Chemotherapy Guidelines: Why We Need Them Survey

*
1. Please fill out the following:

Please fill out the following: Name:
Company:
Address:
Address 2:
City/Town:
State:
ZIP:
Email Address:
Phone Number:

*
2. Please select your practice-setting:

Please select your practice-setting:

*
3. As a result of this activity, I am better able to:

	Not at all/Poor	Somewhat/Fair	Almost Completely/Good	Completely/Excellent
Specify the risks of exposure to nurses when administering hazardous drugs, such as chemotherapy.	*As a result of this activity, I am better able to: Specify the risks of exposure to nurses when administering hazardous drugs, such as chemotherapy. Not at all/Poor	Specify the risks of exposure to nurses when administering hazardous drugs, such as chemotherapy. Somewhat/Fair	Specify the risks of exposure to nurses when administering hazardous drugs, such as chemotherapy. Almost Completely/Good	Specify the risks of exposure to nurses when administering hazardous drugs, such as chemotherapy. Completely/Excellent
Categorize hazardous drugs according to their opportunity for exposure.	Categorize hazardous drugs according to their opportunity for exposure. Not at all/Poor	Categorize hazardous drugs according to their opportunity for exposure. Somewhat/Fair	Categorize hazardous drugs according to their opportunity for exposure. Almost Completely/Good	Categorize hazardous drugs according to their opportunity for exposure. Completely/Excellent
Describe accepted procedures for handling hazardous drugs as published in selected professional guidelines.	Describe accepted procedures for handling hazardous drugs as published in selected professional guidelines. Not at all/Poor	Describe accepted procedures for handling hazardous drugs as published in selected professional guidelines. Somewhat/Fair	Describe accepted procedures for handling hazardous drugs as published in selected professional guidelines. Almost Completely/Good	Describe accepted procedures for handling hazardous drugs as published in selected professional guidelines. Completely/Excellent

*
4. Rate the author:

	Not at all/Poor	Somewhat/Fair	Almost Completely/Good	Completely/Excellent
Kerry Mahar, RN, MSN, AOCN	*Rate the author: Kerry Mahar, RN, MSN, AOCN Not at all/Poor	Kerry Mahar, RN, MSN, AOCN Somewhat/Fair	Kerry Mahar, RN, MSN, AOCN Almost Completely/Good	Kerry Mahar, RN, MSN, AOCN Completely/Excellent

*
5. Please answer the following:

	Not at all/Poor	Somewhat/Fair	Almost Completely/Good	Completely/Excellent
Rate the effectiveness of the educational resources.	*Please answer the following: Rate the effectiveness of the educational resources. Not at all/Poor	Rate the effectiveness of the educational resources. Somewhat/Fair	Rate the effectiveness of the educational resources. Almost Completely/Good	Rate the effectiveness of the educational resources. Completely/Excellent
Was the program relevant to your current practice?	Was the program relevant to your current practice? Not at all/Poor	Was the program relevant to your current practice? Somewhat/Fair	Was the program relevant to your current practice? Almost Completely/Good	Was the program relevant to your current practice? Completely/Excellent
Was the program fair/balanced and free of commercialism?	Was the program fair/balanced and free of commercialism? Not at all/Poor	Was the program fair/balanced and free of commercialism? Somewhat/Fair	Was the program fair/balanced and free of commercialism? Almost Completely/Good	Was the program fair/balanced and free of commercialism? Completely/Excellent

*
6. Do you plan on making changes to your practice due to this program?

Do you plan on making changes to your practice due to this program? Yes

No

Maybe

If so, please describe:

7. What topics would you recommend for future programs?

What topics would you recommend for future programs?

8. Additional Comments:

Additional Comments:

The University of Nebraska Medical Center College of Nursing Continuing Nursing Education is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

This activity is provided for 1.0 contact hours under ANCC criteria. Provided for 1.2 contact hours under Iowa Provider #78. Provider approved by the California Board of Registered Nursing, Provider #13699 for 1.2 contact hours.

Chemotherapy Guidelines: Why We Need Them

1. Evaluation Form

*1. Please fill out the following:

*2. Please select your practice-setting:

*3. As a result of this activity, I am better able to:

*4. Rate the author:

*5. Please answer the following:

*6. Do you plan on making changes to your practice due to this program?