NURSING MANAGEMENT PROCESS

PREPARED BY: MMSANTOS R.N. MAN.

 TOPIC

III. ORGANIZATIONAL AND MANAGEMENT  A. . Concept management  1. Management
1. Factors in management 2. Principles in management



2. Administration
a. Factors b. Principles 

     

3. Leadership 4. Organization 5. Authority 6. Power
a. Forms of power

7. Responsibility 8. Divagations 9. Accountability

RHU       c. Responsibilities in each of these organizations .1 Organization that plan for and or regulate the primary and secondary provides a DOH b.Hospitals b. Organization in health care system   b.B. Educational consultation Medical School Nursing schools b. Organization that provides for HCS (secondary provides) a. Clinic c. Financing institution Medicare GSIS/SSS d. Major areas and organization. Organization that represent Primary and Secondary Provides PNA PMA  e.2 Organization that provides health services a .

Management by objectives l. Steps in planning g. philosophy.C. Movements of plan f. Methods to plan the ward k. Principle of planning h. Planning a.Financial management . Management functions/processes  1. Importance of mission. Aspects of planning d. Characteristics of a plan e. gals and objectives to planning c. Definition b. Financial management j. Management by objectives i.

Principles of organization . Organizing a. . Organization concept c. Basic characteristics d. Functions of organizational structure f. Hospital management service  2. 2. Organizational charts  1. Type of organizational structure e. Definition b. RHU management service  g.

Case 4. Mixed e. Conflict management . Determinants of staffing patterns c. Advantages/disadvantages 2. Time management f. Assignment systems for staffing/\modalities of staffing/\ patient care      1. Types of staffing pattern d. Team 3. Recruitment and retention b. Staffing a. Primary 5. 3.

 4. Definition b. Directing a.Components of directing .

Quality assurance c.b. Controlling a.Performance appraisal d. 5. Definition . Evolution and professional development .

 6. Attributes of reporting b. Reporting and recording a.Good reporting technique .Principles of reporting c.Types of report d.

Budgeting aAdvantages b. 4.Budgeting process c.Types of budget      1. 3. 2. . Operating or revenue and expense budgets Capital expenditure s budgets Cash budgets Labor or personal budgets Flexible budget . 7. 5.

Decision Making Systems a. DEFNITION b. Decision making tools . 4.

 5. Communication systems c. Upward e. Grapevine . Communication process b. Communication Principles a. Diagonal f. Downward d.

TOPIC IV. Nursing Organizations . Continuing education  3. InIn-service education  2. PROFESSIONAL GROWTH AND DEVELOPMENT  1.

.

It is common for RNs to seek additional education to earn a Master of Science in Nursing or Doctorate in Nursing to prepare for leadership roles within nursing.Nursing management     is performing leadership functions of governance and decision-making within organizations decisionnurses. employing nurses. It includes processes common to all management like planning. Management positions increasingly require candidates to hold an advanced degree in . organizing. directing and controlling. staffing.

staffing. and material resources. organizing. . financial. directing and controlling that utilize human . The process of setting and achieving goals through the execution of five basic management functions : planning.

the environment. decision making. time and other sources to achieve organizational goals.Characteristics of a manager       Has an assigned position within the formal organization Has a legitimate source of power due to the delegate s authority that accompanies the positions expected to carry out specific functions duties and responsibilities Emphasizes control. Has a greater formal responsibility and accountability for rationality and control Direct willing and unwilling subordinates . and results Manipulates people. money . decision analysis.

Controlling .Management functions  1. Organizing  3. Directing  4. Planning  2.

Management Process Planning Organizing Controlling Staffing Directing .

Five functions of management process  1. and managing planned change . policies.Planning encompasses determining philosophy. procedures. determining a fiscal course of action. and rules carrying out long and short range projections. objectives. goals.

 2.

Organizing includes establishing the structure to carry out plans, determining the most appropriate type of patient care delivery, and grouping activities to meet unit goals.

 3.

Staffing functions consist of recruiting, interviewing, hiring and orienting staff. Scheduling staff development, and often employee socialization also are included as staffing functions

 4.

Directing sometimes includes several staffing functions. However, this phase s functions usually entail human resource management responsibilities such as motivating , managing conflict, delegating, communicating and facilitating collaboration

Controlling functions includes performance appraisals. legal and ethical control. quality control. fiscal accountability. and professional and collegial control. 5. .

Integrating Nursing Process and Management process  Simplified nursing process Assessing Management Process Function PLANNING PLANNING Planning STAFFING ORGANIZING ORGANIZING DIRECTING Implementing Evaluating CONTROLLING .

