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2015 ACNP
Award for
Quality Use
of Medicines
in Pain
Management
Have you made a difference to people with
persistent pain through the quality use of
medicines?
We want to hear from you!
The award recipient
will receive a one year
membership, and
registration, travel
and accommodation
to attend ACNP
2015 Conference in
Melbourne!
In collaboration with Mundipharma Pty Ltd, ACNP will be recognising
a Nurse Practitioner/Advanced Practice Nurse who is working
effectively with patients/consumers with moderate or severe
pain to optimise their health and wellbeing in the quality use of
medicines.
Please identify the strategies you have implemented which have made a
difference (or been effective), and how these were measured in each patient,
to contribute to achieving better outcomes .
Nominations for the award can be made by anyone interested in QUM and
Pain Management.
Application form is overleaf or to download an application form please visit:
http://acnp.org.au/scholarships
Any enquiries please call Amal Helou (02) 9515 9739.
This award has been supported
by an educational grant from
Mundipharma Pty Ltd
2015 ACNP Award for Quality Use of Medicines
in Pain Management
APPLICATION FORM
Please complete and return this form by 6 July 2015 to:
Jenny Pierson
Secretariat, ACNP
PO Box 637, North Sydney NSW 2059
Email: secretariat@acnp.org.au
Fax: 02 9954 0666
This award is to recognise a Nurse Practitioner/Advanced Practice
Nurse who is working effectively with patients/consumers with
moderate or severe pain to optimise their health and wellbeing in
the quality use of medicines.
Please identify the strategies you have implemented which have
made a difference (or been effective), and how these were
measured in each patient.
Any enquiries please call Amal Helou (02) 9515 9739.
The award recipient will receive a one year membership of the ACNP,
registration, travel and accommodation to attend the 2015 ACNP
Conference in Melbourne.
ACNP will use the information in this application form to determine
the award recipient and will handle all material in accordance with
ACNP policy.
The ACNP Award for QUM in Pain Management has been supported
by an educational grant from Mundipharma Pty Ltd.
APPLICANT DETAILS
Date of application
Applicant name
Postal address
Workplace name
Email
Phone
Submission should be completed under the following headings:
Title of project
• An introduction or background explanation of the evaluated activity
• An aim to indicate what was being measured
• How the evaluation was undertaken (clearly defined methods)
• Who was evaluated (program, clients, service)
• What tools were used? Were they validated tools? How were they validated?
• Results which must reflect the aim
• A conclusion or recommendation that is related to the aim and the results
The total submission should not exceed 2 A4 pages. Typed in Arial 11point with a 2cm margin all around.
The winner will be required to submit an article for the ACNP newsletter and the prize will be presented at the ACNP Annual conference.
DECLARATION
I declare that, to the best of my knowledge, the information contained within my application is a true reflection of my practice.
Signature:
Date: