1 Start 2 Complete What unit do you work on? PICU NICU OR Other... What unit do you work on? Other... What is your job title RN MD Tech Other... What is your job title Other... Please rate Strongly DisagreeDisagreeNeitherAgreeStrongly Agree This course has highlighted the importance of speaking up about safety concerns. It is easy for me to bring patient safety concerns to my supervisor, section head, and/or department chair. This course has highlighted the importance of speaking up about safety concerns. It is easy for me to bring patient safety concerns to my supervisor, section head, and/or department chair. - Strongly Disagree This course has highlighted the importance of speaking up about safety concerns. It is easy for me to bring patient safety concerns to my supervisor, section head, and/or department chair. - Disagree This course has highlighted the importance of speaking up about safety concerns. It is easy for me to bring patient safety concerns to my supervisor, section head, and/or department chair. - Neither This course has highlighted the importance of speaking up about safety concerns. It is easy for me to bring patient safety concerns to my supervisor, section head, and/or department chair. - Agree This course has highlighted the importance of speaking up about safety concerns. It is easy for me to bring patient safety concerns to my supervisor, section head, and/or department chair. - Strongly Agree I see patient safety issues at AFCH that go unreported. I see patient safety issues at AFCH that go unreported. - Strongly Disagree I see patient safety issues at AFCH that go unreported. - Disagree I see patient safety issues at AFCH that go unreported. - Neither I see patient safety issues at AFCH that go unreported. - Agree I see patient safety issues at AFCH that go unreported. - Strongly Agree Please explain Explain your rating Have you ever filed a PSN Yes No If yes, it helped address my safety concern: Strongly Disagree Disagree Neither Agree Strongly Agree Please share any experience that you would like regarding the PSN system Would you like someone to contact you about your concerns Yes No Leave this field blank
