25474360 nursing leadership
TRANSCRIPT
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Nursing Leadership
and Management
Organizing andStaffingPresented by:
BSN 4C 2
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-ANTHEA-
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ORGANIZING!!!Nice Organ!!!!
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Organizing
It is the process of establishing formal authority.
It involves setting up the organizational structure
through identification of groupings, roles andrelationships, determining the staff needed bydeveloping and maintaining staffing patterns anddistributing them in various areas as needed.
It includes developing job descriptions bydefining the qualifications and functions ofpersonnel.
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Elements of Organizational Structure
Setting up the Organizational Structure
Staffing
Scheduling Developing Job Description
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Understanding the organizational structure as awhole facilitates the development of roles andrelationships to enable the achievement of goals.
The organizational structure refers to the process bywhich a group is formed, its channel of authority,span of control and lines of communication.Departmentalization and division of work provideorderliness in administration. Through a breakdownof activities each individual becomes responsible fora specified set of activities and performs such.
Setting up the Organizational Structure
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Purposes of Setting up the Organizational
Structure:
It informs members of their responsibilitiesso that they may carry them out.
It allows the manager and the individual
workers to concentrate on his/her specificrole and responsibilities.
It coordinates all organizational activities so
there is minimal duplication of effort andconflict
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It reduces the chances of doubt and
confusion concerning assignments.
It avoids overlapping of functions because it
pinpoints responsibilities.
It shows to whom and for whom they are
responsible.
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Purposes of Setting up the Organizational
Structure
It informs members of their responsibilitiesso that they may carry them out.
It allows the manager and the individual
workers to concentrate on his/her specificrole and responsibilities.
It coordinates all organizational activities so
there is minimal duplication of effort andconflict
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The organizational structure of the Nursing
Service should be updated, reviewed,
approved and documented by the proper
authority. Date of last review should be
documented.
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The purpose of all staffing activities is to provide
each nursing unit with an appropriate and acceptable
number of workers in each category to perform the
nursing tasks required. Too few or an impropermixture of nursing personnel will adversely affect the
quality and quantity of work performed. Such
situation can lead to high rates of absenteeism and
staff turn-over resulting in low morale anddissatisfaction.
Staffing
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The objective in scheduling is to assign
working days and days off to the nursing
personnel so that adequate patient care is
assured. A desirable distribution of off-duty
days can be achieved and the individual
members of the nursing team will feel that
they are treated fairly. They will also knowtheir schedule in advance.
Scheduling
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A job description is a statement that sets
the duties and responsibilities of a specific
job. It includes the needed characteristics or
qualifications of the individual to performsuch duties successfully. It is an important
management tool to make certain that
responsibilities are wisely delegated, thatwork is efficiently distributed, that talents are
fully used, and morale is maintained.
Developing Job Description
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Principles of Organizing
Unity of Command
Scalar Principle or Hierarchy
Homogenous Assignment or Departmentation Span of Control
Exception Principle
Decentralization or Proper Delegation ofAuthority
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Although employees may interact
with many different employees in the
performance of their duties, they should be
responsible to only one superior. This is toavoid confusion, overlapping of duties and
misunderstanding.
Unity of Command
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Scalar Principle or Hierarchy
Authority and responsibility should flow in
clear unbroken lines from the highest
executive to the lowest. The other term for
this is chain ofcommand, usually a militaryterm.
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Homogenous Assignment or
Departmentation (Specialization)
Workers performing similar assignments
are grouped together for a common
purpose. Departmentation promotes the
specialization of activities, simplifies theadministrators work, and helps maintain
effective control.
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Exception Principle
Recurring decisions should be handled in a
routine manner by lower-level managers
whereas problems involving unusual matters
should be referred to the higher level.
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Decentralization or Proper Delegation
of Authority
Decentralization is the process of
conferring specified decision making to the
lower levels of the organization. Basic top
level decisions and policies must receiveattention at the top levels. The amount of
skills and competence of subordinates and
executives determines the success of anyprogram of decentralization.
