Improving the safety of outpatient parenteral antimicrobial therapy for patients with solid tumors
| Autor: | Patrick M. McDaneld, Meagan Rowan, Natalie Dailey Garnes, Alison Robins, Jalen Bartek, Emma Dishner, Javier A. Adachi, Ying Jiang |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Population Psychological intervention Outpatient parenteral antimicrobial therapy Anti-Infective Agents Statistical significance Neoplasms Outpatients Ambulatory Care Medicine Humans Infusions Parenteral Solid tumor education Hospital readmissions Retrospective Studies education.field_of_study business.industry Nursing research Mortality rate Follow-up OPAT Laboratory monitoring Antimicrobial Anti-Bacterial Agents Oncology Laboratory Test Result Emergency medicine Original Article business |
| Zdroj: | Supportive Care in Cancer |
| ISSN: | 1433-7339 0941-4355 |
| Popis: | Background and objectives Outpatient parenteral antimicrobial therapy (OPAT) for infections has been in use for nearly 40 years, and although it has been found safe and efficacious, its use has been studied primarily among otherwise healthy patients. We aimed to develop and evaluate an OPAT program for patients with cancer, particularly solid tumors. Methods We implemented multiple quality improvement interventions between June 2018 and January 2020. We retrospectively and prospectively collected data on demographics, the completeness of infectious diseases (ID) physician consultation notes, rates of laboratory test result monitoring, ID clinic follow-up, and 30-day outcomes, including unplanned OPAT-related readmissions, OPAT-related emergency center visits, and deaths. Results Completeness of ID provider notes improved from a baseline of 77 to 100% (p p p p = .027). Thirty-day unplanned OPAT-related readmission, ID clinic follow-up, 30-day emergency center visit, and death rates improved without reaching statistical significance. Conclusions Sustained efforts, multiple interventions, and multidisciplinary engagement can improve laboratory test result monitoring among solid tumor patients discharged with OPAT. Although demonstrating a decrease in unplanned readmissions through institution of a formal OPAT program among patients with solid malignancies may be more difficult compared with the general population, the program may still result in improved safety. |
| Databáze: | OpenAIRE |
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