Ajani, Temitope and Young, Marjorie Nurse-Led OPAT (Outpatient Parenteral Antimicrobial Therapy) Care-Coordination Program to Improve Outcomes in Adult Osteomyelitis Patients. 2021. Radford University, Dissertation. Radford University Scholars' Repository.
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Abstract
Abstract Overview: Outpatient Parenteral Antimicrobial Therapy (OPAT) offers numerous benefits and risks. Formal OPAT programs have been proposed to mitigate the risk of complications but there is a paucity of evidence regarding the specific design and efficacy. Purpose: To evaluate the impact of the nurse-led OPAT care coordination program, on the primary outcomes: 30-day readmissions, and adverse central line and/or adverse drug events in adult osteomyelitis patients using the Quality Assurance/Quality Improvement (QA/QI) process. A further purpose is to underscore the contributions of registered nurses as viable members of the interdisciplinary OPAT team and to support program funding. Materials and Methods: The patients in the control group received the traditional post-discharge care while the intervention group received nurse-led OPAT care coordination in addition to traditional care. A retrospective chart review of 456 patients, over 18 months, diagnosed with osteomyelitis, and discharged on parenteral antibiotics to Carilion clinic home health. The search yielded 54 Intervention and 13 Traditional patients. Fisher’s-exact tests and Bonferroni adjustment were used to analyze the impact of OPAT care process on outcomes. Results: There was no evidence to suggest a statistical association or dependence between the intervention and the primary outcomes among the Traditional or OPAT groups. However, a 12.96% readmission rate in the OPAT group is of clinical significance. This is comparable to readmission rates in similar studies that offered formal OPAT care programs. Limitations. Limitations noted were the small sample size, exclusion of non-Carilion facility readmissions, non-standardized charting of adverse events, and a lack of sensitivity of the primary outcome measure to nursing interventions. Application to practice: It is recommended that electronic health records be equipped to capture nurse-led care coordination and that future studies utilize outcome variables that are sensitive to nursing interventions in OPAT care programs. These may improve the safety, design, and sustainability of OPAT care. Keywords: Outpatient Parenteral Antimicrobial Therapy (OPAT), osteomyelitis, quality assurance and quality improvement (QA/QI), care coordination, 30-day readmission, adverse drug events, central line events.
| Item Type: | Dissertation |
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| Subjects: | R Medicine > RM Therapeutics. Pharmacology R Medicine > RS Pharmacy and materia medica R Medicine > RT Nursing R Medicine > RZ Other systems of medicine |
| Divisions: | Radford University > School of Nursing |
| Date Deposited: | 28 Jun 2022 13:23 |
| Last Modified: | 19 Apr 2023 16:59 |
| URI: | http://wagner.radford.edu/id/eprint/767 |
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