Concept Of Stewardship Research Articles

Towards Wiser Prescribing of Antibiotics in Dental Practice: What Pharmacists Want Dentists to Know

Antibiotics have various indications for treatment and prophylaxis in dental practice. While only a handful of antibiotics are typically prescribed in dentistry, unlike in medicine, clear indications and appropriate dosing and duration remain controversial among antibiotic-prescribing dentists, which may result in inappropriate or excessive antibiotic prescriptions. This practice can increase the risk of antibiotic resistance and expose patients to unnecessary side effects. Moreover, the concept of antibiotic stewardship in dental practice remains in its early stages. This review was developed by pharmacists (general and infectious disease pharmacists) in collaboration with a periodontist and a maxillofacial surgeon to provide an antibiotic prescription guide for dentists who frequently prescribe antibiotics. It also sheds light on antibiotic stewardship. The review discusses in detail antibiotic indications for treatment and prophylaxis in dental practice and provides tables that can be used by dentists in their everyday practice. It also discusses the concept of antibiotic stewardship and provides recommendations that can be applied to the practice of antibiotic prescribing in dentistry. Antibiotic prescribing in dental practice should be limited to cases with documented infections or when indicated for prophylaxis. Every dentist can act as an antibiotic steward by prescribing antibiotics wisely and only when necessary, using their discernment to identify appropriate cases and exclude those that do not meet infection criteria. Collaboration with pharmacists is encouraged to provide such recommendations and implement antibiotic stewardship interventions, such as developing antibiotic prescription protocols.

Environmental Ethics Relevance in Theology Perspective: An overview from Islamic, Christian, Hindu, Buddhist, and Confucian

Environmental ethics is an important issue in the context of sustainability and environmental protection. This research aims to discuss Islamic, Christian, Hindu, Buddhist, and Confucian religious perspectives regarding environmental ethics and its importance in the context of sustainability. This research method uses literature study and analysis of sacred texts and religious teachings according to religious perspective. This research found that each religion has different views, but emphasizes the same important aspect of protecting and caring for the environment as the moral responsibility of religious communities. The concept of stewardship is emphasized considering the role of humans as managers and protectors of the universe. Environmental ethics in this religious perspective has similarities in teaching the importance of protecting and caring for the natural environment. This view can be the basis for individuals and communities to develop awareness and responsibility for environmental sustainability. Understanding and practicing religious-based environmental ethics is very relevant to overcoming the environmental challenges facing humanity in this century.

Sacred Soil, Green Ideals

Abstract Shemitah, the Jewish sabbatical year, is increasingly being explored in ecological contexts. This research delves into the concept of stewardship examining the evolving discourse on Shemitah across different community sectors in the Israeli press during the last three sabbatical cycles (2007–2008, 2014–2015, and 2021–2022). Our analysis reveals stewardship worldviews that portray Jewish law as either the practical pathway to implement these worldviews or as an inspiration for contemporary socio-environmental initiatives. The secular-liberal sector emphasizes universal stewardship, aligning with Western environmental concepts, while the national-religious sector integrates both universal and particular stewardship, emphasizing the land’s moral dimensions and connecting religious observance with environmental ethics. The ultra-Orthodox sector, though not explicitly expressing eco-theological views, focuses on soil regeneration. This empirical investigation serves as a significant case study and offers valuable guidance for addressing the challenge of instigating behavioral change in religious and traditional populations.

Implementing an Antimicrobial Stewardship Lecture Series for Family Medicine Residency Programs in South Carolina

