MODULE 1-3: NURSING LEADERSHP AND MANAGEMENT
MODULE 1: LEADERSHIP &
MANAGEMENT NURSING
Leader - Vision, strategize, motivate and
negotiate to achieve goals.
Nursing Leadership
- influencing others to improve the quality
of care.
- Linked to improved staff retention
- Reduced medical errors
- Benefiting the healthcare workplace as
a whole.
Management - process of planning, organizing,
staffing, directing & controlling the effort of
people.
CONCEPTS OF LEADERSHIP AND
MANAGEMENT
1. Mary Parker Follett - “is the art of
getting things done through people”.
2. Harold Koonz - “management is the art
of getting things done through others &
with formality organized groups.”
3. Frederick Winslow Taylor - “do it in the
best and cheapest manner”
4. Mary Cushing Nile - “scientific
management achieves a social
objective”
5. Peter Drucker - “multipurpose organ
that manages a business and manages
managers and workers work”
6. Henry Fayol - management is to
forecast, plan, organize, commend,
coordinate and control activity.
7. Joseph Massie - process by which a
cooperative group directs action toward
common goals.
8. Theo Haimann & William Scott - social
& technical process which utilizes
resources…
LEADERSHIP THEORIES
● The Great ManTheory (1840s) - The
thought that Great Leaders are
born...not developed.
● TheTrait Theory of Leadership
(1930s-1940s) - The thought that there
are ideal characteristics for Leaders.
● The SkillsTheory of Leadership
(1940s-1950s) - The thought that there
are ideal technical, personal and
conceptual skills for both Managersand
Leaders.
● The Style Theories of Leadership
(1940s-1950s) - The thought that
adopting styles like being autocratic &
demanding, democratic & participative
or laissez faire unengaged.
● The Situational Leadership
Theory(1960s) - The thought that
there isn't a one- size- fits- all-
model, leaders must adapt.
● The Contingency Theory (1960s -
The thought that since there isn't
one-size-fits-all-model, organizations
must choose an appropriate leader.
● Transactional Leadership Theory
(1970s) - The thought that people
follow leaders based on transactions'
inside a mix of rewards, incentives &
punishments(quid pro quo
approach).
● Transformational Leadership
Theory (1970s) - The thought that
leaders gain the commitment of
others' by inspiring, encouraging &
caring for them.
● Leader-Member Exchange
Theory(1970s) - The thought is
similar to transactional theory, but
stresses the presence of an ingroup
and out group.
● Servant Leadership Theory
(1970s-1980s) - The thought that
the leader starts by identifying the
needs of the followers and views
their primary role serving others.
LEADERS VS. MANAGERS
MODULE 1-3: NURSING LEADERSHP AND MANAGEMENT
CONTEMPORARY LEADERSHIP
THEORIES
1. Transformational Leader
- leaders focus on the company’s well
being rather than what is best for the
employees.
- 4 tools they use to influence
employees: Charisma “magnetic”,
inspirational motivation, intellectual
stimulation & individualized
consideration.
2. Transactional Leader
- ensures that employees demonstrate
the right behaviors in exchange for
resources.
- Contingent rewards - rewards for
employee’s accomplishments.
- Active management by exception -
leave employees alone to do their job
but proactively predicting potential
problems & prevent it from occurring.
- Passive management by exception -
leave employees alone to do their job
but the manager waits until something
goes wrong before coming to rescue.
3. Leader-Member Exchange Theory
- leaders propose relationships with
employees to promote understanding.
- High-quality LMX relationships -
leader forms a trust based relationship;
the leader and the member are both
ready to go above and beyond their job
descriptions to promote the other’s
ability to succeed.
- Low-quality LMX relationships -
leader and the member have lower
levels of trust, liking, and respect toward
each other.
4. Servant Leadership
- serving the needs of their employees
first.
- feel an obligation to their employees,
customers, and the external community.
5. Authentic Leadership “ be yourself”
- one key characteristic of authentic
leaders is that they are self-aware.
- Ex. authentic leader: Howard Schultz
MANAGEMENT THEORIES
1. Scientific Management by Frederick
Winslow Taylor
- father of scientific management
- provided incentives in the form of wage
increases meet new loading goals.
2. Bureaucratic Management Approach
by Max Weber
- to help eliminate the practice of social
privilege and favoritism prevalent in
family owned businesses.
- his idea that hiring and promotion
should be based on capability and not
social standing is written into US labor
laws.
3. Administrative Management by Henry
Fayol
Management Function:
● Foresight: an organizational
plan for the future.
● Organization: implementation of
the plan.
MODULE 1-3: NURSING LEADERSHP AND MANAGEMENT
● Command: select and lead
workers.
● Coordinate: make sure all
activities are coordinated and
help to reach goal.
● Control: ensure activities are
going as planned.
14 Management Principles by Fayol
● Division of Work - the more people
specialized, the more efficiently they can
perform.
● Authority and Responsibility - the
right to give command and order and
power to exact obedience
● Discipline - obedience To agreement
between parties in the firm must Be
exercised; manager in the organization
needs to respect the rules and
agreement that govern the organization
● Unity of Command employees should
receive orders from only one superior.
● Unity of direction - each group
activities having the same purpose
should operate under one head and one
plan;operativo within the organization
should have the same object (should be
directed by one superior).
● Subordination of individual interest
to general interest or common goal -
the overall objective that the group
seeks to achieve takes precedence over
the objective of the individual works
● Remuneration of personnel
compensation for should be based on
systematic attempt to reward
● Centralization and decentralization -
role of subordinates indecision making;
involves the degree to which
subordinates participate in decision
● Scalar chain/hierarchy/line
authority - a graded chain of authority
from top to bottom through which all
communication flow
● Order - the material and human
instrument of business must be
arranged logically;material should be in
the right place and right time.
● Equity - enforcement of established
rules tempered by the sense of
blindness and justice should prevail in
the organization;both friendly and fair to
everyone
● Stability of tenure of personnel - top
management should implement
practices which encourage the long term
commitment of employees.
● Initiative - employees must be
encouraged to think through and
implement a plan of action;freedom to
conceive and carry out a plan even if
some mistakes may result.
● Esprit de corps - unity of effort through
harmony of interest;promote team spirit
to promote sense of unity.
4. Humanistic Viewpoint (Human
Relation’s Theory) by Mary Parket
Follet
- Mother of Modern Management
- This is related to the idea of authority
deriving from expertise rather than
position or status.
- Workers and managers have equal
importance and make equal
contributions.
- Promoting conflict resolution in groups
known as constructive conflict concepts.
-
of
MODULE 1-3: NURSING LEADERSHP AND MANAGEMENT

