Standard Operating Procedures Research Articles

Analysis of Employee Work Quality Using Statistical Process Control and Compliance with Standard Operating Procedures (Study in the Merchandise Inspection Department of the Foodhall Senayan City)

The objective of this research is to evaluate the effectiveness of employee performance in implementing Standard Operating Procedures (SOP) within the Merchandise Inspection/Receiving Department at The Foodhall Senayan City. This research is of a qualitative descriptive nature, with a focus on Statistical Process Control (SPC) as a measurement instrument. It employs the Implementation of Seven Key Elements in SOP, covering efficiency, consistency, error minimization, problem-solving, and defensive limitations. Five individuals participated in this research: Branch Manager, Receiving Supervisor, and three Receiving Staff members. Data collection techniques were based on direct observation, interviews, and documents used as references for the receiving staff's work procedures. In this study, the author used Statistical Process Control (SPC) on Attribute Control Charts, specifically using P-charts as a measurement tool for Quality Control checks on goods. The Implementation of Seven Key Elements in SOP was used to deepen the investigation into problem-solving that could not be explained using numerical data. Based on the analysis results using Statistical Process Control (SPC) for the current period, the average reversal rate is 0.02, indicating proximity to the Lower Control Limit (LCL) of 0 or zero defects. Meanwhile, regarding the usage of the Implementation of Seven Key Elements in SOP in the Merchandise Inspection/Receiving Department at The Foodhall Senayan City, it is evident that in the implementation of these seven key elements, there are still some shortcomings. These deficiencies include error minimization, process mapping, employee protection, and defensive limitations.

Return to school practices after hematopoietic cell transplantation: a survey of transplant centers in the United States.

To understand transplant center recommendations on return-to-school timing and related support for hematopoietic cell transplant (HCT) survivors, we conducted a two-phase, cross-sectional, web-based survey: In Phase I, medical directors of pediatric HCT centers from the National Marrow Donor Program/ Be The Match Registry were asked regarding the availability of a return to school standardized operating procedure (SOP). In Phase II, HCT physician members of the Pediatric Transplantation and Cellular Therapy Consortium were approached to study inter-physician practice variability regarding return to school post-HCT, factors affecting their decision-making, and support provided by HCT centers for return to school. Out of 46 respondents in Phase I (55% response rate), 28 (61%) reported having a SOP. Wide variations in recommendations were noted in 12 received SOPs. In Phase II, 122 physicians (60 centers) responded (30.6% response rate). The majority (60%) recommended autologous HCT recipients return to school within 6 months post-HCT but 65% recommended allogeneic HCT recipients return to school after 6 months or once off immunosuppression. Our findings indicate a lack of consensus within and across HCT centers regarding recommended return to school timing and underscore need for a guideline to standardize this process to ensure patient safety and re-integration into school.

Enhancing Hospital-Acquired Infection Prevention Practices: Strategies for Healthcare Workers in Low- and Middle-Income Settings: Insights from a Study on Healthcare Workers in Western Uganda

In low- and middle-income hospital settings, hospital-acquired infections can occur among patients or arise among hospital staff, posing a significant challenge. This study aimed to assess the knowledge, attitudes, and practices related to preventing hospital-acquired infections (HAIs) and the associated factors among healthcare workers at Fort Portal Regional Referral Hospital in Kabarole district, western Uganda. Conducted between January and March 2011, this hospital-based cross-sectional study employed simple random sampling to select 236 participants, achieving a 100% response rate. Structured self-administered questionnaires were utilized for data collection. Descriptive analysis was employed to present the main findings, revealing that 90% of participants had good knowledge and 57.2% held positive attitudes towards HAI prevention. However, only 36% demonstrated good practices in this regard, indicating suboptimal scores. Significant associations were found between levels of education and work experience and attitudes and practices related to HAI prevention (P value <0.005). Despite respondents exhibiting good knowledge and positive attitudes towards HAI prevention, this did not consistently translate into appropriate practices. Further, education level and work experience emerged as independent risk factors influencing attitudes and practices concerning HAI prevention. To bridge this gap, continuous on-the-job and off-the-job training, coupled with stringent adherence to updated standard operating procedures, are recommended. Keywords: Healthcare workers, HAI prevention, Hospital staff, Hospital settings, Work experience.

