It's Complicated: Patient and Informal Caregiver Performance of Outpatient Parenteral Antimicrobial Therapy-Related Tasks

Sara C Keller 1, Sara E Cosgrove 1, Alicia I Arbaje 1 2, Rachel H Chang 2, Amanda Krosche 1, Deborah Williams 3, Ayse P Gurses 1 2 4

Affiliations

PMID: 31161769
PMCID: PMC6917971
DOI: 10.1177/1062860619853345

Free PMC article

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.

Keywords: home care; home infusion therapy; human factors engineering; outpatient parenteral antimicrobial therapy; task analysis.