18281818 Nursing Management 2
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Transcript of 18281818 Nursing Management 2
PREPARED BY:AILYN B.PINEDA, RN
NURSING MANAGEMENT
PROCESS
NURSING MANAGEMENT
Is the process of working through staff members to be able to provide comprehensive care to the patient
This includes planning, organizing, directing and controlling
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
NURSING MANAGEMENT PROCESS
NURSING MANAGEMENT PROCESS
Purpose of the Nursing Management Process
To achieve scientifically – based, holistic, individualized care for the patient
To achieve the opportunity to work collaboratively with patients and others
To achieve continuity of care
Characteristics of the Nursing Management Process
SystematicDynamicInterpersonalGoal DirectedUniversally Applicable
MANAGEMENT FUNCTIONNURSING MANAGEMENT PROCESS
PLANNING
PLANNING
Is deciding in advance what to do, how to do a particular task, when to do it, and who is to do it.
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
COMPONENTS OF PLANNING
PLANNING:PREDETERMINE
D ACTION
WHO IS TO DO IT:
-professional, non-professional
HOW TO DO IT:-technique, principles
WHAT TO DO:-nursing activities
Nursing management-planning-
PRINCIPLES OF PLANNING1. Planning is always based and focused on the vision, mission, philosophy, and clearly defined objectives of the organization.2. Planning is a continuous process.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.4. Planning utilizes all available resources.5. Planning must be precise in its scope and nature.6. Planning should be time bounded.7. Projected plans must be documented for proper dissemination to all concerned for implementation and implementation as to the extent of its achievement.
PLANNING
It leads to success in the achievements of goals and objectives
It provides meaning to workIt provides for the effective use of available
personnel and facilitiesIt helps nurses cope with crises and problems
calmly and efficientlyIt is cost effectiveIt is based on past and future activitiesIt reduces the element of changeIt is necessary for effective control
Characteristics of a GOOD PLAN
It should have a clearly worded objectives, including results and methods for evaluation
Be guided by policies and/or procedures affecting the planned action
Indicate prioritiesDevelop actions that are flexible and realistic in
terms of available personnel, equipment, facilities and time
Develop a logical sequence of activitiesSelect the most practical methods for achieving
each objective
PLANNING
TYPES OF PLANNING:
1. STRATEGIC OR LONG-RANGE PLANNING“what are the right things to do”- usually extending 3 to 5 years into the future.
2. OPERATIONAL OR SHORT-RANGE PLANNING“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.
ELEMENTS OF PLANNING
Forecasting or Estimate the futureSet Objectives/Goals and Determine Results
DesiredDevelop and Schedule Strategies,
Programs/Projects/Activities; Set the Time Frame
Prepare the Budget and Allocation of Resources
Establish Policies Procedures and Standards
Elements of Planning-Forecast or Estimate the Future-
Forecasting is looking into the futureRefers to estimation of time series, cross
sectional or longitudinal dataIn making forecast, the planner should
consider 3 things: Agency Community affected Goals of care
Forecast must be supported by facts, reasonable estimates and accurate reflection of policies and plans
Elements of PlanningSet Objectives/Goals and Determine Results
Desired
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
Objectives
The objectives of the Nursing Department is congruent to its vision as well as to the 11 key areas of responsibilities to nursing practice:
To observe ethical principles and standards that govern nursing practice. (ethico-moral-legal responsibilities)
To establish well coordinated referral system for the continuity of patient’s/ client’s care. (communication)
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)
To encourage its nursing personnel to participate in nursing research for improving nursing care. ( research)
To utilize media for information campaign to intensify health education program. (health education)
Nursing management- ELEMENTS OF PLANNING-
MISSION OR PURPOSE
- 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 what services will be provided ( in-patient, out-patient, emergency).
- reason for the existence of the organization (Nursing service exist to promote and maintain health)
Vision
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.
Mission
The BON shall unwaveringly pursue the advancement of nursing development in the country by:
1. providing leadership, information, options, scenarios and lobby efforts to targeted decision makers and stakeholders2. ensuring adherence to professional, ethical and legal standards as mandated by existing regulatory laws3. unifying the nursing sector through good governance 4. fostering linkages with the domestic and international stakeholders
Nursing management- ELEMENTS OF PLANNING-
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.
