PT  - JOURNAL ARTICLE
AU  - Mace, Ariel O
AU  - McLeod, Charlie
AU  - Yeoh, Daniel K
AU  - Vine, Julie
AU  - Chen, Yu-Ping
AU  - Martin, Andrew C
AU  - Blyth, Christopher C
AU  - Bowen, Asha C
TI  - Dedicated paediatric Outpatient Parenteral Antimicrobial Therapy medical support: a pre–post observational study
AID  - 10.1136/archdischild-2017-313071
DP  - 2018 Feb 01
TA  - Archives of Disease in Childhood
PG  - 165--169
VI  - 103
IP  - 2
4099  - http://adc.bmj.com/content/103/2/165.short
4100  - http://adc.bmj.com/content/103/2/165.full
SO  - Arch Dis Child2018 Feb 01; 103
AB  - Objective Despite the many benefits of paediatric Outpatient Parenteral Antimicrobial Therapy (OPAT) programmes, there are risks associated with delivering inpatient-level care outside of hospital. There is a paucity of evidence defining how best to mitigate these risks. We examined the impact of introducing a dedicated medical team to OPAT, to define the role of increased medical oversight in improving patient outcomes in this cohort.Design A prospective 24-month pre–post observational cohort study.Setting The Hospital in the Home (HiTH) programme at Princess Margaret Hospital (PMH) for Children, Western Australia.Patients All OPAT admissions to HiTH, excluding haematology/oncology patients.Interventions PMH introduced a dedicated OPAT medical support team in July 2015 to improve adherence to best-practice guidelines for patient monitoring and review.Main outcome measures Duration of OPAT, adherence to monitoring guidelines, drug-related and line-related adverse events and readmission to hospital.Results There were a total of 502 OPAT episodes over 24 months, with 407 episodes included in analyses. Following the introduction of the OPAT medical team, adherence to monitoring guidelines improved (OR 4.90, 95% CI 2.48 to 9.66); significantly fewer patients required readmission to hospital (OR 0.45, 95% CI 0.24 to 0.86) and there was a significant reduction in the proportion of patients receiving prolonged (≥7 days) OPAT (OR 0.67, 95% CI 0.45 to 0.99).Conclusion The introduction of a formal medical team to HiTH demonstrated a positive clinical impact on OPAT patients’ outcomes. These findings support the ongoing utility of medical governance in a nurse-led HiTH service.