.

.

 IN GENERAL. . HOW TO DO IT. WHEN TO DO IT AND WHO IS TO DO IT. PLANNING IS AN INTELLECTUAL PROCESS BASED ON FACTS AND INFORMATION.  IT IS A COGNITIVE PROCESS FOR DECISION MAKING. NOT ON EMOTION OR WISHES. IS DECIDING IN ADVANCE WHAT TO DO.

.AND HOW . WHEN AND WHERE IS TO BE DONE.A PROACTIVE AND DELIBERATE PROCESS THAT REQUIRES DECIDING IN ADVANCE WHAT TO DO. WHO IS TO DO IT.

PLANNING  Process: Establish objectives (goals) Evaluate the present situation and predict future trends and events Formulate a planning statement (means) Convert the plan into an action statement .

Planning  Is important on both an organizational and a personal level and may be an individual or group process that addresses the questions of : WHAT WHY WHERE WHEN HOW BY WHOM .

 It brings about behaviors that lead to desired actions and outcomes. .REASONS FOR PLANNING  Planning leads to success in achievement of goals and objectives.  Employees can see that result of their labor.

 Knowing that objectives help the employees relate what they are going to meaningful outcome and leads to greater employee satisfaction. .REASONS FOR PLANNING  Planning gives meaning to work.

REASONS FOR PLANNING  Planning provides for effective use of available personnel and facilities. .  Available resources are used to the maximum.  Planning helps in coping with crisis. they allow the worker to function more calmly and efficiently when an actual crisis occurs. Plans anticipate emergencies.

REASONS FOR PLANNING 
Planning

is cost effective. Some costs can be contained through planning of nurses needed operation.  Example: projecting the number of courses needed to care for a group patients or ordering enough supplies for a unit.

REASONS FOR PLANNING 
Planning

based on the past and future helps reduce the element of change. Studying what has been successful or unsuccessful can give the manager a better idea of what to do in the future.

REASONS FOR PLANNING 
By

planning, one discover the need for change.  Planning can point out opportunities or different services.

resources and employees effectiveness when the expected is known. .REASONS FOR PLANNING  Planning is necessary for effective control. Managers can evaluate the environment.

goals and working of the organization  Managers may not understand the significance of planning. that success or failure of work activities relate directly to the quality of the plan .RESISTANCE TO PLANNING Failure to plan may be attributed to the following factors:  Managers may lack knowledge of the philosophy.

. Reluctance may exist because implementation of plans may require new activities that the individual in unwilling to engage in. Some managers prefer to act to immediate problems because they generate immediate feedback Planning may bring unwanted change.RESISTANCE TO PLANNING     Time spent on planning often seems wasted in relation to the day to day doing of one s job Some managers may lack confidence. fearing failure.

SCOPE OF PLANNING  1. Community  C. goals of care Forecast must be supported by facts. agency  B. reasonable estimates and accurate reflection of policies and plans . Forecast or estimate the future It describes the ultimate condition or projections that provide general incentive and direction to planning Should consider the:  A.

setting objectives/goals determine results desired GOALS.ARE STATEMENT OF INTENT GOALSDERIVED FROM THE PURPOSES OF THE ORGANIZATION AND THEY ARE STATED BROADLY AND IN GENERAL TERMS OBJECTIVES.SPECIFIC BEHAVIOR OR TASK OBJECTIVESSET FOR ACCOMPLISHMENT OF A GOAL . 2.

 Strategies are overall plans of the higher management system to achieve objectives.  Set the time frame. . discharge teaching program. outreach programs. Develop and schedule strategies.3.  Programs are series of activities that function together to facilitate attainment of some desired goals  Example: staff development programs. programs / projects / activities.

of plans: (according to time frame)  Long term plans 3 5 years or more  Short term plans 6 months to one year  Type .

Prepare the budget-allocate resources budgetBUDGET  ALLOCATION OF SCARCE RESOURCES ON THE BASIS OF FORECASTED NEEDS FOR PROPOSED ACTIVIIES OVERA SPECIFIED PERIOD OF TIME  A TOOL PLANNING. . 4. MONITORING AND CONTROLING COST OR A SYSTMATIC PLAN FOR MEETING EXPENSES.

of plans: (according to time frame)  Long term plans 3 5 years or more  Short term plans 6 months to one year  Type .

Strategic .PLANNING CAN BE:  A. Contingent  B.

or proactive. It develops the departmental maintenance and improvement goals for the coming year. It may be reactive.operational planning is done in conjunction with budgeting. . usually a few months before the new fiscal year. in response to a crisis. Short range .CONTINGENT PLANNING    The manager identifies and manages the many problems that interfere with getting work done. in anticipation of problems or in response to opportunities.

