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2012
April
H
Hospital Preparedness
Hospital Preparedness
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Project Statement: Hospital Emergency Preparedness
I invite you to participate in a web-based online survey that is anonymous. The survey is intended to gather information regarding hospital preparedness and the overall percieved importance and effectivness of disaster exercises. Your participation in this survey is very important to achieving this goal.
The survey is part of a research project to assess the overall perception of hospital preparedness.
The survey should take less than 10 minutes to complete.
Participation in this research project is voluntary:
There are no direct benefits to you for participating in this research. There are no financial or reimbursement cost for you participation in this study.
The information will be used as part of a Master’s student thesis research project. The results will be published in the thesis. Participants may request a copy of the results by sending an email to the address below.
You may decline to participate in this survey or you may decline to answer certain questions. The web-based survey can be stopped at any time. There is no penalty or loss of benefits.
Your information will be kept confidential.
The web-based survey is administered through QuestionPro. QuestionPro does not collect or maintain any information that would identify who has taken the survey. Only the answers to the questions are recorded. There is no way for the researcher to know who answered which question. All questions are complied into a database for analysis. There are no questions in the survey that could lead to the identification of the individuals taking the survey. Any contact with the researcher must be made by the individual taking the survey, either by phone or email.
Statement of Risk:
There is no foreseeable risk other than the loss of the time to take this survey.
Questions about the research study or this survey:
You may contact the graduate student, (your name), directly by email (your email address) or the faculty thesis advisor (name and email address) or the Department of Emergency Management at Arkansas Tech University at 479-356-2159.
QUESTIONS REGARDING YOUR RIGHTS AS A RESEARCH SUBJECT
THESE MAY BE DIRECTED TO DR. MARY GUNTER – DEAN OF THE GRADUATE COLLEGE, ARKANSAS TECH UNIVERSITY COMMITTEE FOR THE PROTECTION OF HUMAN SUBJECTS (479-968-0398).
By proceeding past this point in the survey you are indicating that you consent to participation in this study. Please print out a copy of this consent form for your records.
Thank you for your time,
Kyah Spence
What is your gender?
Male
Female
What is your age range?
17 and under
18-25
26-33
34-40
40-47
48 and over
What type of position do you hold within your hospital?
Doctor
Nurse
Administrator
Other
How familiar are you with hospital preparedness?
Very familiar
familiar
somewhat familiar
not very familiar
not familiar at all
If you answered 'yes' to the above question, is it a rural or urban hospital?
Rural
Urban
Does not apply
Have you participated in any form of exercise at a hospital?
Yes
No
Does your hospital have a disaster plan?
Yes
No
I don't know
What type of disaster exercises has your hospital participated in (Select all that apply)?
Tabletop
Functional
Full-scale
In your opinion, are disaster exercises an effective tool in disaster preparedness for hospitals? Please explain your answer.
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