Page 58 nursing.elitecme.com Complete Your CE Test Online - Click Here Prescribing Controlled Substances and Preventing Drug Diversion for West Virginia Nurses 1 Contact Hour Screening West Virginia Veterans for Mental Health Issues 2 Contact Hours Falls: Assessment and Prevention 2 Contact Hours Sepsis in the Adult Patient: Identification and Initial Care 7 Contact Hours YES NO YES NO YES NO YES NO 1 m m m m m m m m 2 m m m m m m m m 3 m m m m m m m m 4 m m m m m m m m 5 m m m m m m m m 6 m m m m m m m m 7 m m m m m m m m 8 m m m m m m m m Fill in the circle below numbers 0=Not likely at all, 5=Neutral and 10=Extremely likely How likely is it that you would recommend Elite .................................................................................... 0 1 2 3 4 5 6 7 8 9 10 Prescribing Controlled Substances and Preventing Drug Diversion for West Virginia Nurses: If you answered yes to question 8, how will you change your practice as a result of this activity and indicate any barriers you perceive in implementing these changes: ________________________________________ _______________________________________________________________________________________________________________________________ Screening West Virginia Veterans for Mental Health Issues: If you answered yes to question 8, how will you change your practice as a result of this activity and indicate any barriers you perceive in implementing these changes: ________________________________________________________________ ______________________________________________________________________________________________________________________________ Falls: Assessment and Prevention: If you answered yes to question 8, how will you change your practice as a result of this activity and indicate any barriers you perceive in implementing these changes: ___________________________________________________________________________________________ _______________________________________________________________________________________________________________________________ Sepsis in the Adult Patient: Identification and Initial Care: If you answered yes to question 8, how will you change your practice as a result of this activity and indicate any barriers you perceive in implementing these changes: _____________________________________________________________________ _______________________________________________________________________________________________________________________________ Please describe any clinical situations that you find difficult to manage or resolve that you would like to see addressed in future continuing education: __________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________ List other topics that you would like to see provided: __________________________________________________________________________________ __________________________________________________________________________________________________________________________ qI agree to allow Elite to use my comments. If you answered yes, please provide your name and title as you would like them to appear. ___________________________________________________________________________________________________________ SELF-ASSESSMENT AND EVALUATION (Required - ANCCWV12E18) Your feedback is vital for the planning and design of future educational activities and for continual process improvements. Thank you. Indicate your license type: mLicensed Practical Nurse (LPN or LVN) mRegistered Nurse (RN) mOther __________________________________ Highest education level: mAA or AS mBSN mDiploma mDoctorate (mDNP mPhD mOther ________________________________________) mAdvanced Practice (mAPRN mClinical Nursing Specialist mOther ________________________________) mBoard Certified To receive continuing education credit for this educational activity, completion of the self-evaluation is mandatory. Please answer all the questions for the courses you have completed. Choose the appropriate answer for each course completed, mark you answers. 1. Was the activity evidence-based, free of commercial bias or influence? 2. Was the author’s expertise and knowledge of the subject evident in the content? 3. Did the content of this activity match my current (or potential) scope of practice? 4. Was the course well written, organized, and informative? 5. Was the presentation balanced and objective? 6. Did the activity support the stated learning objectives? 7. After completing the activity, are you more confident in your abilities? 8. Do you plan to make changes to your practice as a result of this activity? 9. The course information provided was: New, Review, or Both. 10. Will this activity have an impact on your knowledge, competence, performance and patient outcomes. New Review Both New Review Both New Review Both New Review Both 9 m m m m m m m m m m m m Yes No No Change Yes No No Change Yes No No Change Yes No No Change 10 m m m m m m m m m m m m