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Exit Survey
 
 

Dear Educator:



Thank you for taking a few minutes of your valuable time to complete this survey for my research project. This survey is designed to gather information on medication administration practices and experiences at local schools and child care settings. My goal for this project is to find opportunities to improve education in those responsible for administering medications to children in schools and child care settings.  



Your responses to the survey will be used to determine if opportunities exist for improving education and practices for those who administer medications to children at school or daycare. Any discomfort or inconvenience to you comes only from the amount of time taken to complete the survey.



This survey is anonymous. Any information that is obtained in connection with this survey that can identify you or your school/childcare facility will remain confidential and will not be disclosed.



If you agree to participate, please complete the following survey. Your completion of this survey constitutes implied consent. It should take no more than 5 minutes to complete this survey. You must answer each question in order to move on to the next question in the survey. If you do not want to answer a question in the survey or you decide to not participate after you have started the survey, you can discontinue the survey at any time and your responses will not be recorded.



If you have questions at any time, please do not hesitate to contact either Tara Hanson or Heather Girand at the email addresses or phone numbers below. If you have questions about your rights or complaints about this research project, contact the Ferris State University Institutional Review Board (IRB) by phone at 231-591-2553 or by email at [email protected].



Thank you for your time.



Investigators:  



Student Investigator: Tara Hanson; [email protected]; 269- 339-8716



Principal Investigator: Dr. Heather Girand; [email protected]; 269-341-7805


 
 
 
* What is the name and location of your school/child care facility? (Note: this is only for tallying how many different schools/facilities are represented in the data. Your other responses will NOT be linked to your response to this question.)
   
 
 
 
* Is your school/facility:
 
Public
 
Private
 
Charter
 
Other (please comment)
 
 
 
 
* Level of school: (Select all that apply)?
 
Child care
 
Pre-school
 
Elementary
 
Middle School
 
High School

 
 
 
* Does your school/facility have a nurse on staff?
 
Full Time
 
Part Time
 
None
 
 
 
* Where are medications stored at your school/facility? (Select all that apply)?
 
Locked cabinet
 
In the office
 
In the classroom
 
Other (please comment)
 

 
 
 
* Who is responsible for medication administration at your school? (title(s) only, no names please) (Select all that apply)
 
Nurse
 
Secretary
 
Administrator
 
Teacher
 
Aide
 
Other (please comment)
 

 
 
 
* What training does that person(s) have in regards to medications?
 
Formal medical training
 
Attended workshop or training session(s)
 
None
 
Unknown
 
Other (please comment)
 
 
 
 
* What paperwork do your students need on file to take medication at school? (Select all that apply)
 
Form signed by parent
 
Form/order signed by doctor or other health care provider
 
Valid prescription container with label
 
Medication care or action plan
 
Other (please comment)
 

 
 
 
* Is there a requirement to document when medications are administered to children/students at your facility?
 
No
 
Unsure
 
Yes, please describe requirement
 
 
 
 
* What types of medications do you commonly see given to children at your school/facility? (Select all that apply)
 
Asthma inhalers
 
Epipen®
 
Acetaminophen
 
Ibuprofen
 
Diphenhydramine/Benadryl®
 
Cough/cold remedies (lozenges, nasal sprays, oral medications)
 
ADHD medications
 
Antibiotics (oral, eye drops, ear drops)
 
Anti-seizure medications
 
Insulin or other diabetic medications
 
Antacids
 
Other (please comment)
 

 
 
 
* Are any students allowed to carry their own medications?
 
No
 
Unsure
 
Yes, please describe the circumstances
 
 
 
 
* Are any students allowed to administer their own medications?
 
No
 
Unsure
 
Yes, please describe the circumstances
 
 
 
 
* Have you witnessed or been involved in a medication error at a school or child care facility?
 
Yes
 
No
 
 
 
* What type of error(s) were you involved in or did you witness? (Select all that apply)
 
Wrong drug
 
Wrong patient
 
Wrong dose
 
Extra dose
 
Wrong time
 
Improper administration or storage
 
Other (please comment)
 

 
 
 
* If a medication error occurred, how would it be reported or documented?
   
 
 
 
* If you personally had to give a medication to a student in an emergency situation, how comfortable would you be to do so?
 
Very comfortable
 
Somewhat comfortable
 
Somewhat uncomfortable
 
Very uncomfortable
 
 
 
Any additional comments you would like to provide?
   
 
 
 
If you are interested in attending a future workshop or inservice to learn more about these topics, please include your email address below and we will contact you with further information. Your contact information will be kept separate from the survey data and cannot be linked back to your survey responses.