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The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon

The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon

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Page 1: The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon

The OPAT experience in Dudley

Kate Owen & Nichola Hughes-Gordon

Page 2: The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon

Dudley Group of HospitalsOutpatient Intravenous Antibiotic Therapy

Kate Owen (District Nurse Specialist Practitioner)

Nichola Hughes-Gordon (Acute medical nurse)

Page 3: The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon

Dudley OPAT Service

• Joint project between hospital and community staff

• Launched in January 2012

• Replaced the original community IV model for treating cellulitis

Page 4: The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon

Dudley OPAT ServiceThe Team:

Hospital Staff• Acute Medical Unit consultant and registrars• Acute Medical Unit nurses• Pharmacy• Microbiology

Community Staff • Virtual IV team of community nurses• Community clinic• Advanced Nurse Practitioners and senior nurses with NMP

Page 5: The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon

Policies and Pathways

Overarching OPAT policyStrict inclusion criteria

Ratified specific pathways for: Cellulitis, Complex UTI (including ESBL and pyelonephritis)

Development of new pathways:Diabetic foot ulcer and osteomyelitisBronchiectasis and pseudomonas chest infections

Future pathways Discitis, Septic arthritis, Infective endocarditis,

Page 6: The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon

PerformanceSince January 2012,

Over 700 bed days saved, more capacity in hospital

Over 90 patients treated with high level of patient satisfaction, only 2 patients readmitted

IV team contacts

0

20

40

60

80

100

120

140

160

January February March April May June July

Series1

Page 7: The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon

DiagnosisDiagnosis

65%

25%

10%

Cellulitis

UTI

Other

Page 8: The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon

A Patient Journey – hospital Patient diagnosis

confirmed and needs

IVAB

Referred toOPAT Hospital team

Patient cannulatedFirst dose of IVAB

administeredTTO prescribed

Referred to Community

Nurses

Page 9: The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon

Patient journey continues in the community Accepted referral

by community nurse

Patient housebound

Patient receives IVAB

Bloods taken day before review

Patient reviewed community or hospital clinic

Patient continues treatment or discharged

Patient can attend clinic

Page 10: The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon

Success!Transferring community nursing services to the acute trust has strengthened the working relationship  between community and acute care

Excellent example of acute and community working together to benefit patient care, reduce hospital admissions and facilitate early discharge

Support from senior management and AMU consultants

Project management team set up with key professionals to develop policy and clinical pathways

Enthusiastic, “can do” attitude

Page 11: The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon

Patient SatisfactionA survey was sent to patients and we received a 43% response rate

100% stated they were satisfied with the service

The level of support during treatment was rated as excellent by 71% of respondents and 29% stated it was very good

“All the staff were brilliant at their job and always took time to talk”

Page 12: The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon

ChallengesEmbedding the referral process for OPAT

Communication to all of the staff on EAU / ward nurses / doctors

Vascular access for some patients however the use of PICC, Tunnelled Central Lines, Midlines and Winged Infusion Devices has helped

Page 13: The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon

Future ChallengesFurther pathways

Further education of all staff

IT challenges – database, electronic authorisation and recoding administration of doses

Funding for the future – business case

Increasing capacity within the community

Developing advanced nursing skills and NMP

Page 14: The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon

What we have learnt so far

• Communication is keyRegular meetings and updates with the OPAT team, to the patients and relatives, and to other staff members within the hospital and community setting

•Keep the team small: experienced, regular team members

•Keep building upon the success: new pathways

•Ensuring constant feedback: boost morale, high levels of patient satisfaction and reduced number of bed days.

Page 15: The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon The OPAT experience in Dudley Kate Owen & Nichola Hughes-Gordon

Conclusion

Excellent working relationship between hospital and community staff

Safe working, pathways developed, success going from strength to strength!