About ROSI

Resources for Opioid Stewardship Implementation (ROSI) is a toolkit of resources developed by a multidisciplinary team of clinicians to assist organisations in initiating or improving existing opioid stewardship programs.

Opioid stewardship promotes the safe and judicious use of opioid analgesic medicines; often an essential inclusion in multimodal analgesic regimens required for the management of acute pain. These medications can facilitate a patient's ability​ to participate in activities that hasten recovery and prevent the development of complications.

Withholding or restricting the appropriate use of opioid medications is not the intention of an opioid stewardship program; however, as most acute pain resolves quickly, the need for opioid medications also rapidly declines.

Good opioid stewardship will ensure that there is a plan for the reduction and cessation of any opioid commenced for the management of acute pain, minimising the risks associated with inappropriate use.

In 2022, recognising the increasing importance of opioid stewardship as a patient safety initiative, the Australian Commission for Safety and Quality in Health Care (ACSQHC) published the Opioid Analgesic Stewardship in Acute Pain Clinical Care Standard (CCS).

The standards aim to provide healthcare organisations, clinicians, and patients with guidelines to minimise harms associated with opioid use and optimise patient care and outcomes.

Nine quality statements within the CCS outline current best practice for opioid analgesic prescribing in acute pain. Each statement is supported by indicators or recommendations to guide opioid prescribing, increase patient safety and support practice change.

Development of the ROSI.

Despite the wealth of academic publications and the broad availability of resources, clinicians consistently report challenges in implementing opioid stewardship programs and adhering to the recommendations outlined in the CCS.

Recognising clinicians' desire for information and guides as to how to improve practice, CSL Seqirus provided an unrestricted educational grant to support the development of the ROSI.

ROSI has been crafted by a multidisciplinary team of clinicians, including pain specialist anaesthetists, acute pain clinical nurse consultants, and pharmacists. These professionals bring extensive experience in facilitating changes in opioid prescribing and have demonstrated significant improvements in patient outcome measures through the use of ROSI tools.

The ROSI can help organisations begin or improve existing opioid stewardship programs, obtain evidence that supports the need for practice change, document improvements over time, and provide evidence of working toward the recommendations contained within the CCS.

The Faculty of Pain Medicine (FPM) endorses the guides contained within the ROSI and encourages hospitals to adapt them to their local context, ensuring compliance with current best practice recommendations for opioid prescribing.

The resources and guides included in the ROSI, have been devloped for clinical application, following a review of the most current literature and consultation with multiple stakeholders. It should be recognised that they have not been formally critically reviewed. Facilities are encouraged to adapt the ROSI guides to suit their local clinical contexts and advancements in research. However, any modifications must preserve the fundamental purpose of the resource.

ROSI guides will undergo regular updates and reviews to reflect new or emerging evidence.


CSL Seqirus were not involved in the creation of intellectual property or any other content contained within the ROSI.

Introduction to ROSI Created with Sketch.

The Resources for Opioid Stewardship Implementation (ROSI) have been developed by Ms. Bernadette Findlay, Clinical Nurse Consultant and Associate Professor Jennifer Stevens, Anaesthetist and Pain Medicine Specialist at St Vincent’s Hospital, Sydney, in conjunction with the Faculty of Pain Medicine. Development of the ROSI has been supported by an unrestricted educational grant from CSL Seqirus.

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Last updated 13:46 3.04.2024