Tables
Main Bundle Components |
Key Aspects of Component |
|
|---|---|---|
Patient Identification/ Selection |
• |
Afebrile and stable vital signs |
• |
Infection should be reasonably stabilised and non-progressive |
|
• |
Not likely to abuse a vascular access system (e.g. injection drug user) |
|
• |
Fully aware of benefits and risks |
|
• |
Appropriate and adequate social support |
|
• |
Capable and responsible for the infusion, care of the vascular access device, and the care of the catheter infusion site, and be able to recognise and report new problems such as fever and rash. |
|
• |
Willingness to comply with follow-up plan |
|
ID Consultation |
• |
Establishment of clinical diagnosis |
• |
Selection of appropriate antimicrobials |
|
Selection of Antimicrobials |
Factors: |
|
• |
the definite or probable infecting organism |
|
• |
the pharmacodynamics and pharmacokinetic properties of antimicrobials and drug stability |
|
• |
patient’s medical condition |
|
Patient/family education |
• |
Vascular access education/sterile technique/teach-back method |
• |
Emergency contact numbers for patients |
|
• |
Side effects of medication |
|
• |
Potential Complications |
|
Care transition |
• |
Clear communication between inpatient and outpatient services |
• |
ID/OPAT plan documented in discharge summary |
|
• |
Laboratory tests ordered as part of discharge plan |
|
Outpatient monitoring |
• |
Clinical response |
• |
Microbiological, laboratory and radiological monitoring |
|
• |
Addressing lab abnormalities |
|
• |
Vascular access care, and removal at the end of therapy |
|
• |
Medications adjustment as needed (choice, dose, duration) |
|
• |
Adverse effects of antimicrobial |
|
• |
Change in management if needed |
|
• |
Good communication between members of OPAT team |
|
Written policies and protocols |
• |
Outline of responsibilities of OPAT team members |
• |
Outline of communications between patient and OPAT team |
|
• |
Outline of service arrangement during severe weather |
|
• |
Patient selection criteria |
|
• |
Patient education materials |
|
OPAT program outcomes measures |
• |
Patient satisfaction |
• |
Readmission rates |
|
• |
Clinical outcomes including any complications of disease and adverse effects of antimicrobials |
|
• |
Complications of vascular access |
|
• |
Program improvements |
|