CHALLENGES AND OPPORTUNITIES FOR IMPROVING MANAGEMENT AND REGULATION OF THE RAIL TRANSPORT SECTOR IN INDONESIA: PERSPECTIVE FROM THE INDUSTRY 4.0 CONCEPT

Objective: The research aims to uncover the causes of train accidents in Indonesia beyond those identified by experts and proposes solutions for inclusion in the regulations and standard operating procedures of the Indonesian Railways Company. Theoretical Framework: The United Nations Economic Commission for Europe (UNECE), operating under the UN Economic and Social Council since its establishment in 1947, has introduced the Industry 4.0 concept, titled 'Increasing the Competitiveness of Transportation between Europe and Asia: European Union Rail R&I. This concept incorporates three crucial indicators known as ACT (Aging, Climate Change, and Technology), aligned with the Railway Sustainable Development Goals. Method: This research employs a qualitative approach, gathering data through in-depth interviews using purposive sampling. Interview reviews are presented in the results section. The study involved 28 participants, focusing on the cities of Palembang and Lampung, situated on the tip of the island of Sumatra, bordering the island of Java. Results and Conclusions: The study identified seven themes for inclusion: The development of Railways in Indonesia; Organizational strengths and weaknesses; Human resources; Infrastructure; Operational aspects; Causal factors in train accidents, and Future solutions and contributions to regulation. These were then simplified into three themes following UNECE guidelines. Notably, the main issues with freight trains, primarily used for coal transportation, include an inadequate number of carriages, damage to rails and train sleepers, and excessive cargo loads, leading to frequent train derailments and accidents. The law regulates general provisions for rail freight transportation, but violations are common, and sanctions are minimal due to the state-owned nature of the managing company. Research Implications: This study suggests measures to enhance regulations and Standard Operating Procedures (SOPs) for the Indonesian Railways Company, including adapting regulations and SOPs to improve the operational safety of goods trains. This involves modernizing signaling systems and addressing human errors, particularly during night shifts. Recommendations also cover optimizing single-path and double-path routes, proposing regulations for the adaptation of automatic control systems, and improving the Grade of Automation (GOA). Ensuring the safety of personnel, especially operators and machinists, is emphasized. Originality/Value: This research explores the paradigm shift within Indonesia Railways, transitioning from GOA 0 to GOA 1. Anticipated to significantly impact the safety of goods (coal) trains, this study offers profound insight into the evolution of transportation governance for freight transport by rail. Both the government and Indonesia Railways can consider integrating these findings into regulations or SOPs, despite facing challenges such as funding constraints and the high cost associated with upgrading to GOA 2 infrastructure.

Prediction of Training Cost and Difficulty for Aircraft-Type Transition Based on Similarity Assessment

As aviation technology advances, numerous new aircraft enter the market. These not only offer airlines technological and fuel efficiency advantages but also present the challenge of how to conduct pilots’ aircraft-type transition training efficiently and economically. To address this issue, this study designed a methodology to quantitatively assess the similarity in panel display control design and standard operating procedures (SOPs) between aircraft types. Then, by combining the results of a questionnaire survey on A320, A330, B737, and B777 transition training and training cost data, it was verified quantitatively that inter-aircraft similarity has a positive impact on reducing the difficulty and cost of transition training. Taking the similarity in aircraft types as a feature, the KNN algorithm was used to successfully construct a difficulty prediction model for the training program of aircraft-type transition training. To overcome the limitation of insufficient training cost data volume, this study adopts the transfer learning method to construct a prediction model of the transition training cost, and the final significant prediction accuracy proves the effectiveness of the method. The research in this paper not only provides strong data support for the resource planning and cost management of airlines’ aircraft-type transition training but also provides new research perspectives and methodological guidance for the field of aviation training.