 Its purpose is to create an image of the desired future and design ways to make those plans a reality. allocates resources. It begins with in depth analysis of the internal environment s strengths and weaknesses and the external opportunities and threats so that realistic goals can be set for the proffered future. assigns responsibilities and determines time frames  .  It determines the direction of the organization. planning and evaluation to guide the future.  Long range and it extends 3 to 5 years into the future.STRATEGIC PLANNING Refers to the process of continual assessment.

IMPORTANCE OF PLANNING 1. Planning gives meaning to work  3. Planning provides for effective use of available resources and facilities  4. Planning helps in coping with crises  . Planning leads to the achievement of goals and objectives  2.

Planning is cost effective  6. It prevents or reduces the recurrence of problems and provides better ideas  8. Planning leads to the realization of the need for change  9.IMPORTANCE OF PLANNING  5.  7. Planning is based on past and future activities. Planning provides the basis for control .

ORGANIZING     Is the process of coordinating the work to be done. it involves identifying the work of the organization. In health care. delivery systems. the mission. Formally. It is an ongoing process that systematically reviews the use of human and material resources. dividing the labor. and assigning authority. skill mix. developing the chain of command. formal organizational structure. and staffing patterns form the basis for the organization. . job description.

 Communication abilities. authority.  Power. motivational techniques and delegation skills also are important. . and leadership style are intimately related to a manager s ability to direct.DIRECTING  Is the process of getting the organization s work done.

.  This includes establishing standards of peformance.CONTROLLING  Involves comparing actual results with projected results. evaluating performance and providing feedback.determining the means to be used in measuring performance.

evaluating outcomes and performance and instituting change as necessary. Some organizations use peer review to control quality of care. Today managers share many of the control functions with the staff. staff participate in and lead the teams. In organizing using a formal quality improvement process.  The efficient manager constantly attempts to improve productivity by incorporating techniques of quality management. such as continuous quality improvement . .

Timmereck (200) founded that health care managers uses these classic functions extensively. health care included. This approach is used widely in all types of organizations. Planning. . organizing. proactive approach to management . directing and controlling reflects a systematic .

a premise that is supported by the contemporary leadership theories discussed previously. . Mintzbergs s Behavioral description Believed that much of a manager s activity involves human relations. Mintzberg also believed managers were more reactive than proactive.

ROLE OF MANAGERS Interpersonal Role Informational Role Decisional Role .

. 3. National conferences. local coalitions and professional meetings are valuable resources for obtaining information and expanding networks. is responsible to see that the organization s goals are accomplished efficiently. Leader  The manager defines work environment of the organization and is responsible fo the work of associates-motivating .Interpersonal Role  1. associatestraining. such as welcoming new employees at orientation or attending social events. as a leader . Figurehead Reflects the ceremonial performance of duties. Liaison deals with expanding the manager s information sources and networks outside the organization.  The manager. 2. and disciplining as needed.

the manager informally seeks information about the organization through internal networks.Informational Role  Monitor. and observations. gossip.  .

Informational Role  Tours of the organization. allow the manager to find out how the organization is functioning and what might be needed to improve it. as well as formal ad informal meetings. .

.Informational Role  Dissemination role either share information between work units or share information from outside the organization.

the manager shares information with individual outside the organization and provides visibility for the organization. .Informational Role  Information is a source of power. sharing information empowers employees and improves job satisfaction  Spokesperson.

offering continuing education and participating in professional organizations are examples of ways in which the manager serves as a spokesperson.Informational Role  Attending community meetings. .

 Reorganizing supplies. or creating new roles are examples. redesigning staff assignments. .Decisional Roles  Entrepreneur constantly seeks ways to solve problems and make improvements in the organization.

such as replacement of staff for sick call. . or missing equipment.Decisional Roles  Disturbance handler responds to unforeseen circumstances. nosocomial outbreaks.

. and manage financial resources  Negotiator deals with outside forces mediating resources and decisions such as resolving collective bargaining disputes or helping decide on major capitol purchases.Decisional Roles  Resource allocator managers schedule their own time. assign staff.

Fundamental skills of a manager  Technical skills PROFICIENCY IN PERFORMING AN ACTIVTIY IN THE CORECT MANNER WITH THE RIGHT TECHNIQUE .

Human relation skills  Dealing with people and how to get along with them .