POLICIES
Policies in general, they are guidelines to help in the safe and efficient achievement of organizational objectives
PROCEDURES
Procedures are specific directions form implementing written policies
Nursing management- ELEMENTS OF PLANNING-
• Develop and Schedule Strategies, Programs/Projects/Activities; Set the Time Frame
Strategy is the techniques, methods, or procedure by which the overall plan of the higher management achieve desired objectives.
Programs are activities put together to facilitate attainment of some desired goals.
Nursing managementPLANNING
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
Nursing managementPLANNING
Principles of Time Management1)Planning for contingencies-planning anticipates
the problem that will arise from actions without thought
2)Listing of task-task to be accomplished should be done in sequence which are prioritized according to importance
3)Inventory4)Sequencing5)Setting and keeping deadlines- and adhering to
deadline is an excellent exercise in self discipline6)Deciding on how time will be spent
Nursing managementPLANNING
Time Saving Techniques, Devices and Methods to Better Use of Time
1. Conduct an inventory of your activities. 2. Set goals and objectives and write them down.3. With the use of calendars, executive planners, logs or journals,
write what you expect to accomplish yearly, monthly, weekly or daily.
4. Break down large projects into smaller parts.5. Devote a few minutes at the beginning of each day for planning.6. Organize your work space so it is functional.7. Close your door when you need to concentrate.8. Learn to delegate.9. In a meeting, define the purpose clearly before starting.10.Take or return phone calls during specified time.11.Develop effective decision-making skills.12.Take rest breaks and make good use of your spare time.
Nursing managementPLANNING
Multitasking Trying to get more things done in less time Examples: answering phone calls while driving,
sending e-mails while in the meeting
Nursing managementPLANNING
DEVELOPING AND SCHEDULING PROGRAMSPrograms are predetermined, developed and
targeted within a time frame to reach the set goals and objectives.
The Planning Formula1.WHAT2.WHEN3.WHERE4.HOW5.WHO6.WHY7.CAN
Nursing managementPLANNING
• PREPARING THE BUDGET1.A budget is the annual operating plan, a financial
“road 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.
2.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.
3.A hospital budget is a financial plan to meet future service expectations.
Factors in BUDGET planning
Type of patient, length of stay in the hospital and acuteness of illness
Size of hospital and bed occupancyPhysical lay out of the hospital, size and plan of
the wards, units, nurse’s station, treatment rooms, etc
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
Grouping of patients such as those in specialized areas
Factors in BUDGET planning
Standards of nursing care: kind and amount of care to be given as it affects the number of hours of bedside care
The method of performing nursing care whether simple or complex; the method of documentation
Proportion of nursing care provided by the professional nurses and those given by non-professionals
Amount and quality of supervision available and provided; the efficiency of job description and job classification
Factors in BUDGET planning
Method of patient assignment whether functional, case, team or primary
Amount and kind of labor-saving devices and equipments
Amount of centralized service provided: sterile supply , central o2 supply, linen supply
Nursing service requirements of the ancillary departments: clinics, admitting office, ER
Reports required by administration whether simple or complex
Affiliation of nursing students or medical students
Establishing Nursing Standards, Policies and Procedures
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 evaluate nursing 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
Establishing Nursing Standards, Policies and Procedures
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
Establishing Nursing Standards, Policies and Procedures
Nursing procedures Procedures are specific directions for implementing
written policies
Procedures are more specific guide to action than policy
NURSING MANAGEMENT FUNCTIONNURSING MANAGEMENT PROCESS
ORGANIZING
Nursing management- ORGANIZING -
ORGANIZING is the process of establishing formal authorityInvolves setting up the organizational structure through
identification of groupings, roles and relationshipsDetermines staff needed through developing and maintaining
staffing patterns and distributes them in the various areas as needed
Develops job descriptions by defining the qualifications and functions of personnel
Organizing
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
Organizing means having qualified people and the right materials, information and equipment needed to deal with contingencies
Nursing management- ORGANIZING -
PRINCIPLES OF ORGANIZATION:Communication: effective and open communication
in all forms; thread that binds the organization together Directions of communication:
Downward Upward Lateral/Horizontal Grapevine
Unity of CommandSpan of ControlDelegation of authoritySimilar AssignmentsUnity of Purpose
ORGANIZATIONAL DESIGN
Organizational design is a formal, guided process for integrating the people, information and technology of an organization.
