Management of coping with the risks of COVID-19 in an onco-hematological outpatient clinic: an experience report

Monteiro, Debora Esteves; Fialho, Isabelle Cristine Tavares Silva; Passos, Patrícia Martins; Fuly, Patrícia dos Santos Claro

doi:10.1590/0034-7167-2020-1080

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Revista Brasileira de Enfermagem

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EXPERIENCE REPORT • Rev. Bras. Enferm. 74 (suppl 1) • 2021 • https://doi.org/10.1590/0034-7167-2020-1080 copy

Management of coping with the risks of COVID-19 in an onco-hematological outpatient clinic: an experience report

Gestión del afrontamiento de los riesgos de COVID-19 en una red oncohematológica ambulatoria: relato de experiencia

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to describe the experience of a private outpatient network for hematology and oncology treatment in the adoption of management tools to face the risk of contamination by SARS-CoV-2.

Method:

an experience report on the use of a root cause analysis method to identify potential risks of contamination by COVID-19 among patients and employees. Through the risks identified through the Ishikawa Diagram, we built an action plan, linked to the 5W2H tool, for planning and decision-making implemented.

Results:

the number of attendances in person and people circulating in the units was reduced, protective distance measures and new protection barriers were fundamental to control the risks of spreading COVID-19 in patients and employees.

Final considerations:

the management tools served as a valuable tool in the construction of measures, making the measures in question more clearly and applicable.

Descriptors:
Coronavirus; Medical Oncology; Health Services Administration; Occupation Health; Pandemics

5 W 2H Method
5W	What	O que?	What action will be taken?
	Who	Quem?	Who will execute/participate in the action?
	Where	Onde?	Where will the action be carried out?
	when	Quando?	When will the action be performed?
	Why	Por quê?	Why will it be executed?
2H	How	Como?	How will the action be performed?
2H	How Much	Quanto custa?	How much does it cost to perform the action?

What?	Who?	Where?	Why?	How?	How much?
Make sure that only those who really need it with minimal or no companions come to the clinic.	Call center staff for confirmation of treatment consultation.	During consultation and treatment confirmation call that is performed previously	So that the number of people in the clinic is reduced.	During the call, the attendant will inform that patients will only come with a companion if they need it.	Absence of additional cost.
Pre-screening.	Call center staff for confirmation of treatment consultation.	During consultation confirmation and treatment call that is performed previously.	So that the number of people with symptoms of COVID 19 in the units is reduced.	During the call, the attendant will inform you that the patient should not come to the unit if he is symptomatic.	Absence of additional cost.
Consultations carried out by telemedicine and/or telephone.	Medical and multidisciplinary team	At the institution, through computers and institutional phones.	So that these patients and their companions do not need to attend the consultation in person.	Making phone calls or video calls at previously scheduled times.	Absence of additional cost.
Screening.	Nursing technician.	At the entrance of the units.	So that symptomatic people do not enter the clinic and need to be directed to an isolated area.	When people arrive at the units, questions will be asked about COVID symptoms and body temperature measurements.	Absence of additional cost through staff resizing.
Oral medication delivery at home.	Courier of the logistics team.	At the moment in the smaller units.	So that this patient does not need to attend the unit.	On the date of delivery of the oral medication, the courier will deliver to patients' homes.	Professionals' costs will cover the deliveries.
Training on the proper use of personal protective equipment	Administrative staff, reception and assistance, assistance team (physicians and multidisciplinary team).	Through virtual tool.	So that the chances of contamination are reduced by using personal protective equipment in the wrong way.	Through a meeting through the ZOOM application and some in person demonstrating the use, handling and correct disposal of personal protective equipment.	Absence of additional cost.
Protection barrier between reception staff and secretaries.	Receptionists and secretaries.	Transparent acrylic protection barrier at reception desks and desks.	So that there is an additional barrier between professionals and patients and companions, reducing the chances of possible contamination.	Placement of a transparent acrylic protection barrier at the reception desk and secretaries.	Cost of acrylics and labor for placement.
Online classes on workplace gymnastics, relaxation and activities between parents and children.	Employees in general.	Online platforms.	So that stress is reduced in relation to the period experienced.	Free and exclusive availability to company employees online classes on workplace gymnastics, relaxation and activities between parents and children	No additional cost, through partnerships acquired with other companies.
Increased time interval between catheter maintenance.	Patients with fully implanted catheters who are not undergoing treatment.	At the units.	So that they need to travel less often to the units.	Guided patients with catheters fully implanted who are not undergoing treatment.	Absence of additional cost.
Withdrawal of symptomatic employees until proof of negative examination for COVID 19.	Employees in general.	At the units.	So that they do not work with the risk of contaminating other people.	Each manager guiding his team in specific.	Absence of additional cost.

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
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[1] Corresponding author: Debora Esteves Monteiro. E-mail: deboram@id.uff.br