Exit this survey COVID- 19 Nursing Workplace Survey Question Title * 1. Name of the facility in which you work Question Title * 2. What type of department/unit do you work in? Question Title * 3. Do you work at a facility that has cared for patients with known or suspected COVID-19? Yes No Unsure Question Title * 4. Have you provided direct care to a patient with known or suspected COVID-19? Yes No Unsure Question Title * 5. How were you informed that you would be caring for a patient with suspected or confirmed COVID-19, including who informed you and when, in relation to your shift? Question Title * 6. Has management communicated actions to take if you believe you have been exposed to a patient with known or suspected COVID-19 or if you exhibit symptoms (e.g., fever, cough, shortness of breath)? Manager notified me Employee Health notified me I learned from the media Nobody notified me Other Question Title * 7. What steps did the employer recommend you take? Follow CDC guidelines Follow advice from employee health I still have unanswered questions Other Comment Question Title * 8. Were you instructed to stay home from work? (check all that apply) I was furloughed I was told to stay home by my manager I was told to stay home by employee heatlh I chose to stay home Question Title * 9. f you were instructed to stay home from work, is the employer paying you or did the employer instruct you to use PTO/EIB or file for worker’s compensation? My employer is paying me Using my PTO or EIB I don't know My employer instructed differently Question Title * 10. Currently, do you feel prepared to provide care for a patient with known or suspected COVID-19? Yes No Unsure Question Title * 11. Does your facility have a plan in place to care for those with known or suspected COVID-19? Yes No Unsure Question Title * 12. Is there a place in your facility to screen and triage patients who come into the facility to make sure that patients with possible COVID-19 are isolated? Yes No Unsure Question Title * 13. Does the facility have negative air pressure rooms? Yes No Unsure Question Title * 14. Do you know where they are located? Yes No Unsure Question Title * 15. Does the facility have N95 respirators available? Yes No Unsure Question Title * 16. Is yearly N95 respirator fit testing been provided? Yes No Unsure My unit uses another type of respirator that does not require fit testing (i.e. CAPR) Question Title * 17. Does your facility have PAPRs or reusable respirators? Yes No Unsure Question Title * 18. Do you have access to adequate supplies of PPE (respirators, eye protection, face shield, gloves) to do your work? Yes No Unsure Question Title * 19. Has management assigned/asked for staff volunteers dedicated to care for patients with COVID-19? Yes No Unsure Question Title * 20. Has your management/supervisor discussed with frontline staff your facility’s response plan for caring for patients with known or suspected COVID-19? Yes No Unsure Question Title * 21. What type of preparation and training has your facility conducted? (check all that apply) Adding questions to intake screening Posting of CDC checklist for patients with known or suspected COVID-19 on your unit Posting phone number of state Department of Health Plan for patient transport from clinic/community to ED Plan for patient transport from ED to inpatient setting Setting up separate screening areas for potential patients Setting up isolation areas specific for patients with known or suspected COVID-19 CDC recommended personal protective equipment (PPE) is immediately available to staff CDC recommended PPE kits ready for use and practice for clinic, public health, ambulatory setting CDC recommended PPE kits ready for use and practice for ED or Urgent Care setting Training staff on current infection control protocols Employer-provided training on when to use PPE, donning, and doffing Discussed safety and patient care delivery in daily huddle Clinical protocols for aerosol-generating procedures (bronchoscopy, intubation, CPR, respiratory suctioning, etc.) Appropriate cleaning materials I don't know Other (please specify) Question Title * 22. If training is being conducted, what methods of instruction are being used? None General meetings/forums Literature provided Videos Webinars Inservices/huddles Review of updated PPE procedures Repetitive hands-on drills appropriate to your role including donning and doffing PPE Next
