finalresear study vgmh

INTRODUCTIONINTRODUCTION

In 1979, the hospital, Gullas In 1979, the hospital, Gullas Medical Center situated in Medical Center situated in Banilad, Mandaue City, Banilad, Mandaue City, Philippines started as a secondary Philippines started as a secondary hospital. The hospital was hospital. The hospital was founded to complement the founded to complement the Gullas College of Medicine and Gullas College of Medicine and the University of the Visayas – the University of the Visayas – College of Nursing.College of Nursing. 2

Later in the year 2001, it was Later in the year 2001, it was renamed Vicente Gullas renamed Vicente Gullas Memorial Hospital and has been Memorial Hospital and has been accredited as a Tertiary Hospital. accredited as a Tertiary Hospital. It was upgraded to 75-100 bed It was upgraded to 75-100 bed capacity involving services which capacity involving services which caters to the needs of both out-caters to the needs of both out-patients and in-patients.patients and in-patients.

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Inday Pining Family Medical Inday Pining Family Medical Clinic (Out Patient Services) Clinic (Out Patient Services) includes Medical Consultations, includes Medical Consultations, D.O.T.S., VGMH TB Diagnostic D.O.T.S., VGMH TB Diagnostic Committee, Family Wellness Committee, Family Wellness Clinic, Well Baby Clinic, Clinic, Well Baby Clinic, Diabetic Clinic and Homeopath Diabetic Clinic and Homeopath and Homotoxicology Clinic.and Homotoxicology Clinic.

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The hospital also caters to The hospital also caters to services both medical and services both medical and surgical with the qualified surgical with the qualified and competent doctors and and competent doctors and nurses, providing technology nurses, providing technology as a tertiary hospital with a as a tertiary hospital with a primary care attitude.primary care attitude.

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Part of the hospital’s special services Part of the hospital’s special services offered are the Tan Kim Ching Cancer offered are the Tan Kim Ching Cancer Center, which is one of the main Center, which is one of the main radiation centers in the city that offers radiation centers in the city that offers external radiation therapy with its up-external radiation therapy with its up-to-date facilities which provides cancer to-date facilities which provides cancer treatment and detection services. The treatment and detection services. The New Life Plastic Surgery Center also New Life Plastic Surgery Center also provides aesthetic services for the provides aesthetic services for the patients.patients.

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Today, not only Gullas Medical Center Today, not only Gullas Medical Center expanded their coverage in the expanded their coverage in the medical venture but they have also medical venture but they have also invested millions of cash to improve invested millions of cash to improve their hospital equipments. Certainly their hospital equipments. Certainly they are going all-out now just trailing they are going all-out now just trailing behind the powerhouses Chong Hua behind the powerhouses Chong Hua Hospital, Perpetual Succour, and Cebu Hospital, Perpetual Succour, and Cebu Doctors Hospital, to name a few.Doctors Hospital, to name a few.

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VISIONVISIONVicente Gullas Memorial Hospital exists Vicente Gullas Memorial Hospital exists primarily to give a Holistic of Health primarily to give a Holistic of Health care to patient as individual person and care to patient as individual person and not just a case number.not just a case number.

Thus the Vision is to keep abreast with Thus the Vision is to keep abreast with the changing modes in Medicine. the changing modes in Medicine. Providing technology as a Tertiary Providing technology as a Tertiary Hospital with a Primary care attitude, Hospital with a Primary care attitude, all for the service of GOD and his all for the service of GOD and his people.people.

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MISSIONMISSIONAs an institution of healing the Hospital As an institution of healing the Hospital aimed to provide efficient clinical services to aimed to provide efficient clinical services to give the best Medical care to the community.give the best Medical care to the community.

An institution of learning, the Hospital is An institution of learning, the Hospital is committed to compliment the Gullas College committed to compliment the Gullas College of Medicine and the UV College of Nursing in of Medicine and the UV College of Nursing in their task to develop complete Physicians and their task to develop complete Physicians and allied Medical Practitioners to become allied Medical Practitioners to become effective instruments of GOD in their service effective instruments of GOD in their service to fellowmen.to fellowmen.

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NURSING SERVICE VISION AND NURSING SERVICE VISION AND MISSIONMISSION

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VISIONVISION

Vicente Gullas Memorial Vicente Gullas Memorial Hospital is the leader in Hospital is the leader in promoting holistic quality promoting holistic quality nursing care, training and nursing care, training and research thus bringing out research thus bringing out healthy mankind.healthy mankind.

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MISSIONMISSION

It is the mission of Vicente Gullas It is the mission of Vicente Gullas Memorial Hospital Nursing service to:Memorial Hospital Nursing service to:Advocate for nurses and other Advocate for nurses and other

nursing personnel in the area;nursing personnel in the area;Observe ethico-moral practices;Observe ethico-moral practices;Establish performance standards;Establish performance standards;Develop nursing human resources;Develop nursing human resources;

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Guarantee equitable, sustainable and Guarantee equitable, sustainable and quality health care;quality health care;

Value research in decision making, Value research in decision making, allocating and generating resources allocating and generating resources and;and;

Participate in research related to Participate in research related to nursing service development in the nursing service development in the clinical and administrative setting clinical and administrative setting both nursing practice and education.both nursing practice and education.

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PHILOSOPHYPHILOSOPHY

The Vicente Gullas The Vicente Gullas Memorial Hospital Nursing Memorial Hospital Nursing service believes the patient service believes the patient have the right to receive have the right to receive holistic are regardless of holistic are regardless of their age, creed, gender, their age, creed, gender, and socio-economic status.and socio-economic status.

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GOALSGOALS

As service oriented, dynamic As service oriented, dynamic and empowered workforce the and empowered workforce the nursing service shall fully nursing service shall fully support the provision of better support the provision of better health outcomes, more health outcomes, more responsive health care system responsive health care system and good governance in all and good governance in all areas of the hospital.areas of the hospital. 15

OBJECTIVESOBJECTIVES

A. GeneralA. GeneralProvide and ensure Provide and ensure the quality nursing the quality nursing service in all areas service in all areas of the hospital.of the hospital.

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B. SpecificB. SpecificEstablish and maintain acceptable Establish and maintain acceptable

stands of nursing care;stands of nursing care;Provide and advocate for the Provide and advocate for the

health safety and rights of each health safety and rights of each patient;patient;

Enhance the competency of Enhance the competency of nursing personnel through staff nursing personnel through staff development.development.

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Provide a safe and Provide a safe and therapeutic environment therapeutic environment among patients and nursing among patients and nursing personnel and staff.personnel and staff.

Monitor the effectiveness of Monitor the effectiveness of nursing service consistent nursing service consistent with the standards.with the standards.

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PEDIATRIC WARDPEDIATRIC WARD

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Pediatric department of VGMH Pediatric department of VGMH provides quality, effective and provides quality, effective and affordable health care services affordable health care services to reduce morbidity and to reduce morbidity and mortality rate of childhood mortality rate of childhood diseases. It has 20 bed diseases. It has 20 bed capacity and categorized into capacity and categorized into respiratory and gastro units.respiratory and gastro units. 20

VISIONVISION

Vicente Gullas Memorial Hospital – Vicente Gullas Memorial Hospital – pediatric staff envisions being a pediatric staff envisions being a specialized department fully specialized department fully equipped by modern facilities, equipped by modern facilities, managing be experience and skilled managing be experience and skilled personnel under the supervision of personnel under the supervision of pediatric specialist in achieving pediatric specialist in achieving excellent service and outcomes.excellent service and outcomes.

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MISSIONMISSION

Vicente Gullas Memorial Hospital Vicente Gullas Memorial Hospital – pediatric department aims to – pediatric department aims to deliver quality health care deliver quality health care services to pediatric patients services to pediatric patients enhancing their growth and enhancing their growth and development with the development with the involvement of the parents in the involvement of the parents in the implementation of health care.implementation of health care.