Comparative analysis of the Potter Tower and a new Track Sprayer for the application of residual sprays in the laboratory

BackgroundEfforts to evaluate the residual efficacy of new indoor residual spraying (IRS) formulations have identified limitations with the industry standard laboratory sprayer, the Potter Spray Tower (PT). Calibrating the PT can be time-consuming, and the dosing of surfaces may not be as accurate or uniform as previously assumed.MethodsTo address these limitations, the Micron Horizontal Track Sprayer with Spray Cabinet (TS) was developed to provide higher efficiency, ease of operation and deposition uniformity equal to or better than the PT. A series of studies were performed using a fluorescent tracer and three IRS formulations (Actellic® 300CS, K-Othrine WG250 and Suspend PolyZone) sprayed onto surfaces using either the PT or the TS.ResultsDeposition volumes could be accurately calibrated for both spray systems. However, the uniformity of spray deposits was higher for the TS compared to the PT. Less than 12% of the volume sprayed using the PT reaches the target surface, with the remaining 88% unaccounted for, presumably vented out of the fume hood or coating the internal surfaces of the tower. In contrast, the TS deposits most of the spray on the floor of the spray chamber, with the rest contained therein. The total sprayed surface area in one run of the TS is 1.2 m2, and the operational zone for spray target placement is 0.7 m2, meaning that 58% of the applied volume deposits onto the targets. The TS can treat multiple surfaces (18 standard 15 × 15 cm tiles) in a single application, whereas the PT treats one surface at a time and a maximum area of around 0.0225 m2. An assessment of the time taken to perform spraying, including the setup, calibration and cleaning, showed that the cost of application using the TS was around 25–35 × less per tile sprayed. Standard operating procedures (SOPs) for calibration and use of both the Potter Tower and Track Sprayer have been developed.ConclusionsOverall, the TS represents a significant improvement over the PT in terms of the efficiency and accuracy of IRS formulation applications onto test substrates and offers a useful additional tool for researchers and manufacturers wanting to screen new active ingredients or evaluate the efficacy of IRS or other sprayable formulations for insect control.Graphical

Hubungan Supervisi Kepala Ruangan Dengan Kepatuhan Tenaga Kesehatan Dalam Menjalankan Standar Operasional Prosedur Pemasangan Infus Di UPTD Puskesmas Mawasangka TimurTahun 2023

Infusion is one of the invasive procedures performed by health workers by injecting a certain amount of fluid into the body into the vein to improve or prevent fluid and electrolyte, blood, and nutritional disturbances. The act of installing an infusion will be of high quality if in its implementation it always complies with the standards that have been set. One of the factors that can affect the performance of nurses, including the compliance of nurses and midwives in providing actions according to the SOP is supervision. This study aims to analyze the relationship between the supervision of the head of the room and the compliance of health workers in carrying out standard operating procedures for infusion at the UPTD Puskesmas Mawasangka Timur in 2023. This study is a correlation analytic study with a cross sectional study design. The sample in this study was 41 people consisting of 21 nurses and 20 midwives. The sampling technique used in this study is nonprobability sampling with total sampling. Data were analyzed using the chi-square test to determine the relationship between the independent and dependent variables. The results of statistical tests showed that there was a relationship between the supervision of the head of the room and the compliance of health workers in carrying out standard operating procedures for infusion at the Mawasangka Timur Health Center UPTD in 2023 (p-value 0.000 <0.05). Supervision of the head of the room has a significant role in increasing the compliance of health workers, especially nurses and midwives, in carrying out standard operational procedures for infusion installation.
 

