scholarly journals 620. Identifying the Role for a Pharmacist on an Outpatient Parenteral Antimicrobial Therapy (OPAT) Team in an Academic Teaching Hospital

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S412-S413
Author(s):  
Garret H Hino ◽  
Jacinda Abdul-Mutakabbir ◽  
Norman Hamada ◽  
Anna Zhou ◽  
Karen K Tan
Keyword(s):  
Teaching Hospital ◽  
Antimicrobial Therapy ◽  
Joint Infection ◽  
Hospital Length Of Stay ◽  
Outpatient Services ◽  
Post Discharge ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Academic Teaching ◽  
Home Infusion ◽  
Academic Teaching Hospital

Abstract Background Outpatient parenteral antimicrobial therapy (OPAT) is currently an emerging practice to continue effective treatment after hospital discharge for patients requiring parenteral (IV) treatment. Pharmacists can collaborate with outpatient services like home infusion services to allow for safe administration and monitoring of IV antibiotics. The role of pharmacists in an OPAT team has been shown to improve patient outcomes such as optimizing antimicrobial therapy and reducing hospital length of stay and readmissions. We sought to define the utility of an OPAT pharmacist at an academic teaching hospital that currently does not have an OPAT service. Methods Patients receiving IV therapy via home infusion from 1/4/21 to 3/4/21 were screened for inclusion and excluded if antimicrobials were not prescribed. Infection characteristics and antimicrobial therapy were recorded. Interventions on day of and after discharge were noted. Duration of therapy (DOT) was calculated by the difference between start and stop dates of appropriate antibiotics. Discharge delays due to OPAT-related reasons were recorded. Continuous data are expressed as median (IQR). Categorical data are expressed as frequencies (%). Results Of the patients screened, 77 of 123 patients met inclusion criteria. Most patients were treated for a bone/joint infection (29/77, 38%). Ceftriaxone (18/82, 22%) and vancomycin (13/82, 16%) were the most frequently prescribed agents. The median DOT was 30 days (IQR 15, 42). On day of discharge, 52 opportunities for a pharmacist initiated intervention were identified with majority being clarifying DOT (19/52, 37%), streamlining or escalating antibiotic (8/52, 15%), and optimizing drug dose (8/52, 15%). OPAT-related discharge delays resulted in an excess of 58 hospital days and over 25% of patients (20/77) were readmitted 30 days after discharge. The most common post-discharge issues (n=56) were worsening infection (11/56, 20%), PICC line issues (9/56, 16%), and drug related adverse events (8/56, 14%). Conclusion A pharmacist on a dedicated OPAT service can assist with antimicrobial selection, treatment duration, and drug monitoring to promote patient safety in patients discharged on antimicrobials. Disclosures All Authors: No reported disclosures

scholarly journals 623. Self-Administered Outpatient Parenteral Antimicrobial Therapy (S-OPAT) in Uninsured Patients

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S371-S371
Author(s):  
Yasir Hamad ◽  
Jaspur Min ◽  
Yvonne Burnett
Keyword(s):  
Antimicrobial Therapy ◽  
Adverse Drug Events ◽  
Hospital Length ◽  
Clinic Visit ◽  
Hospital Length Of Stay ◽  
Uninsured Patients ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Joint Infections ◽  
Insured Patients ◽  
Hospital Days

Abstract Background Uninsured patients requiring long-term intravenous (IV) antimicrobials do not have access to outpatient parenteral antimicrobial therapy (OPAT) and often remain hospitalized for the duration of their treatment, transition to inferior oral antimicrobials, or leave against medical advice. A hospital-supported self-administered OPAT (S-OPAT) program was piloted in uninsured patients to decrease hospital length of stay and improve access to care. Methods Uninsured adult patients requiring IV antimicrobials were enrolled in an S-OPAT pilot study from July 2019 to April 2020. Patients with drug use history or documented non-adherence were excluded. S-OPAT patients attended weekly clinic visits for blood draws, dressing changes, and medication supply. The measured outcomes were hospital days saved, and potential income generated by earlier discharges. The latter was calculated by multiplying the number of hospital days saved by the daily charge for a hospital bed to insured patients. Results Seventeen patients were enrolled in S-OPAT, 14 (82%) were males, 8 (47%) were black, and the mean age was 39 years. The most common indication for OPAT was bone and joint infections in 12 (71%), and most commonly used antibiotic was ceftriaxone in 12 (71%) patients (Table). Early discontinuation occurred in 3 (17%) patients due to clinic visit non-adherence resulted in 2 (12%) and adverse drug events in 1 (6%). Only one (6%) patient had unplanned hospital readmission during OPAT. Transition to S-OPAT resulted in 533 hospital days avoided, and a net saving of approximately $900,000. Conclusion S-OPAT model is safe and can enhance care for uninsured patients while optimizing health-system resources. Table Disclosures All Authors: No reported disclosures

Simulation-Based Education Improves Quality of Care During Cardiac Arrest Team Responses at an Academic Teaching Hospital

CHEST Journal ◽  
2008 ◽  
Vol 133 (1) ◽  
pp. 56-61 ◽  
Author(s):  
Diane B. Wayne ◽  
Aashish Didwania ◽  
Joe Feinglass ◽  
Monica J. Fudala ◽  
Jeffrey H. Barsuk ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Quality Of Care ◽  
Teaching Hospital ◽  
Academic Teaching ◽  
Simulation Based ◽  
Academic Teaching Hospital ◽  
Cardiac Arrest Team

scholarly journals Retrospective Study of Self Esteem in Patients with Pityriasis Versicolor

2020 ◽  
Vol 32 (2) ◽  
pp. 93
Author(s):  
Bagus Meurah Suropati ◽  
Eko Budi Koendhori ◽  
Sawitri Sawitri ◽  
Evy Ervianti
Keyword(s):  
Sex Education ◽  
Teaching Hospital ◽  
Outpatient Clinic ◽  
Basic Education ◽  
Skin Surface ◽  
Self Esteem ◽  
Pityriasis Versicolor ◽  
Academic Teaching ◽  
Education Levels ◽  
Academic Teaching Hospital

Background: Pityriasis Versicolor (PV) is a fungal infection of the skin, caused by the Malassezia sp., a genus of fungi. Patients commonly present with bordered skin patches of white, grey, and sometimes brown on their skin surface. The prominent changing of skin colour in exposed areas of the skin may cause feelings of insecurity to the patients and become limelight for other people, impacting their self esteem. Purpose: To evaluate the self esteem profile in PV patients at the dermatovenereology outpatient clinic of Dr. Soetomo General Academic Teaching Hospital Surabaya. Methods: This was a retrospective descriptive study based on medical records of the dermatovenereology outpatient clinic of Dr. Soetomo General Academic Teaching Hospital Surabaya. The data were collected from June 2018 to May 2019. This research evaluates PV patients's profiles by age, sex, education level, occupation, residential environment, site of infection, duration of the infection, and self esteem. The patient's self esteem was assessed using the Rosenberg Self Esteem Scale (RSES). Result: Fiftythree PV patient’s self esteem values were successfully recorded. Of the 53 patients, the score was low in 3 people (5.67%), the normal score in 50 people (94.33%), and no one had a high score. Of the 3 people with low self esteem scores, 2 of them were men, consisting of 1 teenager and 2 adults, having basic education levels, who were students and housewives. The three patients had the infection for more than 3 months and they resided in Tambaksari, Wonocolo, and outside Surabaya. Conclusion: The majority of PV patients at the dermato-venereology outpatient clinic of Dr. Soetomo General Academic Teaching Hospital have normal self esteem scores.

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