Background: Family medicine physicians are one of the leading prescribers of antimicrobials in both the inpatient and ambulatory setting, however appropriate education on antimicrobial stewardship (AS) is lacking. The Antimicrobial Stewardship Collaborative of South Carolina (ASC-SC) created a family medicine AS lecture series to increase awareness of stewardship, improve antimicrobial prescribing throughout the state, and ultimately combat antimicrobial resistance. Methods: All family medicine residency programs in South Carolina (n=17) were contacted to determine interest in a four 1-hour long lecture series regarding various AS topics provided by infectious diseases physicians and pharmacists. The introductory AS lecture included topics such as interpreting minimal inhibitory concentrations, utilizing antibiograms, guidelines for diagnosing and treating common infections, and antibiotic essentials. Lectures were given on-site, and eight identical pre- and post-lecture questions were asked to assess baseline knowledge and efficacy of the introductory lecture. Not all the attendees answered all the pre- and post-lecture questions. A Chi-square analysis was used to determine statistical significance. Results: To date, 7 family medicine residency programs were given the introductory antimicrobial stewardship lecture and were included in the total analysis. Respondents included 1st year (25 of 99 responses, 25%) and 2nd year family medicine residents (17 of 99 responses 17%). When asked “How familiar are you with the concept of antimicrobial stewardship?”, 43 of 106 (41%) respondents were at least familiar or very familiar prior to the lecture compared to 81 of 93 (87%) after the lecture (p < 0.001). When asked “How confident are you in using antibiograms for antimicrobial decisions?”, 41 of 107 (38%) were confident or very confident pre-lecture and 83 of 101 (82%) post-lecture (p < 0.001). When given a case-based question on using an antibiogram to determine an appropriate empiric agent for inpatient pyelonephritis, 59 of 107 (55%) respondents were able to answer the question correctly pre-lecture compared to 85 of 99 (86%) post-lecture (p < 0.001). Among those who answered the question incorrectly, 60% selected the agent with the highest percentage susceptible rate in the antibiogram, despite it being an inappropriate agent for pyelonephritis. Conclusion: The ASC-SC lecture series was an effective tool to increase awareness and knowledge of antimicrobial stewardship to family medicine providers. This lecture series survey data helps determine what family medicine residents commonly misunderstood in AS concepts and helps guide future initiatives.

Peran Guru Pendidikan Agama Kristen Dalam Mengembangkan Kepedulian Ekologi Pada Generasi Muda Kristen

the increasingly alarming ecological crisis demands efforts to build awareness and concern for the environment, especially among the younger generation of Christians. This study aims to determine the role of Christian Religious Education teachers in shaping a generation of Christians who care about the ecological crisis. Using a qualitative approach with descriptive methods, data collection was conducted through interviews, observations, and filling out questionnaires. The results showed that Christian Religious Education teachers have an important role in shaping a Christian generation that cares about the ecological crisis, which is realized through (a) Integration of ecological material in Christian Religious Education learning, such as the concept of creation, stewardship, and human responsibility towards nature (b) Exemplary teachers in behaving environmentally friendly and educating students to care about the environment (c) Development of environmental awareness-based activities and cleaning activities in the school environment and its surroundings. This study suggests that Christian Religious Education teachers should consistently integrate ecological issues in learning and provide examples of environmentally friendly behavior, as well as develop extracurricular programs that can foster environmental awareness in the Christian generation. The findings of this study confirm the significant contribution of Christian Religious Education teachers in developing ecological awareness in the younger generation of Christians. Keywords: Christian Religious Education Teacher; Christian Generation; Ecology

Microbiological challenges in the treatment of war injuries

The treatment of war injuries represents a continuing and recurrent challenge in modern reconstructive surgery. Previously, tumor resections and sepsis-related resections were mainly responsible for lengthy bone defects in Germany. In recent years another picture has increasingly emerged, particularly caused by the medical support of Ukraine. Aspects of military surgery are also becoming more important in civil hospitals, especially in the treatment of gunshot and explosion injuries. In Germany, war injuries are currently secondarily treated, as the distribution of patients is carried out according to the cloverleaf principle, weeks or months after the occurrence of the primary injury. In addition to complex bone and soft tissue defects of the extremities following such injuries, which often affect neural and vascular structures, reconstruction is often complicated by an increasing spectrum of multidrug-resistant pathogens. The definition of microbiological terms, such as contamination, colonization, critical colonization, local and systemic infections are important in the clinical routine in order to initiate a targeted treatment, especially in treatment with antibiotics. Wound swabs for determination of the spectrum of pathogens and the optimal testing of resistance are important for selecting the appropriate antibiotic agents. The concept of antibiotic stewardship (ABS) is established in many hospitals to improve the quality of antibiotic treatment and to minimize the formation of resistance. The selection of the method of reconstruction depends on the condition of the patient, the overall clinical constellation and the function to be expected after completion of treatment. The treatment of injuries due to violence and terrorism necessitates clear concepts and an interdisciplinary approach, especially with respect to microbiological challenges and increasing resistance situations.

Environmental stewardship: A systematic scoping review.

