NURSING MANAGEMENT

PROCESS
PREPARED BY: AILYN B.PINEDA, RN

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
 Systematic  Dynamic  Interpersonal

 Goal Directed
 Universally Applicable

PLANNING MANAGEMENT FUNCTION NURSING MANAGEMENT PROCESS .

It is the continuous process of assessing. which is subject to change as new facts are known . and who is to do it. establishing goals and objectives and implementing and evaluating them.PLANNING  Is deciding in advance what to do. how to do a particular task.  Is predetermining a course of action in order to arrive at a desired results. when to do it.

principles WHO IS TO DO IT: -professional.COMPONENTS OF PLANNING PLANNING: PREDETERMINED ACTION WHAT TO DO: -nursing activities HOW TO DO IT: -technique. nonprofessional .

Projected plans must be documented for proper dissemination to all concerned for implementation and implementation as to the extent of its achievement. and clearly defined objectives of the organization. 2. . Planning should be pervasive within the entire organization covering the various departments. Planning must be precise in its scope and nature. 7. Planning utilizes all available resources. mission. services and the various levels of management to provide maximal cooperation and harmony. 6. Planning is always based and focused on the vision.Nursing management -planning PRINCIPLES OF PLANNING 1. philosophy. 5. Planning is a continuous process. 3. 4. Planning should be time bounded.

PLANNING  It leads to success in the achievements of goals and        objectives It provides meaning to work It provides for the effective use of available personnel and facilities It helps nurses cope with crises and problems calmly and efficiently It is cost effective It is based on past and future activities It reduces the element of change It is necessary for effective control .

including      results and methods for evaluation Be guided by policies and/or procedures affecting the planned action Indicate priorities Develop actions that are flexible and realistic in terms of available personnel.Characteristics of a GOOD PLAN  It should have a clearly worded objectives. equipment. facilities and time Develop a logical sequence of activities Select the most practical methods for achieving each objective .

2. OPERATIONAL OR SHORT-RANGE PLANNING “how does one do things right” .usually extending 3 to 5 years into the future. involves mapping out the day-to-day activities. 3. . CONTINUOUS OR ROLLING PLANS .PLANNING  TYPES OF PLANNING: 1.deals with day to day maintenance activities. STRATEGIC OR LONG-RANGE PLANNING “what are the right things to do” .similar to operating plans.

Set the Time Frame  Prepare the Budget and Allocation of Resources  Establish Policies Procedures and Standards . Programs/Projects/Activities.ELEMENTS OF PLANNING  Forecasting or Estimate the future  Set Objectives/Goals and Determine Results Desired  Develop and Schedule Strategies.

reasonable estimates and accurate reflection of policies and plans . cross sectional or longitudinal data  In making forecast. the planner should consider 3 things:    Agency Community affected Goals of care  Forecast must be supported by facts.Elements of Planning -Forecast or Estimate the Future Forecasting is looking into the future  Refers to estimation of time series.

are personal goals.management goals of an organization that are established to justify its existence  Short term goals and long term goals .Elements of Planning Set 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.may refer also to organizational goals although on a smaller scale Organizational goals. based on one’s desired in life Group goals.

(health education) . management of resources) To encourage its nursing personnel to participate in nursing research for improving nursing care.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. duties. (ethico-moral-legal responsibilities) To establish well coordinated referral system for the continuity of patient’s/ client’s care. ( research) To utilize media for information campaign to intensify health education program. and responsibilities of every position in the nursing department. (safe & quality nursing care. (communication) To assure the application of acceptable performance of functions.

. emergency).Nursing management . the middle or upper class).ELEMENTS OF PLANNING MISSION OR PURPOSE . and what services will be provided ( in-patient. the needy. who the target clients are ( the poor.reason for the existence of the organization (Nursing service exist to promote and maintain health) .The mission statement outlines the agency’s reason for existing ( whether hospital or health care). out-patient.