PRINCIPLES OF ORGANIZATIONAL DESIGN
1. Division of labor2. Unity of command3. Authority and
responsibility4. Span of Control5. Contingency Factors
Nursing management- ORGANIZING -
ELEMENTS OF ORGANIZING1.Organizational Structure2.Staffing 3.Scheduling4.Developing job descriptions
Importance of organizational structure
It enables members what their responsibilities are so that they may carry them out
It frees the manager and the individual workers to concentrate on their respective roles and responsibilities
It coordinates all
Nursing management- ORGANIZING -
ORGANIZATIONAL STRUCTURE
The organizational structure refers to the process by which a group is formed its channel of authority, span of control and lines of communication.
It is the formal structure, the official arrangement of positions or working relationships that will coordinate efforts of workers of diverse interest and abilities
Patterns of Organizational Structure
Tall or Centralized StructureFlat or Decentralized Structure
TALL OR CENTRALIZED STRUCTURE
Responsible for only a few subordinates, so there is a narrow span of control
Because of the vertical nature of the structure, there are many levels of communication
TALL OR CENTRALIZED STRUCTURE
Advantage It makes use of
expertise, and allows close communication between the workers.
Supervisory individuals screen the communication.
Disadvantage Transpires that the most
skilled individuals end up doing nothing while actual tasks are done by those less capable.
Communication from bottom to top is often difficult, and messages do not get to the top
Workers tend to be very “boss-oriented “ because of the close contact with their supervisor.
Flat or Decentralized Structures
Refers to an organizational structure with few or no levels of intervention between management and staff.
Flat or Decentralized Structure
AdvantagesLower likelihood of
messages being distorted
Workers develop own abilities and autonomy and able to see the organization as humanistic resulting in greater job satisfaction
The principle of “shared governance” produces maximum potential for professional growth
DisadvantagesSupervisor spend less
time with each worker
Supervisors may lack expertise in the variety of operations and may end up making inappropriate decisions
Nursing management- ORGANIZING -
Types of Organization Classified by Nature of Authority
1)Line Organization- each position has general authority over the lower positions in the hierarchy. (also known as Bureaucratic/Pyramidal)
2)Informal Organization- refers to horizontal relationship rather than vertical.(Flat or horizontal organization)
3)Staff Organization- purely advisory to the line structure with no authority to put recommendations into action.
4)Functional Organization – each unit is responsible for a given part of the organization’s workload.
TYPES OF ORGANIZATIONAL STRUCTURE
1) Line Organization/ Bureaucratic/ Pyramidal- shows that each position has general authority over the lower position of the hierarchy.- ARA and power are concentrated at the top.
TYPES OF ORGANIZATIONAL STRUCTURE
2. Flat Organization
- refers to an organizational structure with few or no levels of intervention between management and staff.
TYPES OF ORGANIZATIONAL STRUCTURE
3. Staff Organization- purely advisory to the line structure with no authority to place recommendations into action.
TYPES OF ORGANIZATIONAL STRUCTURE
4. Functional Organization- permits a specialist to aid line position within a limited and clearly defined scope authority.
ORGANIZATIONAL RELATIONSHIP
1. FORMAL RELATIONS
2. INFORMAL RELATIONS
ORGANIZATIONAL RELATIONSHIP
1. FORMAL RELATIONS- represents by uninterrupted lines between units, showing who reports to whom.
ORGANIZATIONAL RELATIONSHIP
2. INFORMAL RELATIONS- represented by a broken or dotted line, where power relationships are coordinated.
Nursing management- ORGANIZING -
• ORGANIZATIONAL CHART
- Organizational chart is a line drawing that shows how the parts of an organization are linked.
Nursing management- ORGANIZING -
Characteristics of an Organizational Chart
1)Division of Work2)Chain of Command3)Type of Work to be performed4)Grouping of Work Segment5)Levels of Management
Nursing management- ORGANIZING -
STAFFING
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.
The process of assigning competent people to fill the roles designated for the organizational structure through recruitment, selection and development.
- STAFFING -
FACTORS AFFECTING TIME REQUIREMENT OF NURSING CARE Patient’s acuteness of illness Degree of dependence Communicability of ailment
Steps in Staffing
Determine the Number and Types of Personnel Needed
Recruitment Interview Induct or Orient the
Personnel in Organization Job Offer
Centralized Staffing
Staffing decisions for all units are made by a central office or computer.
