Literatura científica selecionada sobre o tema "Stewardship Program"

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Artigos de revistas sobre o assunto "Stewardship Program"

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Blondeau, C. M. "METHYL BROMIDE STEWARDSHIP PROGRAM". Acta Horticulturae, n.º 255 (outubro de 1989): 323–26. http://dx.doi.org/10.17660/actahortic.1989.255.39.

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Cunha, Cheston B. "Antibiotic Stewardship Program Perspective". Medical Clinics of North America 102, n.º 5 (setembro de 2018): 947–54. http://dx.doi.org/10.1016/j.mcna.2018.05.006.

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Wimberly, Jamie, Ken Malloy e Kent Van Liere. "The Customer Stewardship Program". Electricity Journal 12, n.º 7 (agosto de 1999): 32–41. http://dx.doi.org/10.1016/s1040-6190(99)00057-3.

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Miller, Michael, Heather Dion, Randy Ngelale, Ashley Shields, Brienne Seiner, Laura Maggos, Eddy Banks e Janine Lambert. "The Nonproliferation Stewardship Program". Nuclear Science and Technology Open Research 2 (11 de novembro de 2024): 73. http://dx.doi.org/10.12688/nuclscitechnolopenres.17586.1.

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The National Nuclear Security Administration (NNSA)’s Office of Defense Nuclear Nonproliferation (DNN) initiated the Nonproliferation Stewardship Program (NSP) in 2020 to provide an enduring pipeline of nonproliferation subject matter experts to Department of Energy (DOE)/NNSA laboratories, sites, and plants. This program provides nonproliferation-relevant science and technology opportunities through a modernized facility infrastructure. This paper provides an overview of NSP, highlights ongoing efforts in uranium and plutonium processing, and describes examples of hands-on experimental work and associated modeling and simulation.
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Barnes, Joy M., e Pamela Bradshaw. "Interventions to Decrease Inappropriate Antibiotic Use for Non-acute Respiratory Illness in Long-Term Care Settings". International Journal of Studies in Nursing 4, n.º 3 (21 de junho de 2019): 28. http://dx.doi.org/10.20849/ijsn.v4i3.599.

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Background: The life-saving power of antibiotics could be lost forever if leaders fail to implement effective antibiotic stewardship programs at all healthcare levels. Grahams’ Knowledge to Action theory guided the development of an antibiotic stewardship program in a long-term care facility that had received a citation for having no active antibiotic stewardship program as required by federal regulations. Purpose: The purpose of this project was to develop and implement an evidence-based antibiotic stewardship program into one long-term care facility. Methods and Materials: This quality improvement project was a population-based systems charter development. The implementation intervention was designed to change the way health care professionals treat non-acute episodes of upper respiratory infections in a long-term care setting. This project utilized the suspected lower respiratory infection (LRI) Situation, Background, Assessment, Recommendation (SBAR) form to reduce the number of antibiotics given during the early part of cold and influenza season of 2018. An antibiotic stewardship policy was developed by multidisciplinary team members and then implemented into the facilities daily practice. Results: The point-prevalence rate of antibiotics within this facility dropped from 24% in 2017 to 6% in 2018 after implementation of the antibiotic stewardship program. Conclusion: This project demonstrates how long-term care facilities can successfully implement an antibiotic stewardship program and potentially improve overall healthcare outcomes for the residents.
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Martin, Caren McHenry. "Implementing an Antimicrobial Stewardship Program". Consultant Pharmacist 32, n.º 5 (1 de maio de 2017): 18–25. http://dx.doi.org/10.4140/tcp.n.2016.532.

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Thomas, Morgan, Louise Amlie-Wolf, Laura Baker e Karen W. Gripp. "The Genetic Testing Stewardship Program:". Delaware Journal of Public Health 7, n.º 5 (dezembro de 2021): 20–23. http://dx.doi.org/10.32481/djph.2021.12.007.

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Vassallo, Angela, Snezana Naumovsky, Tanya Elgourt, Robert Winters, Ellie Goldstein e John Lee. "206Implementing an Antimicrobial Stewardship Program". Open Forum Infectious Diseases 1, suppl_1 (2014): S92. http://dx.doi.org/10.1093/ofid/ofu052.72.

