ncm 107-a lecture 2012 - copy

7/31/2019 NCM 107-A Lecture 2012 - Copy

1/90

NCM 107-A Nursing Leadership &

Management, NursingJurisprudence

June 15, 2012

9:00 am


2/90

Conceptual Paradigm of

Leadership & Management

GOAL

Resources

7 Ms

Theories &Principles

ManagementProcess & Functions

Effective &Efficient

Leadership


3/90


4/90

Goals may be:

INDIVIDUAL GOALS - are personal goals; usually

based on ones desires in life.

GROUP GOALS it pertains to what the individual

members of the group or organization desire to

achieve as a group or an organization.

ORGANIZATIONAL GOALS - are management goalsof an organization that are established to justify its

existence.


5/90

GOALS

GOALS MUST BE:

S - Specific

M - MeasurableA - Attainable

R - Relevant

T - Time Bounded

E - Efficient & Effective

R - Rewarding


6/90

THEORIES & PRINCIPLES

Various theories & principles of leadership &management help provide the basis for

accomplishing a goal.

THEORIES

1. Scientific Management Theory

2. Systematic Management Theory

3. Organizational Theory

4. Social Process

5. Hawthorne Effect

6. Management by Objectives


7/90

7. Management as Decision Making

8. Managerial Roles

9. Hierarchy of Needs

10. Motivation Hygiene Theory

11. Theory of X & Theory of Y

12. Theory Z

THEORIES


8/90

MANAGEMENT PROCESSES &

FUNCTIONS

It is the application of creative problem

solving strategies.

4 functions of management Planning

Organizing

Directing

controlling


9/90

EFFECTIVE & EFFICIENT

Leadership should be efficient & effective

EFFICIENT ability to minimize the use of time and

resources in achieving organizational objectives.

-Performing or functioning in the best possible

manner with the least waste of time and effort.

EFFECTIVE ability to determine whether

appropriate objectives are met.


10/90

Attainment of a goal usually precedes the use

of resources.

7 Ms 1. money 5. methods

2. men 6. moment

3. machine 7. manager

4. materials

RESOURCES


11/90

1. PLANNINGthe selection and sequentialordering of tasks required to achieve an

organizational goal.

- pre determining a course of action in order to arrive

at a desired result.

Concerned with defining goals for future organizational

performance and deciding on the tasks and resources

to be used in order to attain those goals.

Deciding in advance what to do, how to do a particular

task, when to do it and who is to do it.

NURSING MANAGEMENT

PROCESS


12/90


13/90

GOOD PLANNING

involves a continous process of assessment of goals

and objectives, implementation and evaluation of

change as new facts become known.

PROCESS OF GOOD PLANNING

assessment

Establishment of goals & objectivesimplementation

evaluation

A well plan is

half done


14/90

POOR PLANNING Is the failure to set goals make assessments or provide for

implementation or to anticipate any possible change in

circumstances.

INDICATORS OF POOR PLANNING

Delivery dates are not met

Machines are idle

Material is wasted

Some nurses are overworked, others are underworked

Skilled nurses doing unskilled work

Nurses are fumbling on jobs for which they have not been

trained

There is quarreling, bickering, buck-passing and

confusion.

Failing to plan is

planning to fail


15/90

PLAN

Is a living document which can be changedbased on the prevailing circumstances.

PRINCIPLES OF PLANNING

1. Planning is always based & focused on the vision, mission,

philosophy & clearly defined objective of the organization.

2. Planning is a continous process.

3. Planning should be pervasive within the entire organization.

4. Planning utilizes all available resources5. Planning must be precise in its scope & nature

6. Planning should be time- bounded

7. Projected plans must be documented


16/90

IMPORTANCE OF PLANNING

1. Planning leads to the achievement of goals & objectives.

2. Planning gives meaning to work.

3. Planning provides for effective use of available resources.

4. Planning helps in coping with crises.

5. Planning is cost-effective.

6. Planning is based on past & future activities.

7. Planning leads to the realization of the need to change.8. Planning provides basis for control.

9. Planning is necessary for effective control .


17/90

CHARACTERISTICS OF A GOOD PLAN

1. Be precise with clearly- worded objective, including desired

results & method for evaluation.

2. Be guided by policies, procedures affecting the planned

action.3. Indicate priorities.

4. Develop actions that are flexible & realistic in terms of avail.

Personnel, equipment, facilities & time.

5. Develop a logical sequence of activities & time.

6. Include the most practical methods for achieving each

objective.

7. Pervade the whole organization.


18/90

STEPS IN PLANNING

1. Diagnosis

2. Objective/ goal setting

3. Means identification

4. Debate on proposals

5. Decision making

6. Tasking

7. Evaluation


19/90

TYPES OF PLANS

STRATEGIC PLAN the process of defining strategy

or direction, and making decisions on allocating its

resources to pursue this strategy.

