This free survey is powered by QUESTIONPRO.COM
  1. Surveys
  2. 2011
  3. February
  4. H
  5. Hand Hygiene Perception Survey for Health-Care Wor
0%
Exit Survey »
 
 
Introduction
 
 
 
We are interested in your opinion on health care-associated infections and hand hygiene programs. Your answers are anonymous and will be kept confidential. Results from the survey will be used to improve local and provincial hand hygiene programs and your opinion is important. It should take you about 10 minutes to complete this survey
If you have any questions about the survey process please contact your local infection control practitioner from 0900 to 1700 Monday through Friday. The completion of the survey implies consent for storage and use of participant responses for hand hygiene evaluation.
 
 
 
Survey
 
 
 
Facility at which you spend most of your time
   
 
 
 
City
   
 
 
 
Shift(s)Worked (check all that apply)
 
Night
 
Day
 
Weekend

 
 
 
Gender
 
Male
 
Female
 
 
 
Age
 
Under 25 years
 
25-35 years
 
36-45 years
 
46-55 years
 
56-65 years
 
Over 66 years
 
 
 
Profession
 
Nursing Staff: Registered Nurse/Midwife/Licensed Practical Nurse/Care Aide/Nursing or Midwife Student
 
Physicians: Medical Doctor/Resident/Fellow/Medical Student
 
Clinical Support Services: Occupational, Physio or Respiratory Therapist/speech Therapy/Social Work/Dietician/Psychologist/Audiologist/Porter/Pastoral Care/Radiology/Technicians/Lab
 
Other: Housekeeping/Food Services/Clerical/Volunteer/Security
 
 
 
Department (please select the department/area which best represents where you practice)
 
Internal medicine
 
Surgery
 
Mixed medical/Surgical
 
Intensive Care Unit (General, Cardiac, Neurosurgical, Spine)
 
Emergency
 
Burns/Plastics
 
Transplantation Medicine
 
Pediatric Intensive Care Unit or NICU
 
Long-Term Care
 
Rehabilitative Care
 
Psychiatry
 
Outpatient Clinic
 
Other
 
 
Survey Software Powered by QuestionPro Survey Software