MODULE 2: PATIENT
CLASSIFICATION SYSTEM

Types of PCS available

1. Descriptive - a purely subjective

system wherein the nurse selects
which category the patient is best
suited.
2. Checklist - patient is assigned to a
numerical value based on the level CHARACTERISTIC PATIENT
of activity in specific categories. CLASSIFICATION SYSTEM
3. Time standard - nurse assigns a
time value based on the various
activities needed to be completed for
the patient.

DESCRIPTIVE KIND OF PATIENT

CLASSIFICATION CATEGORIES OF
PATIENTCLASSIFICATION SYSTEM
1. Self Care/ Minimal Care - requires only
diagnostic studies, minimal therapy, less
CATEGORY 1: Self-Care requiring 1 – 2 hours
frequent observations, and daily care for
minor conditions and are awaiting
CATEGORY 2: Minimal Care requiring 3 – 4
elective surgery.
hours
2. Moderate Care - moderately ill or under
the recovery stage from a serious illness
CATEGORY 3: Intermediate Care 5 – 6 hours
or operation
3. Maximum Care - Patient needs close
CATEGORY 4: Modified Intensive Care 7 – 8
attention and complete care all through
hours
the shift.
4. Intensive Care - patients are acutely ill
CATEGORY 5: Intensive Care 10 – 14 hours
and high level of nurse dependency is
required.

