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SecurAcath®
easymoov6
All Products
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CVCs
Paediatric Central Venous Catheters
Multicath Highflow UP
Multicath Forward Central Venous Catheter
Insertion Kits
Multilumen / Adult Central Venous Catheters
Arterial
Intravascular Therapies
SecurAcath®
Ports
Oncology
Peripheral Vascular Access
Vascular Access
Hubers
Accufuser®
Midlines
PICCs
Obstetrics, Neonatology & Enteral
easymoov6
MIC-KEY
Enteral Products
Neonatology and Paediatrics
Neohelp™
Surfcath™
Nutriline®
Nutrisafe2
Pain & Airway Management
NRFit™ Epidural Mini-kits
Anaesthesia
Epidural Needles & Packs
Plexus & Nerve Blocks
Standard Basic Universal Tray Set
Emergency
Respiratory
Neurafit™ NRFit Spinal Needles
Other Products
Surgery Products
Custom Packs
Support & Education
Campus Vygon
Neonatal Enteral Feeding
Blended Diet Resources
Intravascular Therapies Hub
NRFit Connectors & Devices
Critical Care Hub
Study Days
In-service Training
Gastrostomies Resources
News
Events
Gastrostomy Study Day October – Manchester
About Vygon
About Us
About Vygon
Our Philosophy
History
Meet the Team
Quality Assurance
Business Responsibility
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Value Life
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Contact Us
home
/ Forms
/ SecurAcath® Evaluation Form
V01721 - SecurAcath Evaluation Form v1
V01721 - SecurAcath Evaluation Form v1
Name
*
Hospital
*
Department
*
Email Address
*
Did you receive any training on the device?
*
Yes
No
Ease of insertion:
*
Easy
Neutral
Difficult
Stability of SecurAcath
*
Stable
Neutral
Unstable
Incidences of dislodgement
*
None
Rare
Occasional
Frequent
Condition of skin around the insertion site
*
Good
Fair
Poor
Any signs of infection or irritation?
*
Yes
No
Unsure
Ease of routine care and maintenance
*
Easy
Neutral
Difficult
Frequency of dressing changes
*
Daily
Every 2-3 days
Weekly
Other (specify)
Other (specify)
Removal process
*
Easy
Neutral
Difficult
Patient’s comfort during removal
*
Comfortable
Neutral
Uncomfortable
Overall satisfaction with SecurAcath
*
Satisfied
Neutral
Dissatisfied
Likelihood of recommending SecurAcath to colleagues
*
Likely
Neutral
Unlikely
Would you continue to use this device in your current practice?
*
Yes
No
Unsure
Additional comments:
We would very much appreciate your consent, so that in the event that we decide to use your evaluation, or part of your evaluation, accompanied with your name, job title and place of work for marketing purposes we are able to do so. You can withdraw your consent at any time by contacting us at Vygon@vygon.co.uk. If you are happy to consent to the use of your data as described above please tick the “yes” option. Our privacy notice can be found in the following location
vygon.co.uk/privacy-notice/
*
Yes, I’m happy for my personal information to be used
No, I do not want my personal information to be used
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