final nursing management

8/7/2019 Final Nursing Management

http://slidepdf.com/reader/full/final-nursing-management 1/34

Final Nursing Management - Presentation Transcript

1. PUT YOUR NOTES IN ONE LONG BOND PAPER NOT FOLLOWING INSTRUCTION MEANS

NO OPEN NOTES DURING THE QUIZ INSTRUCTION FOR THE QUIZ

2. PREPARED BY: Michael Bonito G. Tamayo, RN NURSING MANAGEMENT PROCESS

3. NURSING MANAGEMENT

o Is the process of working through staff members to be able to provide comprehensive care to the

patient

o This includes planning, organizing, directing and controlling

o The task of the nurse manager is to plan, organize, direct and control available financial,

material, and human resources in order to provide effective, economic care to groups of patients

4. NURSING MANAGEMENT PROCESS

5. NURSING MANAGEMENT PROCESS

6. Purpose of the Nursing Management Process

o To achieve scientifically ± based, holistic, individualized care for the patient

o To achieve the opportunity to work collaboratively with patients and others

o To achieve continuity of care

7. Characteristics of the Nursing Management Process

o Systematic

o Dynamic

o Interpersonal

o Goal Directed

o

Universally Applicable

8. MANAGEMENT FUNCTION NURSING MANAGEMENT PROCESS PLANNING

9. PLANNING

o Is deciding in advance what to do, how to do a particular task, when to do it, and who is to do it .



o Is predetermining a course of action in order to arrive at a desired results. It is the continuous

process of assessing, establishing goals and objectives and implementing and evaluating them,

which is subject to change as new facts are known

10. COMPONENTS OF PLANNING PLANNING: PREDETERMINED ACTION WHO IS TO DO IT:

-professional, non-professional HOW TO DO IT: -technique, principles WHAT TO DO: -nursing

activities

11. Nursing management -planning-

o PRINCIPLES OF PLANNING

o 1. Planning is always based and focused on the vision, mission, philosophy, and clearly defined

objectives of the organization.

o 2. Planning is a continuous process.

o 3. Planning should be pervasive within the entire organization covering the various departments,

services and the various levels of management to provide maximal cooperation and harmony.

o 4. Planning utilizes all available resources.

o 5. Planning must be precise in its scope and nature.

o 6. Planning should be time bounded.

o 7. Projected plans must be documented for proper dissemination to all concerned for

implementation and implementation as to the extent of its achievement.

12. PLANNING

o It leads to success in the achievements of goals and objectives

o It provides meaning to work

o It provides for the effective use of available personnel and facilities

o It helps nurses cope with crises and problems calmly and efficiently

o It is cost effective

o It is based on past and future activities

o It reduces the element of change

o It is necessary for effective control

13. Characteristics of a GOOD PLAN



o It should have a clearly worded objectives, including results and methods for evaluation

o Be guided by policies and/or procedures affecting the planned action

o Indicate priorities

o Develop actions that are flexible and realistic in terms of available personnel, equipment,

facilities and time

o Develop a logical sequence of activities

o Select the most practical methods for achieving each objective

14. PLANNING

o TYPES OF PLANNING:

o 1. STRATEGIC OR LONG-RANGE PLANNING

o ³ what are the right things to do´

o - usually extending 3 to 5 years into the future.

o 2. OPERATIONAL OR SHORT-RANGE PLANNING

o ³ how does one do things right´

- deals with day to day maintenance activities.

3. CONTINUOUS OR ROLLING PLANS

- similar to operating plans, involves mapping out the day-to-day activities .

