Authors (including presenting author) :
Ng WS (1), Au Yeung TW (1), Kwan YK (2), Leung KS (2), Ng YY (2), Lam YM (1), Lee MM (1), Yiu WK (1), Lou SF (1)
Affiliation :
(1)Community Care Division, New Territories West Cluster (2)Department of Medicine and Geriatrics, Tuen Mun Hospital
Introduction :
This pilot program of Outpatient Parenteral Antimicrobial Therapy (OPAT) for Residential Care Home for the Elderly (RCHE) Residents had been launched in New Territories West Cluster during winter surge since December 2017. Community Care Division of New Territories West Cluster (CCD NTWC) collaborated with infectious disease (ID) physician to select appropriate patients for receiving intravenous antibiotic therapy in RCHEs.
Objectives :
1)Prevent other hospital associated adverse event such as acquiring nosocomial infection 2)Patient could recover and receive intravenous antibiotic therapy in familiar environment
Methodology :
I)Training - Enhance the technique on IV cannulation for CGAS nurses - Equip RCHEs’ staffs on care of the IV cannulation sites II)Program Design Inclusion Criteria: 1)Elderly patients from NTWC RCHEs with CGAS 2)Medically fit for discharge from acute and convalescent medical wards 3)Patient with at least one dose of antimicrobial administrated in hospital to assess for adverse reaction and drug allergy 4)No potential risk of intravenous drug abuse by patient Workflow of case recruitment 1)Referred by clinical team and selected by ID physician from medical wards 2)Assessed the eligibility of RCHE and discussed with RCHE’s staffs about the acceptance of OPAT by CGAS APN Workflow of discharging OPAT cases from hospital to RCHEs 1)Empower knowledge in IV cannulation care and medication management for RCHE staffs 2)CGAS nurses deliver IV antibiotics at RCHEs and reset IV cannulation if needed 3)Closely monitor patient’s condition by CGAS nurses and RCHE staffs 4)Arrange clinical admission, fast track clinic, day ward admission, early MID clinic follow up, or on-site management by ID physician
Result & Outcome :
Outcome (December 2017-May 2019) 1)22 cases were recruited in the program. 36.4% were male and 63.6% were female with mean age of 83. All cases were chair to bed bound. 2)Daily nurse visit for IV infusion, 119 days of hospital bed saved and hence releasing to other patients in need. No case reported related complication. 3)98 RCHE staffs from 18 different RCHEs were trained. 26 CGAS nurses (83.9%) were refreshed theory lesson and clinical practice on IV cannulation.
