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STAR Awards 2021
Kerri Cardin
2020-11-03T12:26:02-07:00
Southwest Colorado AHEC STAR Awards 2021
To nominate a novice or expert nurse.
Date of Nomination
MM slash DD slash YYYY
Name of nurse being nominated for STAR Award
First
Last
Nominee's Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Réunion
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Nominee's Phone
Nominee's Email
Name of Nominator
First
Last
Nominator's Phone
Nominator's Email
How many years has the nominee been practicing as a nurse?
*
1-9 years
10 or more years
Does the nominee possess an unemcumbered Colorado Nurse's License?
*
Yes
No
The nominee must work in the SW Colorado AHEC region. In which county does the nominee work?
*
Archuleta
Dolores
Hinsdale
La Plata
Montezuma
Ouray
San Juan
San Miguel
Please answer the following 5 questions that demonstrate how the nominee meets the stated Competencies. Give 2-3 SPECIFIC EXAMPLES for each question.
1. How does the nominee demonstrate caring and critical thinking skills to assist the patient/family/group to identify and meet basic health needs?
1.1 How does the nurse coordinate cost-effective quality care using a culturally competent, collaborative and interdisciplinary approach?
2. How does the nominee provide individual/family/group or population-based education to promote, maintain, and restore health from birth through death?
2.1 Does the nurse promote a caring environment, provide culturally appropriate learning activities, and effectively utilize resources and current technology?
3. Does the nominee demonstrate leadership qualities by working well with others to promote: quality of patient care; awareness of costs of care; patient satisfaction?
3.1 How does the nominee demonstrate the ability to coordinate care for individuals or groups by effectively using technology, resources, information, and other systems?
4. Is the nominee accountable for the ethical, legal, and professional responsibilities related to nursing practice?
5. Does the nominee promote a climate in which patients/families/groups may act in their own interest, including accessing available resources, and intervene when they are unable to act in their own interest?
*An additional 1-2 points will be given if the nurse's practice demonstrates the ability to overcome barriers associated with medically underserved and/or rural/frontier populations. Please give very specific examples:
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