Home IV antibiotics service saves 3,261 bed days each year

A free HSE Mid West service where patients on IV antibiotics are discharged early from hospital and treated at home or in the community has improved patient experience and freed up acute beds for other patients.

Along with the significant annual saving of more than 3,200 bed-days through admission avoidance or reduced length of stay, the region’s Outpatient Parenteral Antimicrobial Therapy (OPAT) service also ensures that patients can safely return home with minimal disruption to their lives.

OPAT, established in the Mid West in 2017, operates 365 days a year and aims to ensure that no patient who is receiving IV antimicrobials and is otherwise fit for discharge remains an inpatient in the hospital due to antimicrobial treatment.

Since 2017 to the end of 2024, 1,049 patients have been discharged onto the Mid West OPAT service, saving approximately 24,000 bed-days.

Maria Molyneaux, candidate Advanced Nurse Practitioner (cANP), OPAT, explains:

She added: “Nationally, patient satisfaction with the service is very high; with 98% of patients agreeing they would use the service again, 92% rating it as excellent and 96% agreeing that the experience was preferable to hospital treatment.”

Here in the Mid West, for Joseph O’Carroll Jnr living in Cappamore, County Limerick, the OPAT service experience has been very positive, stemming from the “exceptional kindness and accommodating approach” of nursing and other staff.

“Every visit is a reassuring experience,” added Limerick city resident Oliwia Szafran. “They always take time to listen and address any questions, which made me feel supported and genuinely cared for, throughout my treatment.”

Oliwia is particularly enthusiastic about learning to self-administer her medication. “Being able to manage my treatment from home has brought a sense of normalcy back to my life, allowing me to continue with my daily routines. The nurses taught me each step with patience and clarity, giving me the confidence I needed to handle things on my own.”

The daily service support net reinforces Oliwia’s sense of confidence. “I know I’m not alone,” she said. “The constant support from staff, knowing they’re just a call away, has been incredibly reassuring. This balance of independence and support has made a significant difference to my overall wellbeing and I am grateful to everyone in the outpatient team for their care.”

The OPAT homecare service is available 365 days, 8am to 8pm via the community intervention team (CIT).

Patients remain under the care of the primary consultant and infectious diseases (ID) consultant while receiving IV treatment at home, and there is a weekly review in the OPAT clinic with the ID consultant and senior nursing team or with the primary consultant.

Benefits for the patient include equivalent clinical outcomes to hospital care, without the stress of being in hospital. Promoting admission avoidance and early discharge, the service also promotes antimicrobial stewardship.

CIT provide IV therapy in the home care setting or CIT clinic. Two options are available to suitable patients:

• H-OPAT: a CIT nurse administers the IV antibiotics either at home or in the CIT clinic.
• S-OPAT: the patient self-administers the IV antibiotics.