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. with its unquestionable integrity and commitment. .Vision  The Board of Nursing under the guidance of the Almighty.

ethical and legal standards as mandated by existing regulatory laws 3. fostering linkages with the domestic and international stakeholders .Mission  The BON shall unwaveringly pursue the advancement of nursing development in the country by: 1. providing leadership. unifying the nursing sector through good governance 4. information. options. ensuring adherence to professional. scenarios and lobby efforts to targeted decision makers and stakeholders 2.

Nursing management . .Philosophy is the sense of purpose of the organization and the reason behind its structure and goals.ELEMENTS OF PLANNING PHILOSOPHY .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 .

Set the Time Frame Strategy is the techniques.ELEMENTS OF PLANNING• Develop and Schedule Strategies. methods. Programs/Projects/Activities.Nursing management . Programs are activities put together to facilitate attainment of some desired goals. . or procedure by which the overall plan of the higher management achieve desired objectives.

identifying and eliminating time wastes and use of managerial techniques to reach goal s efficiently . assigning priorities.Nursing management PLANNING  Time Management is a technique for allocation of one’s time through the setting of goals.

Nursing management PLANNING  Principles of Time Management 1) 2) 3) 4) 5) 6) Planning for contingencies-planning anticipates the problem that will arise from actions without thought Listing of task-task to be accomplished should be done in sequence which are prioritized according to importance Inventory Sequencing Setting and keeping deadlines.and adhering to deadline is an excellent exercise in self discipline Deciding on how time will be spent .

Learn to delegate. Devote a few minutes at the beginning of each day for planning. 11. Break down large projects into smaller parts. executive planners. Take or return phone calls during specified time. logs or journals. 12. Set goals and objectives and write them down. write what you expect to accomplish yearly. 2. 8. monthly. 7. Take rest breaks and make good use of your spare time. 10. weekly or daily. . 6. Develop effective decision-making skills. 9. With the use of calendars. In a meeting. Conduct an inventory of your activities. Close your door when you need to concentrate. define the purpose clearly before starting.Nursing management PLANNING Time Saving Techniques. 5. Organize your work space so it is functional. 4. 3. Devices and Methods to Better Use of Time 1.

sending emails while in the meeting .Nursing management PLANNING  Multitasking  Trying to get more things done in less time  Examples: answering phone calls while driving.

WHAT 2. developed and targeted within a time frame to reach the set goals and objectives. HOW 5. WHERE 4. WHY 7. WHEN 3.  The Planning Formula 1.Nursing management PLANNING  DEVELOPING AND SCHEDULING PROGRAMS Programs are predetermined. CAN . WHO 6.

3. 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. a financial “road map” and plan which serves as an estimate for future costs and a plan for utilization of manpower. A hospital budget is a financial plan to meet future service expectations. 1.Nursing management PLANNING • PREPARING THE BUDGET A budget is the annual operating plan.

size and plan of the wards.Factors in BUDGET planning  Type of patient. etc  Personnel policies Salaries paid to various type of nursing personnel including OT pay or shift differential  Extent of VL. holidays  Provision for staff development programs   Grouping of patients such as those in specialized areas . treatment rooms. length of stay in the hospital and acuteness of illness  Size of hospital and bed occupancy  Physical lay out of the hospital. nurse’s station. SL. units.

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 efficiency of job description and job classification . the method of documentation  Proportion of nursing care provided by the professional nurses and those given by nonprofessionals  Amount and quality of supervision available and provided.

admitting office. linen supply Nursing service requirements of the ancillary departments: clinics. team or primary Amount and kind of labor-saving devices and equipments Amount of centralized service provided: sterile supply .      case.Factors in BUDGET planning  Method of patient assignment whether functional. central o2 supply. ER Reports required by administration whether simple or complex Affiliation of nursing students or medical students .

Nursing Programs . 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.Establishing Nursing Standards. Professional Organization. BON.

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.Establishing Nursing Standards. 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 .