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Executives should be developed to handle
situations delegated to them. This delegation
of authority is still subject to the supervision
and control of the delegating superior.
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-UMALI-
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Delmar LearningCopyright 2003 Delmar Learning, a Thomson Learning company
ORGANIZATIONAL
STRUCTURE
ORGANIZATIONAL REDESIGN,
RESTRUCTURING ANDREENGINEERING
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Delmar LearningCopyright 2003 Delmar Learning, a Thomson Learning company
RESTRUCTURING
A significant modification made to the debtoperations or structure of a company. This type of
corporate action is usually made when there are significantproblems in a company, which are causing some form offinancial harm and putting the overall business in jeopardy.The hope is that through restructuring, a company can
eliminate financial harm and improve the business.
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Chapter 9 Copyright 2003 Delmar Learning, aThomson Learning company
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REDESIGNING
make a design of; or a systematic planning
to change the design of (something).
Reorganize, Rearrange, Recast, Reshape
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REENGINEERING
Is the radical redesign of an organization's
processes, especially its business processes.
Rather than organizing a firm into functional
specialties (like production, accounting,marketing, etc.) and looking at the tasks that each
function performs.
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Restructuring and reengineering deals with the
entire organizations structure to improve its
functioning and productivity. It naturally follows organizational affiliations,
mergers, consolidations, and integrations.
Downsizing or right sizing by cutting thenumber of positions is also restructuring
requiring redesign.
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The role of the Nurse Manager through
3 Rs Involves: (Sullivan And Decker, 2001)
Team Building
Coaching
Mentoring Initiating change
Reducing cost
Improving quality of care
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Types of Organizational Structure
Informal Structure
Formal Structure
Pun Line Organization Line and Staff Organization
Functional Line and Staff Organization
Matrix or Free form Organization
Adhocracy or adaptive or organic model
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Purpose of Organizational Structure
The primary purpose of an organizational
structure is to facilitate the accomplishment of
the institutions mission.
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Informal Structure
It is based on personal relationship rather than
on respect for positional authority. It helps
member meet personal objectives and providesocial satisfaction.
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Formal Organization
The organizational structure furnishes the
formal framework in which the management
process takes place. It should provide an
effective work system, network ofcommunication, and identity to individuals
and the organization and should consequently
foster job satisfaction.
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Line and Staff Organization
Line and Staff Organization develops when a
simple line structure is altered to provide
support line authorities. The line functions are command and control.
The Staff functions are separate from chain of
command. Involves specialization, and asupportive to line authorities.
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Functions of Staff
Do what the executives do
Serve the line organization
Submerge personal interest to champion the
executives long range objectives.
Manages policies and procedures
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Functional Line and Staff Organization
Staff have some authority over line executive.
Staff expert responsible for specific
management function , such as staffing, staff
development , or quality improvement.
Has authority to command line executives to
implement staff plans.
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Matrix and Free Form Organization
Matrix organizational design try combine the
advantages of the project and the functional
structures.
The functional line organization provide supportfor the project line organization. The functional
manager has the authority to determine and rate
goals, select personnel, determine pay andpromotion, make personnel, and evaluate
personnel and the project.
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In a matrix organization the functional managershares those responsibilities with the projectmanager . Initially, the functional manager mayexperience a sense of loss in status, authority
and control.
Therefore it is important for the managers to be
able to persuade others by using their personalqualities and knowledge of the program.
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Characteristics of matrix
decision making as far down in theorganizational structure
Most decisions are made at the middle
management level More decentralized with fewer levels of
decision making
Increases the amount of contact amongindividuals & its complexity makes conflictinevitable.
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Adhocracy/ adaptive or Organic model
Adhocracy or organic models are newerorganizational frameworks that are more freeform, open , flexible and fluid than older
bureaucratic models. Boundaries separatinginternal & external relationships are moreeasily penetrated.
adhocracy comes from an ad hoc
committee.Its structures are looselystructured project organizations.