Environmental stewardship is a term describing both the philosophy and the actions required to protect, restore, and sustainably use natural resources for the future benefit of the environment and society. In this paper, we review the environmental science literature to map the types of practical actions that are identified as 'environmental stewardship' using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for scoping reviews. We specifically mapped: 1) the type of actions and outcomes targeting the natural environment that have been categorized as environmental stewardship, 2) the main actors, and the underlying factors influencing their environmental stewardship actions, and 3) the methods used to mobilize environmental stewardship actions once these factors are known. From the 77 selected articles, we found the term environmental stewardship encompassed a multitude of different actions, undertaken by a range of actors and addressing an array of issues that impact biodiversity on the land and in the water. These stewardship actions were conducted on both privately-owned and publicly managed lands and waterways, and across rural and urban landscapes. Despite many studies identifying characteristics and underlying behavioral factors that predicted actors' participation in stewardship actions, there were few studies formally evaluating interventions to increase stewardship. Our review highlighted the term environmental stewardship is not embraced by all and is viewed by some as being inconsistent with aspects of indigenous worldviews. A better understanding of the concept of environmental stewardship and continued practical research into its practice is fundamental to empowering people to demand and enact environmental stewardship as well as for evaluating the success of their actions.

Healthcare professionals’ views on opioid stewardship interventions in postoperative, opioid-naive patients: a qualitative service evaluation

Abstract Introduction Overuse of opioids has led to an opioid crisis.[1] Opioid stewardship interventions have been developed in some countries. However, there are currently no uniform guidelines that can be used to implement opioid stewardship interventions in the United Kingdom. Prescribing opioids postoperatively is a key risk area of opioid use.[2] To the best of our knowledge, no previous study has explored healthcare professionals’ (HCPs’) views on opioid stewardship interventions in postoperative, opioid-naive patients. Aim To explore hospital HCPs’ views on opioid stewardship interventions for postoperative patients who were not taking opioids before surgery. Methods Semi-structured interviews were conducted with pharmacists, doctors, and nurses in one National Health Service hospital trust as a service evaluation. Participants were recruited through purposive sampling and asked about their opinions on opioid stewardship interventions in postoperative, opioid-naive patients. Interviews were audio-recorded and transcribed verbatim. Data were analysed using inductive thematic analysis. Results Interviews were conducted with 3 doctors, 3 nurses and 4 pharmacists of diverse grades. All participants were involved in clinical opioid practice, with 9 responsible for elective surgery and 1 for trauma surgery. The main themes identified were HCPs’ knowledge and attitudes, decision-making processes, communication with patients, and discharge management. In terms of HCPs’ knowledge and attitudes, most participants were unaware of opioid stewardship. However, during the interviews, the pharmacists used their knowledge of antimicrobial stewardship to help them conceptualise opioid stewardship. Most participants were unaware of the risks associated with opioid-naive patients. Although many available resources about opioid stewardship were identified by participants, they suggested that these were not used in practice. Decision-making processes for opioid prescribing were reported as being heavily reliant on individual clinical judgment due to the absence of standardised guidelines. In addition, decisions were primarily made by anaesthetists rather than by the ward staff responsible for postoperative care. Shared decision-making with patients was limited, primarily occurring postoperatively. Time limitations, complex medical information, and patients’ lack of knowledge about opioids were reported to hinder effective communication and information exchange between HCPs and patients. HCPs reported giving patients information verbally, with minimal use of educational materials. In terms of discharge management, HCPs stressed the importance of providing clear and comprehensive information. After patients were discharged from the hospital, HCPs had no further contact with them or the primary healthcare system, leaving follow-up to GPs. Conclusion To the best of our knowledge, this is the first study to explore HCPs’ knowledge in postoperative opioid stewardship practice. Our findings suggest that although pharmacists have some knowledge of the concept of stewardship generally, many HCPs are unaware of opioid-naive patients’ risks, suggesting that more training may be needed. We identified the underutilisation of available resources and reliance on clinical judgment due to the lack of guidelines. Limited shared decision-making and communication challenges were also identified. This study was limited to a small number of participants in one hospital trust, which may compromise the generalisability and representativeness of our findings. Further work should include anaesthetists and other specialists, as well as patients and carers.

National Data Management: A Modern Data Stewardship Approach for the Swiss Administration Enabled by the New Platform “I14Y Interoperability”

To create the basis for the implementation of the Once-Only-Principle in Switzerland, the Swiss Federal Council launched a program called “National Data Management” in 2019. The Once-Only-Principle aims to reduce the administrative burden on citizens and companies. Instead of having to contact them repetitively for the same information, the responsible authorities should strive to exchange the required data. To enable this, we need to actively work on the data landscape of the Swiss administration. The concept of data stewardship is known to be an efficient tool to promote and ensure a consistent high level of data quality. Nowadays public administrations of many countries strive to embrace the idea of data stewardship. This paper describes the approach we have developed for the Swiss administration.