ORGANIZING NURSING MANAGEMENT FUNCTION NURSING MANAGEMENT PROCESS .

roles and relationships  Determines 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 the process of establishing formal authority  Involves setting up the organizational structure through identification of groupings.Nursing management .

information and equipment needed to deal with contingencies .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.

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 Command Span of Control Delegation of authority Similar Assignments Unity of Purpose .Nursing management .

information and technology of an organization. guided process for integrating the people. .ORGANIZATIONAL DESIGN  Organizational design is a formal.

3.PRINCIPLES OF ORGANIZATIONAL DESIGN 1. Division of labor Unity of command Authority and responsibility Span of Control Contingency Factors . 2. 4. 5.

Nursing management . Staffing 3.ORGANIZING  ELEMENTS OF ORGANIZING Organizational Structure 2. Developing job descriptions 1. . Scheduling 4.

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 .

the official arrangement of positions or working relationships that will coordinate efforts of workers of diverse interest and abilities  . span of control and lines of communication.ORGANIZING  ORGANIZATIONAL STRUCTURE  The organizational structure refers to the process by which a group is formed its channel of authority. It is the formal structure.Nursing management .

Patterns of Organizational Structure  Tall or Centralized Structure  Flat 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 .

skilled individuals end up doing nothing while actual tasks are done by those less capable.  Supervisory individuals screen the communication.  Disadvantage  Transpires that the most and allows close communication between the workers. .TALL OR CENTRALIZED STRUCTURE  Advantage  It makes use of expertise. and messages do not get to the top  Workers tend to be very “boss-oriented “ because of the close contact with their supervisor.  Communication from bottom to top is often difficult.

.Flat or Decentralized Structures  Refers to an organizational structure with few or no levels of intervention between management and staff.

Flat or Decentralized Structure  Advantages  Lower likelihood of  Disadvantages  Supervisor spend less 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 time with each worker  Supervisors may lack expertise in the variety of operations and may end up making inappropriate decisions .

(Flat or horizontal organization) 3) Staff Organization.Nursing management .refers to horizontal relationship rather than vertical. (also known as Bureaucratic/Pyramidal) 2) Informal Organization.ORGANIZING  Types of Organization Classified by Nature of Authority Line Organization. 1) .each position has general authority over the lower positions in the hierarchy. 4) Functional Organization – each unit is responsible for a given part of the organization’s workload.purely advisory to the line structure with no authority to put recommendations into action.

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. .

INFORMAL RELATIONS .ORGANIZATIONAL RELATIONSHIP 1. FORMAL RELATIONS 2.

ORGANIZATIONAL RELATIONSHIP 1.represents by uninterrupted lines between units. . showing who reports to whom. FORMAL RELATIONS .

where power relationships are coordinated. INFORMAL RELATIONS .represented by a broken or dotted line.ORGANIZATIONAL RELATIONSHIP 2. .

Organizational chart is a line drawing that shows how the parts of an organization are linked.ORGANIZING • ORGANIZATIONAL CHART .Nursing management . .

ORGANIZING  Characteristics of an Organizational Chart 1) Division of Work 2) Chain of Command 3) Type of Work to be performed 4) Grouping of Work Segment 5) 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. selection and development. The process of assigning competent people to fill the roles designated for the organizational structure through recruitment. .Nursing management .

.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 .

 Tends to be fairer to employees.Centralized Staffing  Staffing decisions for all units are made by a central office or computer.  Most cost effective. because policies are implemented more consistently and impartially.  Frees manager to complete other functions. because it maximizes use of human resources organization-wide. .

which gives them increased autonomy and flexibility. Increases the risk that employee requests may be treated unequally or inconsistently.Decentralized Staffing  Staffing is done at unit level. Allows staff to take requests directly to their own manager. Allows person who knows the individual unit the best to make staffing decisions for that unit. Time-consuming for unit manager. frequently by     unit manager. .

NURSING CARE MODALITIES TOTAL CARE or CASE NURSING  One nurse is assigned to one patient for totality of care during his or her time on duty  PDN  Isolation nurse  Nursing student .

