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PubMed1976

A sequential study of various modes of skin and umbilical care and the incidence of staphylococcal colonization and infection in the neonate.

The rates of colonization and infection of newborns with coagulase-positive staphylococci were studied during five sequential periods using various modes of skin care in the nursery. Colonization and infection were low during the baseline period when total body bathing with 3% hexachlorophene was employed (period 1), but increased dramatically (80% colonization, 9.5% infection) when hexachlorophene was discontinued and replaced by Ivory Soap baths (period 2). Reinstitution of hexachlorophene (period 3) reduced both colonization and infection, but not to the low levels seen during period 1. A second Ivory Soap period (period 4) resulted in a return to high colonization (77%) and infection (11.5%) rates. During period 5, daily Ivory Soap baths were continued and bacitracin ointment was applied to the umbilical area at least three times daily. Colonization was reduced to 10% and infection to 3.0%. Bacitracin could not be detected in serum in 15 infants studied. Colonization with gram-negative enteric bacilli was highest while using hexachlorophene or Ivory-bacitracin, but no increase in gram-negative infections was seen. Colonization of newborns with non-group A beta-hemolytic streptococci was not influenced predictably with various modes of skin care. The local application of bacitracin is a safe and effective method of controlling staphylococcal colonization and disease for infants in nurseries.

1-Propanol↗
PubMed2002

Identification of alternatives for the management of foliar nematodes in floriculture.

The foliar nematodes, Aphelenchoides spp, have emerged as important pests of ornamentals in North America during the last decade. Due to the ban on the use of potentially toxic pesticides, there are currently no nematicides registered to manage foliar nematodes on ornamentals. Therefore, we have evaluated a biological [Burkholderia cepacia (syn Pseudomonas cepacia)], two plant products [clove (Syzygium aromaticum) extract and Nimbecidine (azadirachtin)] and twelve chemical pesticides registered for the management of insects, mites, slugs or diseases of ornamentals, against Aphelenchoides fragariae on the most popular ornamental, hosta (Hosta spp), for two consecutive years. We found ZeroTol (270 g liter-1 peroxyacetic acid), currently labeled as a broad-spectrum fungicide/algicide, to be a very potent nematicide that killed 100% of the nematodes in water suspension. It also caused over 70% reduction in A fragariae population in soil and in the leaves without any phytotoxicity. B cepacia caused 67-85% reduction in A fragariae population in leaves and 50% reduction in the soil whereas insecticidal soap caused over 72% reduction in leaves and 61% reduction in the soil. Clove extract and Nimbecidine did not show any potential for the control of A fragariae on hosta. Although all twelve chemical pesticides were effective in reducing the population of A fragariae in the soil 45 days after treatment (DAT), only diazinon 475 g liter-1 EC, trichlorfon 800 g kg-1 SP, ethoprophos 100 g kg-1 GR, oxamyl 100 g kg-1 GR and ZeroTol caused over 70% reduction in nematode population compared with the control. In the leaves, only diazinon EC, trichlorfon SP, insecticidal soap, oxamyl GR and ZeroTol consistently caused over 70% nematode population reduction compared with the control at 45 DAT in both years. Thus, only diazinon EC, trichlorfon SP, oxamyl GR and ZeroTol consistently caused over 70% reduction in nematode population both in soil and leaves. Due to the recent ban by the US Environmental Protection Agency on the use of the first three of these formulations, only ZeroTol would serve as an effective tool to manage foliar nematodes in ornamentals. Although not as effective as ZeroTol in the soil, insecticidal soap is the only other alternative for foliar nematode management.

Agriculture↗
PubMed1978

Effect of intramolecular fatty acid distribution on aspects of triacylglycerol digestion and absorption studied in vitro.

The triacylglycerols from several natural sources have been used as substrates for in vitro assays of three different aspects of fat digestion and absorption. The triacylglycerol mixtures were chosen because they differed widely both in total fatty acid composition and in the intramolecular distribution of fatty acids. The assays were designed to test the rate of hydrolysis with pancreatic lipase, the ability to form insoluble calcium soaps during the hydrolysis, and the ability to form mixed micelles with bile during the hydrolysis. Differences in the rate of hydrolysis appeared to be related to the structure and the triacylglycerols from lard and human milk, both of which have palmitic acid esterified in the sn-2 position, were hydrolysed most rapidly. Similarly the ability to form calcium soaps was related to structure and those triacylglycerols which released saturated fatty acids on hydrolysis favoured calcium soap formation. While there was a range of abilities to form mixed micelles with bile no obvious correlation with structure was detected.