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-VIRAY-
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ORGANIZATIONAL CHART
Is a line drawing that shows how the parts of
an organization are linked. It depicts the
formal organizational relationships, areas of
responsibility, persons to whom one isaccountable and channels of communication.
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PURPOSES
They can contribute to sound organizational
structures
Show formal lines of communication
Help employees understand their
assignments, especially in relation to other.
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Organizational Concepts and
Structures
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Vertical Chart
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Horizontal Chart
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Circular Chart
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-JRO-
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LINE AND STAFF RELATIONSHIP
Line authority is the simplest and most direct type in
which each position has general authority over the
lower positions in the hierarchy in the
accomplishments of the main operations of the
organization. The unit head has direct responsibility
for the work of a unit.
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Staff personnel provides advice, counsel
or technical support that may be
accepted altered or rejected by the lineofficer.
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GUIDELINES IN ORGANIZING
1. Supply Market It is important that the local supplier capacity is
properly researched prior to organizing abusiness
seminar to ensure that goods and services arerelevant to the needs.
2. Invitations
The invitation should indicate the types ofsuppliers that will be attending the seminar.
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3. Frequency
Due to limited resources, and in order to befair to all countries, generally only
participate in one major supplier event per
country per year.
4. Facilities
The organizing entity should ensure that thefacilities are available for business
seminars:
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5. Agenda
The agenda for the business seminar should beagreed
with other participating organizations and theorganizing entity.
6. Individual meeting with suppliers
A program should be prepared in advance by the
organizing entity. Each supplier meetingshould be scheduled to last for no longer than 15minutes.
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7. Expenses
Organizing entities in developed countries areexpected to cover the travel expenses, hotel and
meals for all participants
8. Supplier fees
Any fees charged to suppliers for participating
should be kept to a minimum and aim to onlycover
costs incurred.
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9. Travel, Accommodation & other practicalinformation
The organizing entity is responsible for making the
necessary accommodation arrangements for
participants.
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-CHICO-
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Staffing
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Staffing
Is the process of determining
providing the acceptable number
mix of nursing personnel toproduce a
desired level of care to meet the patients
demand.
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Factors affecting staffing:
the type, philosophy, and objectives of thehospital and the nursing service;
the population served or the kind of patientsserved whether pay or charity;
the number of patients and severity of theirillness-knowledge and ability of nursingpersonnel are matched with the actual careneeds of patients;
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Factors affecting staffing cont
availability and characteristics of the nursing
staff, including education, level of preparation,
mix of personnel, number and position;
administrative policies such as rotation,
weekends and holiday off-duties;
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Factors affecting staffing cont
standards of care desired which should be
available and clearly spelled out. institution
may utilize the ANSAPs standard of nursing
practice; PRC-ANSAPs standards of safenursing practice and/ or the hospitals
themselves may formulate/develop their own
standards;
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Factors affecting staffing cont
availability and characteristics of the nursing
staff, including education, level of preparation,
mix of personnel, number and position;
administrative policies such as rotation,
weekends and holiday off-duties;
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Factors affecting staffing cont
expected hours of work per annum of each
employee. this is influenced by the 40-hour
week law; and
patterns of work schedule-traditional 5 daysper week, 8 hours per day; 4 days a week, ten
hours per day and three days off; or 3 days
of 12 hours per day and 3 days off per week.
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Factors affecting staffing cont
layout of the various nursing units and
resources available within the department
such as adequate equipment, supplies, and
materials; budget including the amount allotted to
salaries, fringe benefits, supplies, materials,
and equipment;
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Factors affecting staffing cont
professional activities and priorities in
nonpatient activities like involvement in
professional organizations, formal educational
development, participation in research andstaff development;
teaching program or the extent of staff
involvement in teaching activities;
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Factors affecting staffing cont
expected hours of work per annum of each
employee. this is influenced by the 40-hour
week law; and
patterns of work schedule-traditional 5 daysper week, 8 hours per day; 4 days a week, ten
hours per day and three days off; or 3 days
of 12 hours per day and 3 days off per week.
