RESUMO
On January 20, 2020, the first patient with coronavirus disease 2019 (COVID-19) in the United States of America was diagnosed in Washington state, which subsequently experienced rapidly increasing numbers of COVID-19 cases, hospitalizations, and deaths. This placed the Seattle Blood and Marrow Transplant Program at Fred Hutchinson Cancer Research Center (Fred Hutch) in the national epicenter of this pandemic. Here, we summarize the experience gained during our rapid response to the COVID-19 pandemic. Our efforts were aimed at safely performing urgent and potentially life-saving stem cell transplants in the setting of pandemic-related stresses on healthcare resources and shelter-in-place public health measures. We describe the unique circumstances and challenges encountered, the current state of the program amidst evolving COVID-19 cases in our community, and the guiding principles for recovery. We also estimate the collateral impact of directing clinical resources toward COVID-19-related care on cancer patients in need of stem cell transplantation. Although our experience was influenced by specific regional and institutional factors, it may help inform how transplant programs respond to COVID-19 and future pandemics.
Assuntos
Transfusão de Sangue/métodos , Transplante de Medula Óssea/métodos , COVID-19/epidemiologia , Condicionamento Pré-Transplante/métodos , Humanos , Pandemias , Estados Unidos/epidemiologiaRESUMO
BACKGROUND: Healthcare reform and the shift of care to the ambulatory setting has created challenges for preparing nurses to practice in these complex clinical settings. Oncology is an area where dramatic transitions to ambulatory care have occurred, and the ambulatory oncology setting holds great potential for teaching evidence-based care to nursing students. OBJECTIVES: The article summarizes the collaboration between a baccalaureate nursing program and a cancer clinic to establish a dedicated education unit (DEU). METHODS: A pilot project was undertaken to create the DEU and residency program. FINDINGS: The collaboration has provided a clinical setting for baccalaureate nursing students to learn and develop clinical competencies, advance their critical thinking skills, and enhance advanced pathophysiology knowledge. The scope of the program includes a transition-to-practice model which maximizes the use of the DEU as students graduate and are eligible to apply for the oncology residency program. The DEU has created a pipeline for new nurses.