Tends to be fairer to employees, because policies are implemented more consistently and impartially.
Frees manager to complete other functions.
Most cost effective, because it maximizes use of human resources organization-wide.
Decentralized Staffing
Staffing is done at unit level, frequently by unit manager.
Allows person who knows the individual unit the best to make staffing decisions for that unit.
Allows staff to take requests directly to their own manager, which gives them increased autonomy and flexibility.
Increases the risk that employee requests may be treated unequally or inconsistently.
Time-consuming for unit manager.
NURSING CARE MODALITIESTOTAL CARE or CASE NURSINGOne nurse is assigned to one patient for totality of care during his or her time on duty
PDNIsolation nurseNursing student
NURSING CARE MODALITIES
FUNCTIONAL NursingTask-orientedParticular nursing function is
assigned to each nurseTime savingWorker learns w/ mastery-Medication nurse-Charge nurse-Nursing attendant
Nursing Care Modalities
PRIMARY NursingNurse is responsible for the total care of a small group of clients from admission to discharge
Nursing Care Modalities
TEAM NursingThe team leader assigns patients & tasks according to job descriptions
PATIENT CLASSIFICATION SYSTEM
1. “Self care” or Minimal Care Patients
2. Intermediate or Moderate Care
3. Total Care Patients 4. Intensive Care Patients
PATIENT CLASSIFICATION SYSTEM
1. “Self care” or Minimal Care Patients
capable of carrying activities of daily living (ADL) Convalescing, no longer require intensive, moderate, or maximum care
Require dx studies, Minimal therapy Awaiting elective
surgery, Home environment
temporarily makes discharge undesirable
PATIENT CLASSIFICATION SYSTEM
2. Intermediate or Moderate Care
• requires some help from the nursing staff with special treatments.
• Given to moderately ill• Recovering from immediate
effects of a serious illness or operation
• May be ambulatory for short periods (needs assistance)
PATIENT CLASSIFICATION SYSTEM
3. Total Care Patients those who are
bedridden and who lack strength and mobility to do average daily living.
Needs close attention Requires nurse to
initiate, supervise, and perform most of the activities
Requires frequent medication
PATIENT CLASSIFICATION SYSTEM
4. Intensive Care Patients those who are critically
ill and in constant danger of death or serious injury. Acutely ill patients w/ high level of nurse dependency
Unstable condition w/c requires frequent evaluation with adjustment of therapy
Nursing management- STAFFING -
STAFFING FORMULARequirements:STANDARD VALUE OF NURSING CARE
Cases / Patients NCH/pt/day Prof. to Non-Prof Ratio
i. Surgeryii. General Wardiii. Pediatriciv. Pathologic
Nurseryv. Medicalvi. OBvii.ICU/ER/RRviii.CCU
3.43.54.62.83.43.06.06.0
60:4060:4070:3055:4560:4060:4070:3080:20
Nursing management- STAFFING -
Distribution Per Shift
SHIFT PERCENTAGE
AM
PM
NIGHT
45 %
37%
18%
Nursing management- STAFFING -
CATEGORIES OF PATIENTLevels of Care NCH Needed /pt./
dayProf: 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
70:3080:20
Nursing management- STAFFING -
PERCENTAGE OF PATIENTS IN VARIOUS LEVELS OF CAREType of Hospital Minima
l Care
Moderate
Care
Intensive Care
HighlySpl. Care
Primary Hospital
Secondary Hospital
Tertiary Hospital
Special Tertiary Hospital
70
65
30
10
25
30
45
25
5
5
15
45
-
-
10
20
Nursing management- STAFFING -
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
1. Vacation Leave2. Sick Leave3. Legal Holidays4. Special Holidays5. Special Privileges6. Off Duties as per R.A.
59017. Continuing Education
Program
Total Non-Working Days/YearTotal Working Days/YearTotal Working Hours / YearRA 5901 = 40H WK LAW
15 1515 1510 102 23 3104 523 3
152 100213 2651,704 2,120
Nursing management- STAFFING -
Steps for Computing the Staff Needed in the in-patient Unit of the Hospital
COMPUTATION: CASE: 250 BED CAPACITY TERTIARY
HOSPITAL. HOW MANY STAFF NURSES DO WE NEED?