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PHILOSOPHYPHILOSOPHY

Committed to the highest Committed to the highest standard of quality and standard of quality and excellent health services excellent health services through working through working collaboratively to create an collaboratively to create an atmosphere of healing.atmosphere of healing.

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GOALSGOALS

A. Health CareA. Health Care

1.1. To strengthen and improve To strengthen and improve delivery of care to pediatric delivery of care to pediatric patients with compassion.patients with compassion.

2.2. To strive to meet the ideal To strive to meet the ideal standards and best standards and best pediatric services.pediatric services.

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B. Training and Research.B. Training and Research.

1.1. To make sure student affiliates To make sure student affiliates acquire knowledge in paediatrics, acquire knowledge in paediatrics, develop critical thinking and develop critical thinking and analytical skills and possess the analytical skills and possess the proper attitudes and conduct.proper attitudes and conduct.

2.2. To promote and further To promote and further strengthen its pursuit for strengthen its pursuit for excellence in research.excellence in research.

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3. 3. To provide continuing To provide continuing medical education as well medical education as well as professional and human as professional and human development programs for development programs for medical and non-medical medical and non-medical personnel of the hospital.personnel of the hospital.

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1.1. Render optimum and quality health Render optimum and quality health care with scientific and professional care with scientific and professional standards consistent with the standards consistent with the pediatric needs.pediatric needs.

2.2. Development creative and critical Development creative and critical thinking and skills of staff and thinking and skills of staff and student nurses.student nurses.

3.3. Implement nursing standards for Implement nursing standards for practice and education.practice and education.

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4.4. Establish strong collaboration Establish strong collaboration linkages and networking linkages and networking between hospital and affiliated between hospital and affiliated agencies.agencies.

5.5. Participate in strengthening the Participate in strengthening the pediatric care through pediatric care through research.research.

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OPERATING ROOMOPERATING ROOM

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The Operating Room (OR) is designed The Operating Room (OR) is designed and furnished with functional and furnished with functional

surgical facilities.surgical facilities.

Our surgical unit works with competent and Our surgical unit works with competent and committed surgical team.committed surgical team.

The Operating Room caters to cases such as The Operating Room caters to cases such as uncomplicated OB-GYNE, paediatrics, uncomplicated OB-GYNE, paediatrics, orthopaedics, plastic/cosmetic surgeries and orthopaedics, plastic/cosmetic surgeries and other minor procedures.other minor procedures.

Serves as training facility to the University of Serves as training facility to the University of the Visayas College of Nursing.the Visayas College of Nursing. 30

VISIONVISION

Vicente Gull as Memorial Hospital Vicente Gull as Memorial Hospital Operating Room (OR) Department is the Operating Room (OR) Department is the front liner in advocating safe, effective, front liner in advocating safe, effective, cost-efficient, and high quality standards cost-efficient, and high quality standards and state-of-the-art facilities in and state-of-the-art facilities in preoperative practice.preoperative practice.

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MISSIONMISSION

Promotes safety and optimal Promotes safety and optimal outcomes for preoperative clientsoutcomes for preoperative clients

Provides and supports Provides and supports professional development professional development opportunities to the surgical opportunities to the surgical teams.teams.

Ensures availability of modern Ensures availability of modern technologies and resources.technologies and resources.

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PHILOSOPHYPHILOSOPHYThe operating room is a The operating room is a specialized are of the nursing specialized are of the nursing service division that aims to:service division that aims to:

Provide optimum quality care Provide optimum quality care to all perioperatative clients.to all perioperatative clients.

Enhance exposure among Enhance exposure among affiliating institutions towards affiliating institutions towards perioperative care.perioperative care.

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GOALSGOALS

Develops collaborative and Develops collaborative and innovative solutions to the health innovative solutions to the health care challenges.care challenges.

Acquire up-to-date surgical facilities Acquire up-to-date surgical facilities and suppliesand supplies

Facilitates full compliance with Facilitates full compliance with affiliating institutions in policy affiliating institutions in policy making to enhance students’ making to enhance students’ exposure to perioperative care.exposure to perioperative care.

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Provides efficient, well disciplined, Provides efficient, well disciplined, committed and courteous operating committed and courteous operating room personnel.room personnel.

Updates educational standards to Updates educational standards to promote high level of proficiency promote high level of proficiency among the surgical staff.among the surgical staff.

Maintains strict compliance to Maintains strict compliance to standard aseptic techniques in standard aseptic techniques in perioperative care.perioperative care.

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Upholds environment Upholds environment accountability and pollution accountability and pollution prevention in perioperative setting.prevention in perioperative setting.

Ensures accessible quality Ensures accessible quality perioperative care.perioperative care.

Coordinates and collaborates with Coordinates and collaborates with stakeholders regarding the client stakeholders regarding the client care.care.

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Functions / Duties / Functions / Duties / ResponsibilitiesResponsibilities

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Chief NurseChief Nurse

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CHIEF NURSECHIEF NURSE

Plans, organizes and supervises the Plans, organizes and supervises the nursing service in order to provide nursing service in order to provide adequate nursing care to patients;adequate nursing care to patients;

Coordinates all activities of the nursing Coordinates all activities of the nursing service department with other services;service department with other services;

Prepares the nursing service budget to Prepares the nursing service budget to provide adequate personnel, provide adequate personnel, equipment, and physical facilities equipment, and physical facilities needed and submits to Administrative needed and submits to Administrative Office;Office;


Interviews and screen all applicants for the Interviews and screen all applicants for the nursing service and evaluates their qualifications nursing service and evaluates their qualifications and experiences;and experiences;

Observes and evaluates the performance of Observes and evaluates the performance of personnel, as well as analyzes and evaluates the personnel, as well as analyzes and evaluates the nursing activities to determine whether they are nursing activities to determine whether they are meeting the desired standards;meeting the desired standards;

Formulates and recommends policies for Formulates and recommends policies for improvement of patient care, participates in improvement of patient care, participates in planning of personnel policies and interprets to planning of personnel policies and interprets to the Medical Director the needs and interest of the the Medical Director the needs and interest of the nursing personnel;nursing personnel;


Promotes individual growth and Promotes individual growth and development by maintaining a program of development by maintaining a program of staff education; conducts monthly staff education; conducts monthly meetings of nurses and nursing aides;meetings of nurses and nursing aides;

Promotes and maintains cordial Promotes and maintains cordial relationship with patients; their families relationship with patients; their families and community and provides opportunities and community and provides opportunities for nursing staff to work with other groups for nursing staff to work with other groups so that the aims of the hospital can be so that the aims of the hospital can be interpreted to mean good interpersonal interpreted to mean good interpersonal and interdepartmental relationships;and interdepartmental relationships;


Participates in professional Participates in professional meetings as the representatives of meetings as the representatives of the nursing service personnel the nursing service personnel provides for healthful leaving provides for healthful leaving conditions of nursing personnel;conditions of nursing personnel;

Participates in the hospital outreach Participates in the hospital outreach programs;programs;

Subject “to call” as need arises;Subject “to call” as need arises;


Daily ward rounds. To gain an insight Daily ward rounds. To gain an insight to the problems and needs as to the problems and needs as presented by the patient and the presented by the patient and the family, the nurses and other health family, the nurses and other health disciplines;disciplines;

Signs Daily time Records;Signs Daily time Records; Performs other duties as required by Performs other duties as required by

the Medical Directorthe Medical Director Attends seminars, workshop locally Attends seminars, workshop locally

and nationally as the need arises.and nationally as the need arises.

