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Advancing IV Therapy: Speakers News & Updates

News and updates from today’s conference focusing on advancing IV Therapy including implementing the December 2016 revised RCN Standards for Infusion Therapy and monitoring adherence to the NICE Guideline and Quality Standards for IV Therapy. 

Meeting the NEW RCN Standard for Infusion Therapy in Practice
Suman Shrestha,
Advanced Nurse Practitioner, Critical Care Services, Frimley Health NHS Foundation Trust, and Project Board Member, RCN Standard for Infusion Therapy 2016 

In his presentation Suman stated: 

“80% of hospitalised patients receive intravenous therapy at some point during their admission”

“Infusion therapy is common but complex. It is essential in some cases but also comes with greater risks.”

“Poor training, education and staffing levels lead to errors”

“Flushing and locking of infusion devices - There is no evidence that locking CVCs with heparin is any more effective than normal saline or citrate”

“The NMC will be publishing Standards for Medicines Management - The safe administration of medicines is an important aspect of the professional practice”

“You should use the RCN Standards for Infusion Therapy to implement evidence based practice, training and education and clinical governance”

Pre-Event Abstract
The revised edition of RCN Standards for Infusion Therapy which was published in December 2016 provides nurses with guidance to support their care to those patients who receive infusion therapy. The guidance is not limited to nurses but recommended for all other health care professionals who deliver infusion therapy. In this session, I will discuss the challenges and complexity of infusion therapy and how this guideline can be used in clinical practice in order to improve patient safety and quality as well as for the provision of training and education.  The document can be download from:
https://www.rcn.org.uk/professional-development/publications/pub-005704

Suman Shrestha presentation

Developing effective out patient access to intravenous therapy - OPAT
Philip Howard,
Consultant Antimicrobial Pharmacist, Leeds Teaching Hospitals NHS Trust

Pre-Event Abstract
Out-patient (or home) IV antibiotic therapy (OPAT) is a key strategy for delivering much of the NHS Outcomes Framework: reducing time spent in hospital, avoiding hospital admission, improving the patient experience and protecting them from avoidable harm eg healthcare acquired infections such as Clostridium difficile, Staph aureus bacteraemia. In addition, the NHS five year forward view aims to reduce around 2000 to 3000 in-patients hospital beds. Funding of OPAT services is the major barrier to delivering this. Whilst there are best practice tariffs available to encourage out-patient rather than admitting patients for cellulitis treatment, these are limited. The current payment by results (PBR tariff) model is probably unsustainable, so all Sustainability and Transformation Plans (STP) should include OPAT as a solution for transforming NHS in-patient services, but it will require local health economies to work together to find working financial solutions. Unfortunately, the NHS Vanguard programme does not have a work stream explicitly covering OPAT, but it does include two centres whose projects incorporate elements of OPAT. Whilst OPAT may appear to be an easy solution, patient safety is paramount. There are published UK standards for both adult and paediatric OPAT services. These should be the foundation of any OPAT service.   Whilst there are various models for OPAT (patients returning to an infusion centre H-OPAT, administration by a general or specialist nurse in the patient’s home (C-OPAT), patients self-administering in their own home S-OPAT), recent NIHR funded research has identified that the most cost-effective model for OPAT courses less than 7 days is by specialist nurse visiting the patient in their own home, and for longer courses, either home visit by a specialist nurse or patient self-administering as the most cost-effective. What is not clear is the appropriate level of staffing for each model. Capturing bed-days through OPAT is an important measure to achieving this aim. The British Society of Antimicrobial Chemotherapy (BSAC) OPAT initiative www.e-OPAT.com is relaunching it national  OPAT registry system (NORS) to capture real world data to help inform future national planning. Recent clinical developments will have an impact on future OPAT services: firstly, the launch of a long acting IV antibiotic dalbavancin that has a two week duration of action after a single infusion for the treatment of Gram positive infections such a cellulitis. More importantly, the initial results of the UK OVIVA study comparing oral antibiotics against IV antibiotics for serious bone and joint infections after initial short term IV treatment showed no difference in patient outcomes with a 12 month follow up. The final publication is due soon. Further information can be found at www.e-OPAT.com

Philip Howard presentation

Future events:

IV Therapy Summit: Improving quality and safety including effective IV Therapy at home (OPAT)
Thursday 7 December 2017, Manchester


 


15 September 2017

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