Clinical assessment of the patient referred to OPAT

Referral to OPAT may be acute where the aim is admission avoidance (e.g cellulitis) or non-acute where the aim is reduction in length of stay (e.g. following surgery for an infected hip replacement).

A non-acute OPAT referral usually follows a period of hospitalisation and there is often an anticipated discharge date which corresponds to recovery of mobility and the patient’s ability to self-care. In these circumstances suitability for OPAT and timing of discharge is a shared responsibility between the specialist ward-based team and the OPAT team. There is usually a good amount of time to discuss and agree an appropriate OPAT plan.

In the acute setting, assessing a patient’s suitability for OPAT may be more challenging. The OPAT practitioner’s clinical assessment is crucial to ensuring safe and appropriate patient management.

In the following two acute OPAT referral clinical scenarios we would like you to consider what clinical findings and what social, psychological and organisational issues may be of influence and relevance when deciding on the appropriateness of OPAT. Patient selection in these circumstances may be tricky. Let us know what you think!