Stewardship: Christian Responsibility Through Circular Economy – A Community “TAKA PROJECT”

The idea of stewardship, which emphasizes the duty to look after and safeguard the Earth, has its roots in Christian teachings. In light of the circular economy, this article investigates the application of a community “TAKA project” that fosters stewardship. As a strategy for attaining sustainable growth and protecting the environment, the circular economy is garnering more and more attention. Businesses and individuals must align their operations and consumption habits to minimize or eradicate waste and pollution, while also recycling products and resources to restore the ecosystem. As stewards of the planet, humans must accept responsibility for the environment if the circular economy model is to be successfully implemented, which calls for community cooperation. This study examines the execution of a community “TAKA project” that addresses sustainable development in the local community and protects the environment by promoting stewardship through circularity principles. Through sustainable consumption and production, this TAKA project seeks to inform and include the local community, particularly schools. Pope Francis’ call to transform our “throw-away culture” is closely linked to the Christian concept of stewardship and its relationship to the circular economy. It highlights the significance of sustainable development and responsible resource management, which is in line with the biblical call to care for God’s creation by embracing the circular economy’s principles and actively participating in the community to reduce resource depletion and environmental degradation.

Biblical Concept of Stewardship as Portrayed in the Creation Narrative

This paper explores the concept of stewardship as portrayed in the biblical creation narrative and its relevance to the Seventh-day Adventist understanding of stewardship. The study aims to analyze key perspectives of the creation narrative and examines the actions, attitudes and outcomes based on these narratives. The paper adopts a qualitative approach by identifying and analyzing relevant passages from the creation narrative, comparing them with the traditional Adventist teaching on stewardship. The study finds that the concept of stewardship in the creation narrative encompasses not only the responsible management of resources but also the development and sustainable utilization of those resources. It highlights the importance of productivity, protectivity, community involvement and sustainability. Moreover, it emphasizes the dual aspects of growth and increase and the need for a balanced approach that considers both quantitative and qualitative changes over time. Based on these findings, the study concludes that stewardship is a fundamental concept in the biblical narrative, providing a framework for humans to understand their purpose and responsibility in relation to the Creator and the natural world. The study recommends the emphasis of the holistic approach to stewardship that encompasses not only the mobilization of financial resources but also the protection of the environment and the promotion of sustainable practices. This approach aligns with the mission of the church to make disciples and proclaim the gospel while ensuring the well-being of both present and future generations.

Conceptualizing a Methodology for Cultural Heritage Futures: Using Futurist Hindsight to Make ‘Known Unknowns’ Knowable

In a broad conceptual framing, cultural heritage is the result of humankind’s interactions with their environment and one another, both in its tangible and intangible expressions. Cultural heritage management is by nature a retrospective discipline, as the assessment and evaluation of cultural significance of heritage assets requires the passage of time. Practitioners often struggle with the evaluation and management of very modern and contemporary heritage items. There is a need to examine whether current approaches and practices are fit for purpose. Current cultural heritage theory abounds with the concept of heritage stewardship with the embedded futurist stance that we should hand on our heritage in good shape to the next generation, yet all approaches are retrospective and rooted in the values of the present. This paper examines to what extent stewardship, as well as two other futurist concepts, the precautionary principle and strategic foresight, are suitable tools for heritage management. Based on that review, this paper then conceptualizes and proposes an assessment model that positions the valuer into a strategic foresight-derived, modelled future ‘reality’ at a 15 to 30-year horizon, which then allows the valuer to apply standard heritage hindsight assessment methodology to contemporary heritage items.

