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A random sample of one-third of all participating clinics will be selected for the conduct of this fdelity test by supervisors. Phase 2: Second Audit (1 Month Post intervention) In the second audit, a tool to address the value of survey will be circulated to private practitioners (refer Appendix C). This asks questions on practicality of survey to the private practitioner to obtain feedback/ suggestions for improvement of the intervention package. The research nurses will hand-deliver this questionnaire to the private practitioner at the end of the second audit and collect it back from the clinic staff within 2 days. The rest of the audit process will not differ from fow of the baseline audit except the fdelity test will be conducted on every third clinic in the list of participating clinics, excluding the clinics that already had the fdelity test done in phase 1. Phase 3 & 4: Third and Forth Audit the schedule for all audits will be prepared in advance. The work fow for these audits will be similar to that of the second audit, except that the fdelity and value of survey tools will not be administered. Intervention package the research team emphasized practicality, sustainability and the provision of incentives in the development of the intervention package. Additional incentives include two stickers, for the refrigerator and a certifcate of vaccine storage status. The training session on recommended vaccine storage practice for private physician clinics’ staff requires research nurses to give immediate feedback to all accompanying staff during the audit process and advice on temperature charting and maintenance. To reinforce learning, research nurses will show a power point presentation on recommended vaccine storage practice followed by a question and answer session with all clinic staff. Study type this is a quasi-experimental study (non-controlled community trial) conducted in four administrative regions in Malaysia. There is no randomization nor a control group as researchers felt that it would not be ethical not to intervene in the event there are problems in vaccine storage. Ethical considerations Researchers applied for approval prior to conduct of this study. Consent will be obtained from practitioners at the selected clinics prior to the study. This was to ensure that this proposed incentive does not contravene any ethical or medico-legal issues. Variables Scale of Variables Operational Defnition Measurement Yes/No Two door/top loading refrigerator Appropriate type of refrigerator to store vaccines (nominal/categorical) Yes/No Dedicated refrigerator for vaccine Availability of a dedicated refrigerator for vaccines. Availability of a dedicated refrigerator for vaccines Yes/No Fulflled all 6 criteria# 3. Daily monitoring of internal refrigerator temperature this consisted of criterion #1 to #6 and also allowed the Yes/No Fulflled all 6 criteria & drug@ refrigerator to also store drugs together with vaccines. The refrigerator Yes/No Fulflled all 4 criteria+ type and placement of refrigerator was excluded from the (nominal/categorical) criterion list. The refrigerator type and placement of refrigerator was excluded from the Yes/No Fulflled all 4 criteria & drug@ criterion list. This allowed the refrigerator to also store (nominal/categorical) drugs together with vaccines.

