Inpatient length of stay shortened by integrated nurse Outpatient Parenteral Antimicrobial Therapy (OPAT) service

Abstract Description

Authors (including presenting author) :

Tsang KY1, Lau MY1, Lam W2, Chu MY2, Tang HC2, Kwong TS2, Lam KW2, Chan SY2, Ting WM2, Ng KTM3,Law LT3, Yao S1, Yeung MC1, Wu TC2

Affiliation :

1Department of Medicine, Queen Elizabeth Hospital 2Division of Infectious Diseases, Department of Medicine, Queen Elizabeth Hospital. 3Department of Pharmacy, Queen Elizabeth Hospital

Introduction :

Queen Elizabeth Hospital is one of the major acute hospitals with over 1,900 beds. The medical inpatient bed occupancy rate is mostly more than 100%. In order to alleviate the bed occupancy, Outpatient Parenteral Antimicrobial Therapy (OPAT) service was initiated since 2013. Enhanced service was established since 2016. With the use of integrated service model, the roles of the nurse include assessment of the patient’s suitability for parenteral therapy in the outpatient setting, patient education, monitoring and wound care. The nurse also serves bridging functions for the team and plays pivotal role in coordination of care.

Objectives :

The purpose of this study was to review the implementation of the integrated nurse model in OPAT service and the clinical outcomes of the patients.

Methodology :

A prospective cohort study of OPAT from 2013 to 2018 was assessed. All patients enrolled in OPAT service were included in the study. All patients were cared by the specially trained nurses. A standardized compute data sheet was used to record the clinical data. The Patient Satisfaction Survey was conducted at the end of treatment.

Result & Outcome :

560 patients received 573 episodes of OPAT service during the study in 2013 – 2018. A total of 10,702 inpatient bed-days were saved and the median number of days under OPAT service was 11 days. Patients aged between 18 - 97 year. The median age was 58 years. Patients were mostly referred from medical inpatient service. The commonest diagnoses were urinary tract infection (21%), intra-abdominal infection (14%), enteric fever (12%) and bacteraemia (10%). All patients were satisfied with the OPAT service. Readmission rate was only 1.7%.