nursing management planning

8/7/2019 Nursing management planning

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NURSING MANAGEMENT

PLANNING

Namgay Lham

M.Sc 2nd year

KCON


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NURSING MANAGEMENTy Is the process of working through staff

members to be able to providecomprehensive care to the patient

y This includes planning, organizing,directing and controlling

y The task of the nurse manager is to plan,organize, direct and control availablefinancial, material, and human resources inorder to provide effective, economic careto groups of patients


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PLANNING


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PLANNING

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

y Is predetermining a course of action inorder to arrive at a desired result. It isthe continuous process of assessing,

establishing goals and objectives andimplementing and evaluating them,which is subject to change as new factsare known


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COMPONENTS OFPLANNING

PREDETERMINED ACTION

WHO IS TO DO IT: -professional, non-

professionalHOW TO DO IT: -technique, principles

WHAT TO DO: -nursing activities


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PLANNING FOR HOSPITALS

Hospitals are the most complex of buildingtypes. Each hospital is comprised of a wide

range of services and functional units.

These include diagnostic and treatmentfunctions, such as clinical laboratories,

imaging, emergency rooms, and surgery;

hospitality functions, such as food service

and housekeeping; and the fundamental

inpatient care or bed-related function.


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CONT

Many of the medical equipments and modalitieshave special physical requirements includingcontrolling environment, energy and otherengineering services.

The functional units within the hospital canhave competing needs and priorities.

Idealized scenarios and strongly-held individual preferences must be balanced against

mandatory requirements, actual functionalneeds (internal traffic and relationship to otherdepartments), and the financial status of theorganization.


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CONT..

The architect and planers have to keep pacewith the development in modern medicine,nursing technique and general community

expectations.Medical technology is developing very fast so

much so that often hospitals become outdatedeven before they are put to use.

There has been very rapid change in last fivedecades in functioning of hospitals due tomedical advances which have direct bearingon patient care.


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FACTORS WHICH HAS DIRECT

BEARING ON HOSPITAL PLANNING

Costly diagnostic services cannot be providedall hospitals. Thus, there should be properchoice of place and services to be rendered.

Tertiary care cannot be provided in all placesdue to high cost and lack of availability oftrained man power.

Design should follow function, however, theproper use of esthetic quality and humanizedsurrounding must be kept in mind so that itlooks attractive.


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CONT

A study of activities in health facilities atdifferent levels is a prerequisite of planning asit answers several important questions.

For health centers of different sizes and withdifferent functions, what is the proportion ofworking hours devoted to various broadactivities or define tasks:

which different types of staff are needed andin what proportions?

what are the space requirements to dischargethis functions?


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CONT....

What is the inter-relationship between thesefunctions and consequently, what layout will

be more convenient?

As conditions vary from place to place, it isnecessary to undertake such a study for each

project.


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BUILDING ATTRIBUTES

Regardless of their location, size, or budget,all hospitals should have certain commonattributes.

Efficiency and Cost-Effectiveness

An efficient hospital layout should:

Promote staff efficiency by minimizingdistance of necessary travel between

frequently used spaces.Allow easy visual supervision of patients by

limited staff.


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CONT..

Include all needed spaces, but no redundantones. This requires careful pre-design

programming.

Grouping of closely related activities shouldbe put together in one area.

All areas should be located in relation to one

another to allow direct communication andeasy flow of patients, staff and services.


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CONT

Provide optimal functional adjacencies, suchas locating the surgical intensive care unit

adjacent to the operating suite.


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FLEXIBILITY AND EXPANDABILITY

Since medical needs and modes of

treatment will continue to change, hospitals

should:

Allow maximum flexibility and expandabilityin design and the structural system.

Physical planning must allow for future

expansions in all major functional areas of thehospital and for internal adjustments in the

use of space to desired degree of changes

must be feasible.


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FUNCTIONALLY HOSPITAL HAS SIX MAJOR

FACILITY ZONES:

Accident and emergency.