15. ELEMENTS OF PLANNING

o Forecasting or Estimate the future

o Set Objectives/Goals and Determine Results Desired

o Develop and Schedule Strategies, Programs/Projects/Activities; Set the Time Frame

o Prepare the Budget and Allocation of Resources

o Establish Policies Procedures and Standards

16. Elements of Planning -Forecast or Estimate the Future-

o Forecasting is looking into the future

o Refers to estimation of time series, cross sectional or longitudinal data



o In making forecast, the planner should consider 3 things:

Agency

Community affected

Goals of care

o Forecast must be supported by facts, reasonable estimates and accurate reflection of policies and

plans

17. Elements of Planning Set Objectives/Goals and Determine Results Desired

o GOALS are broad statements of intent derived from the purposes of the organization

Is a desired aim or condition toward which one is willing to work

Individual goals- are personal goals; based on one¶s desired in life

Group goals- may refer also to organizational goals although on a smaller scale

Organizational goals- management goals of an organization that are established to justify

its existence

Short term goals and long term goals

18. Objectives

o The objectives of the Nursing Department is congruent to its vision as well as to the 11 key

areas of responsibilities to nursing practice:

o To observe ethical principles and standards that govern nursing practice . (ethico-moral-legal

responsibilities)

o To establish well coordinated referral system for the continuity of patient¶s/ client¶s care.

(communication)

o To assure the application of acceptable performance of functions, duties, and responsibilities of

every position in the nursing department. (safe & quality nursing care, management of

resources)

o To encourage its nursing personnel to participate in nursing research for improving nursing

care. ( research)

o To utilize media for information campaign to intensify health education program. (health

education)



19. 11 key areas of responsibilities to nursing practice

o Safe and quality nursing care

o Management of resources and environment

o Health education

o Legal responsibility

o Ethico-moral responsibility

o Personal and professional development

o Quality improvement

o Research

o Record Management

o Communication

o Collaboration and teamwork

20. Nursing management - ELEMENTS OF PLANNING-

o MISSION OR PURPOSE

o - The mission statement outlines the agency¶s reason for existing ( whether hospital or health

care), who the target clients are ( the poor, the needy, the middle or upper class), and whatservices will be provided ( in-patient, out-patient, emergency).

o - reason for the existence of the organization (Nursing service exist to promote and maintain

health)

21. Vision

o The Board of Nursing under the guidance of the Almighty, with its unquestionable integrity and

commitment, envisions itself to be the ultimate authority in regulating the nursing profession in

the Philippines and to lead nursing development to its highest level of excellence.

22. Mission

o The BON shall unwaveringly pursue the advancement of nursing development in the country

by:

o 1. providing leadership, information, options,



o scenarios and lobby efforts to targeted

o decision makers and stakeholders

o 2. ensuring adherence to professional, ethical

o and legal standards as mandated by existing

o regulatory laws

o 3. unifying the nursing sector through good

o governance

o 4. fostering linkages with the domestic and

o international stakeholders


o PHILOSOPHY

- Philosophy is the sense of purpose of the organization and the reason behind its structure

and goals.

- Philosophy states the beliefs that influence nursing practice and beliefs about health care .

24. o POLICIES

o Policies in general, they are guidelines to help in the safe and efficient achievement of

organizational objectives

o PROCEDURES

o Procedures are specific directions form implementing written policies


o Develop and Schedule Strategies, Programs/Projects/Activities; Set the Time Frame

o Strategy is the techniques, methods, or procedure by which the overall plan of the higher

management achieve desired objectives.

o Programs are activities put together to facilitate attainment of some desired goals .

26. Nursing management PLANNING



o Time Management is a technique for allocation of one¶s time through the setting of goals,

assigning priorities, identifying and eliminating time wastes and use of managerial techniques to

reach goal s efficiently


o Principles of Time Management

o Planning for contingencies-planning anticipates the problem that will arise from actions without

thought

o Listing of task-task to be accomplished should be done in sequence which are prioritized

according to importance

o Inventory

o Sequencing

o Setting and keeping deadlines- and adhering to deadline is an excellent exercise in self

discipline

o Deciding on how time will be spent


o Time Saving Techniques, Devices and Methods to Better Use of Time

o Conduct an inventory of your activities.

o Set goals and objectives and write them down.

o With the use of calendars, executive planners, logs or journals, write what you expect to

accomplish yearly, monthly, weekly or daily.

o Break down large projects into smaller parts.

o Devote a few minutes at the beginning of each day for planning.

o Organize your work space so it is functional.

o Close your door when you need to concentrate.

o Learn to delegate.

o In a meeting, define the purpose clearly before starting.

o Take or return phone calls during specified time.



