Informed Consent

Informed Consent
OUR LADY OF FATIMA

UNIVERSITY CABANATUAN
CAMPUS COLLEGE OF
NURSING
Km. 311, Maharlika Highway, 3100 Cabanatuan City, Nueva Ecija
Consent Form
Exploring Effective Strategies to Improve Patient Safety in Nursing Practice
Principal Investigator: Pee Jay A. Pestaño

Members:
Pauline B. Corbadura
Ethel Joyce F. Mandia
Marsha Ellaine M. Pascual
Mark Allan C. Santiago
Alliana Denice Vicencio
Faculty Advisor: Ma’am Melody M. Gatdula, RN, RM, MAN, LPT
PART I: Information Sheet
Invitation to Participate in a Research Study

A pleasant day! We are third-year students of Our Lady of Fatima University -
Cabanatuan Campus under the Bachelor of Science in Nursing program. We are currently
working on our research paper entitled, EXPLORING EFFECTIVE STRATEGIES TO
IMPROVE PATIENT SAFETY IN NURSING PRACTICE. With the aims of: (1) To identify
risks and harm, nurses must learn skills in patient evaluation, care planning, observing, assistance,
verifying, and communication with other healthcare professionals. (2) In order to prevent practice
errors and create safer, more sustainable healthcare systems, nurses must commit to patient safety
principles in addition to those of clear policies, leadership, research-driven safety initiatives, staff
development, and patient involvement.
With that, we humbly invite you to participate in the study as a respondent. It is entirely
voluntary for you to take part in this study. If you agree to participate, kindly complete the
questionnaire as honestly and as completely as possible. All answers obtained from you will be kept
anonymous and confidential. The information gathered for this study will remain private and will
only be shared as a whole. Your answers to the questionnaire are confidential and will only be
known by the research team. Answering the questionnaire will only be needing a one-time time
commitment of five from you.
Description of Subject Involvement

You must fulfill the following criteria in order to participate in this study: (a) Student nurses;
(b) Currently on their clinical duty; (c) Must be 19 years old to 23 years old of age; (d) 2nd year to
4th year level. There will only be one visit, lasting for about five minutes, as part of your participation.
Procedure of the Study

The adapted questionnaire consists of Three distinct sections covering a total of 20
questions. A letter of request to conduct this study will be prepared by the researchers alongside a
well- constructed survey questionnaire that will be proposed and needs to be approved and
validated. The questionnaire is composed of questions that will enable the researchers to meet the
desired outcome of the study. The said data collection material is a three-part questionnaire. The
First part of the research questionnaire will collect the biographical data of the respondent. The
remaining part will consist of 10 questions with the total of 20 questions. The Likert scale will also
be utilized to enable a more effective approach in collecting the data needed for this study.
Answering the questionnaire will only require a one-time time commitment of five minutes from
you.
Potential Risks and Discomforts

In this section include any potential risk or discomforts, and how those risks will be
addressed if they arise (call 911, refer to health clinic, etc.). If you believe there are no risks
involved, since there is never a guarantee, state that there are “no known risks”.
Potential Benefits
As we, the research team, aims to comprehend the experiences of undergraduate nursing
students in utilizing peer support following clinically significant incidents. In addition, this study
can be beneficial for future applications.
Reimbursements
You will receive one multicolored pen as our token of appreciation for participating in this
study.
Confidentiality
The security of the data collected in hard copy survey questionnaires will be observed as
they will be stored in an envelope that only the research team may access. Electronic versions of the
collected data will be kept in a password-protected account, and will only be accessible by the
research team. Every piece of data obtained from the questionnaire would be handled privately and
exclusively, and will only be used for the completion of the study.
Right to Refuse or Withdraw

If you wish not to participate in this study, you are free to do so without obligation. Your
refusal or withdrawal will not have any impact on your standing within your organization or the
community. We will allow you to examine your responses once again after accomplishing the
survey questionnaire. If you disagree with our interpretation, or our interpretation of your answer is
incorrect, you have the right to remove or modify them.
Contact Information
For any questions and/ or concerns, you may right away us, or you may contact the
principal investigator of this study: Pee Jay A. Pestaño, 09704997235, Bonifacio St. Brgy.
Bonifacio, San Leonardo, Nueva Ecija, papestano1@student.fatima.edu.ph

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OUR LADY OF FATIMA

Exploring Effective Strategies to Improve Patient Safety in Nursing Practice

Principal Investigator: Pee Jay A. Pestaño

Ethel Joyce F. Mandia

Marsha Ellaine M. Pascual

Mark Allan C. Santiago

Alliana Denice Vicencio

Faculty Advisor: Ma’am Melody M. Gatdula, RN, RM, MAN, LPT

PART I: Information Sheet

Invitation to Participate in a Research Study

Description of Subject Involvement

Procedure of the Study

Potential Risks and Discomforts

Right to Refuse or Withdraw

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