Professional Documents
Culture Documents
NS PRINCIPAL
Functions
Participation in the planning of controlling authority relates to the school of nursing
Preparation of the school budget and making recommendation with regard to the
controlling authority
Organizing and administering of curriculum
Active participation in teaching programme
Periodic evaluation of the total programme
Formulation and implementation of realistic polices in relation to staff and students
Determining staff requirement and recruitment of staff in accordance with the policies of
in trolling authority
Welfare of student and staff, including account section, health, recreation and vocation
Maintenance of proper system of records
Participation in planning of nursing services in clinical areas in students are employed
Interpretation of nursing education to other related discipline and to public
Submit periodic report to the controlling authority of state, national nursing council and
others
Budget
The administration of school of nursing requires a budget and how it is allotted and
managed will depend on the type of controlling authority
If the administration of school is completely separate but in most school of nursing, it
will be included in the total budget of hospital.
The items which have to be budgeting for average govt. school of nursing in India are:
Salaries for professional, clerical, domestic staff and drivers
Stipend for students
New equipment and repairs
Linen and other household supplies
Office supplies including stationary and postage
Maintenance of transport and cost effort
Maintenance of library
Fund for educational tours, professional activities, capping, graduation ceremony, prize,
entertainments etc.
Advisory committee
The efficient, effective democratic way of coordinating the activities is by means of committees
Members
NS
Senior tutors
MS
Representative of controlling authority
Representatives from each of the hospital and committee agencies used for clinical
experience
Warden
General educationalist
A local community member
An independent representative of medical professional
Functions
Study the social and educational need of school. To advise the school about the need of
society in relation to nursing service.
Advise on policies and support school staff inn implementing them
Support philosophy of school and advice school authorities in its implementation
Show concern with the welfare of staff and students
Assist in interpreting the educational purpose of school to the public
Courses and educational activities in school of nursing
School of nursing offer the programme of general nursing and midwifery. This
programme 3 years duration and has various subjects take
Students are evaluated by class tests and three sessional examination and one final
examination at the end. Strict attendance – students participate and organize seminars ,
workshop
College of nursing
In colleges under govt.university they have specification of seat for various qurtas
Service institutions are hospitals controlled by central and state govt. and by
religious and social agencies
Staff of the director/head of college (principal/dean who is well qualified and
experience on nursing)
Staff position vary according to organization pattern and controlling bodies as
well as on various departements
A hospital administrator must know what tasks need to be accomplished to achieve the
objectives of this institution
To execute the task economically and efficiently it is necessary to split the activities
These organizing refer to the formal grouping of staff and activities to facilitate achievement of
objectives
Director/principal
Dpy. Director /vice principal
Professor HOD
Associate professor
Assistant professor
Lecturers/clinical instructor
The main objective is to prepare the graduates to function as efficient members of health team
and as a citizen of the country
Budget
Controlling authority takes full responsibility for administering budget
Item which have to be budgeted includes
Salaries for professional, clerical, domestic staff and drivers
Stipend for students
New equipment and repairs
Linen and other household supplies
Office supplies including stationary and postage
Maintenance of transport and cost effort
Maintenance of library
Fund for educational tours, professional activities, graduation ceremony, prize,
entertainments etc.
controlling authority
(board/ trust)
Asso.professor
Assi. professor
Organizational structure
Administrative and programme
Council
Academic control: Minister of health
University state board Secretary of health and family
Board of studies in nursing welfare
Other responsible bodies Sr.Asst. Director of health
principal
teaching staff library office hostel
Registrar
Dean CON
Ass.dean
HOD
Asso.prof
Lecturers
Asst.lecturer
Asst.prof
Office staff
House keeping
Courses and educational activities in CON
The CON usually offers the programme of BSc (N), post certificate BSc(N), MSc(N), Mphil nsg
and Phd Nsg.
Bsc (N) 4 year programme which makes the professional nurse responsible for bedside nursing
care as well as teaching
Msc (N) 2 year programme aimes at preparing the nurse to specialize in area of interest in
nursing
Mphil and Phd programme are offered by limited number of college and it is usually offered by
university. Institutions functions as a channel. It makes it possible for the professional to
undertake and carry out research.
INSTITUTIONAL LEVEL – AT HOSPITAL
Director of nursing
Nursing services must function under a senior competent nursing administrator – variously called
as director of nursing, nursing superintendent, principal matron, or matron-in- chief. She is
responsible to the hospital administrator for overall programme and activities of nursing care of
all patients in the hospital. Nursing programme is administered by her through appropriate
planning of services, determining nursing policies in collaboration with hospital management
and nursing procedures in collaboration with nursing staff, giving general supervision, delegation
of responsibility, coordination of interdepartmental nursing activities‘, and counseling the
hospital administration on nursing problems.
She has a dual role: the first one is the administrative responsibility towards hospital
administration, and the second one is the coordinating of all professional activities of nursing
staff with those of medical staff.
The role of the nursing superintendent starts in a new hospital from helping to establish the
overall goals, policies and organization, and facilities to accomplish these goals in the most
effective and efficient manner. The functional elements of the role of nursing superintendent
includes the following
Formation of the aims, objectives and policies of nursing services as an integral part of
hospital service
Staffing based on nursing requirements in relation to accepted standard of medical care
Planning and directing nursing services
Maintaining supplies and equipments
Budgeting
Records and reports
Nursing supervisor
Each department or clinical division, e.g. Medical, surgical, obstetrical, operation theatres,
outpatient department, nurseries, etc. should have a supervisor. As they may be more than one
nursing unit in each division or department, supervisors have a general administrative and
coordinating function within their respective division. However, supervisors will also have
limited clinical functions
Head nurse / nursing tutor
A head nurse is assigned to a nursing unit, or ward, or a section of department. She works under
the general direction of the supervisor of the division.
Staff nurse / clinical instructor
Staff nurses are employed at the floor‘ level for carrying out skilled bedside nursing. This is the
real work force of the hospital upon whose competency, state of training and dedication depend
the success of the nursing department.
Student nurse
Students nurse cannot be employed on nursing duties except under supervision of fully qualified
staff nurses.
Policies and procedures
In order that a good standard of nursing care be maintained, the nursing superintendent should
develop written policies and procedures to serve as a guides for nurses of the various units of the
hospital.
Important topics that should be incorporated are as follows
Organization
Status and relationship
Responsibilities
Staffing pattern, shift pattern
Departmental functions
Requisitioning of supplies
Utilization, care and maintenance of equipment
Nursing procedures, coordination with domestic services
Handling of the patients clothing and valuables
Isolation technique
Functions of hospital in nursing services and education
As a basic function, to assist the individual patient in performance of those activities
contributing to his health or recovery that he would otherwise perform unaided has had
the strength will, or knowledge.
As an extension of the above basic function, to help and encourage the patients to carry
out the therapeutic plan initiated by the physician
As a member of health team, to assist other members of the team to plan and carryout the
total programme of care
AT COMMUNITY
Organizational set up at the distrit level
Director nursing services
Ward sister
clinical instructor LHV/HS
Staff nurse LHV
ANM
PHCs (Primary Health Care)
Introduction
The PHC is the first contact point between the village community and the medical officer. These
are established and maintained by the state government under minimum needs/ basic minimum
services programme. It acts as a referral unit for six sub centre and has 4-6 beds. A PHC covers
population of 30000 in plain area and 20000 in hilly remote and tribal area. The activities of
PHC‘s involve curative, preventive, promotive and family welfare services.
Definition
Primary health centre is the basic structural and functional unit of public health services for
rendering primary health care in peripheral areas.
Elements of PHC
Ensure safe water supply
Locally endemic disease control
Education/ expanded programme on immunization
Maternal and child health
Environmental sanitation
Nutritional services
Treatment of minor aliments
School health services
Standards of PHC
The PHCs has been prepared keeping in view the resources available with respect to functional
requirement for PHCs with minimum standards such as-
Building
Man power
Instrument
Equipments
Drugs
Other facilities
The standards prescribed are , a PHC covering 20000-30000 population with six beds on well the
block level PHC are ultimately going to be upgraded as CHC with 30 beds of providing
specialized services.
