Defining the OPAT team

Which healthcare professionals should be part of your OPAT team? As in all other aspects of hospital practice, safe patient care within OPAT is dependent on a range of clinical skills and a multidisciplinary approach.Traditionally the core OPAT team consists of a medically trained infection specialist (either an infectious diseases physician or clinical microbiologist), a specialist OPAT nurse and a specialist antimicrobial pharmacist.Other healthcare workers in both primary and secondary care play an important supporting role to OPAT e.g. through patient identification and referral or specialist (medical/surgical specialty) follow up and assessment or shared care.

The core OPAT team

Medically qualified infection specialistThe inclusion of a medically qualified infection specialist within the core OPAT team is to ensure infection management plans, including choice of IV or oral agent(s), criteria for IV to oral switch and duration of antibiotic therapy are appropriate. The medical professional is also usually responsible for overseeing management of other medical conditions (in conjunction with the appropriate specialist or family doctor) and any adverse events that may occur during OPAT.Specialist nurse trained in vascular accessThe specialist nurse has developed expertise in assessment of appropriateness and suitability for home or clinic administration of parenteral antimicrobial therapy, choice and placement of vascular device, liaison and communication with the ward and OPAT medical teams and organisation of logistics around OPAT. In addition the specialist nurse is responsible with others in the OPAT team with outpatient monitoring of the patient.Specialist antimicrobial pharmacistThe specialist antimicrobial pharmacist (AMP) is involved in patient screening and providing pharmaceutical care for those patients who enter the OPAT programme. Within the team the AMP advises on antimicrobial choice and delivery device selection, dosing regimen advice, therapeutic drug monitoring and potential drug interactions. In some services antimicrobial pharmacists will be independent prescribers and may also have extended roles in clinical assessment.Read more about the composition, role and function of the OPAT team in the BSAC OPAT Good Practice Recommendations.Discuss in the comments below:

• What is your role in the OPAT team?
• Do you think anyone else should be included within the OPAT team?