Care of COVID-19 Patients at Risk for Suicide

Special considerations must be taken into account when patients who are suspected or confirmed to have COVID-19 are also deemed high-risk for self-harm or suicide. These clinical cases require a thoughtful and careful balance of infection control and safety monitoring measures.

Patients identified to be high risk for self-harm or suicide will remain under continuous one-on-one observation by a qualified staff member who has demonstrated competence in observing and working with suicidal patients. That staff member will maintain appropriate PPE throughout their shift to assure intervention can occur without delay, if needed.

The procedures outlined in this guidance are expected to vary among UMMS facilities based on staffing and resource structures at each hospital. Questions about modifications that may apply at your respective hospital should be directed to your manager or supervisor.

We thank you for your continued commitment to delivering patient care that is comprehensive and safe for every person who relies on UMMS during their most critical times of need.

Click here to access Guidance for Care of COVID-19 Patients at Risk for Suicide.

FAQs

How will COVID-19 patients who are considered high risk for self-harm or suicide be monitored?


These individuals will be continuously monitored by a qualified staff member who has demonstrated competence in observing and working with suicidal patients. These patients will be placed in a negative pressure room that offers full, continuous visibility from outside the room, if possible.

What happens if a full, continuous view of the patient from outside the room is not possible?


In these cases, we recommend use of tele-sitter technology and stat alarm, along with positioning of a qualified staff member who can monitor from directly outside of the room. The exclusive use of technology with the safety officer positioned in a remote location is not advisable, as it does not allow for immediate intervention if and when required. An iPad can also be placed in the room to allow for technology-aided visual monitoring, assuming the patient’s designated care team does not have concerns about the equipment being used as a weapon for self-harm or harm to others as they enter the room to administer care.

What action will be taken if the patient attempts to harm him/herself?


The staff person responsible for continuous monitoring will immediately respond. He or she will remain dressed in an isolation gown with gloves, a respirator (N95, Elastometric or PAPR) and eye protection immediately accessible for the duration of their shift. This will allow the monitor to enter the patient’s room to intervene without delay, if necessary.

How should PPE be removed as staff members are exiting these patient rooms?


Ideally, these patients will be treated in a negative pressure room with an ante-room to streamline donning and doffing procedures. If no ante-room is available, we recommend that a trash can be positioned directly outside of the door, prior to entry. Doff gowns and gloves inside the room, but as close to the door as possible. Immediately discard used PPE into the trash can and proceed to the nearest sink for thorough hand hygiene. Follow standard doffing procedures for respirators.