The Readiness Estimate and Deployability Index- NAVY

(READI-R- USN-NC Version)

A.How Competent are you: Please rate your level of competency according to the following scale
  1. I need theory, demonstration & supervised practice
  2. I would need review & supervised practice
  3. I would need some review & little supervision
  4. I would need review only
  5. I would need no review or supervision

Competency Scale

Not Competent 1 2 3 4 5 Totally Competent

1.
1 2 3 4 5
2.
1 2 3 4 5
3.
1 2 3 4 5
4.
1 2 3 4 5
5.
1 2 3 4 5
6.
1 2 3 4 5
7.
1 2 3 4 5
8.
1 2 3 4 5
9.
1 2 3 4 5
10.
1 2 3 4 5
11.
1 2 3 4 5
12.
1 2 3 4 5
13.
1 2 3 4 5
14.
1 2 3 4 5
15.
1 2 3 4 5
16.
1 2 3 4 5
17.
1 2 3 4 5
18.
1 2 3 4 5
19.
1 2 3 4 5
20.
1 2 3 4 5
21.
1 2 3 4 5
22.
1 2 3 4 5
23.
1 2 3 4 5
24.
1 2 3 4 5

B. For the following, please indicate your level of agreement according to this scale by indicating the circle for your response

  • 1 = Totally Disagree
  • 2 = Minimally Agree
  • 3 = Moderately Agree
  • 4 = Highly Agree
  • 5 = Totally Agree
25.
1 2 3 4 5
26.
1 2 3 4 5
27.
1 2 3 4 5
28.
1 2 3 4 5
29.
1 2 3 4 5
30.
1 2 3 4 5
31.
1 2 3 4 5
32.
1 2 3 4 5
33.
1 2 3 4 5
34.
1 2 3 4 5
35.
1 2 3 4 5
36.
1 2 3 4 5
37.
1 2 3 4 5
38.
1 2 3 4 5
39.
1 2 3 4 5
 

C. Demographic Data


Active Duty
Drilling Reserve
Individual Ready Reserve
Or Other (Enter Answer):

  • 1900 Professional Nursing
  • 1901 Nursing Administration
  • 1903 Nursing Education
  • 1910 Medical Surgical Nursing
  • 1920 Maternal Infant Nursing
  • 1922 Pediatric Nursing
  • 1930 Psychiatric Nursing
  • 1940 Community Health Nursing
  • 1945 Emergency/Trauma Nursing
  • 1950 Perioperative Nursing
  • 1960 Intensive Care Nursing
  • 1964 Neonatal Intensive Care Nursing
  • 1972 Nursing Anesthesia
  • 1974 Pediatric Nurse Practitioner
  • 1976 Family Nurse Practitioner
  • 1980 Women’s Health Nursing
  • 1981 Nursing Midwife
  • 1806 Health Care Administration
  • 3130 Manpower Systems Analyst
  • 3180 Education and Training Management Systems

years

Yes No

Male Female


  • O1 / Ensign
  • O2 / Lieutenant Junior Grade
  • O3 / Lieutenant
  • Lieutenant Commander
  • Commander
  • Captain

  • Bachelors in Nursing
  • Bachelors in other than nursing
  • Masters in Nursing
  • Masters in other than nursing
  • Doctorate in Nursing
  • Doctorate in other than nursing
  • More than 4 years ago
  • Within the most recent 1-4 years
  • Greater than six months, but less than one year
  • Within the last 6 months
  • I have no education or experience with triage
  • Learned via inservices, nursing journals, handouts, etc.
  • Practiced triage in an in an Emergency Department setting
  • Practiced triage in a field setting

Yes No

Yes No

times

days

From: (mm/dd/yyyy) To: (mm/dd/yyyy)

years

  • Three to five times per week
  • Two times per week
  • One time per week
  • Less frequently than once per week


Less than one year
One to five years
Greater than five years

Yes No Uncertain

Yes No Not Applicable

Yes No Not Applicable

  • Tobacco
  • Religious Faith
  • Relaxation/Meditation Techniques
  • Eating
  • Music
  • Sleeping
  • Reading
  • Talking with Friends
  • Other (please specify below)

Thank you for completing the READI.
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Thank you very much for completing this questionnaire.