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Selection of personnel
Recruitment and Retention
Screening of potential staff
Interview
Orientation
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Selection of personnel
Recruitment and Retention
if a man proceeds confidently in the direction of
his dreams and endeavors to live the life he has
imagined, he will meet with success unexpected in
common hours------henry david Thoreau
The acquisition of qualified people in any agency
is critical for the establishment, maintenance andgrowth of the organizational. Therefore active
recruitment is important, and the attraction of
qualified applicants is the first step in selection of
personnel.
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Selection of personnel
Recruitment and Retention
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Modes for active recruitment
employee recommendations and word of
mouth
advertisement in local newspaper, nursing
organization bulletins, and nursing journal
recruitment literature, such as fliers and
newsletter
Recruitment and Retention
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Modes for active recruitment cont
Posters
career days
job fairs
contract with schools graduating classes
Recruitment and Retention
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Modes for active recruitment cont
placement service
open houses
nursing conventions
Recruiters should know nursing qualificationsand the needs of the institution.
Recruitment and Retention
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Major sources of personnel
persons seeking their first jobs
dissatisfied employees
unemployed individuals
These classifications are important for all
categories indicate types of information the
nursing manager should obtain and they
influence the selection process.
Recruitment and Retention
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Selection of personnel
Recruitment and Retention
Screening of potential staff
Interview
Orientation
S l i f l
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Selection of personnel
Screening of potential staff
investment in well-qualified nurses can produce a
high rate of return and errors
whether they be failure to hire a promising nurse
or hiring someone who fails to achieve the
organizations expectations can be expensive mistaken.
Th h d l i
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There are three underlying
philosophy the screening process:
1. The manager should screen out applicants
who do not fit the agencys image.
2. The manager should try to fit the job to a
promising applicant.
3. Usually the manager should try to fit
applicant to the job.
Screening of potential staff
li i f d
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Application forms and resumes
Data in the personal history educational
background, work experience, and other
pertinent informationcan be used to the
following:
determine whether the applicant meets minimal
hiring requirements, such as minimal educationallevel or minimal job experience
Screening of potential staff
l f d
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Application forms and resumes cont
furnish background data useful in planning theselection interview
obtain names of references who may be
contracted for additional information about theapplicants work experience and general character
Collect information for personnel administration,
that is, social security number, number of
dependents, and so forth.
Screening of potential staff
S l i f l
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Selection of personnel
Recruitment and Retention
Screening of potential staff
Interview
Orientation
- A preemployment interview to predict job
success should be conducted with the most
qualified applicants.
S l i f l
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Selection of personnel
Recruitment and Retention
Screening of potential staff
Interview
Orientation
P f h i i
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Purposes of the interview
to obtain information
to give information
to determine if the applicant meets the
requirements for the position
Interview
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One of the main purpose is to learn about theprospective employee.
The interview answers questions, explains
policies and procedures, and helps acquaint theapplicant with the position.
Finally, the interviewer must predict whether theapplicants overall performance will besatisfactory.
Interview
S l ti f l
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Selection of personnel
Recruitment and Retention
Screening of potential staff
Interview
Orientation - Induction is the first 2 o 3 days oforientation. It can be done by
personnel department employees for
all new employees.
It i l d hi t f th
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It includes a history of the
organization
the vision
purpose
structure
working hours
holiday time
Vacation
sick time
paydays
performance standards
parking facilities
eating facilities
health services
education
opportunities
Orientation
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Orientation is important, and the manager whodoes not take the time to assist a new employee
is making a serious mistake.
Because of the information overload, induction
and further orientation should be conducted over
time. a checklist for orientation that indicates thecontent, time frame, and who is responsible to
teach it can be helpful.