Analisis Defect Rajungan (Portunus pelagicus) Kaleng Menggunakan Metode Failure Mode And Effect Analysis (FMEA) Di PT. XYZ

PT XYZ is an industry that operates in the fisheries sector with superior products, pasteurized crab meat in cans. Increasing market demand, including demand for canned crab exports, requires companies to produce products quickly and correctly. However, in the production of canned crab, defective products are often found or do not meet quality standards. The aim of this research is to identify defect problems in canned crab products and provide suggestions for improvements to overcome the problem in order to minimize the occurrence of defects that are detrimental to the company. Research data collection methods are through observation, interviews and questionary. The Failure Mode and Effect Analysis (FMEA) method is used to identify and analyze defects that occur. FMEA is used to determine the severity level, occurrence level and detection level, so that a Risk Priority Number (RPN) value can be obtained which can determine the priority of defects that must be prioritized for repair. The identification results at PT XYZ found 7 types of defects. The highest RPN defect value that occurs is a rust defect with an RPN value of 324. The defects that occur in this problem are caused by 4 factors, namely humans, methods, materials and the environment. Proposed improvements to reduce the chance of defects occurring in cans include material inspection, human/operator error evaluation, maintaining process environmental conditions, and optimizing the implementation of standard operating procedures (SOP)

Implementation of Administrative Service Policy at The Makassar City Population and Civil Registry Service

<span lang="EN-US">The problem in this study is the implementation of policies that have not been optimal at the Makassar City Population and Civil Registry Office. This study aims to analyze the implementation of administrative service policies at the Makassar City Population and Civil Registry Office. This type of research is qualitative research. Primary data sources were obtained through interviews with 18 informants and supported by observation and documentation review at the Makassar City Population and Civil Registry Office. The results of the study indicate that the implementation of the administrative service policy has interpreted the above policies. However, the arrangement for employee placement is less effective because it only places two employees at the file verification counter so that its implementation results in long queues. This shows the lack of coordination by the implementor on the existing service arrangements and procedures and the lack of socialization to the community, resulting in the weak ability of the community to adapt to the procedures and service innovations that have been made. Thus, it is recommended to apply the Optimal One-Stop Integrated Service Model so that the administrative services of the Makassar City Population and Civil Registration Service are more effective. The need to improve effective coordination between implementing organizations to meet all resource requirements so that Standard Operating Procedures and service innovations are made according to the needs of the organization and society. Furthermore, the Operational Standards and Procedures as well as service innovations should be maximally disseminated by the implementers so that the public knows and understands the existing work mechanisms at the Makassar City Population and Civil Registry Office.</span>

Human Resource Needs Planning in the Technical Implementation Unit Health Laboratory Kendari City

Introduction: Human Resource Planning Is A Structured Process Used To Predict Future Workforce Needs And Availability. Analysis Of Workforce Needs Is A Logical And Planned Step In Evaluating The Number And Competency Of Employees Required In An Organizational Unit. To Overcome The Problem Of Health Human Resource Needs, Laboratory Management Capabilities Are Needed To Accurately Plan Health Human Resource Needs In Accordance With Existing Service Requirements In Each Laboratory Unit. . Method: This Research Aims To Carry Out An Analysis Of Health Human Resource Needs Planning At The Kendari City Health Laboratory Service Technical Implementation Unit. This Type Of Research Is Qualitative Descriptive Research With A Case Study Approach. The Informants In This Study Were 6 People, 2 Informants At The Service Technical Implementation Unit Health Laboratory And 4 Informants At The Kendari City Health Service. Data Collection Was Obtained From Primary Data And Secondary Data Through In-Depth Interviews, Document Review And Literature Review. Data Analysis Techniques Include Data Reduction, Data Presentation And Drawing Conclusions. Results And Conclusions: The Research Results Show That In Planning Health Human Resources Needs There Is No Standard Operating Procedure, There Is No Policy In The Form Of A Planning Team Decree, There Is No Budget In Human Resources Planning, The Availability Of Data And Information Systems In The Form Of The Human Resources Application And The Renbut Application, And Using The Workload Analysis Method In Calculating Human Resources Needs.