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Richards, DeAnn, e Jill Hanson. "Successful Antimicrobial Stewardship Program Collaboration". American Journal of Infection Control 45, n.º 6 (junho de 2017): S19. http://dx.doi.org/10.1016/j.ajic.2017.04.038.

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Morris, Andrew, Thomas Stewart, Maureen Shandling, Scott McIntaggart e W. Liles. "Establishing an Antimicrobial Stewardship Program". Healthcare Quarterly 13, n.º 2 (26 de março de 2010): 64–70. http://dx.doi.org/10.12927/hcq.2013.21672.

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Teses / dissertações sobre o assunto "Stewardship Program"

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Phillips, Robin H. Carleton University Dissertation Geography. "Landowner attitudes toward private stewardship programs; an examination of the Island Nature Trust's private stewardship landowner contact program". Ottawa, 1995.

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Borhart, Glen W. "Stewardship educational program based on the Lukan pericopes (Pentecost season--Series C) /". Online full text .pdf document, available to Fuller patrons only, 1999. http://www.tren.com.

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Holmes, Glen. "The Manitoba Product Stewardship Program, a comparative review and assessment". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape8/PQDD_0018/MQ45060.pdf.

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Breiner, Amber Leigh. "Stewardship planning on conservation easements in the Forest Legacy Program /". Connect to title online (Scholars' Bank), 2008. http://hdl.handle.net/1794/7999.

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Ng, Chun-kong. "Cost effectiveness study of the antibiotics stewardship program in a regional hospital". View the Table of Contents & Abstract, 2006. http://sunzi.lib.hku.hk/hkuto/record/B36886336.

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Ng, Chun-kong, e 吳振江. "Cost effectiveness study of the antibiotics stewardship program in a regional hospital". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B39724906.

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Hudson, Teresa Michelle. "Assessing and evaluating the Forest Stewardship Program : promoting and conducting sound wildlife management /". Thesis, This resource online, 1995. http://scholar.lib.vt.edu/theses/available/etd-01102009-063302/.

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Jennings, Brian M. "Implementation of recommended Forest Stewardship Program practices in West Virginia ten-year assessment /". Morgantown, W. Va. : [West Virginia University Libraries], 2003. http://etd.wvu.edu/templates/showETD.cfm?recnum=2981.

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Thesis (M.S.)--West Virginia University, 2003.
Title from document title page. Document formatted into pages; contains viii, 60 p. : ill. Includes abstract. Includes bibliographical references (p. 58-60).
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Carl, Phillip A. "Identifying and using motives for charitable giving in the development program of a church-related social ministry institution". Theological Research Exchange Network (TREN), 1989. http://www.tren.com.

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Martinek, Michael Anthony. "Evaluation of the US Forest Service - Forest Stewardship Program and Spatial Analysis Project in Illinois". OpenSIUC, 2010. https://opensiuc.lib.siu.edu/theses/344.

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In 1978, the Federal government passed the Forestry Assistance Act which provides guidelines for states to support management on non-industrial private lands through the Forest Stewardship Program (FSP). In 1983, Illinois passed the Illinois Forestry Development Act which outlines the specific requirements for non-industrial private landowners residing in Illinois to take advantage of the FSP. Since the inception of the program, there has been little analysis to determine the quality of land enrolled in the FSP. Launched in 2004, the Spatial Analysis Project is a program sponsored by the US Forest Service to determine the type of land enrolled within FSP. Within each state, the SAP used an aggregate analysis based upon multiple criteria to divide all land available for the FSP into three categories - low, medium, and high stewardship potential. The objective of this project was twofold, first to determine if Illinois is effectively enrolling lands in the high stewardship potential category. Secondly, because timber production must be the primary goal of a FSP plan in Illinois, this study analyzed whether lands classified as high stewardship potential were also high in forest productivity. Results indicate that while Illinois is effectively enrolling high stewardship potential lands, these lands are not necessarily highly productive. This information could be used to give preference for cost-share assistance to those lands that are classified as highly productive, particularly in times when funding is limited, rather than on a first come, first served basis.
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Livros sobre o assunto "Stewardship Program"

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Johnson, Corey. Stewardship Incentive Program. Bellingham, WA: Huxley College of Environmental Studies, 1999.

