RN Practice Council Communication Survey

We would appreciate your input about improving clinical information communication. The Communication Subcommittee of the Nurse Practice Council needs every nurse to participate. We are attempting to gather information about the current avenues of clinical communication. The answers to this survey are completely anonymous, so please be honest. If you have any questions please contact Diane Kasmar (x1584). Thank you for your help. Please complete this survey by December 22, 2006.

The scale is as follows:
1=Always
2=Often
3=Sometimes
4=Minimally
5=Never


  1. How do recieve your clinical/patient information?
        1 2 3 4 5   N/A
    Phone/ Voicemail    
    Fax    
    Face to Face    
    E-mail    
    Written form or narrative    


  1. How would you like to recieve your clinical/patient information?
        1 2 3 4 5   N/A
    Phone/ Voicemail    
    Fax    
    Face to Face    
    E-mail    
    Written Form or Narrative    


  1. If you are having communications issues, who do you speak with?
        1 2 3 4 5   N/A
    Your Supervisor    
    Co-Worker    
    Outside Friend/ Family    
    Another Supervisor    
    Staff Support/ Human Resources    


  1. Please explain the above response. (Optional)


  1. With which of the following departments do you share clinical/patient information?
        1 2 3 4 5   N/A
    MHV/PCC    
    Hospice    
    CareCenter Resources    
    HomeCare    
    Home Care Assistants    


  1. What three pieces of clinical/patient information are most important to recieve or give during these interactions?

          1 2 3    
      Patient Demographics   
      Medications   
      Diagnosis   
      Plan of Care   
      Family Information   
      Staff Information/ Scheduling   


  1. What three pieces of clinical/patient information are most often missing or incomplete?

          1 2 3    
      Patient Demographics   
      Medications   
      Diagnosis   
      Plan of Care   
      Family Information   
      Staff Information/ Scheduling   


  1. What suggestions do you have to improve communication?