DROUGHT DISASTER MANAGEMENT POLICY: A PROPOSAL FOR A REGIONAL DISASTER MANAGEMENT MASTER PLAN IN EAST LOMBOK REGENCY, INDONESIA

Objective: This research aims to analyze the existing drought mitigation policies implemented in East Lombok Regency and evaluate their sustainability and effectiveness. Drought poses a significant threat to East Lombok Regency, Indonesia, potentially impeding sustainable development in the region. Theoretical framework: The study employs the Disaster Risk Reduction Approach as outlined in the Sendai Framework for Disaster Risk Reduction 2015-2030. It involves mapping Drought Disasters as a problem, assessing the Impact of Drought Disasters (Risk), examining the role of Institutions, exploring methods for handling disasters through Drought Emergency Response solutions, addressing Education on drought disasters, and identifying Challenges and Recommendations for the future. Methodology: The research employs a qualitative approach involving the analysis of policy documents, interviews with stakeholders, and field surveys to gather data related to the implemented mitigation efforts. Results: The findings indicate the significance of having a Regional Disaster Management Master Plan to guide mitigation, preparedness, emergency response, and post-disaster recovery. However, it has not been developed in the study area. Current efforts for drought mitigation, preparedness, and emergency response mainly involve routine activities, such as distributing clean water to affected locations, suggesting the need for a more innovative approach. Conclusion: This study concludes that the absence of a Regional Disaster Management Master Plan hinders reactive and coordinated mitigation efforts. The sustainability of these programs is a significant concern and is crucial for establishing a robust strategic foundation for disaster management. Recommendation: The study emphasizes the urgent need to design a comprehensive Regional Mitigation Master Plan. This initiative aims to enhance coordination between institutions, strengthen community capacity, and ensure the sustainability of mitigation efforts. The research contributes to a deeper understanding of the challenges and opportunities in managing potential drought disasters in East Lombok Regency, providing a basis for more effective and sustainable policymaking. Research Implications: The research outlines the implications of formulating policy issues for designing a Regional Disaster Management Master Plan and establishing clearer regulations and Standard Operating Procedures in the future. These findings are crucial for guiding consistent and effective policies, ensuring a more diverse and resilient response to the challenges of recurring drought disasters in East Lombok Regency. Originality/Value: This research delves into the paradigm shift within the field of drought disaster management, which still relies on conservative methods. The study paves the way for new regulatory guidelines by incorporating several crucial points in the draft Regional Disaster Management Master Plan, including Drought Disaster Mitigation Policy, Drought Emergency Response, and Drought Disaster Education. This research contributes new insights to the field, providing a deeper understanding of drought disaster management. A notable challenge is the absence of formulated comprehensive Regional Disaster Management Master Plans by implementers, with the current reliance on temporary regulations established by the Regional Disaster Management Agency.

Standard Operating Procedure for the Arrests and Detentions of Individuals with Autism in Four Countries

Autism spectrum disorder (ASD) is categorized under neuro-developmental disorders. Individuals with this disorder experience deficits in social interaction and communication skills as well as repetitive patterns of thoughts and behaviours. The purpose of this study was to comparatively analyze the similarities and differences in Malaysian PDRM Autism SOPs with other countries, namely Malaysia, Hong Kong, the United Kingdom, and four countries in the United States, namely, Wisconsin, New Mexico, Illinois, and Virginia. This research focuses on discussing the important elements emphasized in SOPs and some aspects of similarities and differences between them. The research design is based on document analysis. The data were analyzed descriptively and thematically. Research results that autistic people put them at risk of committing violations of the law without realizing or intending to do so. Since they are also categorized as persons with disabilities, they are thus entitled to legal guarantees appropriate to their status. Therefore, their rights to equality and non-discrimination as persons with disabilities attracted worldwide attention holistically, resulting in specific Standard Operating Procedures (SOPs) in several countries, including Malaysia, namely, the Royal Malaysian Police Autism SOP (PDRM). Likewise, there are several important elements outlined in all SOPs, in aspects of their application, legal references, methods of arrest and detention, and intermediary assistance, and there are some similarities and differences between the SOPs analyzed. The implications of this study show the importance of SOPs for autism arrest and prisoners, to meet their specific legal needs.

