Implementation Of Standard Operating Procedures Research Articles

GAMBARAN FIGUR OTORITAS TERHADAP KEPATUHAN PERAWAT DALAM IMPLEMENTASI STANDAR PROSEDUR OPERASIONAL KEBERSIHAN TANGAN

Background: Nurses’ obedience in the implementation of Standard Operational Procedures of hand hygiene is an effort in preventing phlebitis in the hospital. Report on surveillance data by Infection Prevention and Control or Pencegahan dan Pengendalian Infeksi (PPI) RSUD Dr. R. Sosodoro Djatikoesoemo Bojonegoro 2017 mentioned the incidence of phlebitis in the Inpatient Installation reached 2.73%. One cause of high rates of phlebitis is incorrect nurse’s hand-washing technique according to the procedures.Aims: This study aimed to analyze the relationship between status of location from RSUD Dr. R. Sosodoro Djatikoesoemo Bojonegoro, personal responsibility, legitimacy, status, and proximity of authority figures and nurses’ obedience to Standards Operational Procedures of hand hygiene before and after intravenous installation.Method: This study was an analytical study with a cross-sectional framework. This study was conducted in April 2018 at in-patient installation of RSUD Dr. R. Sosodoro Djatikoesoemo Bojonegoro by inviting 52 nurses chosen with stratified random sampling.Results: It was found that there was a significant correlation between personal responsibility (p = 0.020), status (0.015) and proximity of authority figure (p = 0.000) and nurses’ obedience to the implementation of Standard Operational Procedures of hand hygiene before and after intravenous installation in in-patient installation of RSUD Dr. R. Sosodoro Djatikoesoemo Bojonegoro.Conclusion: It can be concluded that the majority of the nurses did not follow hand hygiene stages well. The hospital needs to improve nurses’ personal responsibility, authority figure status, and rapport of authority figure.Keywords: hand hygiene, nurse obedience, Standard Operational Procedures

DETERMINAN MARGIN KEUNTUNGAN PRODUK PEMBIAYAAN MURABAHAH

<em>Murabahah financing product at PT. Pegadaian Syariah branch Landungsari Malang, Murabahah Logam Mulia untuk Investasi Abadi (MULIA) is defined as a gold trade financing in a cash or credit in accordance with Sharia laws. This research aims at exploring the determination process of profit margin and the implementation of Standard Operating Procedure in the practice of murabahah financing at PT. Pegadaian Syariah branch of Landungsari Malang. This study uses qualitative method with two approaches. First, the researcher conducted an observation and in-depth interview to Strategi Bisnis Unit (SBU) assistant manager. The result of this study confirms that researcher get total of profit margin Rp. 85.414 in which there is administration cost Rp. 50.000, sales margin 2,5% Rp. 15.725, and installment margin 3,94% namely Rp. 24.783. Researcher get discount margin Rp. 5.094 that’s means net installment margin is Rp. 19.689. The determination of profit margin for murabahah financing has considered the terms of sharia laws by using consensus principle which is mentioned in Quran surah An Nisa verse 29. This verse explains that any transaction should not bother customers. With this basis, therefore, the practice of murabahah financing has been compatible with the regulations written on Standard Operating Procedure of the firm.</em>

HUBUNGAN PENGETAHUAN, SARANA PRASARANA, DAN PENGAWASAN DENGAN PERILAKU PENERAPAN SOP PEKERJA CONFINED SPACE

Working in confined space has very high risks, therefore, one of the hierarchy control to manage identified risk is administrative by implementing Standard Operating Procedures (SOP). The implementation of SOP correlates with the worker behaviors. The purpose of this research is to find out correlation between knowledge, facilities, and supervision to implementation behaviors of sop in confined space. This study is an observational descriptive research using cross sectional approach. The subject is a total population of 19 cleaning workers in Ducting Dust Collector PT. X . The data provided in distribution of frequency tables and was analyzed using crosstabulation followed with Phi and Cramers V Coefficient to see the relation strength. The result of the study shows that most of the workers has a good behavior in implementing the working SOP in confined space. According to Phi and CramersV Coefficient, Knowledge (0,57) and Facilities (0,57) has a strong relation with the implementation behavior of SOP in confined space. Supervision has no relationship at all with the implementation behavior of working SOP within the confined space. Keywords: confined space, behavior, SOP