Orientation
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-CRISTINA-
St ff d l t
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Staff development
Goes beyond orientation
It is a continuing liberal education of the
whole to develop her potential fully
It deals with aesthetic senses, as well as
technical and professional education
It is also related to retention, raises,
advancement to other positions ortermination
P t hi
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Preceptor ships
Used to help recruit, retain, orient, and developstaff.
Is responsible for the quality of patient care andfacilities the students learning.
They are liaison between students and theagency
They help students learn skills and learn how to
organize their work. A work shop to prepare preceptors is desirable.
Preceptor ships
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Preceptor ships
Purposes
Gives agency personnel an opportunity to
evaluate students and determine if they are
suitable candidates employment.
Mentorship
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Mentorship
Should provide an opportunity to shareinformation review works, provide feedback,explore issues, plan strategies and solveproblems.
Preceptors are role model who may becomementors.
Is a confident who personalizes role modelingand serve as a sounding board for decisions.
Are resource people who support thedevelopment of the younger person throughinfluences and promotion.
Mentorship
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Mentorship
Purposes
Gives their times, energy and materials
support teach, guide, assist, counsel and
inspire younger nurses.
Phases of the mentoring process
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Phases of the mentoring process
Invitation
Questioning
Transitional
Career mapping
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Career mapping
Is a strategic plan for ones career
It provides direction for formal education,
experience, continuing education, professional
association and network ship
Career mapping
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Career mapping
Purposes Nurses need to assess their own values and
define success for themselves
Job security , sense of accomplishment andopportunities for professional advancement areoften considered important
Other issues to considered are work hours,
salary, benefits retirements plans,organizational and geographical climate andlocation
Careers typically progress through
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stages:
Exploration (ages 15 to 22 yrs)
Early career(22 to 38 yrs)
Middle career (38 to 55 yrs)
Later career (55 to 70 yrs)
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-JENA-
ASSIGNMENT SYSTEM FOR STAFFING:
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ASSIGNMENT SYSTEM FOR STAFFING:
Changes in assignment systems are a responseto changing needs.
shortage of nurses
manage competition
care to patient through primary nursing
System Used in Staffing
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System Used in Staffing
Case Method Each patient is assigned to a nurse for total patient
care while that nurse is on duty.
Functional Nursing
Hierarchical structure predominant
Efficient system that is least costly and requiresfew RNs
Team Nursing
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Group or Team action
Led by a professional or Technical Nursewho:
Plan
Interprets Coordinates
Supervise
Evaluates Team member is encourage to make
suggestion and ideas
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Primary Nursing Patient should be the focus of professional nurses
instead of task
The RN remains responsible for the care of thepatient 24 hrs per day throughout the patient
hospitalization
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Modular or District Nursing Modification of Team and primary nursing
Uses smaller team who are grouped
geographically
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Managed Care Focused from acute care to promotion of health
and disease management of chronic and terminal
care
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Case Management Focused on chronic long term outpatient
(Psychiatry and social work)
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Collaborative Practice Interdisciplinary team
Nurse-physician interaction in practice or nurse-
physician collaboration on care giving
Advantages and Disadvantages of
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Assignment System
SYSTEM Advantages Disadvantages
Case
Method
Total patient
care
Different nurse,
different shifts,
different days
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Functional
Nursing
Efficiency Nurses do managerial
work
Nurses aides do
patient care
Time needed tocoordinate delegated
work.