o Develop effective decision-making skills.

o Take rest breaks and make good use of your spare time.


o Multitasking

Trying to get more things done in less time

Examples: answering phone calls while driving, sending e-mails while in the meeting


o DEVELOPING AND SCHEDULING PROGRAMS

o Programs are predetermined, developed and targeted within a time frame to reach the set goals

and objectives.

o The Planning Formula

o WHAT

o WHEN

o WHERE

o HOW

o WHO

o WHY

o CAN


o PREPARING THE BUDGET

o A budget is the annual operating plan, a financial ³road map´ and plan which serves as an

estimate for future costs and a plan for utilization of manpower, material and other resources to

cover capital projects in the operating programs.

o A nursing budget is a plan for allocation of resources based on preconceived needs for a

proposed series of programs to deliver patient care during one fiscal year .

o A hospital budget is a financial plan to meet future service expectations.

32. Factors in BUDGET planning



o Type of patient, length of stay in the hospital and acuteness of illness

o Size of hospital and bed occupancy

o Physical lay out of the hospital, size and plan of the wards, units, nurse¶s station, treatment

rooms, etc

o Personnel policies

Salaries paid to various type of nursing personnel including OT pay or shift

differential

Extent of VL, SL, holidays

Provision for staff development programs

o Grouping of patients such as those in specialized areas


o Standards of nursing care: kind and amount of care to be given as it affects the number of hours

of bedside care

o The method of performing nursing care whether simple or complex; the method of

documentation

o Proportion of nursing care provided by the professional nurses and those given by non-

professionals

o Amount and quality of supervision available and provided; the efficiency of job description and

job classification


o Method of patient assignment whether functional, case, team or primary

o Amount and kind of labor-saving devices and equipments

o Amount of centralized service provided: sterile supply , central o2 supply, linen supply

o Nursing service requirements of the ancillary departments: clinics, admitting office, ER

o Reports required by administration whether simple or complex

o Affiliation of nursing students or medical students

35. Establishing Nursing Standards, Policies and Procedures



o Nursing Standards

Standard- a practice that enjoys general recognition and conformity among professionals

or an authoritative statement by which quality of practice or education can be judged

Nursing Care Standard ± a descriptive statement desired quality against which to evaluatenursing care

Purpose of nursing standards

Improved quality of care

Decrease the cost of nursing care

Determine nursing negligence

Sources of nursing standards

DOH, BON, Professional Organization, Nursing Programs


o Nursing Service Policies

Policies in general are guidelines to help in safe and efficient achievement of

organizational objectives

There are 3 general areas in nursing which requires policy formulation. These are:

Areas in which confusion about the locus of responsibility might result in neglect or

malperformance of an act necessary to a patient¶s welfare

Areas pertaining to the protection of patients¶ and families¶ rights as right to privacy

and right to property

Areas involving matters of personnel management and welfare


o Nursing procedures

Procedures are specific directions for implementing written policies

Procedures are more specific guide to action than policy

38. NURSING MANAGEMENT FUNCTION NURSING MANAGEMENT PROCESS ORGANIZING

39. Nursing management - ORGANIZING -



o ORGANIZING is the process of establishing formal authority

o Involves setting up the organizational structure through identification of groupings, roles and

relationships

o Determines staff needed through developing and maintaining staffing patterns and distributesthem in the various areas as needed

o Develops job descriptions by defining the qualifications and functions of personnel

40. Organizing

o Organizing is one way which nursing management coordinates the various activities of a

department or a unit so that the staff can get its work done in an orderly fashion

o Organizing means having qualified people and the right materials, information and equipment

needed to deal with contingencies


o PRINCIPLES OF ORGANIZATION:

o Communication: effective and open communication in all forms; thread that binds the

organization together

Directions of communication:

Downward

Upward

Lateral/Horizontal

Grapevine

o Unity of Command

o Span of Control

o Delegation of authority

o Similar Assignments

o Unity of Purpose

42. ORGANIZATIONAL DESIGN



o Organizational design is a formal, guided process for integrating the people, information and

technology of an organization.

