Daisy Nomination Form | AdventHealth

DAISY Award honorees personify AdventHealth's remarkable patient experience. Following the philosophy of CREATION, designed to help individuals achieve maximum health and wellness, these nurses consistently demonstrate excellence through their clinical expertise and extraordinary compassionate care. Seeking to positively influence all aspects of the patient's life — mind, body and spirit. They are also recognized as outstanding role models in our nursing community.

About the DAISY Foundation

The DAISY Foundation was established in 2000 by the family of J. Patrick Barnes who died of complications of the auto-immune disease Idiopathic Thrombocytopenia Purpura (ITP) at the age of 33. (DAISY is an acronym for disease attacking the immune systems.) During Pat's 8-week hospitalization, his family was awestruck by the care and compassion his nurses provided not only to Pat, but to everyone in his family. One of the goals they set in creating a Foundation in Pat's memory was to recognize extraordinary nurses, teams, and leaders everywhere who make an enormous difference in the lives of so many people by the super-human work they do every

First name of the nurse you are nominating:*

If nominating multiple nurses, please list each name separated by a comma – e.g. Jane, Joe

Last name of the nurse you are nominating:

Nominee's Department/Unit/Clinic *

Which location does your Nominee work?*

What is your relationship to the staff member?

If Other, please answer below:

Are you an employee of AdventHealth?*

Yes No

First Name*

Last Name*

Email*

Phone*

Criteria

Love Me	Demonstrates uncommon compassion through the delivery of whole-person care. Demonstrates a passion for the nursing profession.
Make It Easy	Provides patient and family centered care. Includes patients/families in the planning of their care and advocates on their behalf to meet the patient/family goals.
Keep Me Safe	Demonstrates a commitment to patient safety and excellent critical thinking skills. Develops trust and fosters collaboration.
Own It	Went above and beyond. Demonstrates selflessness. Follows through on commitments.

Please describe a specific situation or story that clearly demonstrates this nurse exceptional care. Only nominations that meet criteria will make it to the scoring/voting committee. Note: If using a mobile device to enter this E-nomination you can easily enter your story by selecting the microphone button on your device and dictating your story instead of typing.*

150 characters minimum in order for the nominee to be considered, please be detailed as possible.

Date of Nomination*

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