Clinical Evaluation Form

Sales Force Login   Speaker Login   Distributor Locator   Contact Us

Home > Clinical Education > Reducing Threats to Skin Integrity > Clinical Evaluation Form

	Clinical Support
	Symposia Presentations Published Studies and Articles Case Studies Continuing Education Professional Guidelines
	Implementation Tools
	Pre-Trial Checklist (.doc) Implementation Plan (.doc) Clinical Practice Assessment Product Evaluation Form Customizable Protocol Performance Improvement Protocol Utilization Tool Basinless Bathing System Comparison
	Education Tools
	Importance of Bathing/Skin Monitoring (flash) Skin Check Training (flash) Training Video (flash) Training Posters
	Publish Your Results
	Submit a Success Story Start a Performance Improvement Plan Example Success Stories
	Related Organizations
	Government/Associations Publications


	Upcoming Events

Clinical Evaluation Form

To create your custom Clinical Evaluation Form, start by entering the following information:

Your Name:		Click here to print the full list of questions. Click here to print a sample of a finished form.
Facility Name:
Unit:
Sage Product #:
Comparing To:
Return Form To:

Next, check the boxes next to the questions you would like to have printed on the form. A maximum of 10 questions can be selected. When finished, click "Next Step."

I recognize the importance of routine skin cleansing and moisturizing in maintaining skin integrity, and this new bathing method better facilitates this process.

This new bathing method enables me to better meet my unit's skin care protocol.

Comfort Personal Cleansing® bath contains a generous amount of cleansing and moisturizing solution.

The Comfort Personal Cleansing® bath washcloths cleanse and moisturize the skin effectively.

My patient responded favorably to the warmth of the Comfort Personal Cleansing® bath washcloths.

The Comfort Personal Cleansing® bath's insulated package retained warmth throughout the bath.

The Comfort Personal Cleansing® bath package is convenient and easy-to-use.

The Comfort Personal Cleansing® Microwave and/or Warmer was easy-to-use and saved time in bath preparation.

I believe this new prepackaged bathing method is an important improvement in the quality of patient care at this facility.

My patients prefer the Comfort Personal Cleansing® bath over our current method of delivering bed baths.

I recommend the Comfort Personal Cleansing® bath over our current method of delivering bed baths.

The Comfort Personal Cleansing® bath's pH-balanced formula is an improvement over our current skin cleanser/soap.

I believe the Comfort Personal Cleansing® bath provides a better infection control measure than basins, laundered washcloths and tap water.

I believe the Comfort Personal Cleansing® bath's disposable washcloths are more sanitary than traditional basin baths (which reuse the same water throughout the bath).

The Comfort Personal Cleansing® bath washcloths are more skin-friendly than my current reusable (laundered) washcloths.

Comfort Personal Cleansing® bath's one-step cleansing and moisturizing washcloths enable me to use my time more efficiently.

The Comfort Personal Cleansing® bath saves time.

The Comfort Bath package reduces time and waste in gathering needed supplies to provide a bed bath.

With Comfort Personal Cleansing® bath, I decreased the amount of linens and supplies used vs. the basin bath (i.e. washcloths, towels, bed linens).

Comfort Personal Cleansing® bath's pH-balanced formula is an improvement over our current prepackaged bath product.

I prefer the Comfort Personal Cleansing® Microwave and/or Warmer over those provided for the other prepackaged bath product.

I prefer the Comfort Personal Cleansing® bath over our current prepackaged bath product.

I recognize the importance of routine skin monitoring, and this new communication tool (I-See-Red Skin Check Guide) better facilitates this process.

The I-See-Red Skin Check Guide is easy to use and understand.

The I-See-Red Skin Check Guide is an effective communication tool between the caregiver and nurse.

This new communication tool (I-See-Red Skin Check Guide) enables me to better meet my units reporting protocol.

The I-See-Red Skin Check Guide is a useful reminder of the importance of routine skin monitoring.

I believe this communication tool (I-See-Red Skin Check Guide) is an important improvement in the quality of patient care at this facility.

Deodorant Bath with Exopheryl Odor Eliminator effectively addresses patient body odor.

This area of our website and its content is intended for healthcare professionals only.