Research and Evidence-Based Practice Program
Appendix D
Nursing Research Project Biannual Updates
UCLA Health
Department of Nursing Research and Education
Study Title:
Principal Investigator
Principal Investigator Credentials
E-mail
Date
-
Month
-
Day
Year
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Patient Population
Unit(s):
Is this a multi-site study?
Please Select
Yes
No
If yes, where?
Study Scope
Please Select
Internal to a Single Organization
Multiple Organizations within a System
Independent Organizations Collaboratively
Study Type(s)
Replication
Qualitative
Quantitative
IRB Approval Date
Pending
Other
Please list all research team members and their role (e.g., research assistant, data collector, etc.):
Name
Role
Name
Role
Name
Role
Name
Role
Name
Role
Name
Role
Name
Role
Name
Role
Role(s) of Nurse(s) in the study
*
Subjects
Consultants
Data collectors
Investigators
Other
Data Analysis:
Initiated
In progress
Completed
1) What work has been completed on the project? (Complete/check all that apply):
Subject Enrollment
Not started
In progress
Completed
Data Collection
Not started
In progress
Completed
Data Analysis
Not started
<=25%
<=50
<=75%
>75% to <100%
Completed
Report/Abstract
Not started
In progress
Completed
Presented
Submitted for publication
Please use this space to clarify above, if applicable:
2) Barriers or issues related to the conduct of this study (please describe):
3) Provide an approximate completion date for your project:
-
Month
-
Day
Year
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4) List any project-related presentations completed to date, since the last update:
None at this time
Yes (complete information below)
Title
Venue (conference or other)
Date
-
Month
-
Day
Year
Date
Type of Presentation
Please Select
Oral abstracts
Poster presentation
Other (e.g. invited speaker)
Title
Venue (conference or other)
Date
-
Month
-
Day
Year
Date
Type of Presentation
Please Select
Oral abstracts
Poster presentation
Other (e.g. invited speaker)
Title
Venue (conference or other)
Date
-
Month
-
Day
Year
Date
Type of Presentation
Please Select
Oral abstracts
Poster presentation
Other (e.g. invited speaker)
5) List any project related publications completed to date (include copies with report submission)
None at this time
Yes
Title
Journal
Status
Please Select
Submitted
In review
In press
Published
Title
Journal
Status
Please Select
Submitted
In review
In press
Published
Title
Journal
Status
Please Select
Submitted
In review
In press
Published
Attach presentation(s) and publication(s) here
Select File(s)
Cancel
of
6) Projected date for presentation of results to Department of Nursing:
-
Month
-
Day
Year
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7) Comments (optional)
Please send by clicking "Submit" below. If you are having difficulty including attachments using above submission link, please email or mail to:
Pamela Miller, PhD, RN, ACNP, CNS
psmiller@mednet.ucla.edu
and
Karyn Greenstone
kgreenstone@mednet.ucla.edu
UCLA Health
Department of Nursing Research and Education
10920 Wilshire Blvd., Suite 1030
Los Angeles, CA 90095
MC: 732846
Dedicated to Bridging Research and Practice
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