Informing the Global Data Future: Benchmarking Data Governance Frameworks

Abstract Data has become a critical trans-national and cross-border resource. Yet, the lack of a well-defined approach to using it poses challenges to harnessing its value. This article explores the increasing importance of global data governance due to the rapid growth of data, and the need for responsible data practices. The purpose of this paper is to compare approaches and identify patterns in the emergent data governance ecosystem within sectors close to the international development field, ultimately presenting key takeaways and reflections on when and why a global data governance framework may be needed. Overall, the paper provides information about the conditions when a more holistic, coordinated transnational approach to data governance may be needed to responsibly manage the global flow of data. The report does this by (a) considering conditions specified by the literature that may be conducive to global data governance, and (b) analyzing and comparing existing frameworks, specifically investigating six key elements: purpose, principles, anchoring documents, data description and lifecycle, processes, and practices. The article closes with a series of final recommendations, which include adopting a broader concept of data stewardship to reconcile data protection and promotion, focusing on responsible reuse of data to unlock socioeconomic value, harmonizing meanings to operationalize principles, incorporating global human rights frameworks to provide common North Stars, unifying key definitions of data, adopting a data lifecycle approach, incorporating participatory processes and collective agency, investing in new professions with specific roles, improving accountability through oversight and compliance mechanisms, and translating recommendations into practical tools.

Evaluation of Healthcare Students' Knowledge on Antibiotic Use, Antimicrobial Resistance and Antimicrobial Stewardship Programs and Associated Factors in a Tertiary University in Ghana: Findings and Implications.

Antimicrobial resistance (AMR) is a major public health problem globally, and Ghana is no exception. Good knowledge regarding antibiotic use, AMR, and the concept of antimicrobial stewardship (AMS) is critical among healthcare students to curb rising AMR rates in the future. Consequently, a need to ascertain this. A cross-sectional survey was undertaken among fifth-year pharmacy, medical students and fourth (final)-year nursing and physician assistantship students at the University of Health and Allied Sciences in Ghana to assess their knowledge on antibiotic use, AMR and AMS using a web-based self-administered structured questionnaire. Descriptive statistics, Fishers' exact test, and multiple logistic regression analyses were performed. A total of 160 healthcare students were interviewed, of which 56.3% (n = 90) were male and 58.8% (n = 94) were in their fourth year of study. Good knowledge of antibiotic use, AMR, and AMS was associated with the study course (p = 0.001) and the number of years of study (p < 0.001). Overall, there were differences in the level of knowledge of antibiotics among the different healthcare students and their years of study. Efforts must now be made to enhance the curricula to ensure an improved and uniform transfer of knowledge of antibiotics, AMR, and AMS among the different healthcare students to sustain the fight against AMR in Ghana given growing concerns.

Antimicrobial Stewardship Programs in Preterm Infants: Encouraging Staff Nurse Engagement.

In NICUs, antibiotics are the most frequently prescribed medications. Misuse or overuse of antibiotics may lead to resistant species and other life-threatening complications and untoward effects. Antimicrobial stewardship programs-coordinated programs that promote the appropriate use of antimicrobials (including antibiotics)-have reduced unnecessary medication administration, costs, readmissions, complications, and mortality rates related to antimicrobial agents, predominantly among adult patients in many hospitals. At the same time, however, implementation of antimicrobial stewardship programs among preterm infants has been challenging, especially for staff nurses in NICUs. This article provides an overview of the literature addressing the concept of stewardship, outlines core elements of antibiotic stewardship programs from the Centers for Disease Control and Prevention, and examines strategies for nursing implementation in NICUs focusing on preterm infants.

Creation of a novel specialty residency in thrombosis and hemostasis management

AbstractAntithrombotic and hemostatic medications are essential, yet high‐risk therapies commonly used for the prevention and treatment of thrombosis and bleeding. Since first demonstrating the ability to improve the safety and quality of heparin and warfarin‐related care many years ago, pharmacists now play an important expanded role in more comprehensive and complex thrombosis and hemostasis management programs. Such programs encompass the prevention and treatment of thrombosis and bleeding across care settings, medical indications, and professional services. These programs impact not only appropriate use of antithrombotic medications, but also of antidotes, blood products, medical devices, laboratory testing, and other important aspects of care. In addition to providing direct patient care, pharmacists are increasingly involved in the development and implementation of system‐level processes and quality improvement activities that require technical knowledge, leadership skills, and effective multidisciplinary collaboration. Evolution in health care regulation and accreditation standards, along with national efforts to advance the concept of Anticoagulation Stewardship, will likely accelerate the growth and expansion of thrombosis and hemostasis management programs, increasing the demand for well‐trained and experienced clinical pharmacists. However, none of the existing accredited specialty pharmacy residency programs encompasses the full range of skills and experiences necessary for new pharmacists to practice effectively in this complex and rapidly evolving field. This manuscript describes the evolution of the Hemostasis and Antithrombotic Stewardship program at Brigham and Women's Hospital and the development of a novel postgraduate year 2 (PGY2) pharmacy residency in this specialty area. It provides details of the new PGY2 residency program curriculum and puts forth a vision of success for such programs at the local and national levels.

