TW Bollard Child Health Excellence in Web view · 2016-02-09NOMINATION FORM. TW Bollard...
3
NOMINATION FORM TW Bollard Child Health Excellence in Clinical Practice Award This Award will be presented to a Registered Nurse who is recognised by their peers as a nurse who demonstrates excellence in clinical practice through the application of advanced nursing knowledge gained through post graduate study. Please complete ALL sections of the nomination form. Nomination forms must be submitted on or before Thursday 24 March 2016 Completed nominations should be emailed to [email protected] NOMINEE DETAILS (Their details) Full name: Current role: Service area: Email address:
Transcript of TW Bollard Child Health Excellence in Web view · 2016-02-09NOMINATION FORM. TW Bollard...
NOMINATION FORMTW Bollard Child Health Excellence in
Clinical Practice AwardThis Award will be presented to a Registered Nurse who is recognised by their peers as a nurse who demonstrates excellence in clinical practice through the application of advanced nursing knowledge gained through post graduate study.
Please complete ALL sections of the nomination form.
Nomination forms must be submitted on or before Thursday 24 March 2016
Completed nominations should be emailed to [email protected]
NOMINEE DETAILS (Their details)
Full name:
Current role:
Service area:
Email address:
NOMINATOR DETAILS (Your details)
Full name:
Service area:
Contact phone number:
Tell us why you are nominating the nurse, please include something in each of the appropriate sections.
What is the post graduate study they have completed and when
How has their learning contributed to improving local nursing practice for infants, children, young people and their family/whānau
Demonstrates advanced child health nursing knowledge in practice
Any other comments
(Maximum word count: 200 per section)
