BAPTIST MEDICAL CENTER EAST Name* First Last Date* MM DD YYYY Facility*Department*Were you in-serviced?*YESNOHave you used Shower Shield on a patient?*YESNOWas Shower Shield easy to apply and remove?*YESNOINDIFFERENTDid the Shower Shield keep the dressing dry during showering or sponge bathing?*YESNOINDIFFERENTIs Shower Shield more effective than the current practice?*YESNOINDIFFERENTWill Shower Shield save time and promote hygiene?*YESNOINDIFFERENTOverall, would you recommend the use of Shower Shield?*YESNOINDIFFERENTWas the patient satisfied with Shower Shield?*YESNOINDIFFERENTWould you like Shower Shield to be available in your hospital?*YESNOINDIFFERENTPlease Review Your Usage of Shower Shield.*YesNoIndifferentWere you in-serviced?Did Shower Shield keep the patient dry?Did the patient like Shower Shield?Will you use Shower Shield?Fifth rowAdditional CommentsPhoneThis field is for validation purposes and should be left unchanged.