43. PRINCIPLES OF ORGANIZATIONAL DESIGN

o Division of labor

o Unity of command

o Authority and responsibility

o Span of Control

o Contingency Factors


o ELEMENTS OF ORGANIZING

o Organizational Structure

o Staffing

o Scheduling

o Developing job descriptions

45. Importance of organizational structure

o It enables members what their responsibilities are so that they may carry them out

o It frees the manager and the individual workers to concentrate on their respective roles and

responsibilities

o It coordinates all


o ORGANIZATIONAL STRUCTURE

o The organizational structure refers to the process by which a group is formed its channel of

authority, span of control and lines of communication.

o It is the formal structure, the official arrangement of positions or working relationships that will

coordinate efforts of workers of diverse interest and abilities

47. Patterns of Organizational Structure

o Tall or Centralized Structure



o Flat or Decentralized Structure

48. TALL OR CENTRALIZED STRUCTURE

o Responsible for only a few subordinates, so there is a narrow span of control

o Because of the vertical nature of the structure, there are many levels of communication

49. TALL OR CENTRALIZED STRUCTURE

o Advantage

o It makes use of expertise, and allows close communication between the workers.

o Supervisory individuals screen the communication.

o Disadvantage

o Transpires that the most skilled individuals end up doing nothing while actual tasks are done by

those less capable.

o Communication from bottom to top is often difficult, and messages do not get to the top

o Workers tend to be very ³ boss-oriented ³ because of the close contact with their supervisor .

50. Flat or Decentralized Structures

o Refers to an organizational structure with few or no levels of intervention between management

and staff .

51. Flat or Decentralized Structure

o Advantages

o Lower likelihood of messages being distorted

o Workers develop own abilities and autonomy and able to see the organization as humanistic

resulting in greater job satisfaction

o The principle of ³shared governance´ produces maximum potential for professional growth

o Disadvantages

o Supervisor spend less time with each worker

o Supervisors may lack expertise in the variety of operations and may end up making

inappropriate decisions




o Types of Organization Classified by Nature of Authority

o Line Organization- each position has general authority over the lower positions in the hierarchy .

(also known as Bureaucratic/Pyramidal)

o Informal Organization- refers to horizontal relationship rather than vertical.(Flat or horizontalorganization)

o Staff Organization- purely advisory to the line structure with no authority to put

recommendations into action.

o Functional Organization ± each unit is responsible for a given part of the organization¶s

workload.

53. TYPES OF ORGANIZATIONAL STRUCTURE

o Line Organization/ Bureaucratic/ Pyramidal

o - shows that each position has general authority over the lower position of the hierarchy.

o - ARA and power are concentrated at the top.


o 2. Flat Organization

o - refers to an organizational structure with few or no levels of intervention between management

and staff .


o 3. Staff Organization

o - purely advisory to the line structure with no authority to place recommendations into action.


o 4. Functional Organization

o - permits a specialist to aid line position within a limited and clearly defined scope authority.

57. ORGANIZATIONAL RELATIONSHIP

o FORMAL RELATIONS

o INFORMAL RELATIONS




o FORMAL RELATIONS

o - represents by uninterrupted lines between units, showing who reports to whom.


o 2. INFORMAL RELATIONS

o - represented by a broken or dotted line, where power relationships are coordinated.


o ORGANIZATIONAL CHART

o - Organizational chart is a line drawing that shows how the parts of an organization are linked .


o Characteristics of an Organizational Chart

o Division of Work

o Chain of Command

o Type of Work to be performed

o Grouping of Work Segment

o Levels of Management


o STAFFING

o Staffing is the process of determining and providing the acceptable number and mix of nursing

personnel to produce a desired level of care to meet the patients¶ demand.

o The process of assigning competent people to fill the roles designated for the organizational

structure through recruitment, selection and development.

63. - STAFFING -

o FACTORS AFFECTING TIME REQUIREMENT OF NURSING CARE

Patient¶s acuteness of illness

Degree of dependence

Communicability of ailment



64. Steps in Staffing

Determine the Number and Types of Personnel Needed

Recruitment

Interview

Induct or Orient the Personnel in Organization

Job Offer

65. Centralized Staffing

o Staffing decisions for all units are made by a central office or computer .

o Tends to be fairer to employees, because policies are implemented more consistently and

impartially.

o Frees manager to complete other functions.

o Most cost effective, because it maximizes use of human resources organization-wide.