Bile↗
PubMed1989

Sudan stain of fecal fat: new insight into an old test.

The 72-h fecal fat determination is used as the gold standard to document the presence of steatorrhea. Although the Sudan stain for fecal fat is advocated as a sensitive screening test, a quantitative correlation between the 72-h fecal fat quantitation and the fecal Sudan stain is lacking. This study was designed to examine the staining properties of different classes of purified lipids in an experimentally defined artificial matrix, and to elucidate the reasons for the lack of quantitative correlation between these two tests. Our results indicate that the "neutral fat" stain without acidification or heating identifies triglyceride; and at an appropriate pH, the "neutral stain" also identifies fatty acid. The "split fat" stain with acidification and heating identifies both triglyceride and fatty acid. After acidification, fatty acid soaps are converted to the nonionized fatty acid. Thus, fatty acid soaps can be identified indirectly as fat droplets that are stained by the split fat stain. Although cholesterol is stained with Sudan stain after heating, upon cooling, cholesterol forms crystals of anhydrous cholesterol, making its staining pattern distinct. Neither the neutral fat nor the split fat stain can detect phospholipid or cholesteryl ester. The 72-h fecal fat determination is a measure of the total fatty acid content after a specimen is saponified. The resulting fatty acids are derived from a variety of endogenous and exogenous sources, including free fatty acids, soaps of fatty acids, triglycerides, cholesterol esters, and phospholipids. Therefore, the 72-h fecal fat quantitation does not differentiate between the primary sources of the measured fatty acid. It is concluded that the 72-h fecal fat determination is not specific for documenting triglyceride (fat) malabsorption. Until new methods are developed that specifically measure fecal triglyceride and fatty acid, the Sudan stain of fecal fat appears to be a more specific method for detecting the presence of triglyceride and fatty acid in a matrix.

Azo Compounds↗
PubMed1988

Hand disinfection: a comparison of various agents in laboratory and ward studies.

The efficacy of 14 handwashing or disinfectant preparations was compared in laboratory tests on staff volunteers. The test organism, Escherichia coli, was applied to the fingertips and log reductions (LR) were measured following treatment with the test agent and control preparations (70% isopropanol and non-medicated bar soap). Alcoholic preparations, particularly n-propanol and isopropanol were the most effective showing LRs of 3.1-3.8. Chlorhexidine (LR 2.9) and povidone-iodine detergent preparations were significantly more effective than non-medicated soap (LR 2.1), but triclosan products were not. In addition the residual effect of several of these formulations was assessed after 10 applications by comparing the survival of E. coli on the fingertips over a 32-min period. This number of handwashes compares favourably with those recorded during an 8 h nursing shift. Chlorhexidine-detergent consistently showed the best residual activity. Alcoholic formulations showed little or no residual effect. The survival studies show that on the whole gram-positive organisms (Staphylococcus aureus and Candida albicans) survive better on the skin than Gram-negative bacilli (GNB). However, it would seem that GNB which are considered to be residents (Acinetobacter calcoaceticus and Enterobacter spp.) survive much better than many other GNB (Pseudomonas aeruginosa, E. coli and Proteus vulgaris). The Klebsiella species varied in survival times. Random sampling of ward staff hands showed that contamination with S. aureus and GNB was greater in dermatological and general wards than in an isolation unit, where handwashing or disinfection was carried out after every patient contact. No cross-infection occurred in the isolation ward during periods of study in which 70% alcohol, chlorhexidine-detergent and non-medicated soap were used.

Alcohols↗
PubMed2005

Process effects on activated carbon with large specific surface area from corn cob.

The main factors that affect the large specific surface area (SSA) of the activated carbon from agricultural waste corn cobs were studied by chemically activated method with solution of KOH and soap which acted as surfactant. The experiment showed that not only the activation temperature, activation time and the mass ratio of KOH to the carbonized material, but also the activated methods using activator obviously influenced the SSA of activated carbon. The experimental operating conditions were as follows: the carbonized temperature being 450 degrees C and keeping time being 4 h using N2 as protective gas; the activation temperature being 850 degrees C and holding time being 1.2 h; the mass ratio of KOH to carbonized material being 4.0; the time of soaking carbonized material in the solution of KOH and soap being 30 min. Under the optimal conditions, the SSA of activated carbon from corn cobs reached 2700 m2/g. And the addition of the soap as surfactant may shorten the soaking time. The structure of the activated carbon prepared had narrow distribution of pore size and the micro-pores accounted for 78%. The advantages of the method described were easy and feasible.