Ambulatory care (outpatients department).

Diagnostic and therapeutic facility.

In-patient (nursing care) units.

Administration departments and business.

Hospital engineering services.

Each of the functionally components need tobe suitably placed depending on their inter-

relationship but with shortest possible travel

to achieve efficiency.


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EMERGENCY DEPARTMENT

An independent unit to function round the

clock like a mini hospital.

Entry to this department has to be prominent

and self-guided so that a very minimum timeis lost in giving immediate treatment to

casualty and emergent cases arriving in the

hospital.


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AMBULATORY CARE UNITS

Has to perform three main functions:To diagnose and treat patients at an early

stage.

Follow up treatment after discharge from thehospital and

To institute health education programme toeducate the public in environment hygiene.

A well organized and well equippedoutpatient department can play role inreducing the load on the inpatient beds andsave a lot of time and expenditure.


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DIAGNOSTIC AND THERAPEUTIC

FACILITY

Includes the radio-diagnostic and imagingdepartment, clinical pathology as diagnosticfacilities whereas radiotherapy, operation

theaters, rehabilitation and physiotherapy astherapeutic areas are to serve in common tooutpatient department and inpatient nursingunits.

These facilities are to be suitably placed atdifferent levels in consideration of theirfunctional use and degree of necessity todependent departments.


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IN-PATIENT NURSING CARE

UNITS(WARDS)

In-patient nursing care units (wards) occupythe maximum share of hospital space.

Nursing care is broadly classified into

general wards, specialty-wise wards andintensive care units.

Basic consideration in placing wards is toensure sufficient nursing care, segregating

patients according to three categories,locating them according to the needs of thetreatment in respective medical discipline andcontrolling cross infection.


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CONT.

Specialty-wise wards however, should belocated closer to their respective outpatient

clinics to act as self-contained centers.

In planning a ward, the aim should be to

minimize the work of the nursing staff andprovide basic amenities to the patients withinthe unit.

The units should be modified in such a way to

meet specific socio-medical requirementswhile attempting to enhance the efficiency ofnurse- patients interaction, observability,lightning and other physical requirements,


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CONT.......

Replenishment system for supply of dietmedical and surgical supplies, linen and other

materials at the door step of nursing activity

have further relieved the nursing staff onnon-nursing functions to attend patient

centered activities.


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SITE SELECTION

It is important for hospital building. It musthave the following characteristics:

Easy approach by people

Enough land availabilitySub-soil water must be deep

Sufficient supply of water and electricity.

While selecting the site, one must keep inmind, any further expansion in future size of

land required.


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CONT.

Watersupply:The need of water for the hospitals is very

high. The requirements of water should be

calculated considering the patient load,(inpatients and outpatients) and also the

residential area.

About 300-500 liters of water per bed per

day (excluding water for gardening) is to be

catered for.


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CONT.

Electricity:Generator supply for certain essential areas

should be catered for.

There should be provision for uninterruptedelectricity supply.

Requirement for the hospital is One kv per

bed per day.


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CONT

"A functional design canpromote skill, economy,

conveniences, and comforts; anon-functional design canimpede activities of all types,

detract from quality of care, andraise costs to intolerable levels."

... Hardy and Lammers.


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CONCLUSION

If hospital can be designed in proper fashion itcan combine science and wisdom to createholistic approach to health care.

Hospital design must be flexibility, to adopt

change and its concern should be the quality ofmedical care and the improvement of itsstandards.

The idea of planning is to prevent the haphazard

mushrooming up of structure, to preventfragmentation of function and to promote logicalflow of patient, staff and equipment and to attaina fair degree of uniformity and standardization.


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REFERENCE

Basavanthappa B T. Nursing Administration.

2nd edition . New delhi ;Jaypee brothers

medical publications:2009

Tabish S A. Hospitals and Nursing Homes

Planning, Organisations and Management. 1st

edition. New Delhi; Jaypee brothers Medicalpublishers(P) Ltd;2003.

nursing management planning

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