How Might Antibiotic Stewardship Programs Influence Clinicians' Autonomy and Organizations' Liability?

Federal and state governments mandate some health care organizations to implement antibiotic stewardship programs (ASPs). Some early adopters developed model ASPs that have helped set industry standards; other benchmarks will likely be forged in subsequent regulation, legislation, and jurisprudence. This article considers how ASP designs can affect professional autonomy, especially of frontline antibiotic stewards who are usually physicians and pharmacists. This article also considers how ASP development and implementation might influence standards of care and malpractice liability.

The early acquisition of viable knowledge: A use of recursive model as an analytical devise (methodolosocial).

In nurse education typically, information is presented to students within the classroom and then applied within a clinical situation. Acquisition of the knowledge required to inform the student's early practice is the focus of this research. This paper centres upon the construction of a cognitive model that is recursive in nature, and forms an integral part of a qualitative research study. The primary study investigated how first year student nurses use the information received in the classroom to underpin their early practice. Data were collected from 10 students and 4 of their lecturers, via blogs and interviews and used iteratively to create a model that is recursive in nature. Recursion is a process of repeatedly revisiting the same thing, in this case the data, which are considered in an iterative or progressive way. Recursion thus facilitated the development of a model, which was seen to change and develop in sophistication as more data were considered and evaluated. Visual devices were used throughout to bring clarity during the construction of the model. This visual process was pivotal to the analysis. This paper chronicles the development of an analytical device through the medium of the study presented. Viable knowledge is represented as the synthesis of concepts, as presented in the classroom, and practice, as experienced within the clinical area. It illustrates how conceptual material delivered within the classroom has become embedded within an individual student's consciousness and is used during a clinical placement to make sense of a specific situation. The study identifies how students use information and makes recommendations as to how appropriate curricula integrate all the facets of the recursive model. The process of recursive modelling is thus offered as an analytical devise, which may be applied by researchers to other qualitative data.