NURSING CARE MODALITIES FUNCTIONAL Nursing  Task-oriented  Particular nursing function is assigned to each nurse  Time saving  Worker learns w/ mastery -Medication nurse -Charge nurse -Nursing attendant .

Nursing Care Modalities PRIMARY Nursing  Nurse is responsible for the total care of a small group of clients from admission to discharge .

Nursing Care Modalities TEAM Nursing  The team leader assigns patients & tasks according to job descriptions .

Total Care Patients 4. Intermediate or Moderate Care 3. Intensive Care Patients 1. .PATIENT CLASSIFICATION SYSTEM “Self care” or Minimal Care Patients 2.

Minimal therapy Awaiting elective surgery.      “Self care” or Minimal Care Patients capable of carrying activities of daily living (ADL) Convalescing. no longer require intensive. moderate. Home environment temporarily makes discharge undesirable . or maximum care Require dx studies.PATIENT CLASSIFICATION SYSTEM 1.

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. Acutely ill patients w/ high level of nurse dependency  Unstable condition w/c requires frequent evaluation with adjustment of therapy . Intensive Care Patients  those who are critically ill and in constant danger of death or serious injury.

Pediatric iv. Medical vi. ICU/ER/RR viii.0 6. Surgery ii.0 6.4 3. OB vii.CCU NCH/pt/day 3.5 4.4 3.Nursing management . Pathologic Nursery v.8 3.6 2.STAFFING  STAFFING FORMULA Requirements: STANDARD VALUE OF NURSING CARE Cases / Patients i. General Ward iii.0 Prof. to Non-Prof Ratio 60:40 60:40 70:30 55:45 60:40 60:40 70:30 80:20 .

STAFFING  Distribution Per Shift SHIFT AM PM NIGHT PERCENTAGE 45 % 37% 18% .Nursing management .

0 7.STAFFING  CATEGORIES OF PATIENT Levels of Care Level I Self-Care or Minimal Care Level II Moderate or Intermediate Care NCH Needed /pt.5 6.Nursing management .50 Prof: Non Prof 55:45 3.0 or higher 65:35 70:30 80:20 ./ day 1.0 60:40 Level III Total or Intensive Care Level IV Highly Specialized or Critical Care 4.

Nursing management .STAFFING  PERCENTAGE OF PATIENTS IN VARIOUS LEVELS OF CARE Type of Hospital Primary Hospital Secondary Hospital Minimal Care 70 65 Moderate Care 25 30 Intensive Care 5 5 Highly Spl. Care - Tertiary Hospital Special Tertiary Hospital 30 10 45 25 15 45 10 20 .

STAFFING  TOTAL NUMBER OF WORKING AND NON-WORKING DAYS AND HOURS OF NURSING PERSONNEL PER YEAR Right s and Privileges Given each Personnel/Yr 1. 6. Vacation Leave Sick Leave Legal Holidays Special Holidays Special Privileges Off Duties as per R. 3. 4.Nursing management . 7.A. 5901 Continuing Education Program Working Hours per Week 40 hours 48 hours 15 15 10 2 3 104 3 152 213 1. 5.120 Total Non-Working Days/Year Total Working Days/Year Total Working Hours / Year RA 5901 = 40H WK LAW . 2.704 15 15 10 2 3 52 3 100 265 2.

STAFFING  Steps for Computing the Staff Needed in the in-patient Unit of the Hospital COMPUTATION: CASE: 250 BED CAPACITY TERTIARY HOSPITAL. TO LEVEL OF CARE  250 X 30% =  250 X 45% =  250 X 15% =  250 X 10% = 75 112.Nursing management .5 3. HOW MANY STAFF NURSES DO WE NEED? 1. CATEGORIZE PATIENT ACCDG.5 25 minimal care moderate care intensive care highly specialized nursing care .

