wayground logo

Free Printable Worksheets

Font size

S
M
L
XL
Worksheets

Practice survey

Total questions: 5

Worksheet time: 3mins

Name
Class
Date
1.

In the last 12 months, have you had any formal training in palliative care/end of life care?

a)

Yes

b)

NO

c)

N/A

2.

In the last 12 months have you done any advanced care plan with a palliative care patient?

a)

Yes

b)

No

c)

N/A

3.

In the last 12 months have you sent a summary of a patient's advanced care plan to the OOH team? 

a)

Yes

b)

No

c)

N/A

4.

Do you feel confident in assessing if a patient maybe in their last 1-2 years of life and hence suitable for palliative care management?

a)

Yes

b)

No

c)

N/A

5.

Do you feel confident in having conversations about end of life care with patients and their carers/relatives? 

a)

Yes

b)

No

c)

N/A