1. CATEGORIZE PATIENT ACCDG. TO LEVEL OF CARE 250 X 30% = 75 minimal care 250 X 45% = 112.5 moderate care 250 X 15% = 3.5 intensive care 250 X 10% = 25 highly specialized
nursing care
Nursing management- STAFFING -
2. FIND THE NURSING CARE HOURS (NCH) NEEDED
75 X 1.5 (NCH @ Level I) = 112.5 NCH/day
112.5 X 3 (NCH @ Level II) = 337.5 NCH/day
37.5 X 4.5 (NCH @ Level III) = 168.75NCH/day25 X 6 (NCH @ Level IV) = 150
NCH/day-------------------
768.75 NCH/DAY
Nursing management- STAFFING -
3. FIND NCH PER YEAR
768.75 X 365 (DAYS/YEAR) = 280,593.75 NCH/YEAR
4. FIND ACTUAL WORKING HOURS NEEDED BY EACH NURSING PERSONNEL / YEAR
8 ( hrs/day ) X 213 (WORKING DAY/YEAR)=1,704 ( working hrs/year )
Nursing management- STAFFING -
5. FIND THE TOTAL NUMBER OF NURSING PERSONNEL NEEDED.
a. TOTAL NCH/ YEAR = 280,593.75 = 165 WORKING HRS / YEAR 1,704
b. RELIEF x TOTAL NSG PERSONNEL 165 X 15%=25
(CONSTANT: 15% FOR 40 HRS/WK & 10% FOR 48 HRS/WK)
c. RELIEVERS + TOTAL # OF NURSING PERSONNEL NEEDED
165 + 25 = 190 TOTAL PERSONNEL NEEDED
Nursing management- STAFFING -
6. DETERMINE PROF FROM NON PROF PERSONNEL
e.g. tertiary hospital
190 X 65% = 124 PROFESSIONAL190 X 35% = 68 NON
PROFESSIONAL
Nursing management- STAFFING -
7. DISTRIBUTE PER SHIFT
PROFESSIONAL(124) NON PROFESSIONAL(66)
AM (45%) 56 30
PM (37%) 46 24
NIGHT (18%) 22 12
Nursing management- STAFFING -
Placement of Staffproper placement:
a. fosters personal growthb. provides a motivating climate for the employeec. maximizes productivityd. organizational goals have better chances of being met
inappropriate placement:a. frustrationb. poor quality of workc. reduced organizational efficiencyd. rapid turn-overe. poor image for the agency
RA 9173 nurses with Master’s degree in Nursing are easily placed in position
Nursing management- STAFFING -
SCHEDULINGA schedule is a timetable showing planned
work days and shifts for nursing personnel.
Factors to Consider in Making a Schedule1.Different levels of the nursing staff2.Adequate coverage for 24 hours, 7 days a week3.Staggered vacations and holidays4.Weekends5.Long stretches of consecutive working days6.Evening and night shifts7.Floating
Nursing management- STAFFING -
Assessing a Scheduling System
1.Ability to cover the needs of the shift2.Quality to enhance the nursing personnel’s
knowledge, training and experience3.Fairness to the staff.4.Stability5.Flexibility
Nursing management- STAFFING -
Types of Scheduling
1.Centralized Schedule2.Decentralized Schedule3.Cyclical Schedule
Nursing management- STAFFING -
SCHEDULING VARIABLESa.Length of scheduling period whether 2 or 4 weeksb.Shift rotationc. Week-ends offd.Holiday offe.Vacation leavef. Special days g.Scheduled events in the hospital , training
programs, or meetingsh.Job categoriesi. Continuing professional education (CPE) programs
Nursing management- STAFFING -
DEVELOPING JOB DESCRIPTION
Job Description is a statement that sets the duties and responsibilities of a specific job.
Contents of a Job Description1.Identifying Data2.Job Summary3.Qualification Requirements4.Job Relationships5.Specific and Actual Functions and Activities
Nursing management- STAFFING -
Uses of Job Description1.For recruitment and selection of qualified personnel2.To orient new employees to their jobs3.For job placement, transfer or dismissal4.As an aid in evaluating the performance of an employee5.For budgetary purposes6.For determining departmental functions and
relationships to help define the organizational structure7.For classifying levels of nursing functions according to
skill levels required.8.To identify training needs9.As basis for staffing10.To serve as channel of communication.