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United States. Environmental Protection Agency. Office of Pesticide Programs. Pesticide Environmental Stewardship Program. 9a ed. [Washington, D.C: U.S. Environmental Protection Agency, Office of Pesticides Programs], 2012.

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Michael, Shannon J., ed. Stewardship source book: A complete stewardship program for your church. Cincinnati, Ohio: Standard Pub., 1987.

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U.S. National Park Service. Wilderness stewardship program: 2011 business plan. Washington, D.C: U.S. Dept. of the Interior, National Park Service, 2011.

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United States. Bureau of Land Management. Experimental stewardship program: Report to Congress. Washington, D.C.]: U.S. Dept. of the Interior, Bureau of Land Management, 1986.

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Gossen, Thomas R. The cottage meeting commitment program. Harrisburg, PA: Morehouse Publishing, 1998.

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Northeastern Area Association of State Foresters, ed. Landscape stewardship project: A quick-start guide for forest stewardship program managers. Newtown Square, Pa.]: Northeastern Area State and Private Forestry, 2011.

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Michael, Reeves. Extravagant generosity: The heart of giving : Program guide. Nashville: Abingdon Press, 2011.

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Gossen, Thomas R. The home to home commitment program. Harrisburg, PA: Morehouse Publishing, 1998.

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C, Collins Kathleen, e National Catholic Educational Association. Dept. of Elementary Schools., eds. Stewardship and the Catholic school tuition program. Washington, D.C: Dept. of Elementary Schools, National Catholic Educational Association, 1993.

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Capítulos de livros sobre o assunto "Stewardship Program"

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Enkerlin-Hoeflich, Ernesto C., Trevor Sandwith, Kathy MacKinnon, Diana Allen, Angela Andrade, Tim Badman, Paula Bueno et al. "IUCN/WCPA Protected Areas Program: Making Space for People and Biodiversity in the Anthropocene". In Earth Stewardship, 339–50. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-12133-8_22.

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Barrows, Gerald L. "The Refractory Ceramic Fiber Industry's Product Stewardship Program". In A Collection of Papers Presented at the 53nd Conference on Glass Problems: Ceramic Engineering and Science Proceedings, Volume 14, Issue 3/4, 190–97. Hoboken, NJ, USA: John Wiley & Sons, Inc., 2008. http://dx.doi.org/10.1002/9780470314098.ch16.

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Stonehouse, D. Peter. "A Critical Assessment of the Ontario Land Stewardship Program". In Soil and Water Conservation Policies and Programs, 191–210. Boca Raton: CRC Press, 2024. http://dx.doi.org/10.1201/9781003574040-15.

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Dave, Priti, Omar Ahmed Omar e Sebastiana A. Etzo. "Ensuring the Continuity of Sexual and Reproductive Health and Family Planning Services During the COVID-19 Pandemic: Experiences and Lessons from the Women’s Integrated Sexual Health Program". In Health Dimensions of COVID-19 in India and Beyond, 99–127. Singapore: Springer Singapore, 2022. http://dx.doi.org/10.1007/978-981-16-7385-6_6.

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AbstractOne of the main aims of the UK aid funded Women’s Integrated Sexual Health (WISH2ACTION W2A) program is to strengthen government stewardship of sexual and reproductive health/family planning (SRH/FP) services across seven countries in South Asia and Sub-Saharan Africa. Options consultancy provides technical assistance within four work streams: 1) creation of a favorable policy and planning environment; 2) improved public sector investment; 3) national stewardship over quality improvement; and 4) establishment of accountability systems to influence and track commitments and policies. This role became even more important since the coronavirus disease (COVID-19) outbreak shifted government’s priorities to the COVID response and led to the disruption in the delivery of essential health services, threatening to undo and reverse the SRH/FP gains made to date. In this chapter, the author shares Options’ approach and experiences in engaging governments during the pandemic to ensure that access to SRH/FP remains a priority, alongside efforts to keep the routine enabling environment work on track. The author draws out wider lessons on the range of actions that can be taken at policy and systems level to protect SRH/FP during a health emergency in different country contexts, including the severity of the outbreak, socio-political environment, and health systems preparedness. The author also highlights how the pandemic can provide new policy opportunities, such as to accelerate self-care, and strengthen health systems resilience.
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Kelly, Sophia. "Site Stewardship Programs". In Encyclopedia of Global Archaeology, 9809–14. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-30018-0_2101.

