Paper addresses liability concerns for antibiotic stewardship programs
A white paper published today in Infection Control and Hospital Epidemiology calls on antibiotic stewardship programs (ASPs) to take steps to address the potential legal implications of stewardship activities.
The paper, written by a team of legal and antibiotic stewardship experts, aims to address some of the concerns that ASPs, which are now required in most US hospitals, have about liability to patients they neither see nor examine. Although there is no legal precedent addressing liability and standards of care, and there have been no specific lawsuits filed involving ASPs, the question is whether ASPs put hospital staff at risk of litigation if they make errors that lead to patient harm. Using the results of a survey of healthcare professionals and analysis of case law, the experts provide an outline of the legal issues and strategies to address those issues.
Among the issues covered in the paper are the principles of medical liability in the context of ASPs, the existing regulatory landscape and whether it insulates ASPs from liability, documentation of ASP recommendations, clinical training of ASP personnel, the use of clinical practice guidelines, and what happens when treating teams do not accept ASP recommendations, or when ASP recommendations are incorrect.
To address these issues, the authors conclude that ASPs should work with hospital administration, treating teams, pharmacists, and other stakeholders to develop: (1) protocols to communicate and resolve differences with treating teams or other stakeholder, (2) documentation to provide the basis of recommendations as well as preserve the record of ASP involvement, and (3) standards for credentialing ASP team members based on experience or formal training.
"Regardless of specific circumstances, considering the best practices for program structure, interventions, and documentation is essential not only for risk mitigation, but also to optimize the quality of antibiotic prescribing and patient care," they write.
May 13 Infect Control Hosp Epidemiol abstract
Global life expectancy rises, but COVID-19 threatens progress
An annual snapshot of the world's health from the World Health Organization (WHO) shows that life expectancy and healthy life expectancy have increased, with the biggest gains in low-income countries, though the COVID-19 pandemic is threatening the progress.
In a statement, the WHO said its 2020 World Health Statistics report gauges progress with key health indicators, revealing progress and gaps in moving toward Sustainable Development Goals.
Low-income countries saw life expectancy rise 21%, or 11 years, between 2000 and 2016, compared with a rise of 4%, or 3 years, in higher-income countries. The WHO said better access to services to prevent and treat HIV, malaria, and tuberculosis, as well as neglected tropical diseases such as Guinea worm, helped move the needle for lower-income countries. Better maternal and child healthcare halved child mortality between 2000 and 2018 and also played a role.
However, the report also highlighted areas where progress has stalled, including immunization coverage, malaria prevention, and services for noncommunicable diseases. The WHO added that the uneven progress reflects unequal access to quality health services, with only one-third to one-half of the world's population able to access essential services in 2017. Cost of healthcare is another challenge, it said, noting that for 2020, about 1 billion people, about 13% of the global population, will spend at least 10% of their household budget on healthcare.
Samira Asma, DDS, MPH, the WHO's assistant director-general, said in the statement, "The COVID-19 pandemic highlights the need to protect people from health emergencies, as well as to promote universal health coverage and healthier populations to keep people from needing health services through multisectoral interventions like improving basic hygiene and sanitation."
May 13 WHO statement
