Hello Clinical Nurse,
We are doing a research study about pediatric cardiac intensive care nurse education and training. As a nurse working with critically ill children with congenital or acquired heart disease, we would like you to participate in this study.
If you choose to be in the study, you will complete an online survey. It will take about 5-30 minutes to complete.
You can skip questions that you do not want to answer or stop the survey at any time. The survey is anonymous, and no one will be able to link your answers back to you. Please do not include your name or other information that could be used to identify you in the survey responses.
Please contact Rebecca Silvers or me with questions about this study. If you have questions or concerns about your rights as a research participant, you can call the UCSF Institutional Review Board at 415-476-1814.
Being in this study is optional. If you want to participate, read the consent below and click on the “I consent” button.
Dr. Sandra Staveski,
UCSF School of Nursing
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
NOTICE / INFORMED CONSENT ADDENDUM FOR USE OF STUDY DATA (EUROPEAN UNION (EU) /EUROPEAN ECONOMIC AREA (EEA))
Global Critical Care Study
Rebecca Silvers DNP, CPNP-AC, CCRN, RNFA Volunteer Assistant Professor Department of Family Health Care Nursing
Sandra Staveski PhD, CPNP-AC Associate Professor Department of Family Health Care Nursing
This research will collect data about you that can identify you, referred to as Study Data. The General Data Protection Regulation (“GDPR”) requires researchers to provide this Notice / Consent to you when we collect and use Study Data about people who are located in a State that belongs to the European Union or in the European Economic Area.
We will obtain and create Study Data directly from you so we can properly conduct this research. As we conduct research procedures with your Study Data, new Study Data may be created.
The Research Team will collect and use the following types of Study Data for this research:
• • Your racial or ethnic origin
• • Your education backgrounds
• • Your work history (years of practice, location of practice)
The following categories of individuals may receive Study Data collected or created about you:
o • Members of the research team so they properly conduct the research
o • Other researchers, including researchers in other countries, so they can conduct
additional research on pediatric cardiac intensive care nursing training
The data you input on the online your Study Data will be held at the research site in the United States. The United States does not have the same laws to protect your Study Data as States in the EU/EEA. However, the research team is committed to protecting the confidentiality of your Study Data. Additional information about the protections we will use is included in the consent document.
The Regents of the University of California, on behalf of UC San Francisco, is responsible for the use of your Study Data for this research. You can contact the UC San Francisco Principal Investigator by phone at: 510-428-3319 or by email at firstname.lastname@example.org if you have:
• • Questions about this Notice
• • Complaints about the use of your Study Data
• • If you want to make a request relating to the rights listed above.
PARTICIPATION IN RESEARCH IS VOLUNTARY. You have the right to decline to participate or to withdraw at any point in this study without penalty or loss of benefits to which you are otherwise entitled.
If you wish to participate in this study, you should click the QR code. Thank you!