NURSING COMPLIANCE IN IMPLEMENTING STANDARD OPERATING PROCEDURES OF PATIENT PREVENTION

Reducing the risk of falling patients is one of the six patient safety goals. To reduce the risk of injury due to falls, the hospital makes the Standard Operating Procedures (SPO) prevention of patients fall as a reference to avoid Unexpected Event (KTD). One of the factors influencing the implementation of SPO is nurse compliance. The purpose of this study to determine the compliance of nurses in implementing standard operational procedures prevention of patients fall in the installation of inpatient hospital Leprosy Sumberglagah. The population in this research were all nurses in the installation of input hospitals Sumberglagah which amounted to 30 nurses, using total sampling technique and sample amounted to 30 nurses. This research uses an observation sheet instrument with 23 statements and is done in 2 weeks. The results of this research indicate that all nurses do not adhere to the Standard Operating Procedures (SPO) prevention of falling patients, of which 30 nurses (100%) in implementing prevention of patients fall out of SPO, either at low risk SPO or medium and high risk. Non-understanding of nurses on the instructions to be the cause of falling nurses on the implementation of SPO prevention of patients fell. In addition, attitude, age, employment and education factors also affect non-compliance of nurses

Educação permanente em saúde e o procedimento operacional padrão: pesquisa convergente assistencial

The present study has the objective of studying permanent education as a strategy for the implementation of Standard Operational Procedures (SOPs) in service at the Dialysis Center. Its objectives were to verify the knowledge of the professionals in terms of permanent education in health and the POPs; identify whether the team uses the SOPs at the moment of the care given to the hemodialysis patients; to describe the possible difficulties for the implementation of SOPs by the team in the context of hemodialysis and to implement permanent education to facilitate the use of SOPs by the professionals of the Dialysis Center. The methodology used was the convergent assistance research, through the problematization, where it is made from the problems faced in reality and takes into account the knowledge and experiences that people already have. The research scenario was the nephrology sector of the Antonio Pedro University Hospital, located in Niteroi, a city in the State of Rio de Janeiro. The research had three stages and the instruments of data collection used were: In the first stage, participant observation; in the second stage, semi-structured interview and; in the third stage, educational groups. In the first stage, a problem and theme that would be worked out from the need of the sector was built. In the second stage, four categories were constructed, after Bardin’s content analysis. They are: 1) "Joy does not only come in the find, but it is part of the search process. And teaching and learning cannot be out of demand, out of good-naturedness and joy."; 2) "No one educates anyone, no one educates himself, men educate one another, mediated by the world."; 3) "If education alone does not transform society, without it neither does society change."; 4) "Teaching is not transmitting knowledge, but creating possibilities for its own production or its construction". In the third stage, the participants were invited to the educational groups, a place for dialogue, reflection and elaboration of hypotheses for solutions, following the proposal of the problematization methodology. In these groups, we discussed what Permanent Education in Health, Continuing Education, and SOPs were; the main SOPs related to hemodialysis were updated; summary flowcharts were constructed on each updated SOP; and from this knowledge a mobile application, where the flowcharts were present so that everyone had access wherever they went, was built. It was concluded that little knowledge was available about the current legislation on permanent health education and that the lack of full meaning was limited to the forms of contact with SOPs. However, the solutions found by the group, even if it did not form uniformly throughout the meetings, were a sum of experiences gathered, which provided what Paulo Freire calls "a certain ethical-critical-political understanding of education" for the convergent assistance research, for the awakening of critical thinking, the improvement of the quality of the dialysis service and the national policy of permanent education in health as an empowerment strategy

Editors' note: Standard operating procedures improve acute neurologic care in a sub-Saharan African setting

