Human Albumin Usage Survey
Please complete this survey to help us understand current practices and perspectives on human albumin use in your clinical setting.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Role/Title
*
Please Select
Physician
Nurse
Pharmacist
Administrator
Other
Department or Specialty
*
Please Select
Intensive Care Unit (ICU)
Emergency Department
Surgery
Internal Medicine
Nephrology
Other
How frequently is human albumin used in your department?
*
Daily
Weekly
Monthly
Rarely
Never
For which indications do you use human albumin? (Select all that apply)
*
Hypoalbuminemia
Sepsis/Septic Shock
Liver Cirrhosis/Ascites
Nephrotic Syndrome
Burns
Other
Please rate your agreement with the following statements about human albumin usage.
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Human albumin improves patient outcomes in my department.
1
2
3
4
5
Human albumin is used according to established guidelines.
6
7
8
9
10
Cost is a significant barrier to human albumin use.
11
12
13
14
15
Alternatives to albumin are readily available.
16
17
18
19
20
Which protocols or guidelines do you follow for human albumin administration?
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Hospital Protocols
National Guidelines
International Guidelines
No specific protocol
Other
How would you rate the safety profile of human albumin in your experience?
*
1
2
3
4
5
What alternatives to human albumin do you use most often? (Select all that apply)
Crystalloids
Synthetic Colloids
Blood Products (other than albumin)
None
Other
Please provide any additional comments or suggestions regarding human albumin use in your department.
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