SYSTEM Advantages Disadvantages
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Team
nursing
Team effort
Frees patient care
coordinator to manage
the unit
Nursing care
conferences help
problem solve and
develop staff
Nursing care plan
Time needed to
coordinate
delegated work
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Modular nursing Useful where
there are few RNs
RNs plan care
Paraprofessionals
do technical
aspects of care
Primary Nursing RNs give total patient care
Primary nurse has 24-hour
Confines nurses talents to
a limited number of
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y
responsibility
Associate nurse works
with patient while the
primary nurse is off duty
Accountability in place
Continuity of care is
facilitated
Reduces number of errors
from relay of orders
Fewer patient complaints
Shorter hospitalization
patients
Associates nurse may
change care plan without
discussing with primary
nurse
Managed Care Incorporates case Questionable
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management
Can be used with
any nursing care
deliver system
Standard critical
paths
Increases
efficiency
Reduces costs
continuity of care
Case Management Focuses on entire episode
of illness
Effort to coordinate
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Emphasizes achievement
of outcomesCare is coordinated by a
case manager
Second-generation
primary nursing
Critical paths
Variation analysis
Intershift reports
Health care team meeting
Interdisciplinary
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-ANJIING-
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Staffing Schedulesfor Productivity
Definition
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Definition
SCHEDULING
is the process of deciding how to commit
resources between a variety of possible tasks.
Time can be specified or floating as part of asequence of events.
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TYPES OF SCHEDULING:
Centralized Schedule- one person, usually the
chief nurse or her designate, assigns the
nursing personnel to the various units of thehospital. This includes the shifts on duty and
off-duty.
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Decentralized Schedule- the shift and off duties arearranged by the supervising nurse or head or senior
nurse of the particular unit.
Self Schedule- it is a system that is coordinated by
staff nurses.It is a process by which nurses and other
staff collectively develop and implement work
schedules, taking policies and variables affecting intoconsideration.
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-KAT-
Patient Care Classification System
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Patient Care Classification System
Is a method of grouping patients according tothe amount and complexity of their nursingcare requirements and the nursing time andskill they require.
This assessment can serve in determining theamount of nursing care required, generallywithin 24 hours, as well as the category of
nursing personnel who should provide thatcare.
LEVEL I
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LEVEL I
- Self Care or Minimal -
Patient can take a bath his own, feed himself,
feed and perform his activities of daily living.
LEVEL II
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- Moderate Care or Intermediate Care -
Patients under this level need some assistance
in bathing, feeding, or ambulating for shortperiods of time.
LEVEL III
http://rds.yahoo.com/_ylt=A0S020x0P0NL1kIA3AOJzbkF;_ylu=X3oDMTBqZDFlYmxzBHBvcwMxNgRzZWMDc3IEdnRpZAM-/SIG=1leh2ocb1/EXP=1262784756/**http:/images.search.yahoo.com/images/view?back=http://images.search.yahoo.com/search/images?p=nurse+patient+cartoons&b=1&ni=20&ei=utf-8&pstart=1&fr2=sg-gac&w=490&h=347&imgurl=www.clipartheaven.com/clipart/health_&_medical/cartoons/nurse_&_patient_19.gif&rurl=http://www.clipartheaven.com/clipart/health_&_medical/cartoons&size=6k&name=nurse+patient+19...&p=nurse+patient+cartoons&oid=1d86629bd9b0ee00&fr2=sg-gac&no=16&tt=413&b=1&ni=20&sigr=11un1vlll&sigi=12mtj35aq&sigb=13c31a97t -
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- Total, Complete or intensive Care -
Patient under this category are completely
dependent upon the nursing personnel.
LEVEL IV
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- Highly Specialized Critical Care -
Patients need maximum nursing care with
ratio of 80 professionals to 20 non-professionals.
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-BABY-
Republic Act 5901 The Fourty Hour Week Law
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Provides that employees working in thehospitals with 100 bed capacity and up willwork only 40 hours a week.
Employees working in agencies with less than100 bed capacity or in agencies located incommunities with less than one million
populations will work 48 hours a week andtherefore will get only one off- duty a week.
Civil Service Commission as per Memorandum Circular
No 6 series of 1996
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No.6, series of 1996
Granting of the three-day special privilege togovernment employees.
Which may be spent for Birthdays, weddings,anniversaries, funerals (mourning), relocation,
enrolment or graduation leave,
hospitalization, and accident leaves.