Nursing management- DIRECTING -
DIRECTING Plan put into action Activities
Delegation – transferring responsibility Updating policy Utilize the policy updates Supervision
Roles in Supervision• Guides• Direct• Facilitates• Motivates• Teaches
Nursing management- DIRECTING -
Principles of Delegation1.Select the right person to whom the job is to be
delegated.2.Delegate both interesting and uninteresting
tasks.3.Provide subordinates with enough time to learn.4.Delegate gradually.5.Delegate in advance.6.Consult before delegating.7.Avoid gaps and overlaps.
Nursing management- DIRECTING -
What Cannot be Delegated
1.Overall responsibility, authority and accountability for satisfactory completion of all activities in the unit.
2.Authority to sign one’s name is never delegated3.Evaluating the staff and or taking necessary
corrective or disciplinary action.4.Responsibility for maintaining morale or the
opportunity to say a few words of encouragement to the staff especially the new ones.
5.Jobs that are too technical and those that involve trust and confidence.
Nursing management- DIRECTING -
Four Rights of Delegation1. task
The right task should be within the scope of the person’s practice and consistent with the job description.2. person
The right person should have the appropriate license or certificate, job description.3. communication
The right communication should be clear, concise, complete and correct.4. feedback
The right feedback should ask for input, get the person’s recommended solution to the problem and recognize the persons effort.
Nursing management- DIRECTING -
• Aspects of Delegation1. Responsibility – denotes obligation2. Authority – the power to make final decisions and give commands.3. Accountability – refers to liability
Nursing management- DIRECTING -
COMMUNICATIONCommunication is the transmission of
information, opinions, and intentions between among individuals.
Purpose of communication1. facilitates work2. increases motivation3. effects change4. optimizes patient care5. increases workers’ satisfaction6. facilitates coordination
Nursing management- DIRECTING -
Types of Communication1. Verbal Communication2. Written Communication3. Non-verbal Communication
a.Personal appearanceb.Intonation of the voicec.Facial expressiond.Posture and gaite.Touch
Nursing management- DIRECTING -
Lines of Communication UPWARD
to superior
HORIZONTAL OUTWARD
to peers and to patient, family
members of the and communityHealth Team to workers’ family
and friends DOWNWARD to subordinates
NURSES
Nursing management- DIRECTING -
DECISION MAKING 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“ why the problem occur”
2. analysis of the problem“getting to the cause of the problem”
3. development of an alternative solution“search for and analysis of alternatives and their
possible consequences”4. selection of the solution
weighing of facts and exploring alternative solutions5. implementation and follow-up
Nursing management- DIRECTING -
Major Management Functions in Implementing Decisions1. Planning which entails consideration and selection of realistic objectives, policies and procedures.2. Organizing which means helping personnel understand the decision and the procedures necessary for implementing the decision.3. Staffing or the selection of the right person/s to carry out the decision4. Controlling the environment and the group to prevent adverse effects.
Nursing management- DIRECTING -
Art of Decision Making:1.Not making decision that others should make,
to preserve morale and authority;2.Not deciding on problems that are not
pertinent to matters at hand to prevent waste of time and energy;
3.Not deciding prematurely to prevent prujudice4.Not making ineffective decisions to avoid losing
the respectability of the decision maker.
Nursing management- DIRECTING -
CONFLICT MANAGEMENT
CONFLICTS – clash, fight, battle or struggle; it may be constructive or destructive
Basis of the Conflict1. Intrapersonal2. Interpersonal3. Group4. Intergroup5. Organizational
Nursing management- DIRECTING -
Sources of the Conflict Cultural differences Different facts Separate pieces of information Different perception of the event Defining the problem differently Divergent views of power and authority Role conflicts Number of organizational levels Degree of association Parties dependent on others Competition for scarce resources Ambiguous jurisdictions Need for consensus Communication barriers Separation in time and space Accumulation of unresolved conflit
Nursing management- DIRECTING -
Types of Conflict1. Intrasender
- conflict originates in the sender who gives conflicting instructions.
