Community Intervention Team

1. Cathryn Ryan
ADPHN

2. “Bringing health care as close as
possible to where people live and work”
Declaration of Alma-Ata International Conference on Primary Health
Care, WHO 1978.

3.  A community nurse led team, supported by other
health professionals and services, which provides a
rapid and integrated response to a patient with an
acute episode of illness.
 It has the capacity to deliver specific clinical
interventions to a patient in their own home
thereby preventing hospital admission or
facilitating early discharge

4. “ensure that the standard of care delivered
by our team must always be equal to, or
greater than acute hospital care”
National CIT governance document
2011

5. Regional Service
 Defined geographical area
 Main hub (Limerick) with 2 satellite teams
Ennis/Nenagh serving a population of 380,000.
 Governance structure within Public Health Nursing
Department.
 Nurse led with skill mix

7.  Hospital Avoidance
Primary Care Team referrals, self referrals
 Admission avoidance
Emergency departments,
AMAU,SAU.
 Early discharge
Inpatient hospital wards( Step down)

9.  365 day service
 14 hours daily 0800-2200
 Service provision 72 hours-14 days( OPAT 6 weeks)
 Delivering clinical interventions which previously
would have required hospital admission
 Rapid response/flexibility of service delivery

10. Intravenous
Antimicrobial therapy
OPAT Diabetic Care/BG monitoring
Medication
Management
Intravenous
Antiviral therapy
Disconnection of
chemotherapy
pumps
Older person
Support
Respiratory care/O2 sat
monitoring Nursing Monitoring
following fractures/falls
Central line Care
Urethral/Suprapubic
catheterisation
Palliative/end
of life care
Stoma care

11. Governance Structure
 Public Health Nursing ,IFPC, QPRS,Health and
Safety, Department PPGs
 National CIT Governance Group
 Commitment from Senior management within the
organization in developing the service.
 Dedicated competent staff ensuring safe quality
patient care

12. Director of Public Health Nursing
Assistant Director of Public Health
Nursing
Registered General
Nurse
Health Care Assistant

13.  Communication
 Co location
 Confidence

14.  Public health Nursing Service
 Primary Care Teams
 Community Nursing Units
 Palliative care services
 Home care package/home help co-ordinators
 Discharge co-ordinators in UHL group
 Acute hospitals staff
 GPs co-operatives
 Local Injuries Units

15.  Clinical Audits
 Patient Satisfaction

16. “The attention that I receive from the team is excellent. I cant
see any changes need to be made to improve the service”
“ first class service
”
“ it helped me to recover much more rapidly at home and it
removed the anxiety of a long hospital stay”
My husband had this service every day at 0900 for 6 weeks. He
was 100% happy. Thank you for giving him a good life for
another 6 months”
Patient Satisfaction Survey 2014

17. 0
500
1000
1500
2000
2500
3000
3500
2007 2008 2009 2010 2011 2012 2013 2014
CIT Service Growth

18.  Allied health professionals in the team
 CIT embedded in clinical care programmes to
maximize utilization.
 GP access to OPAT
 Information technology- electronic referral,
access to patient records, portable devices for
nurses to input and access information in
realtime.
 Role development/expansion
 Specific metrics to measure the cost
effectiveness of the service.