Experience with setting up community intravenous therapy clinics

Outpatient parenteral antibiotic therapy (OPAT) refers to the approach by which intravenous (IV) antimicrobials are administered in the outpatient setting or community (Chapman et al, 2012). In the UK, until recently, OPAT delivery was limited to a few specialist centres led by enthusiastic individuals (Chapman et al, 2012). OPAT is now an increasingly used, safe and effective model of care in the UK, endorsed by the Department of Health and Social Care as a key antimicrobial-prescribing decision within an antimicrobial stewardship programme (Barr et al, 2013). Community nursing teams aim to provide a multidisciplinary and integrated approach between care in the hospital and community, complementing the services provided by the secondary and primary care sectors and community service providers.

Community nursing services administer a variety of IV medications to treat infections such as cellulitis, exacerbation of chronic obstructive pulmonary disease (COPD), community-acquired pneumonia and urinary tract infections (UTIs) (National Institute for Health and Care Excellence (NICE), 2012). These treatments are administered safely and effectively in community clinics or at home for housebound patients, often without the need for hospital admission. Referrals for these services are received from GPs to prevent the need for hospital admissions, and from secondary care, to support earlier discharge of patients who would otherwise need to remain in hospital until their treatment was completed.