Carbon↗
PubMed2004

European norms in hand hygiene.

In the area of hand hygiene, European Norms exist, or are under development, with regard to protective gloves and for assessing the antimicrobial efficacy of hand disinfectants. Important norms for gloves are EN 420 (General requirements), EN 374 (Protective gloves against chemicals and microorganisms) and EN 455 (Medical gloves for single use). A suspension test for the demonstration of bactericidal activity (prEN 12054) is obligatory for hand disinfectants in all fields of application; a test to prove activity against yeasts applies only to hygienic hand rub. (Optional) Claims for virucidal activities can be substantiated by prEN 1476 and, in future, for mycobactericidal capacity by a test which is still under development. In vivo tests exist for post-contamination treatments, hygienic hand wash and hygienic hand rub (EN 1499 and EN 1500 respectively), and for the preoperative surgical hand rub/wash (prEN 12791). The two former tests employ artificially contaminated hands, the latter test is done with clean hands. All in vivo tests use reference hand treatments (with unmedicated soap or 2-propanol 60% (vol.) or 1-propanol 60% (vol.), respectively) against the results of which are compared with those achieved with the product under test and with the same volunteers. An antiseptic soap needs to be significantly more efficacious than unmedicated soap, a product for hygienic hand rub must not be inferior to the reference treatment with 2-propanol, and a surgical hand disinfectant must not cause a smaller bacterial reduction than the reference preparation with 1-propanol, immediately, and after 3 h. An (optional) claim for sustained activity of a surgical disinfectant needs to be demonstrated by achieving a significantly stronger bacterial reduction after 3 h than the reference preparation.

Disinfectants↗
PubMed2004

Comparison of two in vivo and two ex vivo tests to assess the antibacterial activity of several antiseptics.

An ex vivo test was adapted to mimic the in vivo conditions of testing antiseptic activity on human forearms and in the European Standard Hygienic Handwash Test (BSEN 1499). The study was to validate the ex vivo protocols using 4.8% (w/v) para-chloro-meta-xylenol (PCMX, neat Dettol), 0.5% (w/v) triclosan in 70% (v/v) isopropanol, and 2% (v/v) povidone-iodine against a high bacterial inoculum (>10(8) cfu/mL) of Escherichia coli NCTC 10538. Two ex vivo tests using human skin samples, including one introducing a mechanical rubbing effect, were compared with two corresponding in vivo tests (the forearm test and the BSEN handwashing test). All antiseptics assessed in vivo (forearm and handwash tests) produced reductions in bacterial counts that were significantly greater than those for the non-medicated soft soap control. When assessed ex vivo without rubbing, only PCMX and povidone-iodine achieved reductions significantly greater than soft soap. When assessed ex vivo with mechanical rubbing, only PCMX and triclosan achieved reductions significantly greater than soft soap. Overall, the antiseptics at the concentrations tested were more active when tested in vivo than ex vivo. The addition of a mechanical effect, either in vivo by the volunteers washing their hands or ex vivo by a drill rubbing two skin samples against each other, produced a significantly greater reduction in bacterial concentrations. The ex vivo tests were easily adapted to mimic in vivo protocols. The value of such tests, particularly the one that includes a rubbing effect, may be significant as they avoid the need for human volunteers.

Adolescent↗
PubMedDate not supplied

Prevalence and correlates of skin damage on the hands of nurses.