Head NurseHead Nurse

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HEAD NURSEHEAD NURSEUnder direction, responsible for the administration Under direction, responsible for the administration

and supervision of the particular nursing unit, or;and supervision of the particular nursing unit, or; Makes patient round and sees to it that all Makes patient round and sees to it that all

patients in her ward get the necessary care.patients in her ward get the necessary care. Sees to it that all equipment are in order Sees to it that all equipment are in order

and properly kept and supplies are availableand properly kept and supplies are available Makes weekly schedules and daily Makes weekly schedules and daily

assignment of her staff.assignment of her staff. Check and countersigns recording done by Check and countersigns recording done by

the staff nurses.the staff nurses.

HEAD NURSEHEAD NURSE

See to it that doctor’s orders are carried out See to it that doctor’s orders are carried out properly and intelligently by the staff.properly and intelligently by the staff.

Plans and supervises all the nursing activities in Plans and supervises all the nursing activities in the ward.the ward.

Evaluates performance of her staff every six Evaluates performance of her staff every six months.months.

Coordinates ward activities in the administration Coordinates ward activities in the administration of nursing service with all other hospital services. of nursing service with all other hospital services.

Directs and supervises activities of Directs and supervises activities of nonprofessional workers in the ward.nonprofessional workers in the ward.


Participates in the orientation of new staff, Participates in the orientation of new staff, trainees, volunteer nurses, and midwives.trainees, volunteer nurses, and midwives.

Interpret hospital philosophy, objectives and Interpret hospital philosophy, objectives and policies to staff, patients and their families and policies to staff, patients and their families and students.students.

Represents her ward in the nursing service Represents her ward in the nursing service meetings and other hospital meetings when meetings and other hospital meetings when necessary.necessary.

Acts as supervising nurse when so delegated. Acts as supervising nurse when so delegated. Renders direct nursing care if the unit is under Renders direct nursing care if the unit is under

staffed.staffed.


Supervises cleanliness and orderliness of the ward.Supervises cleanliness and orderliness of the ward. Provides/ maintains adequate facilities, equipment Provides/ maintains adequate facilities, equipment

and supplies necessary.and supplies necessary. Provides an environment that is conducive to the Provides an environment that is conducive to the

physical, spiritual and emotional well-being of physical, spiritual and emotional well-being of patients and personnel.patients and personnel.

Participates in Participates in formulating/interpreting/implementing philosophy, formulating/interpreting/implementing philosophy, objectives and policies of nursing services. objectives and policies of nursing services. Establishes, promotes and maintains good Establishes, promotes and maintains good interpersonal relationship.interpersonal relationship.


Evaluates nursing staff in her unit, gives Evaluates nursing staff in her unit, gives them assignments according to their them assignments according to their capacity.capacity.

Identifies nursing problems in the ward.Identifies nursing problems in the ward. Acts as liaison between patient and Acts as liaison between patient and

members of the health team.members of the health team.

Staff NurseStaff Nurse

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STAFF NURSESTAFF NURSE

DefinitionsDefinitions

One who is responsible One who is responsible for rendering nursing care for rendering nursing care within an assigned unit.within an assigned unit.


QualificationsQualifications1.1. Licensed Professional NurseLicensed Professional Nurse

2.2. Bachelor of Science in NursingBachelor of Science in Nursing

3.3. Able to make sound decisionsAble to make sound decisions

4.4. Skilled in communicationSkilled in communication

5.5. Able to relate with supervisors, peers Able to relate with supervisors, peers and co-workersand co-workers


Personal Qualities and Professional Personal Qualities and Professional Proficiency:Proficiency:

1.1.Physically and mentally fit.Physically and mentally fit.

2.2.Has knowledge and skills in Has knowledge and skills in nursing and nursing process.nursing and nursing process.


Functions:Functions:

I.I. Plans and gives comprehensive nursing care to their Plans and gives comprehensive nursing care to their patients according to their individual need.patients according to their individual need.

A. A. Identifies needs and problems through clinical Identifies needs and problems through clinical observation, interaction and Physical assessment.observation, interaction and Physical assessment.

1.1. Interviews and interacts with patients from Interviews and interacts with patients from admission.admission.

2.2. Performs simple physical as inspection, palpation, Performs simple physical as inspection, palpation, percussion and auscultation.percussion and auscultation.

3.3. Analyzes and synthesizes and significant laboratory Analyzes and synthesizes and significant laboratory and diagnostic findings to come up with a nursing and diagnostic findings to come up with a nursing notes.notes.


B. Formulates a comprehensive nursing care B. Formulates a comprehensive nursing care plan as shown in the kardex, especially the plan as shown in the kardex, especially the special nursing needs and approaches.special nursing needs and approaches.

C. Provides hygiene and physical comfort and C. Provides hygiene and physical comfort and measures.measures.

1.1. Renders sponge bath and gives good Renders sponge bath and gives good skin careskin care

2.2. Keeps the patient well-groomed (hair, Keeps the patient well-groomed (hair, nails, etc.)nails, etc.)


3.3. Gives attention to pressure irritated areas.Gives attention to pressure irritated areas.

4.4. Assist patient in nasal-oral-careAssist patient in nasal-oral-care

a)a) Keep patient’s mouth clean and free from Keep patient’s mouth clean and free from halitosis.halitosis.

b)b) Regularly suction nose, mouth and tracheostomyRegularly suction nose, mouth and tracheostomy

5.5. Keeps patient’s bed clean, dry and in good order.Keeps patient’s bed clean, dry and in good order.

6.6. Keeps wound dressing clean and dry.Keeps wound dressing clean and dry.

7.7. Positions patient properly conducive to recovery.Positions patient properly conducive to recovery.

a)a) Frequent turns patient to side as indicated.Frequent turns patient to side as indicated.

b)b) Institute supports (footboard, pillows, splints, Institute supports (footboard, pillows, splints, fracture boards) and uses them correctlyfracture boards) and uses them correctly


D. Assures proper intake (nutrition and fluid electrolyte).D. Assures proper intake (nutrition and fluid electrolyte).

1.1. Maintain NPO strictly as ordered.Maintain NPO strictly as ordered.

2.2. Gives oral fluids, restricts and records as indicated.Gives oral fluids, restricts and records as indicated.

3.3. Assist patient promptly and adequately with meals.Assist patient promptly and adequately with meals.

4.4. Provides tube feedings according to ordered Provides tube feedings according to ordered amount, frequency and specific caloric content.amount, frequency and specific caloric content.

5.5. Checks on the patency and correct patency of NGT.Checks on the patency and correct patency of NGT.

6.6. Administer correct IV fluid bottle with precise Administer correct IV fluid bottle with precise labeling.labeling.

7.7. Regulates IV fluid at proper rate.Regulates IV fluid at proper rate.

8.8. Measures and record intake and output accurately.Measures and record intake and output accurately.


E. Institutes measures for the maintenance of the proper E. Institutes measures for the maintenance of the proper urinary and bowel.urinary and bowel.

1.1. Checks and records urination and bowel Checks and records urination and bowel movement.movement.

2.2. Applies hot and cold compress in case of Applies hot and cold compress in case of urinary retention as ordered.urinary retention as ordered.

3.3. Gives laxatives, enemas and suppositories as Gives laxatives, enemas and suppositories as indicated.indicated.

4.4. Encourage adequate fluid intake unless Encourage adequate fluid intake unless contraindicated.contraindicated.

5.5. Encourages ambulation and activity.Encourages ambulation and activity.


F. Ensures safe and clean environment.F. Ensures safe and clean environment.

1.1. Provides side rails for pediatric and geriatric Provides side rails for pediatric and geriatric patient.patient.

2.2. Restraints patient as needed.Restraints patient as needed.

3.3. Adjust height of bed properlyAdjust height of bed properly

4.4. Properly disposes contaminated articles.Properly disposes contaminated articles.

5.5. Displays proper signs for patient’s safety (NO Displays proper signs for patient’s safety (NO SMOKING)SMOKING)

6.6. See to it that machines or electrical equipment See to it that machines or electrical equipment at bedside are properly connected and at bedside are properly connected and maintained.maintained.