66. Decentralized Staffing

o Staffing is done at unit level, frequently by unit manager .

o Allows person who knows the individual unit the best to make staffing decisions for that unit .

o Allows staff to take requests directly to their own manager, which gives them increasedautonomy and flexibility.

o Increases the risk that employee requests may be treated unequally or inconsistently.

o Time-consuming for unit manager .

67. NURSING CARE MODALITIES

o TOTAL CARE or CASE NURSING

o One nurse is assigned to one patient for totality of care during his or her time on duty

o PDN

o Isolation nurse

o Nursing student

68. NURSING CARE MODALITIES



o Home environment temporarily makes discharge undesirable

73. PATIENT CLASSIFICATION SYSTEM

o 2. Intermediate or Moderate Care

o requires some help from the nursing staff with special treatments.

o Given to moderately ill

o Recovering from immediate effects of a serious illness or operation

o May be ambulatory for short periods (needs assistance)


o 3. Total Care Patients

o those who are bedridden and who lack strength and mobility to do average daily living .

o Needs close attention

o Requires nurse to initiate, supervise, and perform most of the activities

o Requires frequent medication


o 4. Intensive Care Patients

o those who are critically ill and in constant danger of death or serious injury. Acutely ill patients

w/ high level of nurse dependency

o Unstable condition w/c requires frequent evaluation with adjustment of therapy

76. Nursing management - STAFFING -

o STAFFING FORMULA

Requirements:

STANDARD VALUE OF NURSING CARE

Cases / Patients NCH/pt/day Prof . to Non-Prof Ratio

o Surgery

o General Ward

o Pediatric



o Pathologic Nursery

o Medical

o OB

o ICU/ER/RR

o CCU

3.4 3.5 4.6 2.8 3.4 3.0 6.0 6.0 60:40 60:40 70:30 55:45 60:40 60:40 70:30 80:20


o Distribution Per Shift

SHIFT PERCENTAGE AM PM NIGHT 45 % 37% 18%


o CATEGORIES OF PATIENT

Levels of Care NCH Needed /pt./ day Prof: Non Prof Level I Self-Care or Minimal Care Level II

Moderate or Intermediate Care Level III Total or Intensive Care Level IV Highly Specialized or

Critical Care 1.50 3.0 4.5 6.0 7.0 or higher 55:45 60:40 65:35 70:30 80:20


o PERCENTAGE OF PATIENTS IN VARIOUS LEVELS OF CARE

Type of Hospital Minimal Care Moderate Care Intensive Care Highly Spl. Care Primary Hospital

Secondary Hospital Tertiary Hospital Special Tertiary Hospital 70 65 30 10 25 30 45 25 5 5 15 45 - -

10 20


o TOTAL NUMBER OF WORKING AND NON-WORKING DAYS AND HOURS OF

NURSING PERSONNEL PER YEAR

Right s and Privileges Given each Personnel/Yr Working Hours per Week 40 hours 48 hours

o Vacation Leave

o Sick Leave

o Legal Holidays

o Special Holidays

o Special Privileges

o Off Duties as per R .A. 5901



o Continuing Education Program

o Total Non-Working Days/Year

o Total Working Days/Year

o Total Working Hours / Year

o RA 5901 = 40H WK LAW

15 15 15 15 10 10 2 2 3 3 104 52 3 3 152 100 213 265 1,704 2,120


o Steps for Computing the Staff Needed in the in-patient Unit of the Hospital

o COMPUTATION:

o CASE: 250 BED CAPACITY TERTIARY HOSPITAL. HOW MANY STAFF NURSES DOWE NEED?