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Kelly, Sophia. "Site Stewardship Programs". In Encyclopedia of Global Archaeology, 6701–6. New York, NY: Springer New York, 2014. http://dx.doi.org/10.1007/978-1-4419-0465-2_2101.

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Gow, Gordon A., Uvasara Dissanayeke, Chandana K. Jayathilake, Isuri Kumarasinghe, Kumudu Ariyawanshe e Sanduni Rathnayake. "Technology Stewardship Training for Agricultural Communities of Practice: Establishing a Participatory Action Research Program in Sri Lanka". In Communications in Computer and Information Science, 110–24. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-52014-4_8.

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D’Andrea, Ariella, Margaret Von Rotz, Solène Devez, Brandon D. Hupka, Mele Ikatonga Tauati e Siola’a Malimali. "Tonga: Enabling Coastal Communities to Protect Marine Resources and Secure the Livelihoods of Small-Scale Fishers". In MARE Publication Series, 429–50. Cham: Springer Nature Switzerland, 2024. http://dx.doi.org/10.1007/978-3-031-56716-2_20.

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AbstractCoastal fisheries are the food basket of Pacific Islanders, and fishing is deeply rooted in Pacific Islands’ cultures and traditions. In Tonga, during the past century, marine resource management has been the sole responsibility of the government under the law. Although management measures aim to ensure the sustainability of small-scale fisheries, compliance is often a challenge. In 2002 and 2009, Tonga passed new fishery legislation that reformed access to marine resources for local fishers (particularly in lagoons and reef areas) with the introduction of its own community-based fishery management approach, known as the Special Management Area (SMA) program. The SMA program and supporting legislation allow coastal communities and local fishers, with assistance from the Ministry of Fisheries, to regulate adjacent marine areas through local fishery management plans that grant preferential access and assign stewardship duties to community members. Tonga has made a commitment to following the Voluntary Guidelines for Securing Sustainable Small-Scale Fisheries in the Context of Food Security and Poverty Eradication (SSF Guidelines), with the SMA program representing an important step forward. This chapter explores the main venues and opportunities for Tonga to implement the SSF Guidelines while completing the SMA scaling-up process, in line with recent policy commitments made at a Pacific regional level, (In 2021, the members of the Pacific Community (SPC) adopted the Pacific Framework for Action on Scaling up Community-based Fisheries Management: 2021–2025.) to ultimately provide sustainable access for small-scale fishers to marine resources and markets (SDG 14b).
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Ffolliott, Peter F., Malchus B. Baker, Carleton B. Edminster, Madelyn C. Dillon e Karen L. Mora. "Perspectives, Problems, Programs". In Land Stewardship through Watershed Management, 9–33. Boston, MA: Springer US, 2002. http://dx.doi.org/10.1007/978-1-4615-0589-1_2.

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Buckingham, Kerri. "A Case Study: Washington State University Pierce County Extension Master Gardener Program: Volunteer Educators in Home Gardening and Environmental Stewardship". In Sowing Seeds in the City, 343–53. Dordrecht: Springer Netherlands, 2016. http://dx.doi.org/10.1007/978-94-017-7456-7_28.

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Trabalhos de conferências sobre o assunto "Stewardship Program"

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Deanne Meyer, Michael A. Payne, John Menke, Lynn Kuo, Paul E. Martin, D. Denise Mullinax, George Salsa, Allen Dusault e J.P. Cativiela. "California Dairy Quality Assurance Program Environmental Stewardship Certification". In 2005 Tampa, FL July 17-20, 2005. St. Joseph, MI: American Society of Agricultural and Biological Engineers, 2005. http://dx.doi.org/10.13031/2013.19500.