OBJECTIVE: To describe the prevalence and correlates of skin damage on nurses' hands. DESIGN: Prevalence survey using self-report questionnaire of hand care regimens, problems, and skin condition, and visual examination of the hands at 30X magnification by trained investigators to evaluate degree of skin scaling. SETTING: Four hospitals: two in the Mid-Atlantic and two in the northern United States. PARTICIPANTS: Convenience sample of 410 nurses working 30 hours or more per week in acute care units. OUTCOME MEASURES: Damage to skin of the hands. RESULTS: Approximately one fourth of subjects (n = 106) met the criteria for currently damaged hands; 85.6% (n = 351) reported ever having skin problems. Damage was not correlated with age (p = 0.43), sex (p = 0.14), or skin type (p = 0.25), type of soap used at home (p = 0.58), reported duration of handwashing (p = 0.12), or glove brand (p = 0.90), but was significantly correlated with the type of soap used at work (p = 0.01), number of hand washes per shift (p = 0.0003), number of times gloves were worn (p = 0.008), and study site (p = 0.009). Variables significantly predictive of skin damage in a logistic regression analysis were type of soap used at work and number of times gloves were worn (p = 0.04). Geographic location was not a factor, because both the highest and lowest prevalence of skin damage occurred in the northern study institutions. CONCLUSIONS: Damage to skin of the hands is a common and potentially serious problem among nurses, and is associated with gloving and handwashing practices rather than with geographic or demographic factors. Efforts to improve skin condition must focus on improving products and identifying any interactive effects between hand care products and glove materials and brands.

Adult↗
PubMed2000

Epidemiology and molecular characterization of nosocomially transmitted multidrug-resistant Klebsiella pneumoniae.

OBJECTIVES: To describe the epidemiology, antimicrobial susceptibility, genomic profiles, and control of a nosocomial outbreak of multidrug-resistant Klebsiella pneumoniae (MRKP) that occurred in the pediatric oncology unit of the University of Malaya Medical Centre in Kuala Lumpur. MATERIALS AND METHODS: A prospective epidemiologic and microbiologic study was conducted of MRKP isolated from the blood and wound of a boy with necrotizing fasciitis after a 7-day course of ceftazidime and amikacin. In the following 2 weeks, phenotypically similar MRKP were isolated from the blood cultures of four other patients and rectal swabs of another three patients and two liquid soap samples located in the same ward. RESULTS: Antimicrobial profiles demonstrated that all the isolates were resistant to ceftazidime, sensitive to imipenem and ciprofloxacin, and confirmed to be extended-spectrum beta-lactamase producers. Plasmids of varying molecular weights were present in all isolates. In eight of these isolates, which included four from blood, there were common large molecular weight plasmids ranging from 80 kb to 100 kb. Pulsed-field gel electrophoresis analysis using XbaI demonstrated six different DNA profiles, A to F. Profile A was shared by two blood culture isolates and were related by 91%. Profile B was found in one rectal swab isolate and one isolate from liquid soap and were related by 94%. Profile C was shared by one blood isolate and one liquid soap isolate and showed 100% relatedness. Profiles D, E, and F each were demonstrated by one blood isolate and two rectal swab isolates, respectively. These showed only 65% relatedness. CONCLUSIONS: The MRKP strains in this outbreak were not clonal in origin. The decline of the outbreak after 4 weeks was attributed to the reemphasis of standard infection control procedures and the implementation of a program that addressed sites of environmental contamination.

Anti-Bacterial Agents↗
PubMed2004

Crystallization of silver stearate from sodium stearate dispersions.

Silver carboxylates, the common silver source used for photothermographic imaging materials, are normally obtained from the reaction between sodium soap (e.g., sodium stearate) and silver nitrate. They form platelet-like crystals with a lamellar structure in water at room temperature. Light microscopy investigations reveal that the formation of silver stearate (AgSt) crystals follows a diffusion-controlled mechanism. The reaction between the sodium soap and silver nitrate preferentially occurs in solution rather than on the soap fiber solid interface. Cryogenic transmission electron microscopy, together with an on-the-grid reaction technique, provides a useful tool to directly image silver stearate microstructures at the initial stages of AgSt precipitation. The AgSt reaction product first forms particles about 5 nm in size, which is similar to the d-spacing of final AgSt crystals. Those particles aggregate to produce larger and loosely packed embryonic crystals, the precursors to the ultimate silver stearate crystals.

Crystallization↗
PubMed1997

Evaluation of donor skin disinfection methods.

