Skip to content

DAISY Team Nomination Form

About DAISY Team Award:

The DAISY Team Award is designed to honor collaboration by two or more people, led by a nurse, who identify and meet patient and/ or patient family needs by going above and beyond the traditional role of Nursing.

The DAISY Team Award will complement our on-going DAISY Award program that honors individual direct care nurses for their extraordinary compassion and skill.

Some examples of extraordinary collaborations that may be honored with The DAISY Team Award include:
-A "Prom" organized for a patient who is unable to go to her/his own
-An ED team dealing with multiple accident victims
-A wedding for a patient who is unable to attend her/his own outside of the healthcare facility
-A fund to provide haircuts to patients who will lose their hair during treatment and then donating the hair to a charitable organization who can put the hair to good use
-A process for creating mementos of patients to be given to family members
1.Describe how the team members meet DSFH-R purpose and I CARE values and are role models of teamwork and collaboration that impacted the lives of patients, families, and the community they serve:(Required.)
2.Supporting Evidence:
No file chosen
3.Describe the project and related positive patient and family outcomes that went beyond the traditional role of nursing:(Required.)
4.Supporting Evidence:
No file chosen
5.Describe how the team addresses the strategic priorities of DSFH-R:(Required.)
6.Supporting Evidence
No file chosen
7.Full Name of Nurse Leading the Interprofessional Team 1:(Required.)
8.Full Name of the Interprofessional Team Member 2:(Required.)
9.Full Name of the Interprofessional Team Member 3:(Required.)
10.Full Name of the Interprofessional Team Member 4:(Required.)
11.Nominator:(Required.)
12.Date:
Date/Time
Time
: