Nursing Innovation Award nomination form
 
This award recognises an individual nurse or team who have implemented new projects or processes that have resulted in a real difference to patient care, improvements in service delivery or have utilised technology to deliver excellent care.

1. Nominee's name (the one you are putting forward for the award, include all names if nominating more than one person): *

 

2. Job title(s) and base location(s) of the nominee(s): *

 

3. Contact phone number(s) of the nominee(s) (mobile preferred otherwise, landline): *

 

4. Email address(es) of the nominee(s): *

 

5. Your name: *

 

6. Your contact number (mobile preferred, otherwise, landline): *

 

7. Your email address: *

 

8. In more detail, describe why this team or individual should win the Nursing Innovation Award (400 words max):

Prompts:
1. Provide specific examples of how this person or team goes above and beyond the daily tasks required for their role.
2. Who do they impact? Does their behaviour have a positive influence on the team and/or the wider organisation?
3. Why is this person or team deserving of this award? *

Powered by SmartSurvey