In “Standard operating procedures improve acute neurologic care in a sub-Saharan African setting,” the authors showed that implementing standard operating procedures (SOPs) in resource-limited countries is possible and potentially valuable. Dr. Chin points out that while SOP utilization increased in the first 2 years, it was under experimental conditions, which likely artificially increased adherence. He also highlights that clinical outcomes did not change significantly but may improve with the addition of postemergency management SOPs as well. Authors Fassbender et al. agree that health care in sub-Saharan Africa is subject to many formidable limitations, including financial, structural, and personnel constraints, but note that the implementation of SOPs is a positive act that can be accomplished quickly and with available resources. They agree that expanding SOPs into postemergency management and prevention may be the next step. In “Olfaction and risk of dementia in a biracial cohort of older adults,” the authors found an association between worsened olfaction and dementia. Drs. Fuller-Thomson and Jopling suggest the link is cumulative lifetime lead exposure, associated with both deterioration in olfaction and cognitive decline.

IBM BUDIDAYA DAN PENANGANAN PASCA PANEN BUAH JAMBU BIJI UNTUK PASAR SUPERMARKET

Pajambon village is a village center for the cultivation of guava in the district of Kuningan. The cultivation techniques and postharvest handling were not based on Standard Operating Procedure (SOP) and Good Handling Practices (GHP) such as the application of fertilizer was less precise, sanitary land that was not optimal, pest control was less precise, and postharvest handling were not done well. Yet the implementation of SOP and GHP in guava cultivation techniques lead to optimal production and quality of the crop of guava was low. Farmers' knowledge regarding guava cultivation techniques and post-harvest handling needs to be improved. The method was used in this program include counseling, training and monitoring (assistance). Results of these programs i.e. farmers understand the techniques of cultivation and postharvest handling in accordance with the SOP and GHP, the guava fruit yield increase qualified grade A (≥250 g), as well as the decrease in the yield of fruit guava qualified grade C (149 g - 100 g).

A Comparative Study of Routine Microscopic Examination of Urine in Microbiology Laboratories at Primary and Secondary Level Before and After Implementation of Standard Operating Procedure (SOP)

Context : Laboratory services have become an integral and inseparable component of modern medicine and public health. The use of standard operating procedure (SOP) in laboratory testing is one of the most crucial factor in achieving the quality. This cross sectional study was done to assess the quality of routine microscopic examination of urine of a microbiology laboratory at primary level and one microbiology laboratory at secondary level by evaluating the test results before SOP and re evaluating the test results after implementing SOP to see if there was any improvement in quality of those tests.Material and Methods: A cross sectional, descriptive type of study was conducted in Narsingdi Sador Hospital as secondary level microbiology laboratory and Polash Upzilla Health Complex as primary level microbiology laboratory. The study was performed on clinically suspected patients of urinary tract infection (UTI) attending at the primary and secondary level laboratory for microscopic examination of urine. Clinically suspected cases of UTI who had taken any anti microbial treatment in the past 48 hours were excluded from the study. 60 urine samples were collected from each level before implementing SOP and 30 urine samples were collected from each level and tested after following SOP.Result : In routine microscopic examination of urine at primary and secondary level, before SOP, regarding significant number of Pus cells discrepancy was found in 21.67% cases at primary level and 18.33% cases at secondary level. After implementing SOP, discrepancy in the result was reduced to 10% from 21.67% at primary level and 0% from 18.33% at secondary level. This difference in results was statistically significant (p< 0.05).Conclusion: Implementing SOP and after practicing appropriate and standard techniques for collection and examination of urine at primary and secondary level, discrepancy in the results of routine microscopic examination of urine between investigator and Medical Officer (MOPathology) was reduced and overall quality of tests were improved.J Dhaka Medical College, Vol. 25, No.2, October, 2016, Page 87-93

IMPLEMENTASI STANDAR OPERASIONAL PROSEDUR (SOP) PELAYANAN AKTA KELAHIRAN PADA DINAS KEPENDUDUKAN DAN PENCATATAN SIPIL KOTA BENGKULU

