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Determining the Risk of Sepsis Using Nurse-Compounded Elastomeric Pumps for Continuous Infusion in Outpatient Parenteral Antibiotic Therapy

Dobson, Pauline M. MHS, RN; Loewenthal, Mark MMedSci, MB, BS, FRACP, DTM&H; Harris, Lisa BSc (Hons), BPharm (Hons)

doi: 10.1097/NAN.0000000000000220
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Limited availability of compounded antibiotics used for continuous infusion outpatient parenteral antibiotic therapy (OPAT) can delay or interrupt an OPAT course. To solve this problem, OPAT nurses at a hospital in Australia have been compounding elastomeric pumps for immediate use. The incidence of sepsis in 5014 patients before and after the introduction of nurse compounding was compared. There were no cases of laboratory-confirmed bloodstream infection among the nurse-compounded group compared with 2 cases (0.045/1000 catheter days) among the control group without nurse compounding (P = .16). No compounding medication errors occurred in more than 180 patient years of follow-up among the nurse compounding group. Nurse compounding can be a safe and convenient alternative when immediate access to preloaded elastomeric pumps is required.

John Hunter Hospital, Newcastle, New South Wales, Australia (Mss Dobson and Harris, Dr Loewenthal); and University of Newcastle, Newcastle, New South Wales, Australia (Ms Dobson and Dr Loewenthal).

Pauline M. Dobson, MHS, RN, is a clinical nurse consultant in the immunology and infectious diseases unit at John Hunter Hospital in Newcastle, Australia. She has 30 years' experience in the provision of home infusion therapy and established the unit's outpatient parenteral antibiotic therapy program in 1995. She is a conjoint lecturer in the faculty of health and medicine at the University of Newcastle, Australia.

Mark Loewenthal, MMedSci, MB, BS, FRACP, DTM&H, is a staff specialist in infectious diseases and director of the immunology and infectious diseases unit at John Hunter Hospital, Newcastle, Australia. He is also a conjoint senior lecturer in the faculty of medicine and public health at the University of Newcastle, Australia.

Lisa Harris, BSc (Hons), BPharm (Hons), is a clinical pharmacist in John Hunter Hospital's immunology and infectious diseases unit, with particular expertise in antibiotic administration and antimicrobial stewardship.

Corresponding Author: Pauline M. Dobson, MHS, RN, Immunology and Infectious Diseases Unit, John Hunter Hospital, Lookout Road, New Lambton, NSW Australia 2305 (Pauline.Dobson@hnehealth.nsw.gov.au).

The authors have no conflicts of interest to disclose.

© Copyright 2017 by Infusion Nurses Society