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Qualtrics Survey Software
Form Approved OMB Control No. 09201071 Exp. Date: 06/30/2018
Please respond to following
The organization's conference I attended was:
I have made the following changes to my practice incorporating what I learned at [insert
webinar title or session title] (select all that apply):
Infection control practice
Patient teaching strategy
Patient assessment
Educating students and colleagues
Nursing care delivery
Interaction with peers and other healthcare providers
Interaction with patients and families
Quality or performance improvement
Coaching, mentoring or leading others
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Other
I have not made any changes in practice based on what I learned at [insert webinar title or session title].
Please indicate the barriers you have experiences to implement practice changes (select all that apply):
Lack of time
Lack of resources
Lack of organizational support
Still planning to make changes but have not implemented yet
Unsure of how to implement changes
Need more information to implement changes
Other
Additional comments:
Public reporting burden of this collection of information is estimated to average 5 minutes per
response, including the time for reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing the collection of information. An
agency may not conduct or sponsor, and a person is not required to respond to a collection of
information unless it displays a currently valid OMB Control Number. Send comments regarding this
burden estimate or any other aspect of this collection of information, including suggestions for
reducing this burden to CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NE, MS D74,
Atlanta, Georgia 30333; ATTN: PRA 09201071
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| File Type | application/pdf |
| File Modified | 2017-06-15 |
| File Created | 2017-06-15 |