o 1. CATEGORIZE PATIENT ACCDG. TO LEVEL OF CARE

o 250 X 30% = 75 minimal care

o 250 X 45% = 112.5 moderate care

o 250 X 15% = 37.5 intensive care

o 250 X 10% = 25 highly specialized nursing care


o 2. FIND THE NURSING CARE HOURS (NCH) NEEDED

o 75 X 1.5 (NCH @ Level I) = 112.5 NCH/day

o 112.5 X 3 (NCH @ Level II) = 337.5 NCH/day

o 37.5 X 4.5 (NCH @ Level III) = 168.75NCH/day

o 25 X 6 (NCH @ Level IV) = 150 NCH/day

o ------------------- 768.75 NCH/DAY


o 3. FIND NCH PER YEAR

o 768.75 X 365 (DAYS/YEAR) = 280,593.75 NCH/YEAR



o 4. FIND ACTUAL WORKING HOURS NEEDED BY EACH NURSING PERSONNEL /

YEAR

o 8 ( hrs/day ) X 213 (WORKING DAY/YEAR)=

o 1,704 ( working hrs/year )


o 5. FIND THE TOTAL NUMBER OF NURSING PERSONNEL NEEDED.

o a. TOTAL NCH/ YEAR = 280,593.75 = 165

WORKING HRS / YEAR 1,704

b. RELIEF x TOTAL NSG PERSONNEL

165 X 15%=25

o ( CONSTANT: 15% FOR 40 HRS/WK & 10% FOR 48 HRS/WK)

o c. TOTAL # OF NURSING PERSONNEL NEEDED + RELIEVERS

o 165 + 25 = 190 TOTAL PERSONNEL NEEDED

o 85. Nursing management - STAFFING -

o 6. DETERMINE PROF FROM NON PROF PERSONNEL

o e.g. tertiary hospital

o 190 X 65% = 124 PROFESSIONAL

o 190 X 35% = 68 NON PROFESSIONAL


o 7. DISTRIBUTE PER SHIFT

o PROFESSIONAL(124) NON PROFESSIONAL(66)

o AM (45%) 56 30

o PM (37%) 46 24

o NIGHT (18%) 22 12




o Placement of Staff

o proper placement:

o a. fosters personal growth

o b. provides a motivating climate for the employee

o c. maximizes productivity

o d. organizational goals have better chances of being met

o inappropriate placement:

o a. frustration

o b. poor quality of work

o c. reduced organizational efficiency

o d. rapid turn-over

o e. poor image for the agency

o RA 9173 nurses with Master¶s degree in Nursing are easily placed in position


o SCHEDULING

o A schedule is a timetable showing planned work days and shifts for nursing personnel.

o Factors to Consider in Making a Schedule

o Different levels of the nursing staff

o Adequate coverage for 24 hours, 7 days a week

o Staggered vacations and holidays

o Weekends

o Long stretches of consecutive working days

o Evening and night shifts

o Floating




o Assessing a Scheduling System

o Ability to cover the needs of the shift

o Quality to enhance the nursing personnel¶s knowledge, training and experience

o Fairness to the staff .

o Stability

o Flexibility


o Types of Scheduling

o Centralized Schedule

o Decentralized Schedule

o Cyclical Schedule


o SCHEDULING VARIABLES

o Length of scheduling period whether 2 or 4 weeks

o Shift rotation

o Week-ends off

o Holiday off

o Vacation leave

o Special days

o Scheduled events in the hospital , training programs, or meetings

o Job categories

o Continuing professional education (CPE) programs


o DEVELOPING JOB DESCRIPTION

o Job Description is a statement that sets the duties and responsibilities of a specific job.



o Contents of a Job Description

o Identifying Data

o Job Summary

o Qualification Requirements

o Job Relationships

o Specific and Actual Functions and Activities


o Uses of Job Description

o For recruitment and selection of qualified personnel

o To orient new employees to their jobs

o For job placement, transfer or dismissal

o As an aid in evaluating the performance of an employee

o For budgetary purposes

o For determining departmental functions and relationships to help define the organizational

structure

o For classifying levels of nursing functions according to skill levels required.

o To identify training needs

o As basis for staffing

o To serve as channel of communication.