Responding to the need of postgraduate education for Planetary Health: Development of an online Master's Degree.

Planetary Health has emerged as a new approach to respond to the existential risks that the clime and global environmental crises pose to human societies. As stated by various stakeholders, the challenges involved in Planetary Health are of such magnitude that education must be at the forefront to obtain a meaningful response. Universities and higher education institutions have been specifically called to embed the concept of planetary stewardship in all curricula and train the next generation of researchers and change makers as a matter of urgency. As a response to this call, the Universitat Oberta de Catalunya (UOC), the Universitat Pompeu Fabra (UPF), and the Barcelona Institute for Global Health (ISGlobal) developed the first online and asynchronous Master in Science (MSc) in Planetary Health. The aim of the programme is to train a new generation of academics and professionals who understand the challenges of Planetary Health and have tools to tackle them. This article describes the development of the curriculum of this MSc, presents the main characteristics of the programme and discusses some of the challenges encountered in the development of the programme and its implementation. The design of this MSc was based on: the alignment of the programme with the principles for Planetary Health education with a focus on human health; a multi-, inter-, and trans-disciplinary approach; the urgency to respond to the Anthropocene challenges; and the commitment to the 2030 Agenda. The MSc was recognized as an official degree by the Agency for Quality of the Catalan University System, included in the European Quality Assurance Register for Higher Education, and the Spanish National Academic Coordination body in April 2021 and launched in October 2021. There are currently more than 50 students enrolled in the program coming from a broad range of disciplines and geographic locations. The information presented in this article and the discussion on challenges encountered in developing and implementing the programme can be useful for those working in the development of similar programs.

Understanding Government Leadership Styles and Approaches Through Smart and Adaptive Leadership Models

Mass shootings, COVID-19, political partisanship, and natural disasters have made government leadership more challenging and more complex. Unfortunately, the government's current leadership development approaches have been under resourced, ineffective, not comprehensive, and not fully infused with the concept of the public stewardship and public trust. This paper explores an understanding of leadership and its application to government through an exploration of leadership models from emerging research and the literature. The value of this approach is to take a plethora of dispersed complex models and combine them in a context suitable for a smart, needed, and relevant discussion.

Disrupting Privilege as Power and Control: Re-Imagining Business and the Appreciation of Indigenous Stewardship in Management Education Curricula

We explore privilege and its systemic intertwining with management education curricula. We take the view that privilege as power and control is intimately bound up with shareholder primacy as a foundation of mainstream management education (Lund Dean & Forray, 2021). In an attempt to tackle this, we provide a single case study of how we appreciate a broad concept of Indigenous stewardship in a brand-new foundation unit called “Responsible Business Mindset,” as part of a Master of Commerce program at a large Australian university. By proactively engaging with Indigenous stewardship to tackle privilege we contribute to the literature on engaging with privilege in management education curricula. We highlight how a concept of Indigenous stewardship may help us to reimagine business, where business no longer ignores the interconnections and interdependencies it has with the communities and natural environments within which it operates. Such a concept may also be a means to bolster alternative narratives to shareholder primacy that currently exclude a meaningful debate about privilege. At the same time, the entire exercise of introducing a new concept into the curricula has brought about a deep and critical self-reflection of our own privilege and how we as educators can respectfully and meaningfully introduce such concepts with a sense of appreciation rather than appropriation.

Debtholder Stewardship

Debtholder stewardship refers to the involvement of corporate creditors in a firm's governance framework with the aim of improving corporate decision‐making. This article develops the theory of debtholder stewardship by identifying the mechanisms of debtholder influence, assessing their effectiveness in modern capital markets, and outlining the implications of this analysis for investor stewardship and regulatory efforts to support it. The impetus of this study is the expansion of the UK Stewardship Code across a broader range of asset classes, stewardship activities, and topics. The code has moved away from the traditional focus on shareholders by adding investors in other assets to the list of the stewards of corporate activities. Also, the revised concept of stewardship covers broader topics, including environmental, social, and governance (ESG) factors. But our understanding of debtholder stewardship, especially on sustainability matters, is inadequate. This article explains whether corporate creditors, both public and private, can promote responsible business practices through the stewardship of borrowers.