A Matter of Time: A Survey to Explore the Perceived Time Released Following a Timely Appropriate Intravenous to Oral Switch

Introduction: Optimising timely appropriate intravenous to oral switch (TAIVOS) delivers clinical and operational benefits, as intravenous administration is associated with risk and delays to discharge. One underappreciated issue is the nursing workforce impact due to the increased time required to prepare and administer intravenous compared to oral medicines, at 20 minutes more per dose. Improving awareness of the workforce benefits of TAIVOS could be an additional driver to improving rates of TAIVOS. Awareness of these benefits amongst medical and nursing staff is not known therefore we aimed to gauge degree of awareness through a survey

Method: A Microsoft Forms survey was developed by a multidisciplinary working group and distributed to patient facing professionals in acute trusts across the Midlands via QR code, hyperlink, and paper copies. Respondents were asked to estimate the amount of time that could be saved by switching a patient from a three times daily intravenous antibiotic to an oral equivalent.

Results: 508 responses were received, 489 from nurses and 19 from doctors. The median time considered by nurses to be released following TAIVOS was 30 minutes (IQR 20-30 minutes), whereas doctors perceived this to be 60 minutes (IQR 20-60 minutes). The scenario provided to the respondent would have equated to a time saving of around 60 minutes.

Conclusion: There is considerable underestimation of the time required to prepare and administer intravenous medicines, particularly with nursing staff. Further work is required to increase awareness of the benefit of TAIVOS for workforce capacity across the Midlands and beyond.