Clinical Outcomes Information for Potential Publication

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Reducing VAP/HAP Risk Factors

Reducing Threats to Skin Integrity

Preventing Incontinence-Associated Dermatitis (IAD)

Preventing Heel Pressure Ulcers

Reducing Surgical Complications: SSI & VAP

MSDS Sheets

Clinical Outcomes Information for Potential Publication

Sage is committed to helping you present your clinical success story to your peers. Please complete this form and a representative from Sage will contact you to discuss how we can best help you. View success story examples * All fields are required
Clinician Name:
Title:
Facility Name:
Location:
GPO Affiliation:
Phone:
Email:
Facility Type:	Hospital Non-hospital (Long-term Care, Ambulatory Surgery, etc.)
Product/Process Change:	Skin Care Oral Care Incontinence Care Heel Protection Patient Preoporative Skin Preparation
Please choose which of the following best describe your outcome data collection (please check as many boxes as are applicable):		I have at least 3 consecutive months of quantifiable data related to product usage.
		I have collected data on at least 3 patients (n>3) related to product usage.
		I have collected data on 1 patient, about whom I have a very compelling story to tell.
		I have collected data sporadically and have had positive outcomes related to product usage.
		I have collected data using a Sage product and another product on the market and have shown that the Sage product yields better outcomes.
		I have recently started using Sage products and would like to begin collecting data.
Brief description of success story:
How long has the Sage product been in use?

Preferred option to celebrate:	Internal Communication (ex: hospital newsletter) Published Case Study Poster - State, local conference Poster - Other Published clinical journal

Do you have at least 3 months of quantifiable data related to product usage?	Yes No

Will you need approval from administration to participate in Sage's case study program?	Yes No

Are you planning to pursue publishing this same success story in a clinical journal?	Yes No


Other Information:

Sage Rep. Name:

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