Hazards from physical attributes of the home environment among patients on outpatient parenteral antimicrobial therapy.
BACKGROUND
Outpatient parenteral antimicrobial therapy (OPAT) requires that patients and their caregivers administer antimicrobial medications in the home via venous catheters. Hazards from physical attributes of the home environment may impede safe performance of OPAT tasks.


METHODS
We performed a qualitative study, including semistructured telephone interviews and contextual inquiries, of patients performing OPAT tasks inside the home. Eligible participants were discharged from 2 academic medical centers in Baltimore, Maryland, on OPAT. We coded interview transcripts and contextual inquiry forms based on a model of healthcare work systems.


RESULTS
Twenty-nine patients underwent semistructured telephone interviews, and 14 patients underwent contextual inquiry. We identified hazards including bathing, animal or pets, extremes in temperature, household clutter, indoor soil and food exposures, outdoor soil, and travel. Patients often developed strategies to mitigate these hazards.


DISCUSSION
Multiple hazards related to the home environment could have led to harm, and in the absence of specific guidance, patients developed strategies to mitigate these hazards.


CONCLUSIONS
Educational interventions to improve OPAT should incorporate an understanding of hazards that may occur in the home environment.
['Keller|Sara C|SC|', 'Cosgrove|Sara E|SE|', 'Kohut|Michael|M|', 'Krosche|Amanda|A|', 'Chang|Huai-En|HE|', 'Williams|Deborah|D|', 'Gurses|Ayse P|AP|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D000553:Ambulatory Care D000890:Anti-Infective Agents D015142:Baltimore D004781:Environmental Exposure D005260:Female D018575:Home Care Services, Hospital-Based D018718:Home Infusion Therapy D006801:Humans D007407:Interviews as Topic D008297:Male D008875:Middle Aged D010045:Outpatients D017751:Safety Management D055815:Young Adult
OPAT Home infusion therapy Human factors engineering Infection prevention Qualitative research