TriService Nursing Research Program (TSNRP) Grant Application Summary 1. Title of Grant Application (no more than 81 characters, including spaces): 2. Principal Investigator (PI) Branch of Service and Component Army: Active Duty Reserve Guard Retired Navy: Active Duty Reserve Retired Air Force: Active Duty Reserve Guard Retired 3. PI Rank: 4. PI Home Contact Information Address (street, city, state, zip code): Telephone: Mobile Telephone: Fax: Email: 1
5. PI Military Contact Information (if applicable) Duty Title: Address: Telephone: Mobile Telephone: Fax: Email: Alternate Email: 6. PI Civilian Work Contact Information (if applicable) Duty Title: Employer: Address: Telephone: Mobile Telephone: Fax: Email: Alternate Email: 7. Preferred Contact Location Home Work 8. Award Category High-Priority Award Graduate Research or EBP Award Evidence Based Practice Award Initial Research Award Follow-on Research Award vice Investigator Award 2
9. Primary Research Priority Addressed by Grant Application Primary TSNRP Research Priority (check ONLY one) a. Force Health Protection: Fit and ready force Deploy with and care for the warrior Care for all entrusted to our care b. Nursing Competencies and Practice: Patient outcomes Quality and safety Translate research into practice/evidence-based practice Clinical excellence Knowledge management Education and training c. Leadership, Ethics, and Mentoring: Health policy Recruitment and retention Preparing tomorrow s leaders Care of the caregiver d. Other: 3
10. Secondary TSNRP Research Priorities (optional) Secondary TSNRP Research Priorities (check as many as appropriate) a. Force Health Protection: Fit and ready force Deploy with and care for the warrior Care for all entrusted to our care b. Nursing Competencies and Practice: Patient outcomes Quality and safety Translate research into practice/evidence-based practice Clinical excellence Knowledge management Education and training c. Leadership, Ethics, and Mentoring: Health policy Recruitment and retention Preparing tomorrow s leaders Care of the caregiver d. Other: 11. Study Population (check all that apply) a. Active Duty: Army Navy Air Force Marines b. Reserve: Army Navy Air Force Marines c. Beneficiaries: Spouses Children Retirees 4
12. Is this application a revision of a previously submitted grant application? 13. Have you submitted a grant application to TSNRP in the past? If yes, provide the year, title of the grant application, application number (e.g., N08-P04), and whether the application was funded. Begin with the most recent grant application and list chronologically. 14. Have you attended TSNRP s Research and (or) Evidence-Based Practice Grant Camp? 15. Have you attended another grant writing workshop? If yes, provide the date, sponsor, and method of learning for each event. 16. Have you attended TSNRP s Post-Award Grant Management Workshop? If yes, provide the date(s) and location. 17. How and when did you first learn about TSNRP grant awards? 5
18. Report dissemination of information related to each prior TSNRP grant award. Presentations Provide the full information using a consistent reference format. Make sure to include the presenter s name, Presentation title, type of presentation (ex. Poster, Podium), venue (ex. Conference name), date, and location. Publications Provide the full citation using a consistent reference format. If applicable, indicate whether the paper is in review or in press.) 6
19. Based on your experience, how difficult or easy were the following elements of the TSNRP grant application process? Use the following rating scale: 1) Very Difficult 2) Difficult 3) Somewhat Difficult 4) Somewhat Easy 5) Easy 6) Very Easy Ability to understand TSNRP research priorities: Ability to understand the application process: Ability to understand the application requirements: Ability to understand the funding criteria: Ability to submit an application: 20. Please feel free to share more feedback about the application process if you think it would be helpful for TSNRP to consider: 7