Q: What level of service do you provide e.g. nursing service only, nursing plus pharmacist/doctor/micro input?
A: We are a nurse led service providing administration of Intra Venous (IV) antimicrobial therapy. There are 8 nurses in our team.
Patients remain under the care of the referring Trust for the duration of treatment.
We currently have a virtual ward round with the consultant microbiologist for Calderdale and Huddersfield Hospital Trust patients and a virtual ward round with the antimicrobial pharmacists for Mid Yorkshire Hospital Trust patients.
Although we don’t have regular virtual ward rounds arranged with out of area trusts, we do require the referring Trust arranges weekly contact with the OPAT service to undertake a review of the patient’s treatment. Referring trusts are expected to support the OPAT service with any issues that arise with the patient as they remain under the acute trusts care throughout.
The team also undertakes a safety huddle every day to discuss all patients on the caseload and any changes of conditions or presentation of those patients.
Q: Which postcodes do you provide a service to?
A: We provide IV therapy to patients who live in Kirklees. The service covers anyone who pays council tax to Kirklees council / is registered with a GP in Kirklees.
The area includes but is not limited to Batley, Dewsbury, Mirfield, Cleckheaton, Birkenshaw, Golcar, Holme Valley, Marsden, Denby Dale.
The service also covers those patients on the boundary of Kirklees when it is assessed appropriate.
Q: Where do you see your patients e.g. in their own homes, clinic setting?
A: In their own homes, in a care home or rehabilitation setting. The care setting manager must agree for the patient to return to their care setting with a central venous access device (CVAD) or cannula.
Q: Do Locala OPAT service undertake first dose?
A: Patients are to have their first dose in the acute setting under the referring clinician. Where loading doses are required, this must be administered under the referring clinician before referring to the OPAT service.
Q: How do we refer to Locala OPAT Service?
A: Referrals at present can be telephoned through direct to the OPAT Service or via Single Point of Contact.
Patients will be registered, and full details obtained before a decision is made. When the patient is accepted onto the caseload a start and finish date will be agreed. If a patient is being referred from an out of area trust their first visit will be the next working day after the referral is accepted.
Q: Who is the best contact for your service?
A: The OPAT Service can be contacted either directly on 07908529195 / 07773152431 or via Locala’s Single Point of Contact on 0300 304 5555.
Patients cannot be discharged until the OPAT Service have discussed with the ward and accepted the patient onto the caseload.
The Unplanned Care Lead for Locala OPAT Service is Katy Littlewood – 0303 330 9657 [email protected]
Q: Can you administer 24-hour infusions?
A: We currently use Accufuser 24hour pumps from acute Trusts.
All Accufuser devices are administered via a central venous access device.
These devices are provided by the referring trusts who must have and are willing to share their Standard operating procedure for the Opat service to work towards. The referring trusts must provide correct equipment for the OPAT service including storage of the medication allowing for correct cold chain measures.
If you wish to refer someone with an Accufuser device then please contact us. This is discussed on a case by case basis.
Q: What type of access do the team administer via?
A: The team are trained to access CVADS including implanted ports. If there are any issues with the CVAD i.e. blockage or rupture the patient will be sent to the referring trust.
The team are also competent in cannulation. If the team are unable to cannulate the patient the patient will be sent to the referring trust for re-cannulation.
We adhere to the vessel health preservation guidelines and request that any patients with poor venous access or a treatment regime longer than 14 days have a CVAD.
Q: Do you remove central lines in the community?
A: We can remove non tunnelled central venous access devices.
Q: Do your nursing staff take bloods?
A: Yes, both venepuncture and from central venous access devices.
Q: Can you request blood tests, or do you require blood forms and/or blood-taking equipment?
A: Blood forms must be sent with the patient.
Bloods are taken to either Mid Yorkshire Hospitals Trust or Calderdale and Huddersfield Foundation Trust’s pathology labs depending on where the patient lives. We are unable to take bloods to out of area Trusts. We may be able to have the bloods sent to out of area trusts via the pathology labs on request.
Q: Who follows up your blood results i.e. do you have a member of your team who does this, or would you need the referring team to do this?
A: The referring trust is responsible for ensuring treatment is monitored appropriately, including reviewing blood test results, taking appropriate action and reporting back to the OPAT service.
Q: What do you require the referring organisation to provide on discharge e.g. drugs, diluents, flushes, other equipment?
A: We require a legal direction to administer medication. Ideally, this would be a Locala OPAT prescription (from the Locala website). Alternatively, it could be a discharge prescription. Whichever form the direction to administer is in, it must be attributable to an appropriate prescriber.
The drug, dose, route, start and finish date should be clearly documented.
The equipment required would be dependent on whether the patient is prescribed an infusion or bolus dose, via cannula or CVAD.
The referring Trust must provide everything required for the entirety of the treatment to enable administration by the OPAT Service. This includes the weekly CVAD maintenance required and/or the equipment required for potential re cannulation.
Requirements:
We also require a review date, and assurance that the patient remains under the referring consultant’s care with appropriate contact details, particularly where the referring organisation is out of area.
Q: What happens when the patient is discharged from hospital to OPAT?
A: All equipment required including a prescription should be sent home with the patient.
The patient remains under the care of the referring trust and it is expected that the patient is reviewed virtually or face to face at least weekly (dependent on the length of treatment). The review is not the responsibility of the GP.
Any changes to treatment must be discussed with the OPAT Service.
The OPAT nurses review the patients presenting condition and undertake a full set of observations with NEWS score at every administration. Any issues or concerns about the patient or treatment is reported back to the referring consultant and GP for action.