. responding to the big problems.Conceptual skill ability to see individual matters as they relate to the total picture and to develop ways of identifying pertinent factors. and discarding irrelevant facts.

3 levels represented by concentric circles  information  People  action .

Manager conceives the frame  Purpose of the job  Work needed  How it should be done .

Managing involves:  Communicating and controlling at the information  Leading and linking at the people level  Doing at the action level .

Communicating and controlling communicating Involves receiving and sharing information with others  Controlling is using information to manage the work others  .

as a team or as an entire organiztionorganiztion-to take effective action .leading  Involves encouraging and enabling othersothersindividually .

linking  Is establishing networks outside the unit in order to relay needs and exchange influence .

.3rd level of work and most concrete level  Managing action by doing  DOING. handling disturbances.directing change.includes taking supervisory DOINGactionsactions. and negotiating with other departments.

.

as a team or othersas an entire organization  Linking is establishing networks outside the unit in order to relay needs and exchange influence .Leading and linking people in order to encourage people to take action  Leading involves encouraging and enabling others-individually.

managing action by doing  DOING INCLUDES TAKING SUPERVISORY ACTIONSACTIONS-DIRECTING. DISTURBANCES AND NEGOTIATING WITH OTHER DEPARTMENTS . HANDLING.

NURSE MANAGERS IN PRACTICE  First line manager may also be titled as unit manager  Middle manager as department manager  Top level nursing administrator could be named executive manager. chief nursing officer. or vice president of patient care .

all nurse managers must hold a certain competencies. regardless of their titles. . Clinical titles might include professional practice leaders who are clinical specialist or nurse practitioners.

NURSE MANAGERS COMPETENCIES  The American Organization of Nurse Executives (AONE) identified five areas of competency : Skilled communicators and Relationship builders Have a knowledge of the health care environment Exhibit leadership skills Display professionalism Demonstrate business skills .

NURSE MANAGER COMPETENCIES  STAFF NURSE  FIRST LEVEL MANAGEMENT  CHARGE NURSE  CLINICAL NURSE LEADER .

delegation and motivation skills are indispensable. Communication . . In some organization.STAFF NURSE   The staff nurse supervises LPNs . shared governance has been implemented and traditional management are allocated to the work team. other professionals and assistive personnel and so is also a manager who needs .management and leadership skills.

First level management      Is responsible for supervising the work of nonmanagerial personnel and the day to day activities of a specific work unit or units With primary responsibility for motivating the staff toi achieve the organization s goal. In other hospital they call it as coordinator . In the hospital setting . the first level manager represents staff to upper administration and vice versa. the first level manager is usually the head nurse. nurse manager or an assistant. Nurse manager s have 4 hour accountability for the management of a unit or area within a health care organization.

The charge nurse usually has extensive experience. The charge nurse often troubleshoots problems and assists other staff members in decision making. Role modeling. and knowledge in clinical practice and is familiar with the organization s standards and practice. skills. . mentoring and educating are additional roles that the charge nurse often assumes.Charge Nurse      Is an expanded staff nurse role with increased responsibility The charge nurse functions as a liaison to the nurse manager. assisting in shift by shift coordination and promotion of quality patient care as well as efficient use of resources.

 The responsibilities are confined to a specific shift or task. She has limited authority. the charge nurse functions as an agent of the manager and is accountable to the manager for any actions taken or decision made. . whereas the first level manager has a 24 hour responsibility and accountability for all unit activities.

Although often involved in planning and organizing the work to be done .  A charge nurse usually has considerable influence with the staff and may actually have more informal power than the manager.  The charge nurse is often key to a unit's successful functioning. the charge nurse has a limited scope of responsibility. usually restricted tot e unit for a specific time period.  Therefore the charge nurse is an important leader and can benefit by developing the skills considered necessary for a manager.  .

. but instead is a lateral integrator of care responsible for a specified group of clients within a microsystem of the health care setting. complex technological environment.Clinical Nurse Leader  The CNL is not a leader per se.  The CNL role is designed to respond more effectively to challenges in today's rapidly changing.

and evaluates client care by coordinating. . delegating and supervising the care provided by the health care team. technicians and other health professionals. implements. The CNL designs. including licensed nurses.

AONE FIVE AREAS of COMPETENCIES  COMMUNICATION AND RELATIONSHIP BUILDING COMPETENCIES: Effective communication Relationship management Influence of Behaviors Ability to work with diversity Share decision making Community involvement Medical staff relationships Academic relationship .