BACKGROUND: Because most bacteria isolated from contaminated platelet concentrates are thought to originate from the donor's skin, the efficacy of four methods of skin disinfection was compared. STUDY DESIGN AND METHODS: Contact plates were used for antecubital skin cultures after they were demonstrated to be easier to use and at least as sensitive as a swab system. One antecubital fossa of each subject was disinfected by a standard method, the use of a povidone-iodine swabstick containing 0.75-percent available iodine followed by the use of a povidone-iodine swabstick containing 1-percent available iodine. The other arm was disinfected with either a 70-percent isopropyl alcohol scrub followed by an ampoule of 2-percent iodine tincture (Group 1; n = 126); a green-soap sponge followed by a 70-percent isopropyl alcohol swab, used for donors who are allergic to iodine (Group 2; n = 30); or a 0.5-percent chlorhexidine gluconate and 70-percent isopropyl alcohol sponge followed by an ampoule of 0.5-percent chlorhexidine gluconate and 70-percent isopropyl alcohol (Group 3; n = 40). Contact plate cultures were done before and after disinfection, and colonies counted after a 48-hour 37 degrees C incubation period. RESULTS: Similar numbers of bacteria grew from both antecubital fossae of the same subject before disinfection (p = 0.71). Compared to the standard povidoneiodine method, isopropyl alcohol and tincture of iodine resulted in significantly less bacterial growth (p < 0.001), the green soap and isopropyl alcohol method resulted in significantly more bacterial growth (p < 0.001), and the chlorhexidine gluconate and isopropyl alcohol method resulted in similar amounts of bacterial growth (p > 0.3). CONCLUSION: Isopropyl alcohol scrub followed by iodine tincture is more efficacious than povidone-iodine as measured by contact plate cultures. For donors who are allergic to iodine, chlorhexidine gluconate and isopropyl alcohol is more efficacious than green soap and isopropyl alcohol.

1-Propanol↗
PubMed2003

Handwashing among female college students.

Handwashing has been recognized as a critical factor in infection control policies. Whereas handwashing compliance among health care workers and school-aged students has been previously documented, practices among college students remain relatively unknown. The objective of this study was to determine handwashing compliance of female college students after using the bathroom. A researcher situated in a toilet stall unobtrusively observed handwashing compliance among 100 female students. Most students (63%) washed their hands, 38% used soap, 32% washed with soap for 5 or more seconds, but only 2% washed their hands with soap for 10 or more seconds. Fewer students left without handwashing when someone else was present in the sink area (9%) than when they were alone (45%) (P =.002). Substantial bacterial colony counts were found on a female bathroom sink faucet and toilet seat confirming the need for programs to increase handwashing compliance. Potential strategies to optimize infection control include harnessing the influence of peer pressure on handwashing and the installation of motion-activated faucets, disposable seat covers, and exit doors that can be pushed open. These results should be confirmed in a larger study that includes both male and female college students.

Adult↗
PubMed2003

State-of-the-art hand hygiene in community medicine.

Hand hygiene becomes more important in community medicine not only since antibiotic resistant bacteria such as MRSA spread within the community. Hands may be colonized with transient microorganism in up to 75%. Among those transient pathogens S. aureus, C. difficile or the hepatitis C virus may be found. During patient care the number of microorganisms on the hands steadily increases. In addition hands may be contaminated with different kinds of germs even if only "clean" activities are carried out. Gloves may be worn but do not provide complete protection from contamination due to leaks. Therefore hands should always be treated after gloves are taken off. State-of-the-art treatment of hands is the hygienic hand disinfection with alcohol-based hand rubs. They are more effective, quicker to carry out, better tolerated by the skin, with a positive effect on compliance, and cost effective in comparison to antiseptic soaps based on chlorhexidine or triclosan and in comparison to normal non-medicated soaps. Healthy skin easily tolerates alcohol-based products from the beginning on. Only health care workers with an underlying irritative contact dermatitis which is often caused by bar or liquid antiseptic soaps may have difficulties to use alcohol-based products initially. In such a case treatment of the underlying skin condition is the way to go and not staying with a preparation which has caused the dermatitis. All this knowledge is now reflected in current guidelines on hand hygiene. Beside liquids alcohol-based gels can be used if they have an antimicrobial activity equal to alcohol-based liquid preparations. Hand hygiene remains the single most important tool to avoid cross transmission of microorganisms between patients. This state-of-the-art hand hygiene should also be emphasized more in community medicine. This review may help to go the first step into this direction.

Alcohols↗
PubMed1992

Effect of low-fat, high-fat, and fiber-supplemented high-fat diets on colon cancer risk factors in feces of healthy subjects.