It is a process for determining where an organization is

going over the next year or- more typically 3 to 5 years.

It deals with at least one of the 3 questions:

1. What do we do?2. For whom do we do it?

3. How do we excel?


20/90

OPERATING PLANS pertain to activities in

specific departments or organization.

- generally shorter in time frame-involve the middle & lower level managers

CONTINOUS OR ROLLING PLANS involves

mapping out the day to day activities.- this is the task of the staff nurse who has to

devise & implement NCP for pts.


21/90

KEY COMPONENTS OF

STRATEGIC PLANNING

1. Defining and understanding the vision,

mission, values & strategies of the institution.

VISIONit outlines the organizations futureroles and functions; what the organization

want to be; it is a long term view and

concentrates on the future.MISSION defines the fundamental purpose

of the organization; allows everyone to

understand why an organization exists.


22/90

PHILOSOPHY statement of beliefs & values

that direct the organizations life or practice.

VALUES are beliefs that are shared amongthe stakeholders of an organization.

FORECASTING is looking into the future;

weighing the unknown values in the situationand using them as basis for an educated guess

about the future.


23/90

2. Set objectives/ goals and determine results

desired

OBJECTIVESis the backbone of ones goalsand philosophy ; these are the battle plan

GOALS a specific aim to target to be attained

within a short time span of a year; the end tobe accomplished


24/90

3. Conduct a situation analysis ( SWOT )- analysis of

the internal factors attributed to the organization

and external factors beyond control of the

organization.

S

Distinct

Efficient Skilled Market share

Superiorreputation

W

Vulnerability

Adequacy ofresources

Technologiesavailable

O

Possible newcustomers

Status ofcompetitors

Possibilitiesof growth

T

Newcompetitors

Shortage ofresources

Changingneeds of thecustomers

Newregulations


25/90

4. Develop & schedule strategies, programs/

projects/activities; set the time frame

STRATEGYit is the course of action created to

achieve a long term goal; the art of the

general. ( called as the road map);techniques,methods or procedure

PROGRAMS are activities put together to

facilitate attainment of some desired goals.TIME MANAGEMENT finding the most

efficient way to do it.


26/90

TIME SAVING TECHNIQUES, DEVICES &

METHODS TO BETTER USE OF TIME

1. Conduct an inventory of your activities.

2. Set goals and objectives and write them down.

3. With the use of calendars, executive planners, logs or journals, write

waht you expect to accomplish yearly, monthly, weekly or daily.

4. Break down large projects into smaller parts

5. Devote few minutes at the beginning of each day for planning.

6. Organize your workspace so it is functional.

7. Close your door when you need to concentrate.

8. Learn to delegate.

9. In a meeting, define the purpose clearly before starting

10. Take or return phone calls during specified time.

11. Develop effective decision- making skills

12. Take rest breaks and make good use of your spare time.


27/90

EFFECTS OF MISMANAGEMENT OF TIME

Work is rushed and becomes substandard

Deadlines are missed

Bad choices are made

Employees suffer from fatigue

Employees personal lives and relationships are

adversely affected


28/90

5. Preparing the Budget

BUDGET- is the annual operating plan, a financial

road map and plan which serves as an estimate of

future costs and a plan for utilization of manpower,

material and other resources.

A plan for future activities expressed in

operational as well as financial or monetary terms.

BUDGETING systematic financial translation of aplan; allocation of resources; a tool, for planning,

monitoring & controlling cost & meeting

expenses.


29/90

COMPONENTS OF BUDGET

1. REVENUE BUDGET summarizes the income whichmanagement expects to generate during the

planning period.

2. CASH BUDGET amount of money received;planned cash receipts & disbursements, cash

balances.

3. OPERATING BUDGET composed of the revenue

and the expense budget.

4. CAPITAL BUDGET consists of accumulated data for

fixed assets that are expected to be acquired during

the budgeted period.


30/90

6. Establishing Nursing standards, policies

& procedures

STANDARDS indicate the minimal level of

achievement acceptable to meet the set

objectives. Nursing Standards

Example: Standards of Nsg. Practice by ANSAP

1981


31/90

POLICIES are defined as standing plans used

repeatedly, or guides or basic rules that

govern action at all levels in the organization. Nursing Service Policies

Example : Admissions receiving, consent,

notifying doctor, care of patients


32/90

PROCEDURES are defined as a more specific

guide to action than policy.

Nursing Procedures

Example: Discharge of Patient


33/90

ORGANIZING

- it is the process of establishing formal

authority.

- it involves setting up the organizationalstructure through identification of groupings,

roles & relationships.

- it includes developing job descriptions bydefining the qualifications and functions of

personnel.


