Patient satisfaction questionnaire (old)

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Thank you for requesting our services. Please be kind enough to answer our questionnaire by ticking the option that best describes your situation. This survey is anonymous.

From your answers we will try to be as close as possible to your grievances.

    Your quality:
    1. Socio-demographic elements

    (tick the situation that applies to you)

    D1. The sex
    D2. Age
    D3. The environment of origin
    D4. Last school completed
    2. Section
    Day hospitalization (specialty)
    Outpatient (specialty)
    3. Upon admission, you were accompanied to the ward by:
    4. During hospitalization, for travel through the hospital, you were accompanied by designated medical personnel:
    5. Upon admission, you as a patient were informed about:
    5.1. your rights and obligations
    5.2. rules of conduct
    5.3. personal hygiene rules
    5.4. the way to submit suggestions and complaints
    5.5. providing spiritual assistance according to the patient's confession
    6. Did you receive explanations on your understanding of the therapeutic plan established by the attending physician?
    7. Did you receive explanations on your understanding of the care plan?
    8. Did you receive information from the attending physician, on your understanding, about the risks of the prescribed medication and/or the risks of drug combinations?
    9. Do you know an adverse effect or risk for the drugs or therapeutic procedures administered?
    If so, please elaborate in a few words (optional):
    10. Were you informed about the established diagnosis?
    11. Have you been warned by the medical staff about the risk of falling?
    12. Do you know the identity of the medical personnel involved in administering your treatment?
    13. Do the medical staff use disposable gloves for every contact with the patient?
    14. Did you buy medicines or other medical materials during hospitalization?
    15. How did you end up admitted to our hospital (select one of the answer options):
    16. Have you recently been hospitalized in another health facility where you performed microbial treatments?
    17. Rate on a scale from 1 (totally unsatisfactory) to 3 (very good) the quality of services received in our hospital:
    17.1. The attitude of the reception staff
    17.2. The attitude of the staff during your stay in the facility
    17.3. The care given by the doctor
    17.4. Care provided by nurses
    17.5. Nursing care
    17.6. Quality of food and delivery service (as applicable)
    17.7. The appearance of hospital linen and effects
    17.8. The hospital environment (waiting rooms, silence, overall cleanliness)
    17.9. Quality of accommodation-salon conditions (equipment, facilities)
    17.10. The quality of sanitary groups
    18. Do you think that the patient's rights were respected during the hospitalization?
    19. Your consent has been requested regarding the collection, processing and storage of personal data, according to the General Regulation for the protection of personal data no. 679/2016?

    Thank you for collaboration!