Self-care for intravenous antibiotic therapy for muskuloskeletal infections
Self-care intravenous antibiotic pump therapy is a new treatment supported by our Trauma Assessment and Treatment Unit (TATU) virtual ward team, which allows patients to return to the comfort of their own homes while continuing intravenous antibiotic treatment. We expect this to lead to a reduction in risks to patients, reduced costs and a more sustainable model of healthcare.
What are the benefits?
This treatment is only offered to patients with mild to moderate infections who are well enough to be discharged home but may benefit from intravenous (IV) antibiotics. A virtual ward is a way of monitoring your care away from a hospital setting. Using virtual wards and antibiotic pumps we are now able to give you the benefits of intravenous antibiotics but without the need for you to stay in hospital.
Benefits to you
- Recovery from your illness in the comfort of your own home
- Reduction of your travel time and costs by having the treatment at home and not in the hospital
- Reduced risk of hospital acquired infection
- Improved rest
Benefits to the hospital
- Reduced costs
- Reduced waste
- Less labour intensive for staff
- More sustainable for the NHS
How does this work?
If you meet our strict inclusion criteria, an intravenous access device (IV) will be inserted into a vein in your arm by a member of our team. The antibiotic pump will be attached to this IV device. The total duration of treatment is 48 hours and requires two 24-hour antibiotic pumps. Our specialist orthopaedic nurses will teach you the process of using your antibiotic pump.
The first pump will be applied under our guidance in TATU. Only patients assessed as safe to use a self-care antibiotic pump at home will be allowed to proceed with this treatment. You will then be admitted to our virtual ward and a member of the team will provide you with monitoring equipment for clinical observations (temperature probe, heart rate monitor). Upon leaving the hospital we ask you to check your observations every 4 to 6 hours and contact us if there are any changes.
The second pump will be delivered to your home and can be used after the completion of your first pump. The timing of the delivery will be discussed with you before leaving the hospital. You will be provided with all the necessary monitoring equipment and a cool box for temporary storage.
Please contact your virtual ward nurse via a video conference call for support and guidance when applying the second pump. Your virtual ward nurse is available 24/7 should you have any concerns about your treatment or condition.
After 48 hours of antibiotic treatment, our specialist orthopaedic doctors will see you at a face-to-face appointment in TATU. This will be to assess if any further treatment is required. We will arrange this appointment at your initial hospital visit before you leave.
Are there any risks?
As with any treatment, there are risks involved. The main potential risk would be due to mechanical issues with your antibiotic pump or failure of your peripheral cannula. This may present as leaking, swelling or discomfort around the cannula. Should this happen, we advise you to contact your virtual ward nurse for advice. You may be asked to return to the hospital for an assessment.
By meeting our strict inclusion criteria, we do not expect your condition to deteriorate. Your clinical monitoring schedule is the same as we use if you were still in hospital. However, if you become more unwell, then please contact your virtual ward nurse for advice as soon as possible.
What to look out for?
If you develop any of the following symptoms, please contact the TATU ward on 07815 611 771 for advice.
- Feeling increasingly unwell
- Rash
- Redness or increased pain around the IV access
- Swelling around the IV access
- Alarms sounding on the pump.
- Temperature above 37.5° or below 36°
- Heart rate persistently less than 90