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Palacios, F., M. Campos, J. M. Juarez, S. E. Cosgrove, E. Avdic, B. Canovas-Segura, A. Morales et al. "A Clinical Decision Support System for an Antimicrobial Stewardship Program". In 9th International Conference on Health Informatics. SCITEPRESS - Science and and Technology Publications, 2016. http://dx.doi.org/10.5220/0005824904960501.

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Tibbo, Helen R., Christopher A. Lee e Lorraine L. Richards. "Developing a dual degree program to support public sector information stewardship". In the 2012 iConference. New York, New York, USA: ACM Press, 2012. http://dx.doi.org/10.1145/2132176.2132305.

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Knudson, Marcus. "Z Fundamental Science Program." In Proposed for presentation at the Stewardship Science Academic Programs Annual Review held February 16-18, 2021 in Virtual. US DOE, 2021. http://dx.doi.org/10.2172/1845621.

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Susanto, Putu Chris, Ni Made Diana Erfiani, I. Putu Darmawijaya, Putu Indah Lestari e I. Gede Ngurah Wira Pratama. "Designing a Youth Environmental Stewardship Educational Program by Adopting Logical Framework Approach in Catur Village, Kintamani, Bali". In 3rd International Conference on Community Engagement and Education for Sustainable Development. AIJR Publisher, 2023. http://dx.doi.org/10.21467/proceedings.151.41.

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Universitas Dhyana Pura (Undhira) has been involved in various research and community empowerment projects in Catur Village, Kintamani, Bangli, Bali. However, no projects in Catur Village have specifically reached the village youths until 2020. Hence, this article discusses developing an empowerment project called the Youth Environmental Stewardship program in Catur Village (YES Catur). Using the Logical Framework Approach (LFA), the authors describe the underlying problem the village youths face, such as a lack of self-efficacy and awareness of micro and macro-environmental issues facing them and their generation. Furthermore, the LFA became the overarching goal of empowering the youths through an environmental stewardship education program, encouraging positive self-view and worldview, the resources and activities designed to engage them, and the intended outputs and outcomes from the project. From this pilot project, the youths are expected to realize their true potential as they appreciate the great natural potential in their village, especially in ecology. They were encouraged to take on active roles in environmental stewardship (including eco-entrepreneurship and circular economy). Finally, they can share about themselves and their village through storytelling and photography to showcase their potential and share about sustainability issues.
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Sudhanshu S Panda, Syed H Ahmed, Suzie Jude, Tracy Morgan e Kirk David. "Development of Forest Stewardship Program Spatial Analysis Project for Idaho Land Management Planning". In 2007 Minneapolis, Minnesota, June 17-20, 2007. St. Joseph, MI: American Society of Agricultural and Biological Engineers, 2007. http://dx.doi.org/10.13031/2013.23085.

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Bullock, Shana Wales, e Janmichael Graine. "The Army's Chesapeake Bay Program: Managing Land across Political Boundaries to Promote Watershed Protection and Resource Stewardship". In Watershed Management Conference 2005. Reston, VA: American Society of Civil Engineers, 2005. http://dx.doi.org/10.1061/40763(178)12.

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Alhazzaa, Mohammed S., Ioannis Georgiou e Hashem H. Ghanem. "Excellence Journey Towards Environmental Stewardship Through Circular and Sustainable Decarbonization, Ecosystem and Biodiversity Initiatives". In ADIPEC. SPE, 2023. http://dx.doi.org/10.2118/216385-ms.

