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Patient Care Feedback Form👋

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Date of Birth

Which ward or room are you in?

How well do you like your room in terms of cleanliness, amenities and organization? On a scale of 1-5? Tick as appropriate

On admission, on a scale of 1-5, how well where you received by the nurse?

Were you treated with Respect, Kindness and Compassion by the nurses caring for you?

Were your medications on time, and well explained by the nurse at all times?

Throughout your stay in the hospital, can you mention a nurses name that was outstanding in services rendered Nurse

Do you feel well informed and involved enough in decisions about your care and treatment by the doctors

How will you rate the food and services from the kitchen?

Do you feel members of staff or team displayed a good attitude towards you while on admission or to your relative?

Was your discharge from hospital well organised and executed, ranging from Efficient explanation to Bills by a billing officer to Take Home Drugs and Health Education by the nurse?

Please suggest ways you think we can improve on our services rendered?

Would you recommend this hospital to your friends and family?

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