The objectives of PHCs are:-
To provide comprehensive primary health care to the community through the PHC
To achieve and maintain an acceptable standards of quality of care
To make the services more responsible and sensitive to the needs of the community
Minimum requirements are:-
The assured services cover all the essentials of preventive, promotive, curative and rehabilitative
primary health care.
This implies a wider range of services that includes
Medical care
Maternal and child health care
Full rage family planning services including counseling and appropriate referral for
couples having infertility
MTP services
Health education for prevention and management of malnutrition, anemia and vitamin A
deficiency and co-ordinates with ICDS
School health services
Adolescent health care
Disease surveillance and control of epidemics
Staffing pattern
The man power that should be available in the PHC is as follows
AYUSH practitioner - 1
Accountant manager - 1
Pharmacist 1 2
Health worker 1 1
Health educator 1 1
Clerks 2 2
Laboratory technician 1 2
Driver 1 OPTIONAL /
vehicle may
be from out side
Class IV 4
Nursing Superintendent
↓
Student nurse
Review of literature
A cross sectional study was conducted on organization of hospital nursing, provision of nursing
care and patient experience with care in Europe by Luk Bruneel, Baoyue Li et al(2015) This
study integrates previously isolated findings of nursing outcomes research into an explanatory
framework in which care left undone and nurse education levels are of key importance. A
moderated mediation analysis of survey data from 11,549 patients and 10,733 nurses in 217
hospitals in eight European countries shows that patient care experience is better in hospitals
with better nurse staffing and a more favorable work environment in which less clinical care is
left undone. Clinical care left undone is a mediator in this relationship. Clinical care is left
undone less frequently in hospitals with better nurse staffing and more favorable nurse work
environments, and in which nurses work less overtime and are more experienced. Higher
proportions of nurses with a bachelor’s degree reduce the effect of worse nurse staffing on more
clinical care left undone.
Another research study was conducted on Organisational structure and nursing service
management of select Hospitals by Sushma Kumari Saini, Charanjeev Singh. They find that
Organisational structure means the formal structure of authority calculated to define, distribute
and provide for the co-ordination of tasks and contributions to the whole which is very essential
for fulfilling the objectives of an organisation. In order to understand the functioning of an
organisation, it is important to study its organisation structure. Keeping it in mind a study was
conducted to study the organisation structure of nursing department and nursing service
management of three select hospitals i.e. one Autonomous hospital, one private hospital and one
state government hospital. Investigator visited all the three hospitals and information related to
organisation structure and nursing service management was collected from the nursing office.
Results revealed that all the three hospitals had different organisational structure with different
nursing positions and cadres. None of the hospital had all the positions as recommended by the
Indian Nursing Council (a statuary body) and High Power Committee 1990. However, there was
partial implementation of the recommendations in all the select hospitals. There was a wide
scope for improvement in these hospitals as regards the nursing personnel is concerned. If the
decision making regarding nursing is vested in the hands of nursing administrators then better
nursing services can be rendered which will help in turn in providing better services to patients.
Bibliography
k.park preventive and social medicine 21st edition japee publication new delhi
www.Nih.Govt
neeraja KPText book of nursing education Japee Brother medical publishers New Delhi
Basavanthappa BT. Nursing Administration. 1st edition. Jaypee Brothers Medical
Publishers; New Delhi 1998.
http://www.uta.edu/nursing/simulation/smart hospital.php
Bruyneel L, Li B, Ausserhofer D, Lesaffre E, Dumitrescu I, Smith HL, Sloane DM,
Aiken LH, Sermeus W. Organization of hospital nursing, provision of nursing care, and
patient experiences with care in Europe. Medical Care Research and Review. 2015
Dec;72(6):643-64.
Saini S, Singh C. Organisational structure and nursing service management of select
hospitals. Nursing and Midwifery Research Journal. 2008 Jul;4(3).