Dialysis Nurse Satisfaction Survey Questionnaire for Yewtwist Tool in Dialysis Location:(Required) Hospital (In center unit) Outpatient Clinic (community dialysis units) HHD (Home Hemodialysis Program) 1. How often do you encounter tight connections within a week?(Required) 0 times 1 – 5 times 6 – 10 times More than 10 times 2. What is the impact of tight connections? Check all that apply(Required) Delayed or missed treatment Repetitive Strain Injury Inefficient use of resources Damaged catheter or connection Patient or nurse dissatisfaction Other3. Where did you use Yewtwist? Check all that apply(Required) Dialyzer to bloodline connection Catheter to bloodline connection Bloodline to AV fistula needle connection Removing needleless connector from CVC Peritoneal Dialysis catheter to exchange tubing Other4. How much time did you save using Yewtwist?(Required) 0 – 3 mins 3 – 5 mins 5 – 8 mins 8 – 10 mins More than 10 mins 5. Please check all answers that apply. Compared to traditional methods, Yewtwist is:(Required) Safer Faster / More Efficient Easier to use Other6. Was Yewtwist effective in loosening tight connections?(Required) Yes No 7. Would you recommend Yewtwist to other clinicians?(Required) Yes No 8. I believe Yewtwist contributes to a better patient experience(Required) Yes No 9. What is the single best thing you like about Yewtwist?(Required)10. Please provide any additional comments or suggestionsName First Last OptionalEmail Optional