The purpose of this research is to know the implementation of SOP (Standard Operational Procedures) for birth certificate services at the Population and Civil Registration Board of Bengkulu City. The method of the data analysis was used is descriptive and qualitative analysis. The study shows that: (1) the preparation phase of the implementation of SOP services at the Population and Civil Registration Board has been executed well, where socialization SOP has been done properly, the SOP has been well implemented and equipment of the Ministry has been drafted and personals, has been shared with the right personnel, so as to facilitate the process of service to the community and (2) the implementation of SOP implementation the issuance of a birth certificate in the Population and Civil Registration Board of Bengkulu City from the stage of receiving and examining the file the petition for a birth certificate, file verification application scheduled, and collect files petition, enter data and print a birth certificate, check, legacy and sign, and submit the quote birth certificate to the community have been implemented in accordance with the stages of service assigned. Every employee involved in the birth certificate service has been implemented in accordance with the stages of service assigned.Keywords: Policy implementation, Standard Operational Procedure; and Birth Certificate

Impact of pre-analytical variables in the determination of serum galactomannan.

Invasive aspergillosis (IA) is associated with a high morbidity and mortality. Since Aspergillus species are usually not cultured in these patients, presumptive diagnosis of IA is more commonly based on galactomannan (GM) detection. Several factors are known to cause false-positive results in the GM test, but little is known on the influence of pre-analytical variables interfering on the test. Here we studied the influence of temperature and sample storage duration in GM results, using samples known to be negative and positive (spiked) for GM. We also evaluated the effect of hemolysis and hyperbilirubinemia on GM optical indexes. We found no influence of storage time (up to 96 h) and temperatures (refrigerated vs. RT) on GM results. However, bilirubin (P = .022) and haemoglobin (P = .003) content influenced GM readings in samples known for being GM positive and negative at baseline, respectively. We conclude that the Platelia GM test does not suffer major influence of pre-analytical variables such as storage conditions, and low levels of hemolysis and hyperbilirubinemia. Nonetheless, massive haemolysis seems to interfere with GM readings in GM-negative samples, and high levels of bilirubin can affect GM readings in samples that are positive for GM at baseline. These findings may facilitate logistics and the implementation of standard operational procedures in clinical laboratories.

Evaluasi Penerapan Prosedur Operasional Standar Pengelolaan Keuangan Daerah di Provinsi Papua

<em>Implementation of Standard Operating Procedures (SOP) in the regional financial management should be conducted based on an internal control system in the local government. When conducting the examination, BPK shall examine and assess the internal control system of the local government. Thus, if the internal control system of the local government is adequate, then compliance toward SOP can be implemented, and the results of the testing and examination of BPK is expected to give a favorable opinion. The provincial government of Papua has decreased the results of the examination of financial statements for three consecutive years. In 2007-2009 the provincial government of Papua gets a qualified opinion, and in 2010 received a disclaimer opinion. The purpose of this study was to evaluate SOP application compliance of regional financial management, which can be known to through BPK examination report containing the findings and their opinions based on the criteria. The results showed that theProvincial Government of Papua has prepared SOP of its financial management in line with the rule in force. However, the SOP is not fully adhered to in practice, due to several factors: (1) weak of government internal control systems;(2) lack of financial management guidance and supervision.</em>

Quality Assurance of Drug Information Service and Drug Therapy Review Provided by Clinical Pharmacists in an Indian Teaching Hospital

