methods:

• A retrospective review of 1,139 inpatient records at WBHC-NYP from March 14th to June 10th, 2020.
• Comparison of nosocomial infection incidence before and after protocol implementation.
• Statistical analysis to determine the significance of the observed changes.

Main Results:

• The incidence of nosocomial infections decreased from 0.96 per 10 at-risk patients to 1.1 per 100 at-risk patients.
• This represents a statistically significant 9-fold reduction in infection rates (p<.0003).
• The protocol was implemented during the first COVID-19 surge in the New York City metropolitan region.

Conclusions:

• The combined testing and space allocation protocol significantly mitigated the risk of nosocomial infections.
• Findings support the institutional adoption of such protocols in confined healthcare settings.
• This strategy is effective in preventing outbreaks in psychiatric hospitals.