75NCH/day  25 X 6 (NCH @ Level IV) = 150 NCH/day ------------------768.5 NCH/day  37.STAFFING 2.5 X 3 (NCH @ Level II) = 337.5 NCH/day  112.5 (NCH @ Level III) = 168.75 NCH/DAY .5 (NCH @ Level I) = 112.5 X 4.Nursing management . FIND THE NURSING CARE HOURS (NCH) NEEDED  75 X 1.

Nursing management .75 X 365 (DAYS/YEAR) = 280. FIND ACTUAL WORKING HOURS NEEDED BY EACH NURSING PERSONNEL / YEAR  8 ( hrs/day ) X 213 (WORKING DAY/YEAR)= 1. FIND NCH PER YEAR  768.75 NCH/YEAR 4.593.704 ( working hrs/year ) .STAFFING 3.

RELIEF x TOTAL NSG PERSONNEL 165 X 15%=25 (CONSTANT: 15% FOR 40 HRS/WK & 10% FOR 48 HRS/WK) c. a.593.75 = 165 WORKING HRS / YEAR 1. RELIEVERS + TOTAL # OF NURSING PERSONNEL NEEDED 165 + 25 = 190 TOTAL PERSONNEL NEEDED .STAFFING 5. FIND THE TOTAL NUMBER OF NURSING PERSONNEL NEEDED.Nursing management . TOTAL NCH/ YEAR = 280.704 b.

g.STAFFING 6. tertiary hospital 190 X 65% = 124 PROFESSIONAL 190 X 35% = 68 NON PROFESSIONAL .Nursing management . DETERMINE PROF FROM NON PROF PERSONNEL e.

Nursing management .STAFFING 7. DISTRIBUTE PER SHIFT PROFESSIONAL(124) NON PROFESSIONAL(66)  AM (45%) 56 30  PM (37%)  NIGHT (18%) 46 22 24 12 .

organizational goals have better chances of being met inappropriate placement: a. reduced organizational efficiency d. frustration b. poor image for the agency RA 9173 nurses with Master’s degree in Nursing are easily placed in position . rapid turn-over e. provides a motivating climate for the employee c. maximizes productivity d.STAFFING  Placement of Staff proper placement: a. fosters personal growth b. poor quality of work c.Nursing management .

7 days a week 3. Staggered vacations and holidays 4. Floating . Different levels of the nursing staff 2. Adequate coverage for 24 hours. Factors to Consider in Making a Schedule 1. Evening and night shifts 7. Weekends 5.Nursing management . Long stretches of consecutive working days 6.STAFFING  SCHEDULING A schedule is a timetable showing planned work days and shifts for nursing personnel.

training and experience Fairness to the staff. Stability Flexibility .STAFFING  Assessing a Scheduling System 1. 2. Ability to cover the needs of the shift Quality to enhance the nursing personnel’s knowledge.Nursing management . 3. 4. 5.

Nursing management . .STAFFING  Types of Scheduling Centralized Schedule 2. Cyclical Schedule 1. Decentralized Schedule 3.

training programs. Vacation leave f. Holiday off e. Continuing professional education (CPE) programs . or meetings h. Shift rotation c.STAFFING SCHEDULING VARIABLES a. Job categories i. Week-ends off d. Length of scheduling period whether 2 or 4 weeks b. Scheduled events in the hospital .Nursing management . Special days g.

Contents of a Job Description 1. Specific and Actual Functions and Activities . Qualification Requirements 4.STAFFING  DEVELOPING JOB DESCRIPTION Job Description is a statement that sets the duties and responsibilities of a specific job.Nursing management . Identifying Data 2. Job Relationships 5. Job Summary 3.

For recruitment and selection of qualified personnel 2. . As an aid in evaluating the performance of an employee 5. For determining departmental functions and relationships to help define the organizational structure 7. For job placement. For budgetary purposes 6. To orient new employees to their jobs 3. To serve as channel of communication.Nursing management . To identify training needs 9. For classifying levels of nursing functions according to skill levels required. 8.STAFFING Uses of Job Description 1. As basis for staffing 10. transfer or dismissal 4.