How to obtain the image-derived blood concentration from 89Zr-immuno-PET scans

BackgroundPET scans using zirconium-89 labelled monoclonal antibodies (89Zr-mAbs), known as 89Zr-immuno-PET, are made to measure uptake in tumour and organ tissue. Uptake is related to the supply of 89Zr-mAbs in the blood. Measuring activity concentrations in blood, however, requires invasive blood sampling. This study aims to identify the best delineation strategy to obtain the image-derived blood concentration (IDBC) from 89Zr-immuno-PET scans.MethodsPET imaging and blood sampling of two 89Zr-mAbs were included, 89Zr-cetuximab and 89Zr-durvalumab. For seven patients receiving 89Zr-cetuximab, PET scans on 1–2 h, 2 and 6 days post-injection (p.i.) were analysed. Five patients received three injections of 89Zr-durvalumab. The scanning protocol for the first two injections consisted of PET scanning on 2, 5 and 7 days p.i. and for the third injection only on 7 days p.i. Blood samples were drawn with every PET scan and the sample-derived blood concentration (SDBC) was used as gold standard for the IDBC. According to an in-house developed standard operating procedure, the aortic arch, ascending aorta, descending aorta and left ventricle were delineated. Bland–Altman analyses were performed to assess the bias (mean difference) and variability (1.96 times the standard deviation of the differences) between IDBC and SDBC.ResultsOverall, the activity concentration obtained from the IDBC was lower than from the SDBC. When comparing IDBC with SDBC, variability was smallest for the ascending aorta (20.3% and 17.0% for 89Zr-cetuximab and 89Zr-durvalumab, respectively). Variability for the other regions ranged between 17.9 and 30.8%. Bias for the ascending aorta was − 10.9% and − 11.4% for 89Zr-cetuximab and 89Zr-durvalumab, respectively.ConclusionsImage-derived blood concentrations should be obtained from delineating the ascending aorta in 89Zr-immuno-PET scans, as this results in the lowest variability with respect to sample-derived blood concentrations.

Pendidikan Kesehatan Batuk, Pilek Dan Pijat Common Cold Dalam Upaya Mengatasi Ketidakefektifan Bersihan Jalan Napas Pada Balita

Cough and cold symptoms are indicative of respiratory system disturbances that commonly affect toddlers (1-5 years old). Respiratory disorders, or Acute Respiratory Infections (ARIs), are a leading cause of mortality in children. The disease can quickly spread to others through droplets, and its transmission is particularly rapid during the current rainy season due to the weakened immune systems of toddlers. However, parents often perceive coughs and colds as common occurrences, leading them to neglect providing treatment to their children. This becomes problematic when children experience respiratory distress, prompting confusion among parents who then rush their children to the hospital. The community engagement activities involve interactive lectures and training sessions, including role-playing with phantom children, for 15 mothers with toddlers. The activities are conducted over a period of two weeks in Alalak Island RT 3. The mothers' knowledge is assessed before and after the sessions through questionnaires. To evaluate the effectiveness of the common cold massage technique, observations are made following established Standard Operating Procedures (SOPs). The results of the community engagement show an improvement in knowledge levels before and after health education. Regarding the common cold massage technique, a small percentage can perform the procedure directly, while the majority can follow the SOPs using phantom children. It is hoped that the increased knowledge and skills of mothers will enable them to promptly address cough and cold symptoms in their children.

Outcome in very preterm infants: a population-based study from a regional center in Austria.