Rights and Privilegesgiven each personnel per
year
Working hours per week40hours
Working hours per week48 hours
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Vacation leave 15 15
Sick leave 15 15
Legal holidays 10 10
Specials holidays 2 2
Special privileges 3 3
Off
duties as per R.A.5901
104 52
Continuing education
program3 3
Total non-working days
per year
152 100
Total working holidays per
year213 265
Total working hours per
year1,704 2,120
SCHEDULED METHOD PROS CONS
SELF-SCHEDULING - coordinating by staff nurses
-saves manager scheduling time
-increases amount of time staff
spends on scheduling
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g g
-helps develop accountability
-increases perception of autonomy
-increased job satisfaction
-improved team spirit
-improved morale
-decreased absenteeism
-reduced turnover
-effective for recruitment and
retention
ROTATING WORK SHIFTS -can rotate teams -rotate among shifts
-increased stress
-affect health
-affect quality of work
Disrupt development of works group
-high turnover
PERMANENT SHIFTS -can participate in social activities-job
satisfaction-commitment to the
organization-few health problem-less
tardiness-less absenteeism-less
t
-most people want day shift-new
graduates predominantly staff
evening and nights-difficulty
evaluating evening and night shift-
t i t th
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turnover nurses may not appreciate the
workload or problems of other shift
BLOCK, OR CYCLICAL
SCHEDULING
-same schedule repeatedly-nurses
not so exhausted-sick time reduced-
personnel know schedule in social
events-decreased time spend on
scheduling-staff treated fairly-helps
establish stable work groups-
decreased floating-promotescontinuity of care
-rigidity
VARIABLES STAFFING -use census to determine number and
mix of staff-little need to call in
unscheduled staff
ALTERNATING OR ROTATING WORK SHIFTS
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The frequency of alternating between days and evening, ordays and nights, or rotating through all three shifts may varyamong institutions. Some nurses may work all three shiftswithin 7 days.
Alternating and rotating work shift create stress for staffnurses, environmental cues, such as: sunrise and sunset,fluctuate in a predictable cycle.
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Instrument s that designate hours, minute, and seconds correspond to thenatural daily cycle and allow knowledge of ones location in that cycle.
The ability of the body function to adjust varies considerably among
individuals; it takes 2 to 3 days to 2 weeks for a person to adjust to a
different sleep-awake cycle.
PERMANENT SHIFTS
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Permanent shifts relieve nurses from stressand health-related problem associated with
alternating and rotating shift.
When nurses are able to choose the shift thatbest suits their personal life, they can
participate in social activities, even when they
require regular attendance.
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In studies conducted with MONTREALNURSES, those working permanent shifts had
higher average on psychological scales such
as: mental health, job satisfaction, socialinvolvement, and commitment to the
organization.
BLOCK OR CYCLICAL SCHEDULING
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Uses the same schedule repeatedly. With a 6-day forward rotation, personnel are scheduled
to work6 successive days followed by at least
2 days off. The scheduled repeats it every 6weeks.
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Personnel can be scheduled with every otherweekend off and 1 day during the week so
that there are more than 4 consecutive days
of are not exhausted by working too manyconsecutive days, sick leave can be reduced.
TEN HOURS PER DAY, FOUR-DAY WORK
PER WEEK
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PER WEEK
A cyclical scheduled allowed at least 14 hoursoff between shifts and a 4-day weekend every
6 weeks for those who rotated.
The work week began on Sunday and theweekend was Saturday and Sundays for all
shifts.
Variables staffing PROS CONS
8 hours Traditional
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10 hours Time to complete work,
Long weekends,
Extra days off,
Decreased overtime,
Cover peak workloads,
Decreased costs
Longer workday,
Fatigue,
Overlap,
Difficult to find substitute
12 HOURS Lower staffing requirements,Lower
cost per patient day,Increased
knowledge of patients,Get new
admission settled,Not so
rushed,Better continuity of care,Team
development is possible,Less daily to
do staffing,Reduced travel time,Less
personal expenses for gas, meals,
babysitting
Overtime,Exhaustion increases at
end of workweek,Tension increased
at the end of workweek,Increased in
minor accident,Increased medication
errors,Home and social life suffer the
week worked.