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Abstract This paper presents circular environmental initiatives at Abu Ali Island, Eastern Province, Saudi Arabia that led to sustainable and systematic decarbonization, ecosystem, and biodiversity programs. The prosperous ecological system in the Island makes it an excellent hub for wildlife, marine, and birds. The organization environmental initiative programs are: Contribute a net zero-carbon emission by reducing and offsetting greenhouse gas emissions.Support Saudi green initiative through mangrove plantation in the Island.Adapt carbon circular economy (CCE) approaches to turning wasted materials into valuable products.Enhance biodiversity in Abu Ali Island to create an integrated ecosystem. Mangrove forests were a primary driving force behind the island's preservation efforts. The island is home to one of the biggest mangrove ecosystems in the region, with more than 5 million mangrove trees. In 2022, the island embraced the Kingdom's largest mangrove plantation program in a single phase, with a total of 3 million seedlings planted in the mangrove nursery at the island. This new record suppressed previous record held by the organization, which was to plant 2 million mangrove seedlings in 2020. The quantity of mangrove trees contributes to carbon dioxide sequestration as scientific studies have shown that "Mangroves are also able to sequester C at a rate two to four times greater than mature tropical forests and can store three to five times more C per equivalent area than upland tropical," according to (Donato et al., 2011; Alongi, 2014). Moreover, as part of the offsetting efforts, a fish hatchery facility is under development in conjunction with mangrove forests. The fish hatchery can produce up to four distinct fish species at once, with a capacity of 10 million fingerlings per year. To boost local fish stocks, fish will be released into the Gulf. One of the circular economy's principles is to extend product lifetime. The team decided to utilize eleven decommissioned subsea pipelines — after decontamination and cleaning — as artificial coral reefs. Rather than removing these pipelines, which would result in high expense, they were cut into 10-meter sections and kept on seabed to be colonized and transformed into coral reefs. Some of the identified measures as CCE are the reuse of produced sanitary wastewater for irrigation and composted food waste as fertilizer to benefit the plants, and help reduce our environmental footprint.
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Uyghur, Muhammad. "The burden of respiratory infections caused by resistant bacteria and need for antibiotics stewardship program in Balochistan, Pakistan". In ERS International Congress 2018 abstracts. European Respiratory Society, 2018. http://dx.doi.org/10.1183/13993003.congress-2018.pa2326.

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Sutherland, J. W., V. Kumar, J. C. Crittenden, M. H. Durfee, J. K. Gershenson, H. Gorman, D. R. Hokanson et al. "An Education Program in Support of a Sustainable Future". In ASME 2003 International Mechanical Engineering Congress and Exposition. ASMEDC, 2003. http://dx.doi.org/10.1115/imece2003-43422.

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The historical evolution and current status of sustainability education at Michigan Technological University is described. The history considers the last 15 years, during which, the faculty of Michigan Tech have been collaborating on the development of environmental curricula and courses. This development effort initially focused on specialized offerings for the environmental/chemical engineering programs. With time, recognition of the importance of environmental issues (wastes, natural resources, energy, etc.) to other disciplines across the campus grew. For example, chemists, biologists, foresters, etc. each have a role in characterizing the behavior of ecological systems. Engineering disciplines that are focused on the design of products, processes, or systems influence long term societal sustainability. Social scientists must understand the relationship/linkages between the environment, industry, citizens, and government. Greener products, environmentally responsible processes, life cycle thinking, and environmental stewardship need to become part of the modern lexicon of globally aware students. Faculty from diverse disciplines across the campus are now collaborating to develop courses and modify curricula to educate students with respect to the triple bottom line (i.e., sustainable economic, societal, and environmental future). Problems associated with the traditional education paradigm are discussed. A new education model aimed at training students to create a sustainable future is proposed.
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Relatórios de organizações sobre o assunto "Stewardship Program"

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w, shotts. Stockpile stewardship program strategy. Office of Scientific and Technical Information (OSTI), dezembro de 1994. http://dx.doi.org/10.2172/15007680.

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Nemish, Kristen A. STOCKPILE STEWARDSHIP AND MANAGEMENT PROGRAM. Office of Scientific and Technical Information (OSTI), agosto de 2019. http://dx.doi.org/10.2172/1557170.

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Chulock, Hilary N. Environmental Management Education Program: Building Environmental Stewardship. Office of Scientific and Technical Information (OSTI), janeiro de 2004. http://dx.doi.org/10.2172/899679.

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Joan McDonald. Long-Term Stewardship Program Science and Technology Requirements. Office of Scientific and Technical Information (OSTI), setembro de 2002. http://dx.doi.org/10.2172/910659.

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Lambert, Dan, James Duncan, Tyler Scott, Cara Hanson, Nancy Mathews, Rick Paradis, Jennifer Pontius et al. Mount Mansfield Science and Stewardship Center Program, Facilities, and Business Plans. Forest Ecosystem Monitoring Cooperative, abril de 2018. http://dx.doi.org/10.18125/d2s362.

