ElastoMeric Infusion Pumps for Hospital AntibioTICs (EMPHATIC): A Feasibility Study

BACKGROUND: Elastomeric infusion pumps (EMPs) are safe and effective for administering outpatient intravenous (IV) antibiotics. We hypothesized that EMPs may provide benefits in the inpatient setting. This study aimed to assess the feasibility of giving IV antibiotics using EMPs to adult inpatients and to identify barriers and facilitators for their implementation. METHODS AND OBJECTIVES: Patients who were 18 years of age and over requiring at least seven days of IV flucloxacillin, benzylpenicillin or piperacillin/tazobactam and who were clinically stable were eligible. We collected quantitative data for feasibility, clinical outcomes and intervention acceptability. We applied an implementation research framework to help triangulate the data. Analyses were descriptive, with the intent of preparing for future studies. RESULTS: IV antibiotics from 94 EMPs were administered to nine patients, with five patients completing treatment with an EMP. Five of the six patients surveyed said they would use EMPs again. Nurses felt EMPs were safer, less time consuming and improved working conditions. IV antibiotics via EMPs cost GBP 32.50 (GBP 3.35-GBP 83.44) more per day than intermittent infusions. Residual volume in EMPs was an issue which resulted in reduced antibiotic doses being delivered. The main facilitators to use of EMPs in the inpatient setting were adaptability, tension for change, recipient centeredness and needs of the deliverers. The barriers were lack of advantage, critical incidents and cost. CONCLUSION: This proof of concept feasibility study shows that it may be feasible to use EMPs in the inpatient setting. There is potential to improve patient and staff experience; however, cost and residual volume are potential barriers to implementation, with further studies required.