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Oupatient parenteral antimicrobial therapy

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What is OPAT?

Antibiotics are medicines active against bugs or germs that can cause a significant infection. They can be given orally (by mouth) or injected into a vein: this is called intravenous (IV) or parenteral therapy. IV / parenteral antibiotics are usually given to patients in hospital but they can be given safely in an outpatient clinic or at home.

When given in a clinic or at home, this is called OPAT (Outpatient Parenteral Antibiotic Therapy). If you are receiving OPAT then you (or a family member or friend) will either be taught to give the antibiotics, or arrangements will be made for a nurse to visit your home daily to give the doses to you.

Who is in the OPAT Team?

The Team consists of;

  • Consultant Microbiologist / Infection Doctor.
  • OPAT Nurses.
  • Pharmacist.
  • Pharmacy Technician.
  • Community Nursing Teams.

How is the antibiotic given?

The antibiotic is given into your vein through a small narrow flexible tube called a catheter. This will be inserted by your OPAT nurse or one of the in patient IV Team nurses.

There are different types of catheters available and the one chosen for your treatment will depend on your veins and how long you will need the antibiotics for. You will be given further information about the catheter used in your treatment and how to care for it by the OPAT nurse.

Who decides if I should receive OPAT?

Patients being considered for the OPAT service will be those who are ready to go home, but who need further IV antibiotic treatment. If the medical team or nursing team looking after you think that you are suitable for the service then they will refer you to the OPAT team. An OPAT nurse will then meet with you to assess you and see if you are eligible. The OPAT process will be fully explained to you and you can decide whether it is something that you would like to consider. If you decide to go onto the OPAT service then arrangements will be made to make sure you are able to go home safely.

Do I have to go onto the OPAT service?

You will not be discharged onto the OPAT service if you do not wish to be. If you choose not to go onto the OPAT service, alternative options for your treatment plan will be discussed with you.

What are the benefits of the OPAT service?

You will be able to be at home in a comfortable and familiar setting rather than staying in the hospital. OPAT is not always the right choice for everyone but feedback from previous OPAT patients has shown that they would choose it again rather than a prolonged hospital stay. It can also allow you to maintain your independence, be back with your family and friends or even return to work.

Who will give me the IV antibiotics?

The OPAT service will be tailored to your needs. The Community nursing service have nurses who are trained to administer IVs. If you are housebound, they can visit you in your home and administer your antibiotic.

Some patients will choose to give themselves the antibiotic, or a family member / friend will take on this role. Some patients decide that this is the option they would prefer anyway as they then have control of their treatment. If this is the case then you or your family member / friend will be taught how to do this and assessed in hospital by the OPAT team or in your home by the Community IV nurses. You will receive a supply of your IV antibiotics and other supplies needed when you are discharged from hospital.

When will I go home?

This will be different for every patient, depending on circumstances.

When you are ready to go home, the OPAT nurse will arrange your discharge with the Community Nursing Team.

A letter will be sent to your GP informing him / her that you have been admitted to the OPAT service.

How long will my treatment last?

You may require only a few more days of IV treatment or several weeks depending on the nature of the infection. Often this may be followed by a further course of oral antibiotics. This will be explained by the microbiologist looking after you. During your time on the OPAT service you will be under the supervision of the OPAT team at BSUH NHS Trust, who will be reviewing your progress on a weekly basis with the Community nursing teams.

The Community nurses will visit you on a daily or weekly basis (depending on your OPAT plan) your catheter will be reviewed and your dressings changed. Blood samples, to monitor your therapy, may be taken by the Community IV Nurse. This is to ensure that you are responding to treatment and that the IV catheter is maintained appropriately.

When do I need to come to the OPAT clinic?

Whilst on the OPAT programme your progress will be monitored by the OPAT Team and the Community nurses at a weekly virtual ward round. They will look at your blood results and assess your progress.

You may be required to attend a weekly clinic for review by the Infection Doctors. The OPAT Review Clinics are held on Fridays at the Royal Sussex County Hospital Fracture Clinic or at the Day Hospital at Princess Royal Hospital Haywards Heath.

An appointment will be made for you by the OPAT Nurse if necessary and they will contact you directly if they need to review your condition.

What do I need to bring with me to the OPAT clinic?

Please bring your medical records with you to clinic. The doctor seeing you that day may want to see a list of the medicines you are taking each day.

What happens if I feel unwell or I have a problem or concern?

Complications on OPAT are rare but it is important to look after your IV catheter as directed. Very occasionally patients can get problems directly related to the antibiotic they are taking. This can occur whether you are at home or in hospital.

If you have a problem with your vascular access device

please call your Community Nurse.

In the event of an emergency, call 999 or go to straight to your local A&E department.

Pharmacy medicines helpline For information about any medicines that you have been prescribed, you can contact our Pharmacy Department; Tel: 01273 696955 Extension 4038

OPAT Clinics

For the OPAT review clinic, please remember to bring all your IV therapy / OPAT documentation and a list of your medications with you. These clinics are held at either:

Main or Fracture Clinic Out Patients Department

Royal Sussex County Hospital Eastern Road, Brighton, East Sussex BN2 5BE

Fracture Clinic

Princess Royal Hospital Lewes Road, Haywards Heath, West Sussex RX16 4EX

We hope that this leaflet is helpful but if you have identified any potential discriminatory impact please refer it to OPAT Lead Nurse / Clinical Nurse Specialist IV Therapy, together with any suggestions as to the action required to avoid / reduce this impact on 01273 696955 Extension 7056 or 4922.

The information here is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.

This information is for patients receiving treatment at Brighton and Haywards Heath.

Publication Date: September 2015

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