Survey to evaluate usefulness of aerosol boxes and swab shields
Project Aerosol Box and Swab Shield Against COVID-19 - ParaSaPinas
This survey is being done to evaluate the usefulness of the Aerosol Boxes and Swab Shields in the fight against COVID-19. The key performance indicator of the Boxes and Shields is:
NO health professionals using aerosol boxes and swab shields while doing procedures on the mouth, nose, throat and respiratory tree of patients have acquired COVID-19 infection
What hospital are you representing? *
Your answer
What is the complete address of the hospital you are representing? *
Your answer
Please state your full name *
Your answer
Please state your contact number *
Your answer
Please state your email address *
Your answer
Is this hospital a PRIVATE or GOVERNMENT hospital? *
Private
Government
How many beds does the hospital have (approx)? *
Your answer
What departments are using the AEROSOL BOX (check all that apply)? *
Emergency Room
Operating Room
ICU
Floor
Other:
What departments are using the SWAB SHIELD (check all that apply)? *
Emergency Room
Operating Room
ICU
Floor
Triage Tent
Laboratory
Other:
Was the supply delivered in a timely manner (on the agreed schedule)? *
Yes
No
If the supply WAS NOT delivered on time, what was the reason for the delay? (Answer "NA" if this is not applicable) *
Your answer
How many AEROSOL BOXES did you receive? *
Your answer
How many SWAB SHIELDS did you receive? *
Your answer
Was the supply that you received adequate? *
Yes
No
If you answered NO to the question above, what volume do you think will be adequate? How many Aerosol Boxes? How many Swab Shields? (Answer "NA" if this is not applicable) *
Your answer
How often is the equipment used in a month? *
Aerosol Boxes
Swab Shields
Aerosol Boxes
Swab Shields
Every day
Every other day
Once a week
Twice a week
Every other week
How many health workers from your hospital are currently infected with COVID-19 ? *
How many health workers have become infected after doing procedures on a patient's mouth, nose, throat, and respiratory tract even after using the AEROSOL BOX OR SWAB SHIELD? *
Your answer
Your answer
Other comments and suggestions? *
Your answer
Submit
Click to go to form and fill-up:
https://docs.google.com/forms/d/e/1FAIpQLSfDO1rkyTGxDOUlNiYN3R5Y01r1k2WZsoBF7oLMNEY2vWw-RQ/viewform
ROJ@20mar31