To determine short-term morbidity and mortality rates in the first state-wide Austrian neonatal cohort and comparison to (inter)national data. Observational, population-based cohort study, analyzing data of preterm infants (<32 + 0 weeks of gestation) born between 2007 and 2020 (n = 501) in an Austrian state who were admitted to the neonatal intensive care unit. Outcome criteria were mortality, neonatal morbidities: bronchopulmonary dysplasia (BPD), severe necrotizing enterocolitis (NEC), severe intraventricular hemorrhage (IVH grades III-IV), severe retinopathy of prematurity (ROP grades III-V) and survival-free of major complications. Overall survival rate was 95%, survival free of major complications was 79%. Prevalence for BPD was 11.2%, surgical NEC 4.0%, severe IVH 4.6%, and for severe ROP 2.6%, respectively. In the extremely low gestational age neonates (ELGAN) born <28 weeks of gestation (n = 158), survival was 88% and survival free of major complications 58.8%. Over time, mortality decreased significantly, predominantly driven by the improvement of infants born <28 week of gestation and survival free of major complications improved. This study demonstrates a very low mortality rate that decreases over time. Short-term morbidities and survival free of major complications do not differ from (inter)national data in a similar group of very preterm infants. Standard operating procedures, simulation trainings and accordance to international trials may improve patient care and surpass center case loads.

The impact of structured education on knowledge and self-efficacy in type 2 diabetes mellitus patients

Patients diagnosed with Type 2 Diabetes Mellitus (T2DM) need to acquire knowledge and self-confidence to effectively engage in self-care activities. A structured education program has the potential to influence knowledge, self-efficacy, and self-care behavior. This study aimed to investigate the impact of education on the knowledge, self-efficacy, and self-care of individuals with T2DM. The research employed a quasi-experimental non-equivalent control group design with purposive sampling. The total sample size consisted of 60 participants, with 30 in each group. The intervention group attended a four-session T2DM structured education program conducted by internal medicine specialists, nurses, nutritionists, and pharmacists, while the control group continued with their usual monthly check-ups. The results of the independent t-test revealed differences in knowledge, self-efficacy, and self-care between the intervention and control groups in the post-test assessment. Education for T2DM patients was found to be effective in enhancing knowledge (p-value=0.000), self-efficacy (p-value=0.000), and self-care (p-value=0.000), making it a recommended component of self-management education to prevent complications. The implications of this study may assist hospitals in developing Standard Operating Procedures (SOPs) for implementing structured education programs for individuals with Type 2 Diabetes Mellitus as a means of enhancing patients’ management skills for T2DM.

Program concept and implementation CSR PT. Toba Pulp Lestari, Tbk in community empowerment for livelihood sustainability

The issue of the negative impact of PT Toba Pulp Lestari (PT TPL) operations on the environment continues to circulate, but on the other hand, the company has received several awards in the field of community empowerment. This study has the objectives to (1) To find out the concept of the Corporate Social Responsibility (CSR) program of PT TPL in community empowerment for livelihood sustainability. (2) To study the implementation of PT TPL based on the perspective of community empowerment. This research uses the descriptive method and qualitative approach. Data collection techniques were carried out by triangulation. The method of data analysis uses the Miles and Huberman interactive method. The results of this study can be concluded that (1) The concept of PT TPL Program in community empowerment is carried out in accordance with the Standard Operational Procedure (SOP) by involving community leaders, the community, local government, and all elements of society. (2) Implementation CSR PT TPL toward the community1empowerment program consists of 4 categories i.e. human, business, environmental, and institutional development. It has been a good relationship between the local community, the local government, and the company. The CSR program is influencing the level of community welfare.

Improving Patient Safety: Learning from Reported Hospital-Acquired Pressure Ulcers.

