Survey for NP Student
Dear Advanced Practice Registered Nurse,
You are being asked to volunteer in a master’s major project study designed for Nurse Practitioners. The purpose of this study is to explore the perspectives of Nurse Practitioners on the barriers and facilitators of advance care planning. The Advance Care Planning Survey is an online survey. The survey will take 3 to 5 minutes to complete. A link to the survey can be found at the end of this document.
Please review the informational letter before taking the survey. The informational letter will describe and address the following: purpose and procedures of the study, risks, compensation, benefits, and how your information will be protected. The informational letter also contains contact information of the student researcher, faculty advisor, and the Rhode Island College Institutional Review Board.
Your participation is voluntary. If you wish to participate, please click on the survey link found at the end of the informational letter.
Thank you for your participation.
Cherish Dellava, RN, BSN
Rhode Island College
INFORMATIONAL LETTER/CONSENT DOCUMENT
Rhode Island College
Nurse Practitioner Perspectives on the Barriers and Facilitators of Advance Care
You are being asked to volunteer in a master’s major project study on Advance Care Planning. You are being asked to participate because you are a nurse practitioner and we would like to get your perspective on the barriers and facilitators of advance care planning.
Cherish Dellava, a graduate student of Rhode Island College and faculty advisor, Linda Dame DNP, FNP-BC will be doing this study.
Why this Study is Being Done (Purpose)
The purpose of this study is to explore the perspectives of Nurse Practitioners on the barriers and facilitators of advance care planning.
What You Will Have to Do (Procedures)
If you choose to participate in this study, we will ask you to:
- Complete an anonymous, one-time, online survey that you can access by clicking on the survey link found at the end of this section. The survey will take approximately 3 to 5 minutes to complete.
- The survey includes 3 sections. The demographic data section includes age, gender and level of nursing education. Professional data questions include: hours of practice every week; practice setting; years of practice; and education on end-of-life care issues. The practice data section will ask you to rate barriers and facilitators of advance care planning.
- Click on the survey link found at the end of this letter and then click submit once you have completed the survey.
You Will Be Paid (Compensation)
There will be no financial compensation for participation.
Risks or Discomforts
This study has minimal risk. Some questions may be sensitive or upsetting to some participants. We think that these questions are similar to the kinds of things you talk about with your family or colleagues. You can skip questions or withdraw from the survey at any time.
Benefits of Being in the Study
Being in this study will not benefit you directly.
Deciding Whether to Be in the Study
Rhode Island College Institutional Review Board
Expiration Date: 12/12/19
Being in the study is your choice to make. Nobody can force you to be in the study. You can choose not to be in the study, and nobody will hold it against you. You can change your mind and quit the study at any time, and you do not have to give a reason. If you decide to quit later, nobody will hold it against you.
How Your Information will be Protected
Because this is a research study, results will be summarized across all participants and shared in reports that we publish and presentations that we give. Your name will not be used in any reports. We will take several steps to protect the information you give us so that you cannot be identified. The survey settings are set so that the responses cannot be traced to a participant. The survey will not ask for your name or contact information. The survey results will be kept in a password-protected file, and seen only by myself and other researchers who work with me. If there are problems with the study, the records may be viewed by the Rhode Island College review board responsible for protecting the rights and safety of people who participate in research. The information will be kept for a minimum of three years after the study is over, after which it will be destroyed.
Who to Contact
You can ask any questions you have now. If you have any questions later, you can contact myself, Cherish Dellava at firstname.lastname@example.org or 401-486-0791. You can also contact Dr. Linda Dame at email@example.com, or by phone at 401-456-9668 If you think you were treated badly in this study, have complaints, or would like to talk to someone other than the researcher about your rights or safety as a research participant, please contact Cindy Padula at IRB@ric.edu, by phone at 401-456-9720. You can keep a copy of this form for your records.
Statement of Consent
I have read and understand the information above. I am choosing to participate in the study “Nurse Practitioner Perspectives on the Barriers and Facilitators of Advance Care Planning.” I can change my mind and quit at any time, and I don’t have to give a reason. I have been given answers to the questions I asked, or I will contact the researcher with any questions that come up later. I am at least 18 years of age.