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-JOSEPH-
Determination of Number of Nursing
Personnel
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Personnel
Importance: So that there should have sufficient staff to
cover all shifts, off-duties, holidays, leaves,
absences, and time for staff developmentprogram.
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Steps inComputing Number
of NursingPersonnel
Sample Problem
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Find the number of nursing personnel neededfor 250 patients in tertiary hospital.
Eh.. Panu bhe eyun??
Toxic yata??
Illustration:
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Step 1
Categorize the patients according to the levels ofcare needed.
Multiply the total number of patients by the
percentage of patients at each level of care.
250(pts)
250(pts)
250(pts)250(pts)
x .30
x .45
x .15x .10
=75 min. care
= 112.5 mod.care
= 37.5 int. care= 25 h. spcl. care
250
GIVEN
Step 2
Fi d h # f P h l l b h b
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Find the # of Pts at each level by the average number
of nursing care hour needed per day.
Get the sum of the NCH/day needed at the various
levels.
75pts
112.5pts
37.5pts
25pts
x 1.5 (NCH@L1)
x 3 (NCH@L2)
x 4.5 (NCH@L3)
x 6 (NCH@L4)
= 112.5NCH/day
= 337.5 NCH/day
= 168.75 NCH/day
= 150NCH/day
768.75NCH/dayTotal
=75 min. care
= 112.5 mod.care
= 37.5 int. care
= 25 h. spcl. care
Step 3
Fi d th t l b f i h d d b th
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x 365 days/year
280,593.75 NCH/year
Find the actual number of nursing care hours needed by the
given number of patients.
Multiply the total nursing care hours needed per day by the
total number of days in a year.
768.75NCH/day
SAVE
Step 4
Fi d th t l b f ki h d d b h
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8 (hrs/day)
213 (working days/year)
1,704 working hours/year
Find the actual number of working hours rendered by each
nursing personnel per year.
Multiply the number of hours on duty per day by the actual
working days per year.
SAVE280,593.75 NCH/year
x
SAVE
Total NCH/yrWorking hrs/yr
Step 5
Divide the total # of NCH/yr by the actual # of working hrs
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Total NCH/yr =
Working hrs/yr
Relief x Total Nsg Personnel =
Total Nursing Personnel needed
Divide the total # of NCH/yr by the actual # of working hrsrendered by an employee/yr.
Find the number of relievers:- Multiply the number of nursing personnel needed by 0.15
(for those working 40 hours per week) or by 0.12 (for thoseworking 48 hours per week).
Add the number of relievers to the number of nursing
personnel needed.
SAVE
280,593.75 =
1,704
165
x 0.15 = 25
+ =190SAVE1,704 working hours/year 280,593.75 NCH/year
Step 6
Categorize the nursing personnel into professionals and non
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Categorize the nursing personnel into professionals and non-
professionals.
Multiply the # of nsg personnel according to the ratio of
professionals to non-professionals
190
190
x .65 =
x .35 =
124 professional nurses
66 nursing attendants
Step 7
Distribute by shifts
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Professional
124 nurses
124 nurses124 nurses
Distribute by shifts.
124 professional nurses66 nursing attendants
x .45
x .37x . 18
= 56 nurses on AM shift
= 46 nurses on PM shift= 22 nurses on night shift
total 124 nurses
Step 7
Distribute by shifts
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Non-Professional
66 Nsg attendant
66 Nsg attendant
66 Nsg attendant
Distribute by shifts.
66 nursing attendants 124 professional nurses
x .45
x .37
x .18
total 66 Nsg attendant
= 30 Nsg attendant on AM shift
= 24 Nsg attendant on PM shift
= 12 Nsg attendant on night shift
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Tapos na!