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 .

Delegate in advance. 7. Delegate both interesting and uninteresting tasks. 4. Select the right person to whom the job is to be delegated. 3.DIRECTING  Principles of Delegation 1. Avoid gaps and overlaps. Consult before delegating.Nursing management . Delegate gradually. Provide subordinates with enough time to learn. . 5. 6. 2.

. authority and accountability for satisfactory completion of all activities in the unit. 3.DIRECTING  What Cannot be Delegated 1. Responsibility for maintaining morale or the opportunity to say a few words of encouragement to the staff especially the new ones. 2. 5. Jobs that are too technical and those that involve trust and confidence.Nursing management . Overall responsibility. Authority to sign one’s name is never delegated Evaluating the staff and or taking necessary corrective or disciplinary action. 4.

task The right task should be within the scope of the person’s practice and consistent with the job description. job description. feedback The right feedback should ask for input. 3. concise.Nursing management . .DIRECTING  Four Rights of Delegation 1. communication The right communication should be clear. get the person’s recommended solution to the problem and recognize the persons effort. 2. 4. person The right person should have the appropriate license or certificate. complete and correct.

Authority – the power to make final decisions and give commands. Responsibility – denotes obligation 2.DIRECTING • Aspects of Delegation 1.Nursing management . Accountability – refers to liability . 3.

Purpose of communication 1. increases workers’ satisfaction 6. facilitates work 2.Nursing management . increases motivation 3.DIRECTING  COMMUNICATION Communication is the transmission of information. optimizes patient care 5. effects change 4. opinions. facilitates coordination . and intentions between among individuals.

Posture and gait e. Verbal Communication 2. Touch . Personal appearance b. Intonation of the voice c.Nursing management . Facial expression d. Written Communication 3.DIRECTING  Types of Communication 1. Non-verbal Communication a.

Nursing management .DIRECTING  Lines of Communication UPWARD to superior HORIZONTAL to peers and members of the Health Team NURSES OUTWARD to patient. family and community to workers’ family and friends DOWNWARD to subordinates .

implementation and follow-up . definition of the problem “ why the problem occur” 2.DIRECTING  DECISION MAKING Decision is a course of action that is consciously chosen from available alternatives for the purpose of achieving a desired result. selection of the solution weighing of facts and exploring alternative solutions 5.  5 Steps in Decision Making 1. analysis of the problem “getting to the cause of the problem” 3.Nursing management . development of an alternative solution “search for and analysis of alternatives and their possible consequences” 4.

. Staffing or the selection of the right person/s to carry out the decision 4.Nursing management . 2. policies and procedures. 3. Controlling the environment and the group to prevent adverse effects. Planning which entails consideration and selection of realistic objectives.DIRECTING  Major Management Functions in Implementing Decisions 1. Organizing which means helping personnel understand the decision and the procedures necessary for implementing the decision.

to preserve morale and authority. 1. 3.Nursing management . . Not deciding prematurely to prevent prujudice 4. Not deciding on problems that are not pertinent to matters at hand to prevent waste of time and energy. Not making ineffective decisions to avoid losing the respectability of the decision maker.DIRECTING  Art of Decision Making: Not making decision that others should make. 2.

Organizational . it may be constructive or destructive Basis of the Conflict 1. fight. battle or struggle.Nursing management . Intrapersonal 2. Interpersonal 3. Intergroup 5. Group 4.DIRECTING  CONFLICT MANAGEMENT CONFLICTS – clash.

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 . 2.DIRECTING  Types of Conflict 1. Intersender . 3.conflict arises when an individual receives conflicting messages from two or more sources.conflict is the result of disparity between internal and external roles. 4.conflict originates in the sender who gives conflicting instructions. Intrasender . . Person-role . Interrole .conflict can occur when an individual belongs to more than one group.

