scholarly journals Being ‘at-home’ on outpatient parenteral antimicrobial therapy (OPAT): a qualitative study of parents’ experiences of paediatric OPAT

2019 ◽  
Vol 105 (3) ◽  
pp. 276-281
Author(s):  
Bernie Carter ◽  
Debra Fisher-Smith ◽  
David Porter ◽  
Steven Lane ◽  
Matthew Peak ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Antimicrobial Therapy ◽  
Return To School ◽  
Positive Experience ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Home Based ◽  
Parents And Children ◽  
Paediatric Outpatient ◽  
And Control ◽  
At Home

ObjectiveTo better understand the factors that facilitate and hinder a positive experience of paediatric outpatient parenteral antimicrobial therapy (OPAT).DesignQualitative study using semistructured interviews.SettingA dedicated paediatric consultant-led hospital-based, outreach OPAT service in England.ParticipantsParticipants were primarily parents of children who had received OPAT; one child participated.MethodsChildren and parents of children who received OPAT and who had participated in the survey phase of the larger study were invited to be interviewed.Results12 parents (10 mothers and 2 fathers) of 10 children participated; one child (aged 15 years). Data analysis resulted in one meta-theme, ‘At-homeness’ with OPAT, this reflected the overall sense of home being a place in which the children and their parents could be where they wanted to be. Four key themes were identified that reflect the ways in which parents and children experienced being at-home on OPAT: ‘Comfort, security, freedom, and control’; ‘Faith, trust and confidence’; ‘Explanations and communication’ and ‘Concerns, restrictions and inconveniences’.ConclusionsDespite feeling anxious at times, parents reported that they and their children generally had a positive experience of OPAT; being at-home brought many benefits compared with in-patient care. Recommendations arising from the study include a ‘whole-system’ approach to discharge home that includes support related to return to school/nursery, reduction in disruptions to home-based routines, more clarity on choice and preparation for managing potential anxiety, better consideration of dose timing and enhanced preparation and information.

scholarly journals Paediatric Outpatient Parenteral Antimicrobial Therapy (OPAT): An e-survey of the experiences of parents and clinicians

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249514
Author(s):  
Bernie Carter ◽  
Debra Fisher-Smith ◽  
David Porter ◽  
Steven Lane ◽  
Matthew Peak ◽  
...  
Keyword(s):  
Antimicrobial Therapy ◽  
Tertiary Hospital ◽  
Parental Satisfaction ◽  
Hospital Data ◽  
Family Routines ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Open Questions ◽  
Home Based ◽  
Parents And Children ◽  
Paediatric Outpatient

Background Little evidence exists about parental satisfaction and their influence on referral to paediatric Outpatient Parenteral Antimicrobial Therapy (OPAT). Aim This study aimed to examine the experiences of parents, children and clinicians of OPAT at a large tertiary children’s hospital. Method A prospective e-survey, using closed and open questions, of parents (n = 33) of 33 children who had received OPAT (3 children completed a survey), and clinicians (n = 31) involved in OPAT at a tertiary hospital. Data were collected September 2016 to July 2018. Results Data were analysed using simple descriptive statistics. The results show that OPAT offered benefits (less stress, re-establishment of family life) compared to hospital-based treatment for parents and children, although some were anxious. Clinicians’ referral judgements were based on child, home, and clinical factors. Some clinicians found the process of referral complex. Conclusion Most parents and children were satisfied with the OPAT service and preferred the option of home-based treatment as it promoted the child’s comfort and recovery and supported family routines.

scholarly journals A qualitative study of patients’ feedback about Outpatient Parenteral Antimicrobial Therapy (OPAT) services in Northern England: implications for service improvement

BMJ Open ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. e019099 ◽  
Author(s):  
Maureen Twiddy ◽  
Carolyn J Czoski Murray ◽  
Samantha J Mason ◽  
David Meads ◽  
Judy M Wright ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Antimicrobial Therapy ◽  
Local Population ◽  
Health Centre ◽  
Service Improvement ◽  
Self Administration ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Semistructured Interviews ◽  
The Uk ◽  
At Home

