Your Instructor’s Name:
Directions: You must use this form for this assignment. Use the Submit tab on the assignment page to upload it when it is completed. You may use the form to capture information as you conduct your interview, or fill it in later. The form is expandable and will enlarge the textbox to accommodate your answers. Do not rely only on this form for everything you must include! Read the assignment guidelines for more details.
| Criteria | Fill in the answers in this column. |
| Demographics: Provide initials of the RN, official job title of interviewee that includes the type of nursing information roleand the date the interview was conducted.Types of nursing information expert may be considered include, but are not limited to, Nursing Clinical Information Manager; Super User, Director/Manger Clinical Education; Chief Information Officer; Quality Assurance or Performance Improvement Nurse; Nurse Informaticist; Telenursing Specialist; Nurse Abstractor; Case Manager; Compliance Nurse. | |
| Required Questions(answer EVERY question in this section) | |
| 1. Describe your career path to your current position. Include information about education and experiences. | |
| 2. Discuss the value of best evidence as a driving force in delivery of nursing care at your facility. | |
| 3. What safeguards and decision-making support tools are embedded in patient care technologies and information systems that support safe practice at your facility? | |
| 4. Names/lists four or more technologies that improved patient care. | |
| 5. Names/lists three or more groups that rely on information/data AND describes in detail how information is utilized. | |
| Optional Questions(answer only ONE question from the choices below) | |
| 1. Please tell me what challenges you have faced in dealing with other disciplines who may not “understand the needs of nurses/nursing?” | |
| 2. Please share an example of how garbage in/garbage out (GIGO) impacted a decision related to your information/data collection. | |
| 3. Please give me an example of how the lack of interprofessional collaboration impacted your role. | |
| 4. Please describe what a typical day on the job is like for you? | |
| Follow-up Questions(Answer all of these. Please do not ask them during the interview.Instead, reflect and answer them afterward.) | |
| 1. How will completing this interview impact your practice as a BSN-prepared nurse? Give specific examples. | |
| 2. Resources:List scholarly articles or texts that were used prior to the interview to prepare. Write resource in APA format. (The references should be within the last five years).**Clearly states how each resource helped prepare for the interview. | Resource #1:How did this resource prepare you for the interview? |
| Resource # 2:How did this resource prepare you for the interview? |
| NR361 Interview Form.docx 9/2018 Rev. JMJ | 1 |
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