Role Ambiguity .DIRECTING 5. 7. 9. .conflict is common among people whose positions require interaction with other persons who fill various roles in the same organization or other organizations.a condition in which individuals do not know what is expected on them. 6. Intergroup . Interperson .Nursing management .conflict occurs when the group faces a new problem.conflict is common where 2 groups have different goals and can achieve their goals only at the others’ expense. Role Overload .the person is simply unable to accomplish so much within a limited time period. Intragroup . 8.

inspires mutual attention to the problem and utilizes the talents of all parties 4. Collaboration .Nursing management . .in this method. accommodation and adjustment lead to workable situations rather than to the best solution. Avoidance .used by groups who do not want to do something that may interfere with their relationship 2. Accommodation .self-sacrifice 3.DIRECTING  Conflict Resolution 1. Compromise .

one party is resolved thereby making it possible to resolve the issue. Competition .DIRECTING 5.Nursing management . Smoothing . 6. Forcing . 8. 7.disagreements are ignored so that surface harmony is maintained in a state of peaceful co-existence.yields an immediate end to the conflict but leaves the cause of the conflict unresolved. . Withdrawing .it is an assertive position that fosters conflict resolution on the part of the subordinate.

DIRECTING  Rules on Mediating a Conflict Between Two or More Parties: 1. Emphasize shared interests. Stress a peaceful resolution rather than confrontation. 4. Do not postpone indefinitely.Nursing management . . Keep two-way communication. Follow-up on the progress of the plan. 5. 3. Establish clear guidelines and make them known to all. 6. 7. 2. Create an environment that makes people comfortable to make suggestions.

. and in his job. • Orientation Orientation is a planned and guided activities of an employee in the organization.DIRECTING • Staff Development Staff development is geared ultimately to organizational development.Nursing management . the work environment .

Nursing management . and directing activities.CONTROLLING  CONTROLLING Controlling or evaluating is an on-going function of management which occurs during planning. . The controlling process opens opportunities for improvement and comparing performance against set standard. organizing.

8. 7. 2. It justifies the use resources. It provides standards for establishing comparisons. 4. It allows for the setting of sensible objectives and ensures compliance with them. It promotes visibility and a means for employees to monitor their own performance. Evaluation ensures that quality nursing care is provided. It provides an indication of the costs of poor quality. 5.Nursing management .CONTROLLING  Reasons For Conducting Evaluation 1. It provides feedback for improvement. It highlights problems related to quality care and determines the areas that require priority attention. 6. 3. .

The evaluation conference should be scheduled and conducted at a convenient time for the rater and the employee. The employee should be given a copy of the job description. 7. . and evaluation conference. 5. 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. The evaluation must be based on the behavioral standards of 2. The employee’s performance appraisal should include both satisfactory and unsatisfactory results with specific behavioral instances to exemplify these evaluative comments. 4. 3. 6. The evaluation should have enough time to observe employee’s behavior.Nursing management . Areas needing improvement must be prioritized to help the worker upgrade his/her performance.CONTROLLING  Principles of Evaluation. performance standards. 1. performance which the position requires.

. Should be sensitive 1. Should be reliable 3.Nursing management .CONTROLLING  Characteristics of an Evaluation Tool Should be objective 2.

Select qualified individuals for promotion or transfer. Determine training and development needs of employee.Nursing management . 3. . Make inventories of talents within the institution.  Purposes of Performance Appraisal 1. 5.CONTROLLING  PERFORMANCE APPRAISAL Performance appraisal is a control process in which employee’s performance is evaluated against standards. 2. Identify unsatisfactory employees for demotion or termination 4. Determine salary standards and merit increases.

CONTROLLING 6. Provide employee recognition 11. Improve the performance of work groups by examining. 9. 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. improving. Inform employees where they stand.Nursing management . . Discover the aspirations of employees and reconcile these with the goals of the institution 10.

3. 4. 2.Nursing management . 6.CONTROLLING  Methods of Measuring Performance 1. 5. Essay Checklist Ranking Rating Scales Forced-choice Comparison Anecdotal Recording .

CONTROLLING - .Nursing management .

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