Background: To ensure the competent delivery of patient care by clinical pharmacists, it is essential to evaluate services provided by them. Objectives: This study was conducted to assess the impact of Standard operating procedure (SOP) on quality of Drug information (DI) service and drug therapy review provided by clinical pharmacy department. Methods: The study was conducted at department of clinical pharmacy located at tertiary care teaching hospital. Quality assessment checklist was designed to assess the quality of both services. Based on score obtained from checklist each service was graded at different levels. Quality of services provided was compared before and after implementation of SOP. Also questionnaire was circulated among health care professionals of various medical departments to evaluate their perception and opinion about mentioned services provided. Results: Before implementation of SOP, out of 70 DI evaluated, 35.7% of them were found to be excellent, 41.4% of them were found to be good, whereas it was found that 22.9% of DI needed improvement.After implementation of SOP, out of 85 DI evaluated, 82.4% of DI provided was found to be excellent and remaining DI provided (17.6%) was found to be good. Before implementation of SOP, out of 64 interventions provided, 65.6% of them were found to be excellent and 26.6% of them were found to be good, however, 7.8% of them needed improvement. After implementation of SOP, 64 interventions were evaluated and out of which 87.5% of them were found to be excellent and 7.8% of them were found to be good. However, only 4.7% of them needed improvement. Majority of medical staff (77%) felt that clinical pharmacists actively contribute in drug therapy decision making and overall performance of clinical pharmacist was rated as “Good” by medical staff. Conclusion: The quality of both, DI service and drug therapy review was found to be improved after implementation of SOPs. Also, quality of both services provided is an important factor influencing the acceptability of clinical pharmacist’s contributions.

Quality Assessment of Widal Test in Microbiology Laboratories at Primary and Secondary Level Before and After Implementation of Standard Operating Procedure (SOP): A Comparative Study

Context: The use of standard operating procedures (SOP) in laboratory testing is one of the most crucial factors in achieving the quality. In primary and secondary level laboratory, the scope for microbiological test is limited. Enteric fever is one of the major public health problem in the developing countries, including Bangladesh. An undiagnosed and maltreated case of enteric fever may result in serious complication and even prove fatal. Widal test is the very extensively used serological test in laboratory at all level to aid in the diagnosis of enteric fever. It is the only available practical test for demonstrating antibodies to Salmonella typhi and S. paratyphi. In this study, an attempt has been made to evaluate the present status of microbiology laboratory by comparing the test results of investigator with that of laboratory staff for widal test at primary and secondary level before and after implementation of standard operating procedure (SOP) .Methods: The present study was performed on clinically suspected cases of enteric fever attending at the primary and secondary level laboratories for widal test. A 120 blood samples were collected before implementing SOP and 50 blood samples were collected and tested after following SOP. A cross sectional, descriptive type of study was conducted in Narsingdi Sador Hospital as secondary level microbiology laboratory and Polash Upzilla Health Complex as primary level microbiology laboratoryResults: Before standard operating procedures (SOP), significant titre of widal test was found more by the investigator than the staff at both primary and secondary level. This difference in results was statistically significant (p<0.05). After SOP difference in the results of significant titre of widal test between investigator and staff was not statistically significant (p>0.05).Conclusion: Implementing SOP for widal test and after practicing appropriate and standard techniques for dilution of serum at primary and secondary level, discrepancy in the results of widal test between investigator and staff was reduced and overall quality of tests were improved.J Dhaka Medical College, Vol. 23, No.2, October, 2014, Page 227-233

Perioperatives Wärmemanagement in Abhängigkeit von der Krankenhausgröße in Deutschland

Improvement of quality of care and patient safety while decreasing costs are major challenges in healthcare systems. This challenge includes the avoidance of perioperative hypothermia to reduce the associated adverse effects, length of stay and treatment costs. Due to the medical and economic relevance the national S3 guidelines for the prevention of perioperative hypothermia were recently published. This study presents and analyses the reality of utilization of thermal management in German hospitals depending on the size of the hospital, which is based on the number of beds. Based on the data of an online survey among all members of the German Society of Anesthesiology and Intensive Care Medicine about perioperative thermal management, a subgroup analysis differentiating between the size of hospitals was performed. The survey included questions about the structural and organizational conditions, the practical implementation of temperature measurement and warming therapy and the developmental status of clinical standard operating procedures (SOP) and educational training. Comparing the structural quality, major differences were found with respect to the availability of core body temperature measurement and the provision of warming devices especially at different peripheral anesthesia workplaces as well as the existence of SOPs and educational training. The availability increased with hospital size. With respect to process quality, the frequency of prewarming increased with hospital size as well as the frequency of intraoperative temperature measurements during different anesthesia procedures. Major differences were found in several aspects of perioperative thermal management depending on the hospital size. The main potential for improvement was found in smaller hospitals. Developmental needs primarily exist in the configuration of peripheral anesthesia workplaces, educational training, implementation of SOPs and prewarming of patients.