A hospital-acquired pressure ulcer (HAPU) is a localized lesion or injury to the underlying tissue (wound) while the patient is on admission. It occurs when standardized nursing care is not correctly followed in the presence of friction and shear, leading to skin or underlying tissue breakdown. Unfortunately, inadequate knowledge of nurses to assess and provide standardized care for pressure ulcers or manage HAPUs results in patient harm. We aim to share lessons from a reported HAPU incident and address the knowledge gap in patient safety risk assessment, identification, and wound management at Nyaho Medical Centre (Accra, Ghana). A review of HAPU incidents was conducted using quality improvement tools such as cause-and-effect analyses to identify contributing factors and root causes. Subsequently, plan-do-study-act (PDSA) cycles were used to test interventions to improve pressure ulcer assessments and wound management. A run chart was used to analyze and evaluate the interventions over 12 weeks (Aug-Oct 2021). Development of policies and a standard operating procedure for pressure ulcers and wounds improved accuracy in identifying pressure ulcer risks and management of wounds. Eighty-three patients were assessed with the pressure ulcer assessment tool. Complete (100%) adherence to the pressure ulcer and wound policy and standard operating procedure (SOP) was achieved, and the number of HAPUs decreased from five to one during the study period. This study demonstrated that the combined use of quality methods and tools can be suitable for improving processes and outcomes for patients at risk for HAPUs.

Impact of Implementing a Standard Operating Procedure to Reduce Blood Wastage in Blood Centers of Iran.

Blood wastage leads to additional costs and reduced blood availability to patients. Above all is the moral issue of wasting donor gifts. This study aimed to determine the rate of blood wastage before and after implementing a new standard operating procedure (SOP) in Iran. In this interventional study, a SOP for wastage management was prepared and implemented in all blood centers throughout the country. Data were extracted from the integrated software of the Iranian Blood Transfusion Organization (IBTO). The wastage rate of blood components in the post-intervention years (2016-2017) was then compared with that in the pre-intervention years (2013-2015) using the Z test. The overall wastage rate decreased by 36.86% (P<0.001, 95% CI [36.84-36.88]) after the intervention. Red blood cell (RBC) wastage decreased from 2.6% to 2.5%, platelet wastage from 19.5% to 10.6% and plasma wastage from 15.5% to 7.3% (P<0.001). The highest percentage of waste reduction pertained to plasma components, which decreased by 52.90% (P<0.001, 95% CI [52.86-52.94]). Expiration was the most common cause of RBC and platelet wastage. The most common causes of plasma wastage were RBC contamination and rupture or leakage of the bags. The intervention resulted in a drop of over 250000 discarded components each year, equal to approximately thirty-six million dollars in savings. This intervention effectively reduced waste and increased efficiency. Ongoing blood wastage reviews, auditing, and receiving feedback from the central headquarters were powerful tools in following the compliance of blood centers. Further studies are recommended, especially concerning blood wastage in hospital blood banks and various wards.

Determination of Inducible Clindamycin Resistance and Correlation with Vitek2 Inducible Clindamycin Resistance Test in Staphylococcus aureus Isolated from Clinical Samples.

To compare the performance of Vitek2 with the gold standard D test in terms of inducible clindamycin resistance (ICR) detection. Descriptive study. Place and Duration of the Study: Indus Hospital and Health Network Karachi, Pakistan, from November 2021 to April 2022. Standard operating procedures of the laboratory were followed for processing of clinical samples. Methicillin-resistant Staphylococcus aureus (MRSA) isolates were included. The isolates from the same patient within two-week time period were excluded. Clinical laboratory standards institute guidelines were followed for performing and interpreting D test. The results of the D test were compared with Vitek2 results for ICR. A total of 313 isolates were MRSA, of which 93 isolates tested positive for ICR on both the D test and Vitek2. Nine isolates were positive for ICR on Vitek2 and negative on the Kirby-Bauer disk diffusion method. One isolate tested positive on the disk method and negative on Vitek2. Vitek 2 appeared to give false positive results. Reporting false susceptibility of clindamycin can cause therapeutic failure which can markedly affect the patient's outcome. This discordance needs to be investigated further with a large sample size and stringent observation of D-test results to pick laboratory error. Methicillin-resistant Staphylococcus aureus, Inducible clindamycin resistance, D zone, Vitek2.