2. Intersender- conflict arises when an individual receives conflicting messages from two or more sources.
3. Interrole- conflict can occur when an individual belongs to more than one group.
4. Person-role- conflict is the result of disparity between internal and external roles.
Nursing management- DIRECTING -
5. Interperson- conflict is common among people whose positions require interaction with other persons who fill various roles in the same organization or other organizations.
6. Intragroup- conflict occurs when the group faces a new problem.
7. Intergroup- conflict is common where 2 groups have different goals and can achieve their goals only at the others’ expense.
8. Role Ambiguity- a condition in which individuals do not know what is expected on them.
9. Role Overload- the person is simply unable to accomplish so much within a limited time period.
Nursing management- DIRECTING -
Conflict Resolution1. Avoidance
- used by groups who do not want to do something that may interfere with their relationship2. Accommodation
- self-sacrifice3. Collaboration
- inspires mutual attention to the problem and utilizes the talents of all parties
4. Compromise- in this method, accommodation and adjustment
lead to workable situations rather than to the best solution.
Nursing management- DIRECTING -
5. Competition- it is an assertive position that fosters conflict
resolution on the part of the subordinate.6. Smoothing
- disagreements are ignored so that surface harmony is maintained in a state of peaceful co-existence.
7. Withdrawing - one party is resolved thereby making it
possible to resolve the issue.8. Forcing
- yields an immediate end to the conflict but leaves the cause of the conflict unresolved.
Nursing management- DIRECTING -
Rules on Mediating a Conflict Between Two or More Parties:1. Establish clear guidelines and make them known to all.2. Do not postpone indefinitely.3. Create an environment that makes people comfortable to make suggestions.4. Keep two-way communication.5. Stress a peaceful resolution rather than confrontation.6. Emphasize shared interests.7. Follow-up on the progress of the plan.
Nursing management- DIRECTING -
• Staff DevelopmentStaff development is geared ultimately
to organizational development.
• OrientationOrientation is a planned and guided
activities of an employee in the organization, the work environment , and in his job.
Nursing management- CONTROLLING -
CONTROLLINGControlling or evaluating is an on-going
function of management which occurs during planning, organizing, and directing activities.
The controlling process opens opportunities for improvement and comparing performance against set standard.
Nursing management- CONTROLLING -
Reasons For Conducting Evaluation1.Evaluation ensures that quality nursing care is
provided.2. It allows for the setting of sensible objectives and
ensures compliance with them.3. It provides standards for establishing comparisons.4. It promotes visibility and a means for employees to
monitor their own performance.5. It highlights problems related to quality care and
determines the areas that require priority attention.6. It provides an indication of the costs of poor quality.7. It justifies the use resources.8. It provides feedback for improvement.
Nursing management- CONTROLLING -
Principles of Evaluation.1. The evaluation must be based on the behavioral standards of
performance which the position requires.2. The evaluation should have enough time to observe employee’s
behavior.3. The employee should be given a copy of the job description,
performance standards, and evaluation conference.4. The employee’s performance appraisal should include both
satisfactory and unsatisfactory results with specific behavioral instances to exemplify these evaluative comments.
5. Areas needing improvement must be prioritized to help the worker upgrade his/her performance.
6. The evaluation conference should be scheduled and conducted at a convenient time for the rater and the employee.
7. 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.
Nursing management- CONTROLLING -
Characteristics of an Evaluation Tool1.Should be objective2.Should be reliable3.Should be sensitive
Nursing management- CONTROLLING -
PERFORMANCE APPRAISALPerformance appraisal is a control process in
which employee’s performance is evaluated against standards.
Purposes of Performance Appraisal1.Determine salary standards and merit increases.2.Select qualified individuals for promotion or transfer.3.Identify unsatisfactory employees for demotion or
termination4.Make inventories of talents within the institution.5.Determine training and development needs of
employee.
Nursing management- CONTROLLING -
6. Improve the performance of work groups by examining, improving, correcting interrelationship between members
7. Improve communication between supervisors and employees and reach an understanding on the objectives of the job
8. Establish standards of supervisory performance.9. Discover the aspirations of employees and
reconcile these with the goals of the institution10. Provide employee recognition11. Inform employees where they stand.
Nursing management- CONTROLLING -
Methods of Measuring Performance1.Essay2.Checklist3.Ranking4.Rating Scales5.Forced-choice Comparison6.Anecdotal Recording
Nursing management- CONTROLLING -