Nurses in Southampton are running a pioneering scheme that enables children with complex infections to be treated increasingly at home.
The paediatric outpatient parenteral antibiotic therapy (p-OPAT) service is led by clinicians at Southampton Children’s Hospital.
The service allows young patients who are medically stable, but in need of prolonged intravenous antibiotics, to be managed safely outside of hospital.
“It is a fantastic example of hospital and community professionals working together to improve patient care”
In some cases, hospitalisation may be entirely avoided and in others length of admission may be shortened.
Previously patients would be admitted for the duration of their antibiotic course which, for some patients, could last up to six weeks, said University Hospital Southampton NHS Foundation Trust.
The service was the idea of Dr Sanjay Patel, a consultant in paediatric infectious diseases, and Helen Green, a clinical nurse specialist in paediatric infectious diseases.
As part of the scheme, Ms Green became the only nurse in the country trained to insert peripherally inserted central catheter lines in children under general anaesthetic using ultrasound guidance.
Use of the PICC lines to provide antibiotics through one of the large veins in the arm for a prolonged period of time helps speed up discharge.
Once a patient has returned home, their customised antibiotics continue to be made in hospital and administered by community nursing teams across Hampshire, Dorset and Wiltshire.
For children on complicated antibiotic therapy, pump bags known as elastomeric devices are being used to administer antibiotics continuously over a 24-hour period.
The team treats children suffering from a range of severe infections, including bacteria in the blood or blood poisoning, bone and joint infections, endocarditis, brain abscesses, meningitis and central line infections.
During a 21-month trial period, 80 patients who would have required a total of 1,472 hospital bed days were treated at home, resulting in an estimated cost-saving of £250,000.
When surveyed, 100% of families agreed or strongly agreed p-OPAT was preferable to inpatient treatment, according to a poster presentation on the service.
“This service really is at the forefront of patient innovation in the NHS and has resounding benefits for patients, their families and healthcare organisations,” said Dr Patel.
“It is a fantastic example of hospital and community professionals working together to improve patient care and we are delighted feedback has been so positive among parents and their children.”
He added: “The model is now being adopted by other leading children’s hospitals in the UK.”
The team, including Ms Green and Dr Patel, have also drawn up good practice recommendations for p-OPAT in the UK.