SIMULATION STUDY OF A VEHICLE PRODUCTION LINE FOR PRODUCTIVITY IMPROVEMENT

This paper presents the study of a motorcycle frame production line in a particular company in Malaysia. Due to the high demand, the company needs to increase its production by at least 12% compared with current output. In order to improve productivity, the production-floor data was collected and simulated using the discrete event simulation approach. Later, a number of suggestions for improvement were simulated to identify the effect of the suggestions on productivity. In addition, cost analysis was also undertaken to identify the profit margin for a particular period of time for each suggestion. Simulation results indicate that there are three suggestions that are able to fulfill the 12% volume increment. In the short term, the suggestion to hire an assistant line leader will give instant effect to the profit. Meanwhile, for the medium term, Poka-yoke will give higher profit compared with the others, while in the long term, SOP (standard operating procedure) implementation will yield a better profit margin. In future, the simulation of a dynamic demand model for this product is suggested to cope with new trends in the market.

Use of checklists facilitates guideline adherence in prehospital emergency care

Background: High quality emergency medical care requires transfer of evidence based knowledge into practice. The implementation of Standard Operating Procedures (SOP) alone is not sufficient to ensure adherence to guidelines.1 Checklists have proven to reduce perioperative mortality significantly.2 Our study investigated the usability of checklists in order to improve quality and safety in prehospital emergency care.

A Tiered Quality Assurance Review Process for Clinical Data Management Standard Operating Procedures in an Academic Health Center

Standard operating procedures (SOPs) were once considered the province of the pharmaceutical industry but are now viewed as a key component of quality assurance programs. To address variability and increase the rigor of clinical data management (CDM) operations, the Cincinnati Children's Hospital Medical Center (CCHMC) decided to create CDM SOPs. In response to this challenge, and as part of a broader institutional initiative, the CCHMC leadership established an executive steering committee to oversee the development and implementation of CDM SOPs. This resulted in the creation of a quality assurance review process with three review panels: an SOP development team (16 clinical data managers and technical staff members), a faculty review panel (8 senior faculty and administrators), and an expert advisory panel (3 national CDM experts). This innovative, tiered review process helped ensure that the new SOPs would be created and implemented in accord with good CDM practices and standards. Twelve fully vetted, institutionally endorsed SOPs and one CDM template resulted from the intensive, iterative 10-month process (December 2011 to early October 2012). Phased implementation, which incoporated the CDM SOPs into the existing audit process for certain types of clinical research studies, was on schedule at the time of this writing. Once CCHMC researchers have had the opportunity to use the SOPs over time and across a broad range of research settings and conditions, the SOPs will be revisited and revalidated.

Analisis Pelaksanaan Prosedur Operasional Standar Sarana dan Prasarana Belajar Laboratorium Berdasarkan Manajemen Mutu ISO 9001:2008 & IWA 2:2007 di Jurusan Teknik Sipil Universitas Negeri Jakarta

