Multipurpose Tube Holder Product Evaluation

We value your opinion

We appreciate your input on the Dale Multipurpose Tube Holder.

Please answer the following questions:

150 | Multipurpose Holder Evaluation Form

What do you normally use to secure this tube?

Compared to your current method indicated above, please tell us how the Dale Hold-n-Place Multipurpose Tube Holder compares in the following areas:

	Better	Same	Worse
Securement tab/locking mechanism
Adhesive base
Overall ability to hold tubing securely in place
Ability to reposition or advance tubing without having to change the Hold-n-Place Multipurpose Tube Holder
Patient Comfort
Ease of application
Ease of removal

How long was the product worn before it was replaced or removed?

Why was the product replaced or removed?

Fell off

Tube was removed

Protocol

Other

If it was protocol please explain:

Was the Hold-n-Place Multipurpose Tube Holder an appropriate size?

Too small

Just the right size

Too large

Would you support the use of the Hold-n-Place Multipurpose Tube Holder for this facility?

Yes

Please cite any additional comments you may have:

Salutation

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