Tumori Journal Abstract Book - October 2020 - 209

U - Oncology Nursing

209

which risks configuring a state of abandonment of the
patient especially in the terminal stages.

has changed the care and perception of operators, intensifying this feeling of psychological imbalance.

U09

U10

Moral distress in healthcare
personnel during Covid-19
pandemic: experience from
Piacenza Oncology Department

Nursing-based screening and
prevention strategies for cancer
patients during the COVID-19
pandemics

Maserati M.1, Pisani S.1, Faverzani C.1, Stroppa E.1, Muroni M.1,
Cremona G.1, Riscazzi V.1, Cavanna L.1

Rossi V.1, Acunzo G.1, Capuozzo V.1, Germoglio A.1, Del Prato F.1,
Ferrillo L.1, Grizzuti G.1, Innamorati M.1, Landolfi C.1, Micallo G.1,
Palazzo I.1, Portinaio F.1, Santucci P.1, Olivetta R.1, Mirabella R.1,
D'Auria S.1, Esposito M.R.1

Dipartimento Onco-ematologico AUSL Piacenza, Piacenza

Background: Italy has been one of the countries most
affected by Covid-19 emergency, in particular Piacenza
has reached the record for the number of victims caused by
the virus and is still facing a copious number of infections.
The healthcare staff of Piacenza Hospital faced this emergency demonstrating a strong spirit of adaptation, alleviating suffering, loneliness and leading many patients infected
with the virus towards healing. Moral distress is a common
reaction in morally difficult situations, and includes feelings of frustration and lack of power when healthcare professionals are prevented from acting in accordance with
their values and ideals (Gustavsson et al, 2019). Morally
demanding choices add a greater burden to working in an
already stressful environment. The Covid-19 emergency
as a pandemic can be considered a real catastrophe, characterized by health needs that exceed existing capacities
and so often health professionals have had to make difficult decisions, quickly choose who to treat and how to use
optimal limited resources available. The study aims to
investigate the Moral Distress of oncologic operators of
Piacenza Oncology during Covid-19 emergency period.
Material and methods: We conducted an observational
qualitative study, the data collection tool is a semi-structured
interview, consisting of sequential and standardized questions. 26 operators were interviewed (8 doctors, 13 nurses
and 5 OSS) who worked in the Medical Oncology Unit of
Piacenza hospital during the emergency period. The data
analysis took place with analysis of the thematic content.
Qualitative analysis involves the fragmentation of data into
simpler units and the subsequent recomposition in new ways.
Results: The results of the interviews were divided into four
macrocodes: Sensations associated with Moral Distress,
Negative episodes, Changes, Positive episodes, in turn
divided into several microcodes. The Moral Distress therefore emerges that this pandemic has evoked in operators
despite their professionalism and preparation for end of life.
Conclusions: Moral Distress is a usual condition for
Oncology operators who are used to being in contact with
suffering and death, caused by the high psychological and
physical contact that is established with the sick person,
but the results of our work highlighted how the pandemic

1
Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli, Italia,
Napoli

Background: Ensuring treatment continuity during the
COVID-19 pandemics was a major commitment of our
Institution. To this end a specific response plan, integrating
recommendations from relevant networks (AIOM, NCCN,
ISS, ANIPIO, FNOPI), was implemented to minimize exposure risks and fatality rates for patients (pts.) and personnel.
Methods: From March 10, triage checkpoints at hospital main
entrances were activated to regulate access to wards, outpts.
chemotherapy facility and diagnostics units (A). From April,
additional stations were established at further building allocating outpts. clinics and surgical day care (B). Nursing staff was
involved in several intervention domains: 1. development and
updating of triage forms for pts. and caregivers (10 updates). 2.
Education and guidance on personal protective equipment
(PPE). 3. regulation of inflow at triage stations. This was
achieved through a specific protocol including support for
access forms compilation, collection of travel/contact history,
thermoscan survey, monitoring of peripheral oxygen saturation for unfit patients, direct interaction with referral physicians through point-of-care (POC) audits to secure access for
symptomatic patients and 'suspect COVID-19 cases' in need
of non-deferrable treatments. These POC audits were mainly
aimed at separating cancer and treatment-symptoms from
indicators of possible SARS-CoV-2 infection. 4.
Nasopharyngeal swabbing for personnel and 'suspect cases' at
POC and within a precautionary program for all immunocompromised petients accessing the hematology-oncology Unit. 5.
From May 15, setup and administration of rapid testing for
SARS-CoV-2 IgG/IgM with POC nasopharyngeal swabbing
for those displaying positive antibody results. 6. Health education for pts., caregivers, personnel and outsourcing operators,
including hand hygiene, selection and use of PPE.
Results: Overall results (March-May 2020), are shown
below.
Conclusions: Efforts made by nursing team significantly
contributed to warrant oncology care continuity and operators safety. Nursing triage effectively identified potential
SARS-CoV-2 carriers.

Tumori Journal Abstract Book - October 2020

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