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djfvkZYWKpHswksMFoJ2LZGYK4uuXXZofemVPXfToch375taFFe9ePnXQgyzEiiGyaUAsgR8eoy58Nox3F4N

Safety: Nurse Work Environment, HRO survey

Please complete the survey below.

Thank you!

SAFETY; NURSE WORK ENVIRONMENT; HRO

Dear Perioperative Nurse:

You are being invited to participate in a research study by answering questions in the attached survey about safety culture, high reliability, and the nurse work environment. This study is conducted by Dr. M. Imelda Wright of the University of Louisville. There are no known risks for your participation in this research study. The information collected may not benefit you directly. The information learned in this study may be helpful to others. The information you provide will help examine non-identifiable demographic data as well as measure culture of safety, high reliability and the nurse work practice environment. Your completed survey will be stored at a password-protected computer at the University of Louisville School of Nursing. The survey will take approximately 20 minutes time to complete.

Individuals from the Department of the School of Nursing, the Institutional Review Board (IRB), the Human Subjects Protection Program Office (HSPPO), and other regulatory agencies may inspect these records. In all other respects, however, the data will be held in confidence to the extent permitted by law. Should the data be published, your identity will not be disclosed.

Taking part in this study is voluntary. By answering survey questions, you agree to take part in this research study. You do not have to answer any questions that make you uncomfortable. You may choose not to take part at all. If you decide to be in this study, you may stop taking part at any time. If you decide not to be in this study or if you stop taking part at any time, you will not lose any benefits for which you may qualify.

If you have any questions, concerns, or complaints about the research study, please contact: M. Imelda Wright at (502) 641-6859. If you have any questions about your rights as a research subject, you may call the Human Subjects Protection Program Office at (502) 852-5188. You can discuss any questions about your rights as a research subject, in private, with a member of the Institutional Review Board (IRB). You may also call this number if you have other questions about the research, and you cannot reach the research staff, or want to talk to someone else. The IRB is an independent committee made up of people from the University community, staff of the institutions, as well as people from the community not connected with these institutions. The IRB has reviewed this research study.

If you have concerns or complaints about the research or research staff and you do not wish to give your name, you may call 1-877-852-1167. This is a 24-hour hot line answered by people who do not work at the University of Louisville.

Sincerely,

M. Imelda Wright

DEMOGRAPHICS

Diploma

Associates degree

Baccalaureate degree

Graduate degree

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Yes

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THE PRACTICE ENVIRONMENT SCALE OF THE NURSING WORK INDEX (PES-NWI)

The PES-NWI uses a 4-point Likert scale (ranging from 1 = strongly disagree; 2= disagree; 3= agree; 4 = strongly agree) to identify factors present in the work environment that support nursing's ability to deliver high quality care; a higher score, represents a favorable nursing practice environment

For each item, please indicate the extent to which you agree that the item is PRESENT IN YOUR CURRENT JOB.

Strongly disagree

Disagree

Agree

Strongly agree

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Strongly disagree

Disagree

Agree

Strongly agree

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Strongly disagree

Disagree

Agree

Strongly agree

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Strongly disagree

Disagree

Agree

Strongly agree

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Strongly disagree

Disagree

Agree

Strongly agree

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Disagree strongly

Disagree slightly

Neutral

Agree slightly

Agree strongly

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The High Reliability Characteristics Scale

The High Reliability Characteristics Scale items are measured on a 5-point scale: 1 = disagree strongly; 2= disagree; 3= neutral; 4= agree; 5= agree strongly.

For each item, please indicate the extent to which you agree that the item is PRESENT IN YOUR CURRENT JOB.

Disagree strongly

Disagree

Neutral

Agree

Agree strongly

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Disagree strongly

Disagree

Neutral

Agree

Agree strongly

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You have reached the end of this survey. We greatly appreciate your valuable responses and that you shared the gift of your time.

As a thank you for participating in this survey, you can enter a drawing for one of four $50 gift cards which will be drawn after the survey closes.

If you wish to enter these drawings, email Imelda Wright at miwrig01@louisville.edu. Please place the words "Gift Card" in the subject line. Your email will not be associated with this survey,

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.