MODULE 2: MODALITIES OF
CARE

Case Manager
● Help the family to identify all the options
for care and treatment, ask questions to
obtain greater understanding of the
overall problem, and work with the
family in the decision- making process.
MODULE 1-3: NURSING LEADERSHP AND MANAGEMENT
● Follow the patient from the diagnostic
phase through hospitalization,
rehabilitation and back to home care.
ADVANTAGES: FOR THE PATIENT
● Establishing and achieving a set of
“expected” or standardized patient care
outcomes for each patient.
● Facilitating early patient discharge or
discharge within an appropriate length
of stay.
● Facilitating the continuity of patient care
through collaborative practice of diverse
health professionals.
ADVANTAGES: FOR THE NURSE
● Enhancing nurse’s professional
development and job satisfaction.
● Facilitating the transfer of knowledge of
expert clinical staff of novice staff.
● Assists with decision-making by
ensuring that plans are made in
advance for the next needed step.
● Ensure that the patient receives care
that will achieve the most positive
outcomes in the most efficient manner.
CASE MANAGER EMPLOYED BY THE
HOSPITAL
● Planned until the time of discharge
● Facilitates follow up and solve any
problem
CASE MANAGERS IN PRIVATE PRACTICE
● Focus on particular group of client
INTEGRATED MODEL OF CARE:
1. CRITICAL PATHWAY
➢ Relies on critical pathways to guide care
➢ Provide direction for managing the care
of a specific patient during a specified
time period
ADVANTAGES:
● Accommodate unique characters and
conditions of patients.
● Reduce costs and length of stay.
● Use appropriate sources
DISADVANTAGES:
● Need to be revised or additional data
may be needed before changes are
made.
● Include a means to identify variances
easily and to determine whether the
outcome has been met.
2. DIFFERENTIATED PRACTICES
➢ Sorting nursing practice roles, function
and work based on education,
experience, and competence or some
combination of them.
ADVANTAGES:
● Nurses are allowed to work in
specialized roles for which they were
educated, leading to greater career
satisfaction.
DISADVANTAGES:
● Nurses who have experience,
knowledge and capability to function
beyond their original education may
NOT recognized.
● Organizations that have determined
minimal educational requirements for
RN positions may have DIFFICULTY IN
RECRUITING staff with the requisite
credentials.
PRIMARY NURSING
● Organizing patient care delivery in which
one RN functions autonomously as the
patient’s primary nurse throughout the
hospital stay
● 24-hour responsibility for planning
the care of one or more patients
● The only type of patient care delivery
that requires a one- to one relationship
between a nurse and a patient
MODULE 1-3: NURSING LEADERSHP AND MANAGEMENT
DIRECT CARE NURSE’S ROLE
● Provide Holistic care ( physical ,
emotional ) to a group of
● patients during defined work time.
● Complete functions of care assessment,
personal hygiene
● NO delegation tasks
ADVANTAGES:
● provides nurses with high autonomy and
responsibility.
● One nurse give all care to the same
patient(s) for the entire shift that lead to
satisfaction of patients..
● Assigning patients is simple and direct
and does not require the planning.
● Continuous, holistic, expert nursing
care.
● Total accountability or the nursing care
of the assigned patient(s) for that shift.
● Continuity of communication with
the patient, family, physician(s), and
staff from other departments
● The lines of responsibility and
accountability are clear.
● The nurse , patient , and family
usually trust one another and work
together toward specific goal.
● Changes in the patient’s status can be
easily noticed.
● Critical care units or Post anesthesia
recovery areas.
DISADVANTAGES:
● RNs spend some time doing tasks that
could be done more cost-effectively by
less skilled persons.
● There is little opportunity for
Supervision or observation
● The greatest disadvantage of total
patient care delivery occurs when the
nurse is inadequately prepared to
provide total care to the patient.
● In the early history of nursing, only RNs
provided care; now a variety of nursing
care personnel, many of who have no
license and limited education, work with
patients.
● Nursing shortages
● Unsafe Care
FUNCTIONAL NURSING
● Method by which staff member (licensed
and unlicensed) perform specific tasks
for a larger group of patients rather than
care for specific person
NURSE MANAGER’S ROLE
● Teaching, and coordinating patient
activities.
● Responsible for more than one unit.
● Determine which nurse are competent
and interested in becoming a charge
nurse or a team leader
● Provide an adequate staff mix.
● Orient team members to the team
nursing system.
● Providing continuing education
NURSE MANAGER: IMPORTANT ROLE
● Unit quality manager.
● Delegation.
● Budget controller.
● Decision making.
● Ac as role model, consultant , coach.
DIRECT CARE: IMPORTANT ROLE
● Caregiver, Decision maker, Teacher,
Care coordinate, manager.
● Primary nurse depend on associate
nurse.
● Changing in the plan can be made
by the associate nurse in coordination
with the primary nurse.
CHARACTERISTICS:
● Must be sensitive to the quality of