94. Nursing management - DIRECTING -

o DIRECTING

Plan put into action

Activities

Delegation ± transferring responsibility

Updating policy

Utilize the policy updates



Supervision

Roles in Supervision

Guides

Direct

Facilitates

Motivates

Teaches


o Principles of Delegation

o Select the right person to whom the job is to be delegated.

o Delegate both interesting and uninteresting tasks.

o Provide subordinates with enough time to learn.

o Delegate gradually.

o Delegate in advance.

o Consult before delegating.

o Avoid gaps and overlaps.


o What Cannot be Delegated

o Overall responsibility, authority and accountability for satisfactory completion of all activities

in the unit.

o Authority to sign one¶s name is never delegated

o Evaluating the staff and or taking necessary corrective or disciplinary action.

o Responsibility for maintaining morale or the opportunity to say a few words of encouragement

to the staff especially the new ones.

o Jobs that are too technical and those that involve trust and confidence.




o Four Rights of Delegation

o 1. task

o The right task should be within the scope of the person¶s practice and consistent with the job

description.

o 2. person

o The right person should have the appropriate license or certificate, job description.

o 3. communication

o The right communication should be clear, concise, complete and correct.

o 4. feedback

o The right feedback should ask for input, get the person¶s recommended solution to the problemand recognize the persons effort.


o Aspects of Delegation

o 1. Responsibility ± denotes obligation

o 2. Authority ± the power to make final decisions and give commands .

o 3. Accountability ± refers to liability


o COMMUNICATION

o Communication is the transmission of information, opinions, and intentions between among

individuals.

o Purpose of communication

o 1. facilitates work

o 2. increases motivation

o 3. effects change

o 4. optimizes patient care

o 5. increases workers¶ satisfaction



o 6. facilitates coordination


o Types of Communication

o 1. Verbal Communication

o 2. Written Communication

o 3. Non-verbal Communication

o Personal appearance

o Intonation of the voice

o Facial expression

o Posture and gait

o Touch


o Lines of Communication

o UPWARD

o to superior

o HORIZONTAL OUTWARD

o to peers and to patient, family

o members of the and community

o Health Team to workers¶ family

o and friends

o DOWNWARD

o to subordinates

NURSES


o DECISION MAKING



o Decision is a course of action that is consciously chosen from available alternatives for the

purpose of achieving a desired result.

5 Steps in Decision Making

1. definition of the problem

³ why the problem occur´

2. analysis of the problem

³ getting to the cause of the problem´

3. development of an alternative solution

³ search for and analysis of alternatives and their possible consequences´

4. selection of the solution

weighing of facts and exploring alternative solutions

5. implementation and follow-up


o Major Management Functions in Implementing Decisions

o 1. Planning which entails consideration and selection of realistic objectives, policies and

procedures.

o 2. Organizing which means helping personnel understand the decision and the procedures

necessary for implementing the decision.

o 3. Staffing or the selection of the right person/s to carry out the decision

o 4. Controlling the environment and the group to prevent adverse effects.


o Art of Decision Making:

o Not making decision that others should make, to preserve morale and authority;

o Not deciding on problems that are not pertinent to matters at hand to prevent waste of time and

energy;

o Not deciding prematurely to prevent prujudice

o Not making ineffective decisions to avoid losing the respectability of the decision maker .




o CONFLICT MANAGEMENT

o CONFLICTS ± clash, fight, battle or struggle; it may be constructive or destructive

o Basis of the Conflict

o 1. Intrapersonal

o 2. Interpersonal

o 3. Group

o 4. Intergroup

o 5. Organizational


o Sources of the Conflict

o Cultural differences

o Different facts

o Separate pieces of information

o Different perception of the event

o Defining the problem differently

o Divergent views of power and authority

o Role conflicts

o Number of organizational levels

o Degree of association

o Parties dependent on others

o Competition for scarce resources

o Ambiguous jurisdictions

o Need for consensus

o Communication barriers



o Separation in time and space

o Accumulation of unresolved conflit


o Types of Conflict

o 1. Intrasender

o - conflict originates in the sender who gives conflicting instructions .

o 2. Intersender

o - conflict arises when an individual receives conflicting messages from two or more sources .

o 3. Interrole

o - conflict can occur when an individual belongs to more than one group .

o 4. Person-role

o - conflict is the result of disparity between internal and external roles.


