Impact of an antimicrobial stewardship-led intervention forStaphylococcus aureusbacteraemia: a quasi-experimental study
Cynthia T. NguyenTejal GandhiCarol ChenowethJessica LassiterJennifer Dela‐PenaGregory EschenauerJerod Nagel
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BackgroundStaphylococcus aureus bacteraemia (SAB) carries high rates of morbidity and mortality. Antimicrobial stewardship programmes (ASPs) are well situated to promote adherence to quality performance measures in order to optimize the management of SAB and associated clinical outcomes.Keywords:
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Antimicrobial resistance is a growing public health threat that at times may appear to be unsolvable.However, in the last few years, great advances have been made to address this issue in Canada and around the world.Our Federal Action Plan on Antimicrobial Resistance and Use in Canada has identified three pillars to address antimicrobial resistance: surveillance, stewardship and innovation.In this supplement are examples of successful stewardship programs for the community, physicians and health care organizations; there are many more.Given that we know successful stewardship programs are possible, it is important to continue this work across the country.Each success helps and multiple successes can create a synergistic effect that can lead to a change in patient expectations and prescribing patterns.Our antimicrobials are a precious resource.It is well worth the effort to contribute to this synergy and build a culture of stewardship so that antimicrobials will continue to be effective for generations to come.
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Inappropriate antibiotic use and associated consequences, including pathogen resistance and
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The opioid stewardship model is born out of the antimicrobial stewardship model, and thus there are many shared characteristics. Both opioid stewardship and antimicrobial stewardship are based on the principle that there is an indication for a particular medication in the right patient at the right time. As antimicrobial stewardship is in a later stage of development, looking at the two in parallel can lead to interesting learning and development opportunities for opioid stewardship. Two requirements of antimicrobial stewardship that need to be applied to opioid stewardship for optimum outcomes are the requirement for dedicated resources, more specifically a trained pharmacist, and a declaration that opioid stewardship is essential for health-system accreditation.
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ABSTRACT Recently, there have been a number of studies on the determinants of religious giving, looking at giving in a variety of denominations. One consistent finding across these studies has been the importance of stewardship programs. However, researchers have been less successful in identifying exactly which aspects of a stewardship program are likely to be most productive. This study analyzes the effect of implementing various stewardship techniques in U.S. Catholic parishes. The empirical findings show that just organizing an official parish-level stewardship committee has an impact, as does the introduction of the concept of tithing.
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We wholeheartedly agree with Dik et al. ([1][1]) that a combined approach is the future of stewardship and commend the authors for their innovative model. Incorporating infection control and epidemiology into an integrated diagnostic and antimicrobial stewardship model further capitalizes upon the
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Stewardship refers to the management of resources belonging to another. Based on three parables of Jesus, we find that in general, stewardship requires that managers address the competing demands of physical resources, subordinate laborers, clientele, and personal interests. We present a conceptual framework to guide consideration and discussion of the issue of balancing competing demands. This framework can provide an operational model to qualitatively or quantitatively assess a manager's stewardship profile. Finally, ethical decision-making based on the concept of stewardship requires attention to the question of ownership of the resources, and we present our analysis and conclusions on that issue.
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This chapter focuses on stewardship in the primary care and long-term care settings. Antibiotic prescribing in the community accounts for 80% total antibiotic prescribing and approximately 75% of this is for acute respiratory tract infections, many of which are viral. There is also significant variation in prescribing practices that is not explained by differences in presenting patients. These factors suggest that antimicrobial stewardship programmes are necessary. This chapter identifies the components of stewardship that have been successful in influencing antibiotic prescribing in primary care and shares local experiences with practical examples. The lack of UK evidence about antimicrobial stewardship in long-term care facilities is discussed, along with successful interventions from overseas. Challenges within these settings are highlighted, including patient demand, lack of access to microbiological and diagnostic tools, competing targets, time pressures, and clinical uncertainty.
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