patient care delivered and the
institution’s budgetary constraints.
● Achieving patient outcomes.
● By using effective management and
leadership skills, can improve the
staff’s perception of their lack of
independence.
● Rotate assignments among staff.
MODULE 1-3: NURSING LEADERSHP AND MANAGEMENT
● Staff meetings should be conducted
frequently. This encourage staff to
express concerns and empowers them
with the ability to communicate about
patient care and functions.
ADVANTAGES;
● the staff become very efficient and
effective at performing their regular
assigned tasks.
● tasks are completed quickly.
● Little confusion regarding
responsibilities.
● Unskilled workers can be trained to
perform specific tasks.
● Cost effectivee
● Functions well in areas such as:
- Operating Room
- Long -Term Care Facilities.
- Ambulatory clinics.
- In crises and emergencies
situations.
DISADVANTAGES:
● Fragmentation of care.
● Lack of holistic understanding of the
patient(spiritual and psychological
needs).
● Problems with follow-up and patient
progress.
● Use of unlicensed assistive
personnel (UAPs) to deliver nursing
care
● (low job satisfaction).
● Employees focus only on their own
efforts, with less interest in overall
results.
● Patients become confused with many
different care providers
● Patient’s response to care is difficult to
assess.
● Critical changes in patient status may go
unnoticed.
● Can lead to Patient and family
dissatisfaction and frustration.
TEAM LEADER’S ROLE
● Developing or updating nursing care
plans.
● Delegate the work.
● supervise, and coordinate team
members.
● Assisting team members.
● Resolving problems encountered by
team members.
● Follow up with members to evaluate the
quality of care the patients assigned to
their team.
● Facilitates patient care conferences.
TEAM NURSING
● Developed that reduced the
fragmented care that accompanied
functional nursing.
● Ancillary personnel collaborate in
providing care to a group of patients
under the direction of a professional
nurse
MODULAR NURSING
● A mini-team (2-3 members
approach).
● Members are sometimes called
“care pairs”.
● A small team requires less
communication, allowing members
better use of their time for direct
patient care activities.
ADVANTAGES:
● Improved continuity, quality and
coordination of care.
● Decentralization of nursing care
decisions,authority, and responsibility to
the staff nurse.
● Patient and family are satisfied with the
care.
● Nurses develop skill in primary nursing
care delivery, they feel challenged and
rewarded.
● 24-hour accountability for nursing care
activities by one nurse
MODULE 1-3: NURSING LEADERSHP AND MANAGEMENT
● High job satisfaction.
● Decrease the number of unlicensed
nurses.
● All staff are RN(professional staff)
● Motivation
● Autonomy
DISADVANTAGES:
● Nurse may not have the experience or
educational background.
● Lies primarily in improper
implementation.
● It requires excellent communication
between the primary nurse and
associate nurses.
● Primary nurses must be able to hold
associate nurses accountable for
implementing the nursing care as
prescribed.
● Because of transfers to different units,
critically ill patients may have several
primary care nurses, disrupting the
continuity of care inherent in the model.
● This method is difficult to implement
because of the degree of responsibility
and autonomy required of the primary
nurse
PRACTICE PARTNESHIP
● Senior RN direct the work of the junior
partner according to partner’s abilities.
● Two partners work in concern with
patients.
● Senior RN perform selected patient care
activities and delegates less ones to the
junior.
ADVANTAGES: GENERAL
● Improved continuity of care .
● Offered an efficient way of nursing skills
of a mix of different levels of
experiences.
● Less expensive for the organization.
● Satisfying professionally for the partners
ADVANTAGES: FOR PATIENT
● Establishing and achieving a set of
“expected” or standardized patient care
outcomes for each patient.
● Facilitating early patient discharge or
discharge within an appropriate length
of stay.
● Using the fewest possible appropriate
health care resources to meet
expected patient care outcomes.
● Facilitating the continuity of patient care
through collaborative practice of diverse
health professionals.
ADVANTAGES: FOR THE NURSE
● Enhancing nurse’s professional
development and job satisfaction.
● Facilitating the transfer of knowledge of
expert clinical staff of novice staff.
● Assists with decision-making by
ensuring that plans are made in
advance for the next needed step. and
helps to ensure that the patient receives
care that will achieve the most positive
outcomes in the most efficient manner.
This process helps to eliminate costly
delays in progress.
● Accommodate unique characters and
conditions of patients.
● Reduce costs and length of stay.
● Use appropriate sources
DISADVANTAGES:
● The critical pathway may need to be
revised or additional data may be
needed before changes are made.
● The critical path must include a means
to identify variances easily and to
determine whether the outcome has
been met.
● Nurses who have experience,
knowledge and capability to function
MODULE 1-3: NURSING LEADERSHP AND MANAGEMENT