G. Participates in the education and rehabilitation of patients as well as G. Participates in the education and rehabilitation of patients as well as in the promotion of mental health.in the promotion of mental health.

1.1. Instructs the patient and his family on the reasons for special Instructs the patient and his family on the reasons for special diet, fluid restriction (if any) and other health related to nutrition.diet, fluid restriction (if any) and other health related to nutrition.

2.2. Gives health teachings and demonstrations to patient and family Gives health teachings and demonstrations to patient and family regarding activity and body mechanics in relation to adequate regarding activity and body mechanics in relation to adequate oxygenation and ventilation and the prevention of complications.oxygenation and ventilation and the prevention of complications.

3.3. Teaches the diabetic patient on the regime set by the physician Teaches the diabetic patient on the regime set by the physician on his plan of care.on his plan of care.

4.4. Orients patient/family to the hospital system.Orients patient/family to the hospital system.

5.5. Explains test and procedures.Explains test and procedures.

6.6. Explains actively, encourages questions, generally makes Explains actively, encourages questions, generally makes patient family feel at ease.patient family feel at ease.

7.7. Observes the patient’s spiritual needs.Observes the patient’s spiritual needs.


II. Assist in meeting the patient’s spiritual needs.II. Assist in meeting the patient’s spiritual needs.

1.1. Inform patient of spiritual service available.Inform patient of spiritual service available.

2.2. Obtained such service if requested or Obtained such service if requested or indicated.indicated.

3.3. Provides privacy during counseling services.Provides privacy during counseling services.

4.4. Observes protocols of the patient’s religion Observes protocols of the patient’s religion in such things as diet or ritual.in such things as diet or ritual.

5.5. Assist the priest/minister in giving Assist the priest/minister in giving sacraments.sacraments.

JOB SUMMARYJOB SUMMARY

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Emergency RoomEmergency Room

Assess the patients’ Assess the patients’ injuries or condition upon injuries or condition upon reception. Place the reception. Place the patients in a prioritized patients in a prioritized order in which seen by order in which seen by the doctor.the doctor.

Medical-Surgical Medical-Surgical WardWard

Responsible for managing the Responsible for managing the care of the adult or elderly patient care of the adult or elderly patient experiencing general medical experiencing general medical conditions or general surgical conditions or general surgical procedures, which require general procedures, which require general assessments related to specific assessments related to specific conditions and general therapies conditions and general therapies and interventions.and interventions.

Pediatrics Pediatrics WardWard

Involve in the Involve in the treatment and care of treatment and care of infants, children and infants, children and teenagers.teenagers.

DETAILED DUTIES & DETAILED DUTIES & RESPONSIBILITIESRESPONSIBILITIES

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Emergency RoomEmergency Room Handle patients that are accepted into the emergency Handle patients that are accepted into the emergency

room with the cases of Cardiac arrest, heart attack, room with the cases of Cardiac arrest, heart attack, gun and stub wounds, seizure, asthma and chronic gun and stub wounds, seizure, asthma and chronic obstructive pulmonary disease etc.obstructive pulmonary disease etc.

Deliver first-aid to the patient, prepare for inspection Deliver first-aid to the patient, prepare for inspection by the emergency-room physician on-duty, by the emergency-room physician on-duty, undresses, measure pulse-rate, temperature, blood undresses, measure pulse-rate, temperature, blood pressure and perform any other necessary pressure and perform any other necessary examination.examination.

Take the patients vitals such as weight, temperature Take the patients vitals such as weight, temperature and blood pressure.and blood pressure.

Record information to give to the attending physician.Record information to give to the attending physician.


Assist the physician in checking the patient and Assist the physician in checking the patient and delivers the treatment that was ordered by the delivers the treatment that was ordered by the physician, including disinfecting and bandaging physician, including disinfecting and bandaging wounds and bruises, smearing ointments, wounds and bruises, smearing ointments, dispensing medications, connecting the patient into dispensing medications, connecting the patient into infusionsinfusions

Responsible for carrying out the care plan the doctor Responsible for carrying out the care plan the doctor prescribes.prescribes.

Administer medications or injects shots and explain Administer medications or injects shots and explain any discharge instructions to the family and patient, any discharge instructions to the family and patient, and prepare to take over care at home and deal with and prepare to take over care at home and deal with inquiries from patients and their family members.inquiries from patients and their family members.


Assess patients and provide necessary triage, Assess patients and provide necessary triage, perform procedures such as intubation, placing perform procedures such as intubation, placing IVs and administering medications.IVs and administering medications.

Determine the medical needs of patients with Determine the medical needs of patients with life-threatening injuries either independently or life-threatening injuries either independently or in consultation with doctors and other in consultation with doctors and other healthcare workers.healthcare workers.

Liable for seeing each of the patients, Liable for seeing each of the patients, evaluating based on the early, limited feedback evaluating based on the early, limited feedback she receives and then prioritizing the injuries.she receives and then prioritizing the injuries.


In-charge in answering additional In-charge in answering additional questions a patient might have forgotten questions a patient might have forgotten to ask when the doctor was present, and to ask when the doctor was present, and instruct patients about prescriptions and instruct patients about prescriptions and how often medications should be taken.how often medications should be taken.

Encode patient’s information into a Encode patient’s information into a hospital’s computer system, including hospital’s computer system, including documenting each patient’s treatment and documenting each patient’s treatment and any medications that were prescribed and any medications that were prescribed and keep record of patient’s health condition.keep record of patient’s health condition.


Responsible for assisting with Responsible for assisting with moving patients from the ER to moving patients from the ER to operating rooms when necessary.operating rooms when necessary.

Ensure compliance to hospital Ensure compliance to hospital policies and state laws.policies and state laws.

Participate in various health Participate in various health campaigns and educational campaigns and educational programs.programs.


Conduct an individualized patient assessment, Conduct an individualized patient assessment, prioritizing the data collection based on the adult or prioritizing the data collection based on the adult or elderly patient’s immediate condition or needs elderly patient’s immediate condition or needs within timeframe specified by the client facility’s within timeframe specified by the client facility’s policies, procedures or protocols.policies, procedures or protocols.

Conduct ongoing assessments as determined by the Conduct ongoing assessments as determined by the adult or elderly patient’s condition and/or the client adult or elderly patient’s condition and/or the client facility’s policies, procedures or protocols and facility’s policies, procedures or protocols and reprioritizes care accordingly.reprioritizes care accordingly.

Develop plan of care that is individualized for the Develop plan of care that is individualized for the adult or elderly patient reflecting collaboration with adult or elderly patient reflecting collaboration with other members of the healthcare team.other members of the healthcare team.


Perform appropriate treatments as ordered by the Perform appropriate treatments as ordered by the physician in an accurate and timely manner.physician in an accurate and timely manner.

Perform therapeutic nursing interventions as Perform therapeutic nursing interventions as established by individualized plan of care for the established by individualized plan of care for the adult or elderly patient and his/her family.adult or elderly patient and his/her family.

Provide individualized patient/family education Provide individualized patient/family education customized to the adult or elderly patient and customized to the adult or elderly patient and his/her family.his/her family.

Documents patient assessment findings, Documents patient assessment findings, physical/psychosocial responses to nursing physical/psychosocial responses to nursing intervention and progress towards problem intervention and progress towards problem resolution.resolution.


Initiate emergency resuscitative measures Initiate emergency resuscitative measures according to adult resuscitation protocols.according to adult resuscitation protocols.

Maintain confidentiality in matters related to Maintain confidentiality in matters related to patient, family and client facility staff.patient, family and client facility staff.

Provide care in a non-judgmental, non-Provide care in a non-judgmental, non-discriminatory manner that is sensitive to the adult discriminatory manner that is sensitive to the adult or elderly patient’s and family’s diversity, or elderly patient’s and family’s diversity, preserving their autonomy, dignity and rights.preserving their autonomy, dignity and rights.

