Research RN

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Please rate your experience / frequency within the last year

0 = No Experience / Observed Only

1 = Limited Experience / Rarely Done (<6 times/year)

2 = May Need Some Review / Occasionally Done (1 - 2 times/month)

3 = Experienced / Frequently Done (daily or weekly)

AGE OF PATIENTS CARED FOR

Newborn/Neonate (birth to 30 days)

1

2

3

Infant (1 month to 1 year)

1

2

3

Toddler (1 year to 3 years)

1

2

3

Preschooler (3 years to 5 years)

1

2

3

School Age Child (5 years to 12 years)

1

2

3

Adolescents (12 years to 18 years)

1

2

3

Young Adults (18 years to 39 years)

1

2

3

Middle Adults (39 years to 64 years)

1

2

3

Older Adults (64 years to 79 years)

1

2

3

Elderly Adults (over 79+ years)

1

2

3

GENERAL SKILLS

Patient Head to Toe Assessment

1

2

3

Pain Management

1

2

3

Automated Med Dispensing Systems

1

2

3

Care Planning & Discharge Planning

1

2

3

Patient/Family Education

1

2

3

Electronic Documentation

1

2

3

Systems Used - Please List

Knowledge of Normal Serum Lab Values

1

2

3

Obtaining Cultures (Blood, Sputum, Swab)

1

2

3

Administration of Blood & Blood Products

1

2

3

Interpersonal Communication Skills

1

2

3

EXPERIENCE IN RESEARCH

Acute Care Setting

1

2

3

Clinic Setting

1

2

3

Long Term Care Setting

1

2

3

Urban Home Setting

1

2

3

EXPERIENCED WITH:

Research Process

1

2

3

Evidence-Based Nursing

1

2

3

Institutional Regulatory Board policies

1

2

3

Coordination of Study Treatments

1

2

3

Data Collection

1

2

3

Quantitative Studies

1

2

3

Data Analysis

1

2

3

Presentation of Research Study

1

2

3

Microsoft Office

1

2

3

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