The objectives of this study to determine the percentage level implementation of Standard Operating Procedures learning facilities Laboratory of Civil Engineering, State University of Jakarta in the implementation of quality management ISO 9001: 2008 & IWA 2: 2007. The study lasted for three months from September to November 2013.Place of research conducted at the State University of Jakarta, precisely at 5 Laboratory of the Laboratory of Wood, Land, Material, Stone, and Plumbing Department of Civil Engineering, State University of Jakarta. The population in this study was 5 5 Laboratory of Laboratory of Civil Engineering Laboratory UNJ include Wood, Land, Material, Stone, and Plumbing. The method used in this research is survey method with data collection using a questionnaire or questionnaires. The trial questionnaire of 115 statements. The test is done to 7 respondents. After the test phase the results obtained valid instruments as much as 112-point declaration.Data analysis technique is done by searching percentage. The results show that: (a) Laboratory of Civil Engineering UNJ have a Standard Operating Procedure (POS) especially Infrastructures based quality management standard ISO 9001: 2008 and IWA 2: 2007 (b) There are four (4) POS on Infrastructures Laboratory Civil engineering UNJ whose accomplishments are not up to 100%. which amounted to 64.7% which can be categorized fulfillment are lacking, (c) Acquired four (4) percentage level of achievement of the implementation of POS Infrastructures Civil Engineering Laboratory UNJ the percentage rate of the unit does not reach 100%. The results are the result of the analysis of data derived from the 5 respondents who are Laboran of 5 laboratories in this study are: Health, Safety and Environment Laboratory (weight percentage of 73.3%) were categorized been fulfilled, Use of Laboratory (weight percentage of 71% ) categorized been met, Laboratory Equipment Loan (weight percentage of 66.8%) categorized as less fulfilled, and the maintenance and care Laboratory (weight percentage of 47.8%) were categorized are lacking, (d) There is inequality between understanding Laboran percentage of POS by 82 , 8% by POS regarding Infrastructures Laboratory of 64.7%.

Methodological Approaches for Dietary Intake Assessment in Formula‐fed Infants

The estimation of dietary intake remains a challenge in human nutritional studies. In infants, the use of food diaries (FDs) is a suitable method already validated; however, this method is not exempt from error. In formula-fed infants, dilution of powdered formulas may produce errors. Our aim was to develop and validate standard operating procedures (SOPs) for the assessment of dietary intake in formula-fed infants, attending potential sources of error. We analysed sources of error in a random subsample of 3-day FDs from 100 infants enrolled in the European Childhood Obesity Project. Calculations to estimate intakes were standardised and included in a software tool (SOPsystem). An evaluation of a simulated FD was performed by 9 trained nutritionists and 23 nutrition students (n=225 and n=575 bottle evaluations, respectively) to compare the results obtained when using or not the SOPsystem. Correct answers (%), coefficients of variation, and the time spent (minutes) to assess the simulated FD were analysed. Overall, 60% of the FDs contained reports of incorrect volumes, and 37% reported incorrect formula dilutions. When the SOPsystem was used, correct answers in the simulated FD were more frequent (P<0.001) and the mean coefficient of variation and the time spent were lower (P<0.005 and P<0.01, respectively). The development and implementation of SOPs with a software tool that identifies specific sources of error in record-keeping achieved a harmonised and improved process for assessing dietary intakes in formula-fed infants, minimising errors in calculations and reducing the work time invested.

Structured smoking cessation training for health professionals on cardiology wards: a prospective study

Smoking is a major cardiovascular risk factor, and smoking cessation is imperative for patients hospitalized with a cardiovascular event. This study aimed to evaluate a systems-based approach to helping hospitalized smokers quit and to identify implementation barriers. Prospective intervention study followed by qualitative analysis of staff interviews. The prospective intervention study assessed the effects of implementing standard operating procedures (SOPs) for the provision of counselling and pharmacotherapy to smokers admitted to cardiology wards on counselling frequency. In addition, a qualitative analysis of staff interviews was undertaken to examine determinants of physician and nurse behaviour; this sought to understand barriers in terms of motivation, capability, and/or opportunity. A total of 150 smoking patients were included in the study (75 before and 75 after SOP implementation). Before the implementation of SOPs, the proportion of patients reporting to have received cessation counselling from physicians and nurses was 6.7% and 1.3%, respectively. Following SOP implementation, these proportions increased to 38.7% (p < 0.001) and 2.7% (p = 0.56), respectively. Qualitative analysis revealed that lack of motivation, e.g. role incongruence, appeared to be a major barrier. Introduction of a set of standard operating procedures for smoking cessation advice was effective with physicians but not nurses. Analysis of barriers to implementation highlighted lack of motivation rather than capability or opportunity as a major factor that would need to be addressed.