Report patient condition to appropriate personnel Report patient condition to appropriate personnel during each shift.during each shift.

Maintain current competency in adult medical Maintain current competency in adult medical surgical nursing.surgical nursing.


Assist the paediatrician in administering to Assist the paediatrician in administering to the diagnostic procedures to assess the the diagnostic procedures to assess the ailment of injuries of children.ailment of injuries of children.

Meet with attending paediatrician, patient-Meet with attending paediatrician, patient-children and their parents or guardians to children and their parents or guardians to discuss issues regarding treatment optionsdiscuss issues regarding treatment options

Observe work shift schedules and may be Observe work shift schedules and may be required to extend work beyond shift.required to extend work beyond shift.

Monitor patient’s convalescence and post-Monitor patient’s convalescence and post-surgical response to medication. surgical response to medication.


Assist paediatrician in minor surgical operations.Assist paediatrician in minor surgical operations. Maintain and update patient’s medical histories.Maintain and update patient’s medical histories. Conduct essential and routine diagnostics like Conduct essential and routine diagnostics like

blood tests, urine and stool samples, blood blood tests, urine and stool samples, blood pressure, and pulse rates.pressure, and pulse rates.

Request appropriate laboratory tests, interpret Request appropriate laboratory tests, interpret lab results and communicate said results to lab results and communicate said results to patient and parents/guardians.patient and parents/guardians.

Follow-up on treatment medications as directed Follow-up on treatment medications as directed by the paediatrician.by the paediatrician.

STAFFING SCHEDULESTAFFING SCHEDULE

78

GENERAL POLICIES AND GENERAL POLICIES AND GUIDELINESGUIDELINES

1.1. Clinical areas of Vicente Gullas Memorial Hospital Clinical areas of Vicente Gullas Memorial Hospital are staffed within a minimum of two Registered are staffed within a minimum of two Registered Nurses and a Nursing attendant 24 hours a day, Nurses and a Nursing attendant 24 hours a day, everyday.everyday.

2.2. All the nursing staff in these clinical areas will All the nursing staff in these clinical areas will render 40 hours on duty per week either in the render 40 hours on duty per week either in the morning shift (7:00 AM to 3:00 PM), afternoon shift morning shift (7:00 AM to 3:00 PM), afternoon shift (3:00 PM to 11:00 PM) or night shift (11:00 PM to (3:00 PM to 11:00 PM) or night shift (11:00 PM to 7:00 AM), except during weeks with national or 7:00 AM), except during weeks with national or local holidays when an off can be claimed. Any local holidays when an off can be claimed. Any excess thereof shall be considered as overtime and excess thereof shall be considered as overtime and must be properly documented.must be properly documented.


3.3. The first line of authority and in communication The first line of authority and in communication regarding staffing schedules belongs to the Head regarding staffing schedules belongs to the Head Nurse who shall then refer certain problem not Nurse who shall then refer certain problem not solved at his/her level to the Chief Nurse.solved at his/her level to the Chief Nurse.

4.4. Staffing schedules are made available at least six Staffing schedules are made available at least six days before the schedule is implemented. days before the schedule is implemented.

5.5. Each staff has the privilege to request off duty or Each staff has the privilege to request off duty or certain schedules. A request form is provided in certain schedules. A request form is provided in the Nurse’s station that is to be filled by the the Nurse’s station that is to be filled by the respective staff and submitted at least seven respective staff and submitted at least seven days before formulation of the monthly schedule.days before formulation of the monthly schedule.


6.6. In the event of the inability of the staff to report for In the event of the inability of the staff to report for duty as scheduled, the previous shift’s staff or the duty as scheduled, the previous shift’s staff or the endorsing staff shall extend his/her duty hours until endorsing staff shall extend his/her duty hours until the Head Nurse is able to arrange for a complete set the Head Nurse is able to arrange for a complete set of staff, to go on duty on the affected shift.of staff, to go on duty on the affected shift.

7.7. No 16-hour shifting is allowed to increase one’s No 16-hour shifting is allowed to increase one’s number of OFF days.number of OFF days.

8.8. When unable to report for duty as scheduled, the When unable to report for duty as scheduled, the concerned staff is obliged to communicate to the concerned staff is obliged to communicate to the highest-ranked nurse present in the hospital or the highest-ranked nurse present in the hospital or the Head Nurse at least three hours before the said duty Head Nurse at least three hours before the said duty schedule to allow ample time for arrangements.schedule to allow ample time for arrangements.


9.9. No exchange of duties is allowed, except in No exchange of duties is allowed, except in circumstances like:circumstances like:

emergency situationsemergency situations Important personal matters ariseImportant personal matters arise When directed to do so in the line of service.When directed to do so in the line of service.

10.10. A letter, signed by the two exchanging parties, with the A letter, signed by the two exchanging parties, with the valid reason states, noted by the Head Nurse, and valid reason states, noted by the Head Nurse, and addressed to the Chief Nurse, must be presented at least addressed to the Chief Nurse, must be presented at least twelve hours before the actual day schedule, or in twelve hours before the actual day schedule, or in emergencies, communication shall be taken note in the emergencies, communication shall be taken note in the communication logbook and noted by the Head Nurse communication logbook and noted by the Head Nurse and the Chief Nurse. Letters and all communication and the Chief Nurse. Letters and all communication must be properly filed.must be properly filed.


11.11. On-calls that have been served must be legally On-calls that have been served must be legally documented on the Daily Time Record.documented on the Daily Time Record.

12.12. Filing of any type of Leave of Absence, other Filing of any type of Leave of Absence, other than sick leave should be done at least seven than sick leave should be done at least seven days before the next month schedule. The days before the next month schedule. The Head Nurse or his/her delegate must be made Head Nurse or his/her delegate must be made aware of such leave application to facilitate aware of such leave application to facilitate scheduling.scheduling.

13.13. Granting of the leave of absence will be subject Granting of the leave of absence will be subject to availability of staff to cover such absence to availability of staff to cover such absence except in emergency situations or sick leave.except in emergency situations or sick leave.


14.14. It is the responsibility of the staff who applies It is the responsibility of the staff who applies for the leave to fill out leave forms properly for the leave to fill out leave forms properly and have them signed by proper authorities and have them signed by proper authorities after the Chief Nurse has affixed her/his after the Chief Nurse has affixed her/his initials on the said form indicating that the initials on the said form indicating that the leave has been accommodated in the staffing leave has been accommodated in the staffing schedule.schedule.

15.15. Staffing schedule forms which have been duly Staffing schedule forms which have been duly approved and noted by the Chief Nurse and approved and noted by the Chief Nurse and Medical Director respectively becomes the Medical Director respectively becomes the property of the hospital.property of the hospital.


16.16. In counting for the official working In counting for the official working days and working hours less no. of days and working hours less no. of Saturday, Sunday s and Holiday in the Saturday, Sunday s and Holiday in the calendar days for the month. To have calendar days for the month. To have working hours for the month: no. of working hours for the month: no. of working days required for the month working days required for the month multiplied by 8 hours per day is multiplied by 8 hours per day is equivalent no. of working hours equivalent no. of working hours required for the month.required for the month.


