ABSTRACT
Background: Due to the growing demand for hematooncology inpatient beds, on February 12th a new twentybed ward was opened at our center. By that time, the Hospital Clinic of Barcelona (HCB) admitted the first COVID-19 patient who tested positive in Catalonia. Then, the pandemic spread, reaching its peak in April, in Spain. The restrictions where implemented all over to contain the virus. The hematology ward sealed up: visits strictly limited, all having to wear day long surgical masks, one-way valve patients' masks avoided, and staff PCR periodically performed. In this context, aiming to provide specialized cancer care for those who contracted the virus, it was decided that the brand-new hospitalization ward will treat hemato-oncology patients with suspected or diagnosed COVID-19. This would allow to continue usual activity at the Hematology and Oncology units, including highly specialized cancer care such as Stem cell transplantation (SCT), acute leukemia or palliative care. Methods: All Arrangements were aimed to contain the virus in the "COVID-19 specific ward": only cancer COVID-19+ and doubtful patients were admitted. Exclusive personnel, cancer trained, assigned to work in that unit and nowhere else. All the ward common areas were considered "clean" and rooms "dirty", so the processes for donning and doffing personal protective equipment (PPE) was mandatory for all entering each patient' room. Regular treatment route adjustments and schedules were made to minimize nurse-patient exposure. Premade material kits were prepared to facilitate procedures, and patients were empowered from monitor some of their own vital signs to flushing their ports were promoted. Results: During Spanish lockdown due to SARS-CoV-2, from March 16th to May 10th, 2020, 12 SCT were performed at the HCB, being six of them allogenic, the same number as the same period in 2019. Six CAR-T infusions were performed, one more compared to the same period the year before. COVID-19 patient suffering from hemato-oncology disease received care by oncology nurses, continuing their care plans and even being able to administer chemotherapy if needed even with the persistence of SARS-CoV-2 virus. Conclusions: Having a COVID-19 hemato-oncology monographic ward was determinant, allowing to actively treat the underlying cancer condition during pandemic restrictions, such experience and service reorganization may help to face future situations. The previous knowledge of oncology nurses on protective isolation measures against opportunistic infections has been a great advantage to face COVID. At the same time hematologic patients and caregivers were also used to deal with infection prevention having hygienic habits integrated into their everyday routine. It also made easier for them to assimilate new care provision and preventive measures to prevent COVID-19. Patient isolation increased patient care needs during hospitalization so nurses' ratios should be revised to decrease exposure and not having to rush. Lockdown measures and fear of being infected, keep patients at home avoiding essential hospital visits, highlights once more the need for a specific emergency pathway only used by oncologic patients.