beyond their original education may not 3. manage a village or community

recognized. 4. ability to lead
● Organizations that have determined 5. utilize mechanism of networking
minimal educational requirements for
RN positions may have difficulty in Beginning nurse's role in research
recruiting staff with the requisite 1. nursing and health related research
credentials. 2. evaluate research study report
3. applies research process
MODULE 3 PHILIPPINE
Four Domains of the nursing practice
REGULATION BOARD OF
standards
NURSING 1. VALUE-BASED NURSING PRACTICE

R.A 7164 - Philippine Nursing act of 1991 2. KNOWLEDGE-DRIVEN NURSING

article 3 sect 4 states enumerates the power PRACTICE
duties and function of PRBON. the impetus in
the development of nursing standards emanated 3. OUTCOME-ORIENTED
from PROFESSIONAL RELATIONSHIP

R.A 9173- Philippine Nursing Act of 2002 article 4. LEADERSHIP AND GOVERNANCE
3 sect 9 state that the PRBON is empowered to
monitor and enforce standard of nursing practice SEC. 4. Qualifications of the Chairperson
in the Philippine. Providing more responsive and Members of the Board.
nursing profession
The Chairperson and Members of the Board
shall, at the time of their appointment, possess
Board Of Nursing resolution no. 82- it was
the following qualifications:
adapted September 30, 1998 that promulgate
the standards
➢ (a) Be a natural born citizen and
resident of the Philippines;
3 years- the PRBON came up with 2012
➢ (b) Be a member of good standing of the
National Nursing core competencies standards
accredited professional organization of
nurses;
3 major role of nurse
➢ (c) Be a registered nurse and holder of a
1. beginning Nurse's role in client care
master's degree in nursing, education or
2. beginning Nurse's role in leadership and
other allied medical profession
management
conferred by a college or university duly
3. beginning Nurse's role in Research
recognized by the Government:
➢ (d) Have at least ten (10) years of
Beginning nurse's role in client care
continuous practice of the profession
1. legal principle
prior to appointment: Provided, however,
2. Nursing process
That the last five (5) years of which shall
3. chart as document( accurate updating
be in the Philippines; and
system)
➢ (e) Not have been convicted of any
4. collaborate relationship
offense involving moral turpitude;
➢ Provided, That the membership to the
Beginning nurse's role in leadership and
Board shall represent the three (3)
management
areas of nursing, namely: nursing
1. management and leadership
2. accountability and safe
MODULE 1-3: NURSING LEADERSHP AND MANAGEMENT

education, nursing service and

community health nursing.

SEC. 6. Term of Office.

➢ The Chairperson and Members of the
Board shall hold office for a term of
three (3) years and until their
successors shall have been appointed
and qualified: Provided, That the
Chairperson and Members of the Board
may be reappointed for another term.

Any vacancy in the Board occurring within the

term of a Member shall be filled for the
unexpired portion of the term only. Each Member
of the Board shall take the proper oath of office
prior to the performance of his/her duties.

SEC. 7. Compensation of Board Members.

➢ The Chairperson and Members of the
Board shall receive compensation and
allowances comparable to the
compensation and allowances received
by the Chairperson and members of
other professional regulatory boards.