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Nurse Practitioner Needs Assessment
1.
Which state(s) do you work in? (check all that apply)
Maine
New Hampshire
Vermont
Other (please specify)
2.
What is your subspecialty?
Family FNP
Adult-Gerontology AGNP
Neonatal NNP
Pediatrics PNP
Women's Health WHNP
Psychiatric-Mental Health PMHNP
Other (please specify)
3.
How long have you been a nurse practitioner?
5 years or less
5-10 years
10 years or more
4.
What type of setting do you primarily work in?
Office-based
Hospital acute care
Hospital rehabilitation
Other (please specify)
5.
What age groups represent the patients in your practice? (check all that apply)
Infants
Pediatrics
Adolescents
Adults 18-60 years of age
Adults 60+ years of age
6.
Have you ever called the poison center for patient management/treatment advice or other questions?
Yes
No
7.
Do any of the following prevent you from calling the poison center? (check all that apply)
Other policy or procedure in place
Don't have the poison center number
Lack of time, busy with patient care
Not sure if the poison center can help
Poor cell phone reception
Other (please specify)
8.
How can the poison center help your practice? (check all that apply)
Provide data and trends
Provide advice for managing your patient
Provide patient education
Provide staff training
Other (please specify)
9.
What poison-related information are you interested in? (check all that apply)
Pharmacology/toxicity
Expected clinical findings
Management of poisoned patients
Trends/statistics
Other (please specify)
10.
Which of the following medications would you be interested in learning more about? (please select up to 5)
Supplements, vitamins and naturopathic products (hormones, dietary supplements, etc.)
Psychiatric and behavioral medications (antidepressants, antipsychotics, anxiolytics, etc.)
Antibiotics/anti-infectives/antivirals
Alzheimer medications
Prescription drugs involved in substance use
Diabetic medications
Vaccines
Anticoagulants/antiplatelets
Over-the-counter medications (ibuprofen, acetaminophen, cough and cold preparations, etc.)
Anti-rheumatic agents (methotrexate, etc.)
Cannabis/marijuana and CBD products (flower, edibles, topicals, etc.)
Cardiac medications
11.
Which of these poisoning topics would you be interested in learning more about? (please select up to 5)
Fumes, gases and vapors (carbon monoxide, cyanide, chlorine gas, etc.)
Drug interactions
Adverse events from medications
Street drugs and illicit substances (cocaine, methamphetamine, ecstasy, etc.)
Environmental and occupational poisonings (pesticides, herbicides, etc.)
Prevention for teens and adults
Current trends and emerging issues
Heavy metals (lead, cadmium, mercury, arsenic, etc.)
Self-harm attempts
Prevention for older adults
Prevention for young children
Household products (cleaners, hydrocarbons building products, etc.)
E-cigarettes
Plants and mushrooms
12.
What education platforms do you prefer for your practice? (check all that apply)
In-person presentations
Phone conversations with poison center staff
Podcasts
Recorded, on-demand presentations
Zoom, GoToMeeting, or other live, remote platforms
13.
If you are interested in professional education or materials from the poison center, please provide your contact information.
Name
Practice Name
City/Town
State/Province
ZIP/Postal Code
Email Address
Phone Number
14.
Please provide any additional comments here.
Current Progress,
0 of 14 answered