ObjectiveOutpatient parenteral antimicrobial therapy (OPAT) provides opportunities for improved cost savings, but in the UK, implementation is patchy and a variety of service models are in use. The slow uptake in the UK and Europe is due to a number of clinical, financial and logistical issues, including concern about patient safety. The measurement of patient experience data is commonly used to inform commissioning decisions, but these focus on functional aspects of services and fail to examine the relational aspects of care. This qualitative study examines patients’ experiences of OPAT.DesignIn-depth, semistructured interviews.SettingPurposive sample of OPAT patients recruited from four acute National Health Service (NHS) Trusts in Northern England. These NHS Trusts between them represented both well-established and recently set-up services running nurse at home, hospital outpatient and/or self-administration models.ParticipantsWe undertook 28 semistructured interviews and one focus group (n=4).ResultsDespite good patient outcomes, experiences were coloured by patients' personal situation and material circumstances. Many found looking after themselves at home more difficult than they expected, while others continued to work despite their infection. Expensive car parking, late running services and the inconvenience of waiting in for the nurse to arrive frustrated patients, while efficient services, staffed by nurses with the specialist skills needed to manage intravenous treatment had the opposite effect. Many patients felt a local, general practitioner or community health centre based service would resolve many of the practical difficulties that made OPAT inconvenient. Patients could find OPAT anxiety provoking but this could be ameliorated by staff taking the time to reassure patients and provide tailored information.ConclusionServices configurations must accommodate the diversity of the local population. Poor communication can leave patients lacking the confidence needed to be a competent collaborator in their own care and affect their perceptions of the service.

Effectiveness and safety of ertapenem used in hospital-at-home units: data from Spanish Outpatient Parenteral Antimicrobial Therapy Registry

2018 ◽  
Vol 13 (12) ◽  
pp. 1363-1373 ◽  
Author(s):  
Pedro Sanroma ◽  
Pedro Muñoz ◽  
Manuel Mirón-Rubio ◽  
Ana Aguilera ◽  
Oriol Estrada ◽  
...  
Keyword(s):  
Antimicrobial Therapy ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Hospital At Home ◽  
At Home

scholarly journals P64 Implementation of a paediatric outpatient parenteral antibiotic therapy (p-OPAT) service at a specialist children’s hospital

2020 ◽  
Vol 105 (9) ◽  
pp. e39.2-e40
Author(s):  
Hannah Porter ◽  
Kate Stock
Keyword(s):  
Data Collection ◽  
Antibiotic Therapy ◽  
Antimicrobial Stewardship ◽  
Antimicrobial Therapy ◽  
List Type ◽  
Parenteral Antibiotic ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Paediatric Outpatient ◽  
Bed Days ◽  
One Year

AimThe aim of this project is to optimise patient care, enhance patient experience, improve antimicrobial stewardship and assist patient flow through the hospital.MethodData collection was conducted one day a week over five consecutive weeks. All eligible wards were visited. Patient medication charts were inspected to see if intravenous antimicrobials were prescribed and a patient - specific data collection form was then completed. All the patients that met the eligibility criteria to be put forward for OPAT referral were then considered from a clinical perspective by a paediatric consultant as to their suitability for OPAT or IVOST and discharge. If the patient was deemed suitable for an OPAT discharge or IVOST and discharge a decision was made as to what antimicrobials they would theoretically have been on when discharged home. The number of potential bed days saved was calculated as the number of days between the patients review by the consultant (ie the day of data collection) and the date of their discharge prescription from that episode of care.The following was examinedpercentage of patients with identified pathogenspercentage of patients that had received input from the ID teampercentage of patients that had received input from microbiologythe prevalence of antimicrobials prescribedthe location of the patient’s home residencepatient/parent willingness to go home on OPAT.The data for patient numbers and bed day savings was then extrapolated to 52 weeks in order to be indicative of one year.ResultsOver the five days, 66 patients were identified that met the exclusion criteria to be referred for OPAT or IVOST. After clinical consideration the consultant deemed 4 patients to be suitable for OPAT and 19 for IVOST and discharge which generated a potential bed day saving of 38 bed days. This was comprised of 17 days through providing IVAs via OPAT and 21 days from timelier IVOST and discharge of patients. Extrapolated to be representative of one year, this would be a bed saving to the Trust of 1, 976 bed days.ConclusionThe potential has been identified for the hospital to make considerable bed day savings through the investment in an extended antimicrobial stewardship programme and establishment of a paediatric OPAT service. A business case has been submitted to the hospital board for consideration, with the hope that the service will be funded for a six month probationary period in order to assess its impact over the winter months, when demand for beds and pressures on PICU and theatres are highest.ReferencesPatel S, et al. 2015. Good practice recommendations for paediatric outpatient parenteral antibiotic therapy (p-OPAT) in the UK: a consensus statement. Journal of Antimicrobial Chemotherapy2015;702:360–373.Carter B, et al. Delivery, setting and outcomes of paediatric outpatient parenteral antimicrobial therapy (OPAT): a scoping review. BMJ Open, 2018;8:e021603.Hodgson KA, et al. The use, appropriateness and outcomes of outpatient parenteral antimicrobial therapy. Archives of Disease in Childhood, 2016:10:886–893.Knackstedt ED, et al. Outpatient parenteral antimicrobial therapy in pediatrics: an opportunity to expand antimicrobial stewardship. Infection Control & Hospital „Epidemiology 2015:36:222–224.

scholarly journals 756Emergency Department Visits During Outpatient Parenteral Antimicrobial Therapy (OPAT) Administered at Home

2014 ◽  
Vol 1 (suppl_1) ◽  
pp. S213-S214
Author(s):  
Nabin Shrestha ◽  
Jugnu Shrestha ◽  
Angela Everett ◽  
Don Carroll ◽  
Steven Gordon ◽  
...  
Keyword(s):  
Antimicrobial Therapy ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
At Home

Intravenous antimicrobial therapy in the hospital-at-home setting: data from the Spanish Outpatient Parenteral Antimicrobial Therapy Registry

2016 ◽  
Vol 11 (3) ◽  
pp. 375-390 ◽  
Author(s):  
Manuel Mirón-Rubio ◽  
Víctor González-Ramallo ◽  
Oriol Estrada-Cuxart ◽  
Pedro Sanroma-Mendizábal ◽  
Antonio Segado-Soriano ◽  
...  
Keyword(s):  
Antimicrobial Therapy ◽  
Home Setting ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Hospital At Home ◽  
At Home

Costs of outpatient parenteral antimicrobial therapy (OPAT) administered by Hospital at Home units in Spain

2017 ◽  
Vol 50 (1) ◽  
pp. 114-118 ◽  
Author(s):  
V.J. González-Ramallo ◽  
M. Mirón-Rubio ◽  
A. Mujal ◽  
O. Estrada ◽  
C. Forné ◽  
...  
Keyword(s):  
Antimicrobial Therapy ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Hospital At Home ◽  
At Home

scholarly journals Outpatient Parenteral Antimicrobial Therapy With Ceftolozane/Tazobactam via Continuous Infusion for Multidrug-Resistant Pseudomonas aeruginosa Osteomyelitis

2020 ◽  
Vol 7 (11) ◽  
Author(s):  
Judith Álvarez Otero ◽  
Jose Luis Lamas Ferreiro ◽  
Ana Sanjurjo Rivo ◽  
Javier de la Fuente Aguado
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antibiotic Therapy ◽  
Continuous Infusion ◽  
Antimicrobial Therapy ◽  
Multidrug Resistant ◽  
Effective Alternative ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
At Home

Abstract We present a case of Pseudomonas aeruginosa osteomyelitis treated with surgery and antibiotic therapy with ceftolozane-tazobactam in continuous infusion at home using an elastomeric pump. We discuss the use of ceftolozane-tazobactam in continuous infusion administered at home as an effective alternative for the treatment of multidrug-resistant Pseudomonas aeruginosa osteomyelitis.

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