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Improving outpatient IV antibiotics

Improving outpatient IV antibiotics

What are outpatient IV antibiotics (OPIVA)?

Certain types of infections, such as those affecting the knee joint, require extended periods of treatment with antibiotics which need to be given intravenously (IV). Some of these patients require ongoing IV antibiotic treatment but are otherwise well enough to be discharged home. In such cases, they are eligible for outpatient intravenous antibiotics (OPIVA) treatment. This means that patients can continue to receive IV antibiotic treatment while recovering in the comfort of their own homes.


Why is OPIVA important?

Many of our patients tell us that they prefer to recuperate in the comfort of their own homes. OPIVA treatment reduces the length of time they have to stay in the hospital and helps patients return back to their work, school, university and other activities; all while still receiving high quality and safe antibiotic treatment for their infection.


What have we done?

Historically our OPIVA service has delivered treatment via Baxter pumps or by a district nurse. We wanted to further enhance our model of care by providing patients the opportunity to self-manage their antibiotics.

OPIVA treatment can now be delivered one of three ways depending on the infection and the antibiotic required:

  1. Via a “Baxter Pump” – a small bottle that holds 24 hours of antibiotics which is slowly infused into the patient via a special IV line (PICC). The majority of patients learn to change their own infusors after a few supported changes by a district nurse, otherwise a district nurse will change thir infusor daily either at the patient’s home or in the district nurs clinic
  2. A daily infusion is administered by a district nurse either at the patient’s home or in the district nurse clinic
  3. The patient or one of their family/whānau are taught to administer their own IV antibiotics by injection as a patient centred alternative, giving increased autonomy over their care

OPIVA clinical nurse specialist

As part of a wider OPIVA team which includes two infectious disease consultants, a pharmacist who specialises in antibiotic treatment and district nurses, a clinical nurse specialist role was introduced to:

  • OPIVA bookletcoordinate the OPIVA service
  • work with the patient before discharge from hospital to develop a care plan
  • provide education for patients, including learning how to administer their own antibiotics
  • be the single point of contact for OPIVA patients after discharge

The CNS is able to offer appropriate patients the opportunity to learn to administer their own antibiotics. We have developed a resources to support patients who are able to self-administer their own IV antibiotics including a laminated procedure mat, which are also available in Chinese and Korean.

OPIVA self-administration procedure mat
OPIVA laminated procedure mat for self-administration of IV antibiotics


Did we make a difference?

Without an OPIVA service, patients would have to stay in hospital for the duration of their course of antibiotics and we estimate we save over 6000 inpatient bed days per year. This is the number of days OPIVA patients would have spent in hospital instead of being discharged to finish their antibiotic treatment at home. 

Over the last 12 months we have supported approximately 270 patients with 45 of these being taught to self-administer their antibiotics, exceeding our initial goal of 20 patients.


Feedback

Results from a patient survey showed us that patients were very satisfied with the service and happy to have been able to return to their home environment under the care of the CNS as well as the district nurse service.

Patient feedback on OPIVA service

What worked well for our patients:

What worked well for our patients


Where to from here?

The OPIVA service is growing in response to the increasing number of patients requiring our service. We aim to improve our service by looking at other initiatives such as creating videos for our patients to educated them on home administering of antibiotics or changing their Baxter infusors.

Members of our OPIVA team
Members of our OPIVA team