17. The working time in the different areas are the following: 17. The working time in the different areas are the following:

OPDOPD

8:00 AM – 12:00 NN; 1:00 PM – 5:00 PM8:00 AM – 12:00 NN; 1:00 PM – 5:00 PM

Regular PersonnelRegular Personnel

Morning (AM) Morning (AM) 7:00 AM – 3:00 PM7:00 AM – 3:00 PM

Afternoon (PM)Afternoon (PM) 3:00 PM – 11:00 PM3:00 PM – 11:00 PM

Night (NOC)Night (NOC) 11:00 PM – 7:00 AM11:00 PM – 7:00 AM

Nurse TraineeNurse Trainee




OR/DROR/DR




Proposed FloaterProposed Floater

10:00 am – 7:00 pm (8 hours) Special Areas10:00 am – 7:00 pm (8 hours) Special Areas


18.18. The cyclical pattern in scheduling shall be adopted by VGMH The cyclical pattern in scheduling shall be adopted by VGMH Nursing Service Department as proposed by the staff and Nursing Service Department as proposed by the staff and personnel and as approved by the Chief Nurse, Four days AM personnel and as approved by the Chief Nurse, Four days AM shift straight followed by one day off, 4 days PM shift followed shift straight followed by one day off, 4 days PM shift followed by one day off, 4 days NOC shift then 2 days off.by one day off, 4 days NOC shift then 2 days off.

19.19. When the staffing of schedule is already prepared by the When the staffing of schedule is already prepared by the Chief Nurse it is considered as approved and it will signed and Chief Nurse it is considered as approved and it will signed and noted by the Medical Director. The schedule cannot be noted by the Medical Director. The schedule cannot be officially altered.officially altered.

20.20. Schedule is considered as final since approved and noted by Schedule is considered as final since approved and noted by the Medical Director, internal agreement and exchange of the Medical Director, internal agreement and exchange of schedule is allowed by internal agreement between a staff schedule is allowed by internal agreement between a staff but it must be properly communicated/documented in the but it must be properly communicated/documented in the communication book and must be verbally endorsed to some communication book and must be verbally endorsed to some of the nurses for the awareness.of the nurses for the awareness.


21)21)The event of extended duty hours, the staff is The event of extended duty hours, the staff is only allowed up to 16 hours of duty per day in only allowed up to 16 hours of duty per day in cases of emergency the exigency of service cases of emergency the exigency of service but she is allowed for a compensatory off on but she is allowed for a compensatory off on the following days and entitled of OT pay.the following days and entitled of OT pay.

22)22)It is the responsibility of the staff who applies It is the responsibility of the staff who applies for the leave to fill out leave forms properly for the leave to fill out leave forms properly and have them signed by proper authorities.and have them signed by proper authorities.

MANAGEMENT MANAGEMENT STYLESTYLE

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In any institution does exist a In any institution does exist a different management style in order different management style in order for the employees/staff and those for the employees/staff and those people from the top management people from the top management to plan, lead, organize and control. to plan, lead, organize and control. Vicente Gullas Memorial Hospital Vicente Gullas Memorial Hospital put this into a bureaucratic style of put this into a bureaucratic style of management. management.

There is the principle of fixed and official There is the principle of fixed and official jurisdictional areas, which are generally ordered by jurisdictional areas, which are generally ordered by rules, that is, by laws or administrative regulations. rules, that is, by laws or administrative regulations. The organizational chart indicates that there is a The organizational chart indicates that there is a defined order of hierarchy and this hierarchy is defined order of hierarchy and this hierarchy is expressed to you from the day you start. This expressed to you from the day you start. This hierarchy also defines their authority and decision hierarchy also defines their authority and decision making capabilities within the hospital. Although making capabilities within the hospital. Although the chief nurse, the supervisor and staff nurses of the chief nurse, the supervisor and staff nurses of the said hospital has different designated functions the said hospital has different designated functions but all decisions are made at the top of but all decisions are made at the top of organization. organization.

All rules and standard operating All rules and standard operating procedures are developed at the top of procedures are developed at the top of the hierarchy. Within this structure, it the hierarchy. Within this structure, it is each level of management’s is each level of management’s responsibilities to convey the decisions responsibilities to convey the decisions and rules to the level beneath. In our and rules to the level beneath. In our opinion, if this hospital wants to remain opinion, if this hospital wants to remain in the future they must examine how in the future they must examine how the management handles their people. the management handles their people.

The best leadership style is that which motivates The best leadership style is that which motivates people to perform to their potential. Because people to perform to their potential. Because people are self-interested, they will be turned on people are self-interested, they will be turned on by what really excites them or most closely meets by what really excites them or most closely meets their needs. The simplest leadership style is that of their needs. The simplest leadership style is that of problem solver, someone who knows what to do problem solver, someone who knows what to do and who earns respect by being knowledgeable and who earns respect by being knowledgeable and decisive. Leaders who are confident without and decisive. Leaders who are confident without being arrogant can generally get by with most being arrogant can generally get by with most team members. But to improve your leadership team members. But to improve your leadership style beyond this basic level, figure out how to style beyond this basic level, figure out how to adapt your approach to different situations and adapt your approach to different situations and varying human needs.varying human needs.

In Vicente Gullas Memorial Hospital, the In Vicente Gullas Memorial Hospital, the staff are not given freedom to express staff are not given freedom to express negative comments regarding the negative comments regarding the management, which is in contrast with the management, which is in contrast with the way good management or best leaders way good management or best leaders should treat the staff in order for them to should treat the staff in order for them to meet their personal or professional meet their personal or professional growth. Bureaucratic management does growth. Bureaucratic management does not allow the freedom or risk that an not allow the freedom or risk that an institution needs to stay on top.institution needs to stay on top.

Employee Involvement (EI) is a means of allowing Employee Involvement (EI) is a means of allowing employees to become more involved in decision employees to become more involved in decision making and have more influence over their jobs. making and have more influence over their jobs. Marchington et al (1992) write of means of Marchington et al (1992) write of means of implementing schemes based around EI such as implementing schemes based around EI such as quality circles whereby a representative cross-quality circles whereby a representative cross-section of employees are chosen to meet and section of employees are chosen to meet and resolve problems in conjunction with the democratic resolve problems in conjunction with the democratic leader. This says a study by Pasmore and leader. This says a study by Pasmore and Friedlander (1982) is of great benefit to the Friedlander (1982) is of great benefit to the organisation in that they found when the organisation in that they found when the suggestions of the employees were taken up overall suggestions of the employees were taken up overall employee performance grew significantly.employee performance grew significantly.

We believe, that there is no We believe, that there is no particularly accepted style of particularly accepted style of management, but styles that lead management, but styles that lead to increased staff motivation, job to increased staff motivation, job satisfaction and productivity satisfaction and productivity should be encouraged. While should be encouraged. While those that have the opposite those that have the opposite effect should be discouraged.effect should be discouraged.

NETWORKING NETWORKING ACTIVITIESACTIVITIES

97

HOSPITALSHOSPITALS

GOVERNMENT Vicente Sotto Medical CenterVicente Sotto Medical Center

is a general, tertiary medical center is a general, tertiary medical center teaching/ training medical facility owned by teaching/ training medical facility owned by the Philippines Government. It aims to provide the Philippines Government. It aims to provide health care services that are available, health care services that are available, affordable, accessible and acceptable to all affordable, accessible and acceptable to all regardless of social status. Patients sometimes regardless of social status. Patients sometimes shift to other hospital like VSMMC which is a shift to other hospital like VSMMC which is a government own hospital due to financial government own hospital due to financial constraints.constraints.

HOSPITALSHOSPITALS

PRIVATEPRIVATE Cebu Doctors Hospital / Perpetual Cebu Doctors Hospital / Perpetual

Hospitals / Chong Hua Hospitals Hospitals / Chong Hua Hospitals

are among those who are highly are among those who are highly specialized hospitals here in cebu, specialized hospitals here in cebu, Patients choose this hospital because of Patients choose this hospital because of its new and innovative technology its new and innovative technology offered to patients who are more critical offered to patients who are more critical and with serious conditions.and with serious conditions.

