APPROACH Forms

This web site contains examples of forms used by nurses and unit clerks who do the majority of the data collection for the database (APPROACH users). These forms show the level of detail of the data collected into the database.

There are also forms provided to researchers and administrators interested in receiving APPROACH data for the purposes of quality assurance or research.

The following forms for use with APPROACH are available for download:

Access Request Form

The Access Request Form allows participating hospitals to request new user accounts.

Access Request Form

Sign On Agreement Form

APPROACH recognizes and supports a patient’s right to privacy in relation to his/her health information. All staff are expected to treat patient information as confidential. Staff are to adhere to the privacy and security guidelines outlined at their site and as outlined in the APPROACH Confidentiality Policy.

It is the policy of APPROACH that patient health information contained in the APPROACH database is to be accessed and/or used only by those personnel authorized to do so.


Sign On Agreement Form

Data Entry Templates

Forms for APPROACH Users - The following are examples of forms used by nurses and unit clerks at participating Alberta hospitals as they collect information that is used in the APPROACH database:

Admissions - At participating hospitals, APPROACH collects data when a patient has been admitted with a cardiac emergency.

Catheterization - APPROACH collects clinical and demographic information for each patient undergoing cardiac catheterization.

Percutaneous Coronary Intervention (PCI) - APPROACH collects data anytime a patient undergoes percutaneous coronary intervention (also known as angioplasty).

Coronary Artery Bypass Graft (CABG) - APPROACH collects data anytime a patient undergoes coronary artery bypass graft (CABG) surgery (also known as bypass surgery).

Patient Questionnaire - Patients coming to the catheterization laboratory or admitted to a participating CCU/ICU are asked if they will allow APPROACH researchers to contact them with a follow-up quality-of-life questionnaire at 1, 3 and 5 years intervals.
Data Form

 

Data Request Form

Reseachers and administrators may request access to APPROACH data using the data request form.
Data Request Form

Consent Form

Patients coming to the catheterization laboratory or admitted to a participating CCU/ICU are asked if they will allow APPROACH researchers to contact them with a follow-up quality-of-life questionnaire at 1, 3 and 5 years intervals. If they are willing to be sent a questionnaire, they sign a consent form.
Consent Form


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