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Table 2-3 identifes the components of this research question as they relate to and are congruent with thefes the components of this research question as they relate to and are congruent with thefes the components of this research question as they relate to and are congruent with thefes the components of this research question as they relate to and are congruent with thefes the components of this research question as they relate to and are congruent with thefes the components of this research question as they relate to and are congruent with thefes the components of this research question as they relate to and are congruent with the three research question criteria. The reader has to infer the research that research question from thequestion from the title of the report, the abstract, the introduction, or the purpose. The purpose of the study encompasses the aims or objectives the investigator hopes to achieve with the research, not the question to be answered. For example, a nurse working with rehabilitation patients who have bladder dysfunction may be disturbed by the high incidence of urinary tract infections. Trough the researcher’s selection of verbs, the purpose statement suggests the manner in which theresearcher’s selection of verbs, the purpose statement suggests the manner in which theresearcher’s selection of verbs, the purpose statement suggests the manner in which theresearcher’s selection of verbs, the purpose statement suggests the manner in which theresearcher’s selection of verbs, the purpose statement suggests the manner in which theresearcher’s selection of verbs, the purpose statement suggests the manner in which theresearcher’s selection of verbs, the purpose statement suggests the manner in which the researcher planned to study the question and the level of evidence to be obtained throughresearcher planned to study the question and the level of evidence to be obtained throughresearcher planned to study the question and the level of evidence to be obtained throughresearcher planned to study the question and the level of evidence to be obtained throughresearcher planned to study the question and the level of evidence to be obtained throughresearcher planned to study the question and the level of evidence to be obtained throughresearcher planned to study the question and the level of evidence to be obtained through the study fndings. Verbs such as discover, explore,discover, explore,discover, explore, or describe suggest an investigation of an infrequently researched topic that might appropriately be guided by research questions ratherinfrequently researched topic that might appropriately be guided by research questions ratherinfrequently researched topic that might appropriately be guided by research questions ratherinfrequently researched topic that might appropriately be guided by research questions ratherinfrequently researched topic that might appropriately be guided by research questions ratherinfrequently researched topic that might appropriately be guided by research questions ratherinfrequently researched topic that might appropriately be guided by research questions rather than hypotheses. In contrast, verb statements indicating that the purpose is to test the efec-than hypotheses. In contrast, verb statements indicating that the purpose is to test the efectiveness of an intervention or compare two alternative nursing strategies suggest a study withtiveness of an intervention or compare two alternative nursing strategies suggest a study withtiveness of an intervention or compare two alternative nursing strategies suggest a study withtiveness of an intervention or compare two alternative nursing strategies suggest a study withtiveness of an intervention or compare two alternative nursing strategies suggest a study with a better-established knowledge base that is hypothesis testing in nature. You should remembera better-established knowledge base that is hypothesis testing in nature. You should remember that when the purpose of a study is to test the efectiveness of an intervention or compare thethat when the purpose of a study is to test the efectiveness of an intervention or compare thethat when the purpose of a study is to test the efectiveness of an intervention or compare thethat when the purpose of a study is to test the efectiveness of an intervention or compare thethat when the purpose of a study is to test the efectiveness of an intervention or compare thethat when the purpose of a study is to test the efectiveness of an intervention or compare thethat when the purpose of a study is to test the efectiveness of an intervention or compare the efectiveness of two or more interventions, the level of evidence is likely to have more strengthefectiveness of two or more interventions, the level of evidence is likely to have more strengthefectiveness of two or more interventions, the level of evidence is likely to have more strengthefectiveness of two or more interventions, the level of evidence is likely to have more strengthefectiveness of two or more interventions, the level of evidence is likely to have more strength and rigor than a study whose purpose is to explore or describe phenomena. Box 2-1 providesand rigor than a study whose purpose is to explore or describe phenomena. The evaluator will often fnd that hypotheses are embedded in the data analysis, results, or discussion section of the research report. Similarly, the population may not be explicitly stated but will have been identifed in the background, signifcance, and literature review. It is then up to you to discern the nature of the hypotheses and population being tested. In light of that stylistic reality, it is important for you to be acquainted with the components of hypotheses, how they areit is important for you to be acquainted with the components of hypotheses, how they areit is important for you to be acquainted with the components of hypotheses, how they areit is important for you to be acquainted with the components of hypotheses, how they areit is important for you to be acquainted with the components of hypotheses, how they areit is important for you to be acquainted with the components of hypotheses, how they areit is important for you to be acquainted with the components of hypotheses, how they are developed, and the standards for writing and evaluating them. Hypotheses fow from the research question, literature review, and theoretical framework. A hypothesis is a statement about the relationship between two or more variables that suggests an answer to the research question. A hypothesis is atwo or more variables that suggests an answer to the research question.

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As health workers are the only group authorised to demonstrate infant formula feeding, it is essential that they show the correct methods and monitor methods regularly. Parents without literacy skills or from a non–english speaking background may need extra help to make sure bottle-feeding is done safely. A testing program undertaken in new south wales did not fnd any cases of contamination in the samples of infant formula tested. A systematic literature review identifed common problems with preparation of formula feeds,462 including over-concentration, under-concentration and the addition of cereal to the bottle. However once opened, ‘Ready to drink’ formats (glass bottle or tetra pack) may be poured into numerous sterilised bottles provided that these bottles are refrigerated below 5°c continuously and used within 24 hours. Any unfnished formula left in the bottle after a feed must be discarded and not kept for use in a later feed. Preparing feeds in advance Ideally only one bottle of formula should be prepared at a time. Alternatively, prepared sterilised bottles of boiled water may be refrigerated and used as required, frst warming by standing bottle in a container of warm water and then adding formula. Refrigerated prepared formula should be warmed by standing the bottle in a container of warm water before feeding the infant. Using a microwave to heat infant formula is not recommended as heating can occur unevenly and burn the infant’s mouth. If feasible, the use of ‘ready to drink’ infant formula can be considered in situations where sterilisation is not possible. Transporting feeds It is much safer to prepare bottles of infant formula at the destination, rather than transporting bottles of prepared formula. Ready-made bottles of prepared formula can be a breeding ground for bacteria if the bottles have been sitting in a car or baby bag for several hours, especially on a warm day. Because of the potential for growth of harmful bacteria during transport, feeds should frst be cooled to no more than 5°c in a refrigerator and then transported. It is also recommended to take one or more separate sterilised bottles of cooled boiled water at the correct volume, so the formula can be prepared at the destination. Allow the equipment to cool in the saucepan until it is hand hot and then remove it – be very careful if children are present. Store equipment that is not being used straight away in a clean container in the fridge. Boil all equipment within 24 hours of use Sterilising using chemicals A chemical sterilant is an antibacterial solution that comes in liquid or tablet form. Microwave steam sterilisers sterilising units designed for use in a microwave oven are available. Flow rate is tested by holding a bottle of room-temperature milk mixture upside down.

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