Bioviglance Component / Hemovigilance Module

Webinar/In-person Instructor Led Training Policy and Request Form

NHSN is committed to the training and education of its users. Because NHSN staff receives more requests for training than can be accommodated, the following policy and procedures have been established to assist in responding more equitably and effectively.

Please read the NHSN Training Policy before you submit the training request form.

II. Policy

1. Requests for instructor-led Hemovigilance Module training must be made a minimum of 3 months prior to the training date.
2. Priority will be given to training sessions aimed at NHSN users and potential users.
3. NHSN will provide training on the topics shown in the attached list as outlined in the course descriptions.
4. In-person trainings will not be offered to fewer than 50 participants.
5. Airfare, lodging, meals, and ground transportation in destination city must be provided in-kind by the requesting organization(s).
6. Webinar trainings will not be offered to fewer than 20 participants.
7. Webinar service and related webcast costs must be provided by the requesting organization.
8. All accepted webinar trainings will be posted on the NHSN website training calendar so that any NHSN user or potential user may have an opportunity to register and attend the webinar training sessions offered.
9. Hands-on, interactive computer training will be limited to national conferences or CDC-sponsored trainings only.

III. Procedures

1. Complete a Request for Hemovigilance Module Training form and submit it to the NHSN training mailbox. Please keep a copy of the request and applicable course description(s) for your reference.
2. The training request will be processed within 2 weeks of submission. A written response will be provided to the point of contact on the Hemovigilance Module Training Request Form.

Training Request Form

Organization(s) sponsoring the training (List all):

Point of contact for training request

Name

Address

Phone

E-mail

Which topic(s) will be covered during the training?

Click on the course title for information on pre-requisites, resource materials, and related course materials

Introduction to the Hemovigilance Module
Adverse Reaction coding and data entry
Incident coding and data entry
Introduction to analysis and reporting
Other (please specify)

Total time available for speaker to deliver requested topics: Select one ... ------------------- 60 minutes 90 minutes 2 Hours 3 Hours 4 Hours

Proposed training method: Webinar In-person

Proposed training date:

Alternate training date:

Proposed training location (for in-person training)

Number of people expected to attend (Approx.; must be >50)

Intended audience (Check all that apply)

Transfusion Services Staff
Data Entry Staff
Transfusion Safety Officers
Hospital Epidemiologists
State Health Department Personnel

Clinicians
Quality Specialist
Hospital/Institution Leadership
Blood Collection Center Staff
Other, specify

I have read and understand that the requesting organization(s) will be responsible for the webinar service and any related costs for providing the webinar.
Yes No NA

The requesting organization is willing to publicly post the webinar training for other NHSN users or potential users to access.
Yes No NA

I have read and understand that the requesting organization(s) will provide airfare, lodging, meals, and ground transportation in destination city in-kind, and that the organization may not use federal money to pay for these expenses.
Yes No NA

Other comments:

Thank You!