Normal healthy volunteers (n = 8) received low- and high-fat (14% and 53% energy/day, respectively) and dietary fiber-supplemented high-fat diets (fiber 25 g/day, fat 52% energy/day) for 10 days each. Colon cancer risk factors in feces were measured by colonic nuclear aberration assay, the Ames Salmonella test using strain TA100, and measurement of bile acids and calcium soaps. Nuclear aberrations in colonic epithelium increased during the high-fat diet period and then decreased during the fiber-supplemented high-fat diet period. There were no significant differences in the mutagenicity on Salmonella TA100 or in the concentration of bile acids during the high-fat diet period. Bile acids decreased during the fiber supplementation period. The marked increase in calcium soaps during the high-fat diet period indicates an increase in long-chain fatty acids in the fecal lipid component and conversion of these fatty acids to insoluble calcium soaps when enough calcium is present.

Adult↗
PubMed2000

Entertainment-education and HIV/AIDS prevention: a field experiment in Tanzania.

Entertainment-education is the process of designing and implementing an entertainment program to increase audience members' knowledge about a social issue, create more favorable attitudes, and change their overt behaviors regarding the social issue. The results of a field experiment in Tanzania to measure the effects of a long-running entertainment-education radio soap opera, Twende na Wakati (Let's Go with the Times), on knowledge, attitudes, and adoption of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) prevention behaviors are presented. Multiple independent measures of effects and the experimental design of this study confer strong internal and external validity regarding the results of this investigation. The effects of the radio program in Tanzania include (1) a reduction in the number of sexual partners by both men and women, and (2) increased condom adoption. The radio soap opera influenced these behavioral variables through certain intervening variables, including (1) self-perception of risk of contracting HIV/AIDS, (2) self-efficacy with respect to preventing HIV/AIDS, (3) interpersonal communication about HIV/AIDS, and (4) identification with, and role modeling of, the primary characters in the radio soap opera.

Adolescent↗
PubMed1999

Double-blind, randomized trial of a synthetic triacylglycerol in formula-fed term infants: effects on stool biochemistry, stool characteristics, and bone mineralization.

BACKGROUND: The low sn-2 palmitate content of infant formulas results in formation of fatty acid calcium soaps in the stools and reduced calcium absorption. OBJECTIVE: Our objective was to test the hypotheses that increasing the proportion of sn-2 palmitate in formula for term infants would result in greater skeletal mineral deposition and reduced stool hardness. DESIGN: Healthy term neonates were randomly assigned to receive standard formula (n = 103) or formula containing 50% sn-2 palmitate (high-sn-2 formula; n = 100) for 12 wk. One hundred twenty breast-fed infants were also studied. The main outcome measures were 1) radial (single-photon absorptiometry) and whole-body (dual-energy X-ray absorptiometry) bone mineral content (WBBMC) at 12 wk and 2) stool frequency, volume, and consistency at 6 and 12 wk. Secondary outcome measures included stool fatty acid content. RESULTS: Infants receiving high-sn-2 formula had higher WBBMC (128.1 +/- 9.7 compared with 122.7 +/- 10.1 g, adjusted for size and sex), softer stools at 6 and 12 wk, and a lower proportion of stool soap fatty acids than did infants receiving the control formula. Breast-fed infants had adjusted WBBMC values (128.3 +/- 9.1 g) similar to those of infants fed high-sn-2 formula and significantly higher than those of infants fed the control formula. CONCLUSIONS: Changing the stereoisomeric structure of palmitate in infant formula resulted in higher WBBMC, reduced stool soap fatty acids, and softer stools more like those of breast-fed infants. The greater bone mass measured could be important if it persists beyond the trial period; this merits further investigation.

Absorptiometry, Photon↗
PubMed1979

Implementation of the problem-oriented progress note in a skilled nursing facility.

Problem-oriented style progress notes were implemented in a skilled nursing facility where problem-oriented medical records were not in use. The problem-oriented note consists of subjective information, objective information, analysis or assessment of the problems, and plan for treatment, and is called a SOAP note. Six physical and occupational therapists used the method of note writing for an eight-week trial period. The author audited the records for errors in using the SOAP note throughout the experimental period. Therapists responded to a questionnaire following the study to assess their attitudes on using the SOAP note. Implementation of the problem-oriented progress note was satisfactory, with the exception of defining the problem list. The therapists reacted positively toward using the problem-oriented method of recording patient progress or status and recommended that its use be taught to physical and occupational therapy students.

Evaluation Studies as Topic↗