GOVERNMENT INSURANCEGOVERNMENT INSURANCE

Philhealth Insurance Philhealth Insurance

Is aIs a Government Owned and Controlled Corporation, Government Owned and Controlled Corporation, which provide an Adequate and Affordable Social which provide an Adequate and Affordable Social Health Insurance Coverage for ALL Filipinos, it ensure Health Insurance Coverage for ALL Filipinos, it ensure adequate financial access of every Filipino to quality adequate financial access of every Filipino to quality health care services through the effective and efficient health care services through the effective and efficient administration of the National Health Insurance administration of the National Health Insurance Program. Funding came from the National and Local Program. Funding came from the National and Local Government Units for the annual premium of enrolled Government Units for the annual premium of enrolled Sponsored Members and the Contribution of members Sponsored Members and the Contribution of members into the Program.into the Program.

Hospitals like VGMH is accredited to this institution to Hospitals like VGMH is accredited to this institution to help its client for its hospitalization coverage. help its client for its hospitalization coverage.

PRIVATE INSURANCEPRIVATE INSURANCE

Many Hospitals are connected to this kind Many Hospitals are connected to this kind of Insurance Company to accommodate of Insurance Company to accommodate patients who are utilizing HMO on their patients who are utilizing HMO on their hospital needs. hospital needs.

A Health Maintenance Organization or HMO A Health Maintenance Organization or HMO is a pre-paid health care delivery system is a pre-paid health care delivery system that finances and delivers a package of that finances and delivers a package of comprehensive health services such as comprehensive health services such as out-patient consultations and treatments, out-patient consultations and treatments, preventive health care programs &preventive health care programs &

PRIVATE INSURANCEPRIVATE INSURANCE

if necessary, hospitalization for its actively if necessary, hospitalization for its actively enrolled members. In lieu of charging a fee for enrolled members. In lieu of charging a fee for each service rendered, the company collects each service rendered, the company collects membership fees upon enrollment to cover a membership fees upon enrollment to cover a pre-determined range of medical services pre-determined range of medical services during the period of an enrollee's coverage.during the period of an enrollee's coverage.

The probability of financial loss due to illness or The probability of financial loss due to illness or accident is diminished, if not entirely prevented. accident is diminished, if not entirely prevented. Medical expenditures are determinable because Medical expenditures are determinable because most of the essential services you will need are most of the essential services you will need are covered by the regular membership fees. covered by the regular membership fees.

DEPARTMENT OF DEPARTMENT OF HEALTHHEALTH

The Department of Health and Hospitals The Department of Health and Hospitals interconnected with each other to offers interconnected with each other to offers a variety of services for families and a variety of services for families and children, varying from physical fitness children, varying from physical fitness programs and behavioral health options programs and behavioral health options to maternal and child health programs. to maternal and child health programs. By providing accurate and timely By providing accurate and timely information on a variety of health issues information on a variety of health issues DOH usually make a big role to the DOH usually make a big role to the hospitals. hospitals.

CITY HEALTH OFFICECITY HEALTH OFFICE

Aside from its health services, Aside from its health services, hospital records for a newborn are hospital records for a newborn are submitted at the City Health office submitted at the City Health office for registration purposes. for registration purposes.

DEPARTMENT OF SOCIAL DEPARTMENT OF SOCIAL WELFAREWELFARE

Provide social protection and Provide social protection and promote the rights and promote the rights and welfare of the people, welfare of the people, especially the poor for they especially the poor for they are vulnerable for abuse.are vulnerable for abuse.

DIAGNOSTICS / LABORATORY DIAGNOSTICS / LABORATORY CLINICSCLINICS

Patients are referred to different clinics such as Patients are referred to different clinics such as LH Prime, Primecare and Hi Precision, provides LH Prime, Primecare and Hi Precision, provides for further test/laboratory procedure after for further test/laboratory procedure after confinement or for a more precise and top quality confinement or for a more precise and top quality healthcare for customers through advanced healthcare for customers through advanced technology and unsurpassed service at affordable technology and unsurpassed service at affordable prices. In light of this, facilities are furnished with prices. In light of this, facilities are furnished with state-of-the-art computerized equipments which state-of-the-art computerized equipments which allow our highly trained, licensed professional allow our highly trained, licensed professional medical technologists to conduct integrated and medical technologists to conduct integrated and fully automated lab examinations. fully automated lab examinations.

REPORTS & REPORTS & RECORDSRECORDS

107

I. I. Title of Report: Title of Report: Philippine Health Philippine Health Insurance Corporation Mandatory Insurance Corporation Mandatory Hospital ReportHospital Report

Timing of Submission:Timing of Submission: Monthly Monthly

Contents:Contents:

A.A. Daily Census of NHIP Patients (Every Daily Census of NHIP Patients (Every 12:00MN)12:00MN) Census for the Day = ( Census for the Census for the Day = ( Census for the

Previous Day plus Admission of the Day Previous Day plus Admission of the Day minus Discharge of the Day)minus Discharge of the Day) 108

B.B. Quality Assurance IndicationQuality Assurance IndicationMonthly Bed Occupancy RateMonthly Bed Occupancy RateMonthly NHIP Beneficiary Occupancy RateMonthly NHIP Beneficiary Occupancy RateAve. Length of Stay per NHIP PatientAve. Length of Stay per NHIP Patient

C.C. Newborn CensusNewborn Census

D.D. Most Common Causes of ConfinementMost Common Causes of Confinement

E.E. Surgical Output – Top 10 ProceduresSurgical Output – Top 10 Procedures

F.F. Total Surgical SterilizationTotal Surgical Sterilization

G.G. Obstetrical ProceduresObstetrical Procedures

H.H. Monthly Mortality Census (All Causes)Monthly Mortality Census (All Causes)

I.I. ReferralsReferrals Most Common Reason for ReferralsMost Common Reason for Referrals 109

II. II. Title of Report: Title of Report: Hospital Operations Hospital Operations Report for DOHReport for DOH


Contents:Contents:

A.A. Summary of Patients in the HospitalSummary of Patients in the Hospitala.a. Patients Remaining in the Hospital as Patients Remaining in the Hospital as

Midnight Last Day of Previous Midnight Last Day of Previous Month/YearMonth/Year

b.b. Total Admission (Excluding Newborn)Total Admission (Excluding Newborn)

c.c. Total Discharge (Alive)Total Discharge (Alive) 110

d.d. Total In-patients DeathsTotal In-patients Deaths

e.e. Total Patients Admitted and Discharge the Total Patients Admitted and Discharge the Same DaySame Day

f.f. Total In-patients Service Days for the Total In-patients Service Days for the PeriodPeriod

g.g. Average Daily Census of Admitted PatientsAverage Daily Census of Admitted Patients

h.h. Referrals (In-patient)Referrals (In-patient) From RHUFrom RHU From Other Hospital/Health CentersFrom Other Hospital/Health Centers To Other Health FacilitiesTo Other Health Facilities

111

B.B. DischargesDischarges

a.a. Services Rendered and Patients Services Rendered and Patients AttendedAttended

Recovered/ImprovedRecovered/Improved Home Against Medical AdviceHome Against Medical Advice TransferredTransferred AbscondedAbsconded UnimprovedUnimproved Died Upon AdmissionDied Upon Admission 112

C.C. Average Length of Stay Average Length of Stay (ALOS) of Admitted Patients(ALOS) of Admitted Patients

D.D. Other Hospital ServicesOther Hospital Servicesa.a. Dietary ServiceDietary Service

Number of Meals ServedNumber of Meals Served Number of Patients Given Diet Number of Patients Given Diet

CounselingCounseling

113

III. III. Title of Report: Title of Report: Quarterly Quarterly Report for DOHReport for DOH


Contents:Contents:

A.A.Hospital Infection Rate Hospital Infection Rate (Nosocomial Infection)(Nosocomial Infection)a.a. Gross InfectionGross Infection

b.b. Net Infection RateNet Infection Rate 114

B.B. Surgical OperationsSurgical Operationsa.a. Major Operations (Excluding CS)Major Operations (Excluding CS)

b.b. Minor Operations (In-Patient)Minor Operations (In-Patient)

c.c. Minor Operations (Out-Patient)Minor Operations (Out-Patient)

C.C. ER ServicesER Servicesa.a. Total of Patients AttendedTotal of Patients Attended

b.b. Average Number of ER Patients per DayAverage Number of ER Patients per Day

c.c. Ten (10) Leading Causes of Emergency Ten (10) Leading Causes of Emergency Cases in the ER Dept.Cases in the ER Dept.

