1. Age: | |||||
a. 20–29 | b. 30–39 | c. 40–49 | d. 50–59 | e. 60–69 | f. 70+ |
2. Gender | |||||
a. Male | b. Female | ||||
3. Current profession: | |||||
a. Nurse | |||||
b. Advanced Practice Provider (NP/PA) | |||||
c. Physician | |||||
d. Pharmacist | |||||
e. Respiratory Therapist | |||||
f. Physical therapy | |||||
g. Occupational therapy | |||||
h. Emergency Medical Trans port | |||||
i. Other | |||||
4. Years of clinical practice in current profession | |||||
a. <5 years | b. 5–10 years | c. 11–15 years | d. 16–20 years | e. 20+ years | |
5. In what type of facility do you practice? Select all that apply: | |||||
a. Level 1 trauma center | |||||
b. Level 2 trauma center | |||||
c. Level 3 trauma center | |||||
d. Level 4 trauma center | |||||
e. Community hospital | |||||
f. Academic medical center | |||||
g. Emergency medical trans port | |||||
6. What is the size of the institution? | |||||
a. <100 beds | |||||
b. 100–200 beds | |||||
c. 201–499 beds | |||||
d. 500–749 beds | |||||
e. 750–999 beds | |||||
f. N/A |