 KNOWLEDGE IN THE HEALTH CARE ENVIRONMENT: Clinical practice knowledge Patient care delivery models and work design knowledge Health care economics knowledge Heath care policy Understanding of governance Understanding of evidence based practice Outcome measurement Knowledge of and dedication to patient safety Understanding of utilization management Knowledge of quality improvement and metrics Knowledge of risk management .

 LEADERSHIP SKILLS Foundational thinking skills Personal journey discipline The ability to use systems thinking Succession planning Change management .

 PROFESSIONALISM Personal and professional accountability Career planning Ethics Evidenced based clinical management practice Advocacy for the clinical enterprise and for nursing practice Active memebership in professional organization .

 BUSINESS SKILLS: Understanding of health care financing Human resource management and development Strategic Management Marketing Information management and technology .

.

Organizational change is essential for adaptation. . creative change is mandatory for growth. This climate for change produces new opportunities for nurses.. Nurses are rethinking the way health care is organized and delivered. never needed more in the rapidly evolving system of health care.WHY CHANGE?     Leading change is an art.

 Change is necessary for growth. it can be threatening and a source of conflict .  Even when planned. although it often produces anxiety and fear.

the status quo. This is particularly true when change is unplanned or beyond human control. . a grief reaction still may occur. Those who initiative and manage change often encounter resistance form those experiencing unease and possibly symptoms of anxiety and grief. There is a sense of loss of the unfamiliar.CHANGE      IS THE PROCESS OF MAKING SOMETHING DIFFERENT FROM WHAT IT WAS. Even when change is expected and valued.

Once the desired state has been reached. the process begins again. and ultimately comes to a desired state. however. . moves through a transition period. Change is a continually unfolding process rather than an either/event.  The process begins with the present stae. is disrupted.

as an integral part of the system.  A change agent an be a role model for others by touting the positive outcomes of changechange-improved patient care. is key to stimulating the need for change and crucial for the success of planned change. .  The nurse .THE NURSE AS CHANGE AGENT  Is one who works to bring about a change.

planned change will not proceed past the wouldn t it be a good idea if stage.THE CHANGE PROCESS  Assessment Emphasis is placed n the assessment phase of change for two reasons  Without data collection and analysis. .

STEPS IN THE CHANGE PROCESS  1. Identify the supporters or opposers . Identify the problem or opportunity  2. Develop a plan for change . Select and analyze data  4. including time frame and resources  5. Collect necessary data and information  3.

if successful . Help people prepare for change  8. Evaluate effectiveness of the change and . Build a coalition of supporters  7. stabilize the change .STEPS IN THE CHANGE PROCESS  6. Prepare to handle resistance  9. Provide a feedback mechanism to keep everyone informed of the progress of change  10.

SUCH AS: Where are we now? What is the unique about us? What should our business be? What can we do that is different from and better than what our competitors do? What is the driving stimulus in our organization?What determines how we make our final decisions? What prevents us from moving in the direction we wish to go? What kind of change is required? .IDENTIFY THE Problem or the Opportunity  START BY ASKING THE RIGHT QUESTIONS.

Collect Data  Once the problem or opportunity has been clearly defined. the change agent collects data external and internal to the system. This step is crucial to the eventual success of the planned change.  All driving and restraining forces are identified so the driving forces can be emphasized and the restraining forces reduced. .

Analyze the Data  The kinds. amounts and sources of data collected are important.  The change agent should focus more energy on analyzing and summarizing the data than on just collecting it. . and build a case for whoever option is selected. but they are useless unless they are analyzed.  The point is to flush out resistance identify areas of consensus.

how.Planning  Planning the who. . The more involved they are at this point. and when of the change is a key step.  What will be the target system for the change?  Members from this system should be active participants in the planning stage. the less resistance there will be later.

Implementation  Methods to Change Individuals  Methods to change groups .

Evaluation  Evaluate effectiveness  Stabilize the change .

Change Strategies  Power Coercive Strategies Based on application of power by legitimate authority . or political clout of the change agent Assumes that people are set in their ways and will change only when rewarded for the change or are forced by some other power coercive method . economic sanctions.

. Humans are rational beings who will change documenting the need for change.RationalRational-empirical strategies  Give current research as evidence to support change.

. Power is gained by skill in interpersonal relationship. easily influenced by others than by facts  Does not require change agent to have a legitimate power base. Humans are social animals.Normative-reNormative-re-educative strategies  Use group norms to socialize and influence people so change will occur.

Sign up to vote on this title
UsefulNot useful

Master Your Semester with Scribd & The New York Times

Special offer for students: Only $4.99/month.

Master Your Semester with a Special Offer from Scribd & The New York Times

Cancel anytime.