It's Complicated: Patient and Informal Caregiver Performance of Outpatient Parenteral Antimicrobial Therapy-Related Tasks. (March 2020)

• Record Type: Journal Article
• Authors: Keller, Sara C.; Cosgrove, Sara E.; Arbaje, Alicia I.; Chang, Rachel H.; Krosche, Amanda; Williams, Deborah; Gurses, Ayse P.
• Is Part Of: American journal of medical quality. Volume 35:Number 2(2020)
• Page Start: 133
• Page End: 146
• Publication Date: 2020-03
• Subjects: outpatient parenteral antimicrobial therapy -- home care -- home infusion therapy -- task analysis -- human factors engineering; Medical care -- Quality control -- Periodicals; Medical care -- Evaluation -- Periodicals; Medical care -- Utilization review -- Periodicals; Medical care -- United States -- Periodicals; 362.1
• DOI: 10.1177/1062860619853345
• Languages: English
• ISSNs: 1062-8606

Abstract

Outpatient parenteral antimicrobial therapy (OPAT) requires patients and caregivers to infuse antimicrobials through venous catheters (VCs) in the home. The objective of this study was to perform a patient-centered goal-directed task analysis to identify what is required for successful completion of OPAT. The authors performed 40 semi-structured patient interviews and 20 observations of patients and caregivers performing OPAT-related tasks. Six overall goals were identified: (1) understanding and developing skills in OPAT, (2) receiving supplies, (3) medication administration and VC maintenance, (4) preventing VC harm while performing activities of daily living, (5) managing when hazards lead to failures, and (6) monitoring status. The authors suggest that patients and caregivers use teach-back, take formal OPAT classes, receive visual and verbal instructions, use cognitive aids, learn how to troubleshoot, and receive clear instructions to address areas of uncertainty. Addressing these goals is essential to ensuring the safety of and positive experiences for our patients.