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Alban, Laura Miller, Scott A. Thomasma e Mark J. Twery. Forest Stewardship Planning Guide (version l.00) user's manual (Computer Program). Radnor, PA: U.S. Department of Agriculture, Forest Service, Northeastern Forest Experimental Station, 1995. http://dx.doi.org/10.2737/ne-gtr-203.

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Wan, A., e K. Scott. National Ignition Facility Experiments in Support of Stockpile Stewardship Program (SSP). Office of Scientific and Technical Information (OSTI), julho de 2014. http://dx.doi.org/10.2172/1158875.

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8

Alban, Laura Miller, Scott A. Thomasma e Mark J. Twery. Forest Stewardship Planning Guide (version l.00) user's manual (Computer Program). Radnor, PA: U.S. Department of Agriculture, Forest Service, Northeastern Forest Experimental Station, 1995. http://dx.doi.org/10.2737/ne-gtr-203.

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9

Storm, E. Science and technology in the stockpile stewardship program, S & TR reprints. Office of Scientific and Technical Information (OSTI), abril de 1998. http://dx.doi.org/10.2172/2497.

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Waldfogel, Julie M., Michael Rosen, Ritu Sharma, Allen Zhang, Eric B. Bass e Sydney M. Dy. Making Healthcare Safer IV: Opioid Stewardship. Agency for Healthcare Research and Quality (AHRQ), dezembro de 2023. http://dx.doi.org/10.23970/ahrqepc_mhs4opioid.

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Resumo:
Objectives. Opioid stewardship interventions promote the appropriate use of prescribed and ordered opioids to reduce the risk of opioid adverse events. Our main objectives were to determine the effectiveness of these interventions in healthcare settings on opioid prescribing and clinical outcomes (e.g., number of opioid prescriptions, opioid dosage, overdose, emergency department visits, and hospitalizations) including unintended consequences (e.g., changes in patient-reported pain intensity), and ways these interventions can be effectively implemented. Methods. We followed rapid review processes of the Agency for Healthcare Research and Quality Evidence-based Practice Center Program. We searched PubMed and the Cochrane Library to identify eligible systematic reviews from January 2019 to April 2023 and primary studies published from January 2016 to April 2023, supplemented by targeted gray literature searches. We included systematic reviews and studies that addressed opioid stewardship interventions implemented in healthcare settings in the United States and that reported on opioid prescribing and clinical outcomes. Findings. Our search retrieved 6,431 citations, of which 34 articles were eligible (including 1 overview of systematic reviews, 13 additional systematic reviews, 13 randomized controlled trials (RCTs) [reported in 14 articles] and 6 nonrandomized studies). Systematic reviews, mostly summarizing pre-post studies, included a wide variety of opioid stewardship practices that focused on patient and family engagement, healthcare organization policy, or clinician knowledge and behavior interventions, in inpatient, perioperative, emergency department, and ambulatory settings. RCTs addressed multicomponent interventions (typically a combination of prescriber education, care management and facilitated access to resources), and patient education and engagement, mainly in ambulatory chronic pain. Opioid stewardship practices involving clinical decision support or electronic health records, or multicomponent interventions (including for chronic pain) were associated with decreases in opioid prescribing or reduced doses and no increases in pain, emergency department visits, or hospitalizations (low strength of evidence for all outcomes). Patient engagement and education interventions had mixed results for opioid prescribing outcomes (insufficient strength of evidence) and no increases in pain, emergency department visits, or hospitalizations (low strength of evidence). The evidence was insufficient on other types of interventions and on outcomes of opioid refill requests and refills, patient satisfaction, or overdose. Barriers included lack of training, workload, gaps in communication, and inadequate access to nonpharmacological resources. Facilitators included clinician and patient acceptance of intervention components. Conclusions. Selected opioid stewardship interventions may be effective for reducing opioid prescribing and dosing without adversely affecting clinical outcomes overall, although strength of evidence was low. Unintended consequences were often not measured or not measured rigorously. Interventions to reduce opioid use should monitor unintended consequences and include access to nonpharmacological pain management resources with appropriate patient education and engagement.
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