An assessment of the safety, efficacy and patient satisfaction of Intravenous antibiotics administered at home as a continuous infusion through a peripheral intravenous cannula, by 4 Australian Hospital in the Home (HITH) services

This will be a multicentre (4 Australian Hospital in the Home (HITH) services) prospective cohort study where the patient population will be HITH patients prescribed short term (<2 weeks) continuous antibiotics as an infusion via a Peripheral Intravenous Cannula (PIVC). The practice of providing a continuous antibiotic infusion via a PIVC at home is something that has been occurring at all 4 sites for a number of years and will be offered to all suitable patients (as per study protocol) with a diagnosis and clinical scenario in whom IV antibiotics are indicated and where the antibiotic is suitable to be provided as a continuous infusion (dependent on antibiotic stability as an infusion and low risk of peripheral venous irritation) - this is regardless of whether they consent to study participation or not. It is already standard practice at all 4 sites (and many other HITH services in Australia) prior to this study and supported by prior local retrospective audits at the Canberra Hospital and Bankstown-Lidcombe Hospital HITH services All HITH patients are admitted to the respective HITH Unit under the care of an admitting medical specialist and are seen at least once daily by a HITH nurse who checks on the PIVC site daily and changes over the antibiotic infusion daily. The nurse also measures the patients vital signs are how they are responding to the antibiotic therapy at this visit - which most often occurs in the patients home but may also occur at the HITH Unit clinical base. This daily check of the PIVC is routine nursing care and is recorded in the patient medical record to note that the PIVC site is patent and noninflamed (including the recording of a VIP (Visual Infusion Phlebitis) score each day. Whilst this is already standard practice, there is also a specific data collection form that has been developed for the study to reinforce the data that is being requested for the purpose of this study. It is standard practice at all sites (as per general hospital PIVC management policy) to change the PIVC every 72 hours (if it is still required). The PIVC will also be replaced earlier than 72 hours if there are any signs of inflammation, bleeding, infiltration, occlusion etc as per the data collection form and as standard practice. At The Canberra Hospital it is authorised that PIVCs inserted by the IVAT (IV Access Team) nurses under ultrasound guidance using sterile technique may be left in situ until the removal of the PIVC is clinically indicated rather than every 72 hours - this may be because IV antibiotic therapy is no longer indicated or because there are PIVC site issues as above. The PIVC and antibiotic infusion is largely managed by the HITH nurses as above but patients (and/or carer) are educated about issues to look out for in terms of the cannula (eg signs of inflammation such as pain and redness) and the infusion (eg infusion bottle not emptying as anticipated over the 24 hour period) and to phone the HITH nursing team if these issues occur between daily nursing visits