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C3Q-safety (The Critical Care Nursing Competence Questionnaire for Patient

Safety).v2

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Masatoshi Okumura
Aichi Medical University
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 The Critical Care Nursing Competence Questionnaire for Patient Safety

C3Q-safety v2.0
PLoS One. 2019 Nov 27;14(11) [PMID:31774872]

INSTRUCTION: Please read following statement carefully. Objectively evaluate your actions at ICU.
For each statement, circle one number from 1 to 5.

About
Never Seldom Half the Usually Always
Time
Before a patient enters the ICU, you have prepared the items 1 2 3 4 5
1
needed for the patient care.
You begin patient monitoring within 3 minutes of the patient arriving 1 2 3 4 5
2
at the ICU.
You begin physical examination within 5 minutes of the patient 1 2 3 4 5
3
arriving at the ICU.
4 You execute the doctor’s orders on time (within 5 minutes). 1 2 3 4 5
You conduct a physical assessment using the ABC (Airway,
5 1 2 3 4 5
Breathing, Circulation) approach.
When you notice abnormal vital sign or specific physical findings, 1 2 3 4 5
6
you tell a doctor or other nurses.
You prioritize a monitoring and an execution of doctor’s orders 1 2 3 4 5
7
according to the patient's condition.
8 You frequently communicate with co-worker ICU nurses. 1 2 3 4 5
You frequently communicate with other medical staff (e.g. 1 2 3 4 5
9
pharmacist, physical therapist, clinical engineering technician).
10 You share your anxiety with others. 1 2 3 4 5
11 You repeat aloud to oral instructions. 1 2 3 4 5

12 You can recognize your role and be acting accordingly. 1 2 3 4 5

13 You can fulfill your role. 1 2 3 4 5

14 You clean up the finished medicines and the lines. 1 2 3 4 5

15 You respond flexibly to the changed order. 1 2 3 4 5

16 After finishing your role, you find a new role by yourself. 1 2 3 4 5

17 You solve a question in clinical practice. 1 2 3 4 5

18 You take thoughtful care of patients (e.g. smile, touching). 1 2 3 4 5
19 You value the information that patient says. 1 2 3 4 5
You actively provide patients with nursing that leads to patient
20 1 2 3 4 5
recovery.
21 You listen attentively to the patient's family anxiety. 1 2 3 4 5
22 You provide nursing equally to all patients. 1 2 3 4 5

Note: You do not need to obtain the author's permission to use this questionnaire.

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