Johns Hopkins University School of Medicine, Baltimore, MD.
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Am J Med Qual. 2020 Mar/Apr;35(2):133-146. doi: 10.1177/1062860619853345. Epub 2019 Jun 4.
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.
门诊患者的静脉输注抗菌药物治疗(OPAT)需要患者及其照护者在家中通过静脉导管(VC)输注抗菌药物。本研究的目的是进行以患者为中心的目标导向任务分析,以确定成功实施 OPAT 所需的条件。作者对 40 名患者进行了半结构化访谈,并对 20 名患者及其照护者进行了与 OPAT 相关任务的观察。确定了 6 个总体目标:(1)了解并发展 OPAT 技能,(2)接受用品,(3)药物管理和 VC 维护,(4)在进行日常生活活动时防止 VC 损伤,(5)管理出现危害时的失败,以及(6)监测状态。作者建议患者及其照护者使用回述、参加正式的 OPAT 课程、接受视觉和口头指导、使用认知辅助工具、学习如何排除故障以及获得明确的指令来解决不确定的问题。解决这些问题对于确保患者的安全和积极体验至关重要。