o 5. Interperson

o - conflict is common among people whose positions require interaction with other persons who

fill various roles in the same organization or other organizations.

o 6. Intragroup

o - conflict occurs when the group faces a new problem .

o 7. Intergroup

o - conflict is common where 2 groups have different goals and can achieve their goals only at the

others¶ expense.

o 8. Role Ambiguity

o - a condition in which individuals do not know what is expected on them.

o 9. Role Overload

o - the person is simply unable to accomplish so much within a limited time period.




o Conflict Resolution

o 1. Avoidance

o - used by groups who do not want to do something that may interfere with their relationship

o 2. Accommodation

o - self-sacrifice

o 3. Collaboration

o - inspires mutual attention to the problem and utilizes the talents of all parties

o 4. Compromise

o - in this method, accommodation and adjustment lead to workable situations rather than to the

best solution.


o 5. Competition

o - it is an assertive position that fosters conflict resolution on the part of the subordinate.

o 6. Smoothing

o - disagreements are ignored so that surface harmony is maintained in a state of peaceful co-

existence.

o 7. Withdrawing

o - one party is resolved thereby making it possible to resolve the issue .

o 8. Forcing

o - yields an immediate end to the conflict but leaves the cause of the conflict unresolved .


o Rules on Mediating a Conflict Between Two or More Parties:

o 1. Establish clear guidelines and make them known to all.

o 2. Do not postpone indefinitely.

o 3. Create an environment that makes people comfortable to make suggestions .

o 4. Keep two-way communication.



o 5. Stress a peaceful resolution rather than confrontation.

o 6. Emphasize shared interests.

o 7. Follow-up on the progress of the plan.


o Staff Development

o Staff development is geared ultimately to organizational development.

o Orientation

o Orientation is a planned and guided activities of an employee in the organization, the work

environment , and in his job.

113. Nursing management - CONTROLLING -

o CONTROLLING

o Controlling or evaluating is an on-going function of management which occurs during planning,

organizing, and directing activities.

o The controlling process opens opportunities for improvement and comparing performance

against set standard.


o Reasons For Conducting Evaluation

o Evaluation ensures that quality nursing care is provided.

o It allows for the setting of sensible objectives and ensures compliance with them.

o It provides standards for establishing comparisons.

o It promotes visibility and a means for employees to monitor their own performance.

o It highlights problems related to quality care and determines the areas that require priority

attention.

o It provides an indication of the costs of poor quality.

o It justifies the use resources.

o It provides feedback for improvement.




o Principles of Evaluation.

o The evaluation must be based on the behavioral standards of performance which the position

requires.

o The evaluation should have enough time to observe employee¶s behavior .

o The employee should be given a copy of the job description, performance standards, and

evaluation conference.

o The employee¶s performance appraisal should include both satisfactory and unsatisfactory

results with specific behavioral instances to exemplify these evaluative comments.

o Areas needing improvement must be prioritized to help the worker upgrade his/her

performance.

o The evaluation conference should be scheduled and conducted at a convenient time for the rater and the employee.

o The evaluation report and conference should be structured in such a way that is perceived and

accepted positively as a means of improving job description.


o Characteristics of an Evaluation Tool

o Should be objective

o Should be reliable

o Should be sensitive


o PERFORMANCE APPRAISAL

o Performance appraisal is a control process in which employee¶s performance is evaluated

against standards.

o Purposes of Performance Appraisal

o Determine salary standards and merit increases.

o Select qualified individuals for promotion or transfer .

o Identify unsatisfactory employees for demotion or termination

o Make inventories of talents within the institution.



o Determine training and development needs of employee.


o 6. Improve the performance of work groups by examining, improving, correcting

interrelationship between members

o 7. Improve communication between supervisors and employees and reach an understanding on

the objectives of the job

o 8. Establish standards of supervisory performance.

o 9. Discover the aspirations of employees and reconcile these with the goals of the institution

o 10. Provide employee recognition

o 11. Inform employees where they stand.


o Methods of Measuring Performance

o Essay

o Checklist

o Ranking

o Rating Scales

o Forced-choice Comparison

o Anecdotal Recording


final nursing management

Documents