Arkansas Children's Hospital
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DAISY Award for Extraordinary Nurses PartnerDAISY Award for Extraordinary Nurses

Colleague Nomination Form

Nominations received by the 15th of the month will be considered as a nominee for the following month’s award.

I nominate , RN from as a deserving recipient of the DAISY Award. This person consistently meets all of the following criteria (review criteria and enter comments where required).

Compassionate, Quality, Family-Centered Care

Quality of Care

  • Provides high-quality, family-centered, and compassionate care while upholding the ACH safety and behavioral standards
  • Supports evidence-based practice while promoting achievement of positive patient outcomes
  • Develops and supports an environment in which high quality care is provided

Interdisciplinary Relationships

  • Promotes positive interdisciplinary relationships and views them as essential to exceptional
    patient care
  • Collaborates with health care team members and promotes a sense of mutual respect among all disciplines

Nurse as Teacher

  • Incorporates teaching into all aspects of patient care and recognizes its importance in the
    development of other nurses as well as in the provision of quality family-centered care
    Communication
  • Models excellent interpersonal skills, has a positive attitude and exhibits outstanding customer service skills
  • Encourages and values feedback

Describe how the nurse meets the above criteria:

 

Leadership

Autonomy

  • Displays independent clinical judgment within the context of an interdisciplinary approach to care and consistent with professional practice standards

Nursing Leadership

  • A leader who is knowledgeable and a risk taker who exudes the ACH mission on giving care, love and hope
  • Takes initiative and conveys a strong sense of advocacy in supporting the staff, patients and families Quality Improvement
  • Participates in the quality improvement process and perceives the process as one that is essential in improving the quality of patient care

Achievement of Departmental and Organizational Goals

  • Promotes the achievement of departmental and organizational goals in delivering excellent care
  • Abides by ACH principles and values, is in good standing, and has no disciplinary action

Describe how the nurse meets the above criteria:

 

Professionalism

Image of Nursing

  • Serves as a role model by representing the profession of nursing and upholding excellence in standards of practice
  • Demonstrates that caring and compassion are integral to providing patient care

Professional Development

  • Values personal and professional growth and development. For example, mentors/precepts fellow staff, teaches others, participates in research activities, publications and presentations, or continues formal education
  • Strives for clinical advancement and maintains clinical competency

Describe how the nurse meets the above criteria:

 

Anyone can nominate an RN for the DAISY Award.

Your Name: Credentials Unit

Relationship to Nominee:

Phone: Pager: E-Mail: Date:

 

 

 





Arkansas Children's Hospital
Arkansas Children's Hospital, 800 Marshall St., Little Rock, AR 72202-3591, (501) 364-1100 or TDD (501) 364-1184

ACH is a tobacco free campus.

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