SURVEY: Accessing Implantable Ports

Complete the survey below. Please complete the following statement by selecting the number that describes your rating of the program that you have just completed. The rating scale ranges from 1 to 4, where1=Poor to 4=Excellent
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A red asterisk (*) indicates required questions.

  1. To what extent have you achieved the objectives of this session?*
     
      1 2 3 4  
    Poor  Excellent


  1. The learner was able to define the term “implantable port”*
     
      1 2 3 4  
    Poor  Excellent


  1. The learner was able to list at least 3 indications for selection of an implantable port*
     
      1 2 3 4  
    Poor  Excellent


  1. The learner was able to identify at least 5 physical descriptions rof an mplantable ports *
     
      1 2 3 4  
    Poor  Excellent


  1. The learner was able to identify at least 4 locations for port placement and describe 2 aspects of post-surgical placement nursing care*
     
      1 2 3 4  
    Poor  Excellent


  1. The learner was able to determine the best choice of needle type, length, and gauge on the basis of patient assessment and evaluation.*
     
      1 2 3 4  
    Poor  Excellent


  1. The learner was able to identify symptoms, causes, trouble shooting and treatment for at least 5 major complications related to implantable ports.*
     
      1 2 3 4  
    Poor  Excellent


  1. The learner is able to describe the procedure and rationale for a positive pressure flush*
     
      1 2 3 4  
    Poor  Excellent


  1. The learner is able to describe how to access, use and maintain an implantable port.*
     
      1 2 3 4  
    Poor  Excellent


  1. To what extent was the format of this program appropriate?*
     
      1 2 3 4  
    Poor  Excellent


  1. Overall, the program was . . .*
     
      1 2 3 4  
    Poor  Excellent


  1. How much time (in minutes) did you spend on this activity?*
    0-30 minutes
    30-60 minute
    60-90 minutes
    90 minutes or greater


  1. Was this program fair, balanced, and free of commercial bias?*
    Yes
    No


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