115

D.D. Out-Patient ServicesOut-Patient Servicesa.a. Total Number of Patients Total Number of Patients

AttendedAttended

b.b. Ave. Number of Out-Patient Ave. Number of Out-Patient per Dayper Day

c.c. Ten (10) Leading Causes of Ten (10) Leading Causes of Consultation @ OPDConsultation @ OPD

116

ANALYSIS AND ANALYSIS AND INTERPRETATION OF INTERPRETATION OF ORGANIZATIONAL STRUCTUREORGANIZATIONAL STRUCTURE

117

Based on the data that we gathered, the Vicente Based on the data that we gathered, the Vicente Gullas Memorial Hospital organizational Gullas Memorial Hospital organizational structure is connected with a strong line of structure is connected with a strong line of hierarchy. This hierarchy also represent a free hierarchy. This hierarchy also represent a free flow process of information or ideas in a cycle flow process of information or ideas in a cycle process which results to a better decision process which results to a better decision making and more effective operation. Each making and more effective operation. Each hierarchy is subdivided into different division hierarchy is subdivided into different division which include the nursing administration, which include the nursing administration, nursing service and clinical service. Each nursing service and clinical service. Each division has the same management style in use division has the same management style in use but it has a specific function. but it has a specific function.

118

For Nursing Administration, For Nursing Administration, they are responsible for the they are responsible for the hospital maintenance, hospital hospital maintenance, hospital finances, hospital supplies and finances, hospital supplies and equipments, security, equipments, security, ambulance service, medical ambulance service, medical records safe keeping and records safe keeping and laundry services. laundry services. 119

For Nursing Services, they are For Nursing Services, they are responsible in planning, organizing responsible in planning, organizing and supervising in order to provide and supervising in order to provide adequate nursing care to patients. adequate nursing care to patients. They also are responsible for the They also are responsible for the performance appraisal of nursing performance appraisal of nursing personnel, as well as analyze and personnel, as well as analyze and evaluate the nursing activities to evaluate the nursing activities to determine whether they are meeting determine whether they are meeting the desired standards. the desired standards. 120

Promotes individual growth and Promotes individual growth and development by maintaining a development by maintaining a continuing program of education for the continuing program of education for the staff, and promotes and maintains staff, and promotes and maintains cordial relationship with patients, their cordial relationship with patients, their families and community. Provide families and community. Provide opportunities for nursing personnel to opportunities for nursing personnel to work with other groups so that the goal work with other groups so that the goal of the hospital in creating a good of the hospital in creating a good interpersonal and interdepartmental interpersonal and interdepartmental environment will be achieved. environment will be achieved. 121

For Clinical Services they are For Clinical Services they are responsible for managing the care responsible for managing the care of the adult, infant, pediatrics and of the adult, infant, pediatrics and elderly patients experiencing elderly patients experiencing different medical conditions or different medical conditions or surgical procedures, which require surgical procedures, which require assessments related to specific assessments related to specific conditions, therapies and conditions, therapies and interventionsinterventions.. 122

RECOMMENDATIONSRECOMMENDATIONS

123

This study is concerned with the various aspects This study is concerned with the various aspects of operation management of Vicente Gullas of operation management of Vicente Gullas Memorial Hospital in Banilad, Cebu City. Like Memorial Hospital in Banilad, Cebu City. Like any other hospital institutions, the hospital is any other hospital institutions, the hospital is also facing different problems that is quite also facing different problems that is quite opposite with the designated jobs of employees. opposite with the designated jobs of employees. In this hospital, the administrative and the In this hospital, the administrative and the executive level has the sole responsibility for executive level has the sole responsibility for the budget and decision making. The the budget and decision making. The employees are free to suggest but they just employees are free to suggest but they just have to wait whatever development or changes have to wait whatever development or changes that are to be done. that are to be done. 124

The chief nurse must know the budget The chief nurse must know the budget system as well, as stipulated in her function system as well, as stipulated in her function so that it can be easily evaluated if it is so that it can be easily evaluated if it is adequate enough for the personnel, adequate enough for the personnel, equipments can be check from time to time equipments can be check from time to time and the physical set up of the hospital in and the physical set up of the hospital in order to deliver utmost care to the patients order to deliver utmost care to the patients and to promote their sense of well being. and to promote their sense of well being. The chief nurse must welcome and open to The chief nurse must welcome and open to whatever negative comments from the staff whatever negative comments from the staff so that there will be room for improvementso that there will be room for improvement. . 125

With the widespread use of computers, With the widespread use of computers, the management doesn’t adapt to the the management doesn’t adapt to the new system that most of the hospitals new system that most of the hospitals are using now. Staff nurses cannot key are using now. Staff nurses cannot key in the data of the patient and other in the data of the patient and other important matters in the hospital. important matters in the hospital. They have to call the in charge person They have to call the in charge person and check the papers kept in the and check the papers kept in the cubicles in order to get the records of cubicles in order to get the records of the patient.the patient. 126

Computers are widely used in the operation of Computers are widely used in the operation of medical services in other advanced countries. medical services in other advanced countries. The hospital must have continuous The hospital must have continuous development or adapt in the computer development or adapt in the computer system. The application of computers will system. The application of computers will make the operation and the information make the operation and the information system of the hospital more efficient. The system of the hospital more efficient. The database of computer network will provide the database of computer network will provide the management with different kinds of management with different kinds of information and promote proper and efficient information and promote proper and efficient functioning of the hospital and decision lag functioning of the hospital and decision lag can be minimized.can be minimized. 127

In reality, there is only one charge nurse In reality, there is only one charge nurse assigned in each level. To ensure the assigned in each level. To ensure the safety and to promote holistic quality safety and to promote holistic quality nursing care there should be at least two nursing care there should be at least two charge nurses. The additional nurse could charge nurses. The additional nurse could either act as an assistant to the original either act as an assistant to the original nurse. The service given to the patients nurse. The service given to the patients can improve considerably especially during can improve considerably especially during the busiest hours such as giving the busiest hours such as giving medications in the morning and during medications in the morning and during rounds of doctors.rounds of doctors. 128

The management should involve the The management should involve the staff of the hospital in some decision staff of the hospital in some decision making. There should be a two way making. There should be a two way communication for the reason that it communication for the reason that it will motivate the staffs at the same will motivate the staffs at the same time their problems in the area can be time their problems in the area can be resolve. Management style can be resolve. Management style can be change from time to time depending change from time to time depending on the situation or problem that exists. on the situation or problem that exists.

129

Communication should flow through the hospital Communication should flow through the hospital not only in taking care of a patient but also on not only in taking care of a patient but also on how to deal with the problems in the hospital in a how to deal with the problems in the hospital in a constructive manner. If these communication constructive manner. If these communication procedures are followed properly then the procedures are followed properly then the hospital will run a lot smoother, the patients and hospital will run a lot smoother, the patients and families will be a lot happier, the right people are families will be a lot happier, the right people are making the right decisions, and the finances of making the right decisions, and the finances of the hospital will improve dramatically, and then the hospital will improve dramatically, and then the mission statement will fall in to place on its the mission statement will fall in to place on its own.own.

130

THANK YOU THANK YOU

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finalresear study vgmh

Documents

maintains

primary care

client facilitys

quality health

leave forms

promotes individual

minor operations

leadership