Patients who are medically stable and whose only reason for admission is the requirement for IV antimicrobial therapy can be safely and effectively treated in a primary care setting or as an outpatient. Administration of the antibiotic may be by an appropriately trained community nurse, nursing staff in a care home or community hospital, an acute Trust outreach nurse, attendance daily or several times a week at a ward or clinic, or occasionally patient or carer administration.
The doctor prescribing the antimicrobial for OPAT use assumes clinical responsibility for the drug and the consequences of its use. Patients remain under the care of the acute Trust discharging consultant until their parenteral therapy is complete, unless that aspect of their care is formally transferred to another consultant. T
Arrangements should be made by the discharging team for regular follow up of the patient whilst they remain on OPAT, and at the end of the course, including arrangements for removal of the line.
To refer a patient for OPAT
- Assess the suitability of the patient for OPAT (see the checklist in the OPAT policy).
- Discuss an appropriate antibiotic regime with a consultant microbiologist. (Note that once daily regimes are preferred wherever possible).
- Then make an electronic OPAT referral via iCM to the parenteral therapy team (PTT) (simply type in "OPAT" at the order entry screen). The referral should be completed by the medical team as this indicates their acceptance of responsibility for patient follow up. The PTT will insert a PICC or midline if not already in place, and assess the options for who can administer treatment in the community. The PTT will make the referral to the community nurses. Capacity is limited and not all referrals can be accepted. Ideally 48 hours notice is required, but the patient will be accepted sooner if possible. Referrals are not accepted at weekends. Do not discharge patients sooner than arranged without prior agreement with the community nursing teams as they may not have staff available to administer treatment.
- Contact the OPAT pharmacist who will process the TTO, arrange for supplies of ancillary equipment and advise on the monitoring needed. The OPAT team will check blood results and alert the parent team of results outside normal limits, but do not clinically follow the patients up.
Consultant Microbiologist and OPAT Lead: 01332 788 513
OPAT pharmacist: 07823 373 820
OPAT pharmacy technician: 07823 373 909
Parenteral therapy team: 07879 115 934 or 07879 115 935
Single Point of Access (SPA):
Derby City: 01332 258 258
Amber Valley SPA: 01773 525 090