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214 797-0345

DYNAMIC, VIRTUAL ORGANIZATION THAT PROVIDES ONLINE OPPORTUNITIES FOR BUSY PERIOPERATIVE NURSES
TO REMAIN FULLY INVOLVED IN INFORMATION, EDUCATION, NETWORKING AND OTHER PROFESSIONAL ACTIVITIES

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eChapter Evidence Based Practice Grant Application

Funding application is open August 1 - January 31

Note: Funds for (1) eChapter EBP or Research grant are limited to $1500.00 are available to eChapter members ONLY. Please see the eChapter website for rules and restrictions before applying.

Date of Application *

Name *

First Name

Last Name

Email *

Preferred Phone *

(###)

###

####

Contact Information for other participants

Select All That Apply *

AORN Member

eChapter Member

I have received funding from another source*

I have pursued professional development ** opportunities

* I have received funding from

*In the amount of

**Outline your involvement with Professional Development *

Evidence of professional development activities: Transcripts/certificates reflecting continuing education either academically or professionally; participation in professional organizations; evidence of attending perioperative conferences; demonstration of professional certification(s); articles published; posters or presentation detail etc.

Amount of funding requested

NOTE that there is a 500 limit per study/project

Is this a group proposal *

Yes***

*** If yes, provide names and contact information for each person

Study/Project is associated with a Dissertation/Thesis/Course project? *

Yes

Human Subjects/Institutional Review Board Approval *

Will your research/project require approval by the Human Subjects Review/IRB before data collection begins?

Yes

No - it is exempt (confirmed by an IRB)

Not yet determined

Title of EBP Project *

Project Description *

Describe the project in 1-3 single spaced pages with appropriate citations a statement of the problem being investigated, the significance to perioperative nursing, the question(s) being asked, a synthesis of the literature supporting the project, design methodology to be employed including aims, data collection methods, sample selection including size, and data management, anticipated outcomes and method(s) for measuring, and reasons funding is necessary

Statement of Understanding *

I will follow the guidelines stated here

I have read, understood, and followed the eEBP Project Grant guidelines

My EBP project proposal contains a detailed budget with quotes.

My proposal contains references to previous work in the field.

My proposal contains a clearly stated question and design.

I will present my results to eChapter BOD, Research Committee and membership and submit an AORN Expo poster/presentation/AORN journal article proposal.

I agree to participate in periodic eChapter Research Committee reviews of the EBP project.

I will submit a copy of receipts demonstrating funding usage within 1 week of project completion.

Signature *

Date *

Thank you!