Urology Solutions - Nurses pre-screener to be considered Question Title * 1. Contact info Name Company City/Town State/Province Country LinkedIn or Social media Profile Email Address Phone Number OK Question Title * 2. What is your current job title? Registered Nurse (ICU, OR, PICU, NICU, Neuro ICU, Surgical Trauma ICU, etc.) Nurse Manager Nurse Aid Nurse Technician Other (please specify) OK Question Title * 3. And how long have you been employed as a nurse? OK Question Title * 4. How many hours a week do you work as a nurse in a clinical setting? More than 20 hours a week Less than 20 hours a week None of the above OK Question Title * 5. What setting do you work in? Acute Care Other (please specify) OK Question Title * 6. What department do you work in? Critical Care/ICU Cardiovascular ICU Operating Room Other (please specify) OK Question Title * 7. What shift do you typically work? Day Shift Evening Shift Night Shift Other (please specify) OK Question Title * 8. How often do you directly interact with patients to provide clinical care? Often Sometimes Rarely Never OK Question Title * 9. Do you assist in making medical device purchasing decisions at your facility? Often Sometimes Rarely Never OK Question Title * 10. Do you have experience with urine output collection and measurement? Yes No OK Question Title * 11. Do you use any Automated Urine Output Monitoring or Urine Measurement Systems in your day-to-day job responsibilities? Which ones from this list – Accuryn Monitoring System, BD/Adaptec Sensica, Clarity RMS, Ishida Medical, Urine-Mate Monitoring, Sentinel Bedside UO Monitor, Sippi Observe Medical? OK Question Title * 12. What is the name of the hospital or company at which you currently work OK Question Title * 13. How old are you? OK Question Title * 14. Which gender do you best identify with? Male Female Prefer Not to Say Other (please specify) OK Question Title * 15. In the last 3 months, have you been an employee or contractor working for a urine output monitoring company or business? Yes No OK Question Title * 16. When was the last time, if ever, that you participated in an evaluation of a product or a study? Never Previously, record topic and exact date/time Participated in a urine output monitor study within the past 6 months OK Question Title * 17. Do you, or does any member of your immediate family, work for any of the following types of companies? An advertising agency A market research company A marketing company, marketing dept. or a research dept. of a company A public relations company or PR dept. of a company A medical device or pharmaceutical company No/none of the above OK Question Title * 18. Do you ever wear any type of corrective lenses at your workplace? Yes, glasses or contacts No OK Question Title * 19. In order to participate in this research activity, you will be required to sign a Non-Disclosure Agreement (NDA) and Informed Consent Document. Are you able to meet this requirement? Yes No OK Question Title * 20. This study is a remote session that will be conducted by video conference. Do you have access to a computer with a webcam and a reliable internet connection? Yes No OK Question Title * 21. Do you have a quiet, “distraction-free” area where you can complete this session? Yes No OK Question Title * 22. Are you willing to provide your RN license number in order to participate in the session? Yes No OK Question Title * 23. How did you hear about this research study? Received an email Facebook Post Friend Referred Me Unsure Other (please specify) OK DONE
