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Delivery of an integrated OPAT service in Buckinghamshire Marie Coward. Delivery of an integrated OPAT service in Buckinghamshire. Marie Coward – IV specialist Nurse / OPAT lead. April 2012 BSAC. Buckinghamshire Healthcare trust (BHT).
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Marie Coward – IV specialist Nurse / OPAT lead
April 2012 BSAC
Adult Community Healthcare Teams (ACHTs).
-ESD - the team shares care with the referring clinician
-AA - the team shares care with the patient’s GP.
We operate as an MDT.
ESD - referral form with telephone discussion
We also attend a weekly orthopaedic ward round .
AA - phone calls from GP or A&E
We also visit A&E areas daily to find patients.
Inclusion / exclusion criteria but also assess on an individual basis.
Generic paperwork for all referrals and have dedicated authorisations for IV administration in the community.
Includes vascular access assessment and referral
Includes assessment for self administration with competency assessment.
Agree antibiotic regimen with consultant microbiologist.
Prescribing by the referring team/A&E plus authorisations for community administration
ESD- Facilitate discharge date /equipment / pharmacy
AA -template prescription sheet for rapid turn around
Adrenaline is prescribed to take home in all cases.
Liaison with ACHTs to support a 1st visit with the patient.
Hand held notes for the home setting
4. Follow up and monitoring
Most IV administration by ACHTs
Daily VIP & EWS on all patients.
Clinical checks appropriate to condition
Weekly bloods -monitor results at weekly virtual ward round with the microbiology consultant.
Outpatient review at 2 weeks for long courses
We attend specific OPA’s with patients to ensure treatment plans are followed or problems discussed as we don’t have our own clinics. Often give IV’s when they attend.
Our oral follow on patients get monitored at 2 weeks and if stable discharged from the service.
C.L. Mackintosh et al JAC(2011).
1, OPAT Team & Service.
2, Patient Selection.
3, Antimicrobial management & drug delivery.
4, Monitoring of the patient.
5, Outcome monitoring & clinical governance.