34/90

ORGANIZATION

consists of the structure & process which allow

the agency to enact its philosophy & utilize its

conceptual framework to achieve its goal.

it is the backbone of management.

it is the form of every human association for the

attainment of a common purpose.

it is a form of identifying roles and relationshipsof each staff in order to delineate specific tasks or

functions that will carry out organizational plans &

objectives.


35/90


36/90

ORGANIZATIONAL STRUCTURE

refers to the process by which a group is formed,

its channels of authority, span of control & lines of

communication.

is a process in which a group is formed including

its Authority, Responsibility and Accountability

( ARA), span of control, and lines of

communication.

PURPOSES OF SETTING UP AN


37/90

PURPOSES OF SETTING UP AN

ORGANIZATIONAL STRUCTURE

It informs members of their responsibilities so that they

may carry them out.

It allows the manager & the individual workers to

concentrate on his/her specific role & responsibilities. It coordinates all organizational activities so there is

minimal duplication of effort or conflict.

It reduces the chances of doubt & confusion concerning

assignments.

It avoids overlapping of functions because it pinpoints

responsibilities.

It shows to whom & for whom the are responsible.

CHARACTERISTICS OF


38/90

CHARACTERISTICS OF

ORGANIZATIONAL CHART

1. DIVISION OF WORK each box represents the

individual or sub-unit responsible for a given task of

the organizations work load.

2. CHAIN OF COMMANDlines indicate who reportsto whom and by what authority.

3. Type of Work to be performed indicated by labels

or descriptions for the boxes.4. Grouping of Work Segments shown by the

clusters of work groups.

5. Levels of Management indicate individual &

entire management hierarchy.


39/90

PRINCIPLES OF ORGANIZING

1. UNITY OF COMMAND refers to the structure an

employee has one superior & there is only one

manager or leader.

2. SCALAR PRINCIPLES OF HIERARCHY- authority &

responsibility flow in clear lines from the highest

executive to the lowest.

3. HOMOGENEOUS ASSIGNMENT/ DEPARTMENTATIONworkers performing similar assignments are grouped

together for a common purpose.


40/90

PRINCIPLES OF ORGANIZING

4. SPAN OF CONTROL member of workers that a

supervisor can effectively manage.

5. EXCEPTION PRINCIPLE recurring decisions should

be handled in a routine manner by lower level

managers; whereas problems involving unusual

matters should be referred to higher level.

6. DECENTRALIZATION/ PROPER DELEGATION OFAUTHORITYprocess of conferring specified

decision making to the lower levels of the

organization.


41/90

ADVANTAGES OF TALL


42/90

ADVANTAGES OF TALL

STRUCTURE

The quality of performance will improve due to close

supervision.

Discipline will improve.

Superior - Subordinate relations will improve. Control and Supervision will become easy and convenient.

The manager gets more time to plan and organize the future

activities.

The efforts of subordinates can be easily coordinated.

Tall Organization encourages development of staff.

There is mutual trust between superior and subordinates.

DISADVANTAGES OF TALL


43/90

DISADVANTAGES OF TALL

STRUCTURE

Tall Organization creates many levels of management.

There are many delays and distortion in communication.

Decisions and actions are delayed.

It is very costly because there are many managers. Themanagers are paid high salaries.

It is difficult to coordinate the activities of different levels.

There is strict supervision. So the subordinates do not have

any freedom.

Tall Organisation is not suitable for routine and standardized

jobs.

Here, managers may became more dominating.


44/90

SAMPLE OF TALL STRUCTURE

2 FLAT OR DECENTRALIZED/


45/90

2. FLAT OR DECENTRALIZED/

HORIZONTAL STRUCTURE

Characterized by fewer levels and a broad span of

control

Decision- making is spread among many people.

Communication from lower to higher levels is easy

and direct.

is characterized by fewer levels of management, low

burearucratic costs, higher motivation of employees(empowerment), more communication between

managers andemployees

ADVANTAGES OF FLAT


46/90

ADVANTAGES OF FLAT

STRUCTURE

Flat Organization is less costly because it has only few

managers.

It creates fewer levels of management.

Quick decisions and actions can be taken because it has only a

few levels of management.

Fast and clear communication is possible among these few

levels of management.

Subordinates are free from close and strict supervision and

control.

It is more suitable for routine and standardized activities.

Superiors may not be too dominating because of large

numbers of subordinates.

DISADVANTAGES OF FLAT
http://kalyan-city.blogspot.com/2011/05/levels-of-management-top-middle-and.htmlhttp://kalyan-city.blogspot.com/2011/05/levels-of-management-top-middle-and.html


47/90

DISADVANTAGES OF FLAT

STRUCTURE

There are chances of loose control because there are

many subordinates under one manager.

The discipline in the organization may be bad due to

loose control. The relations between the superiors and

subordinates may be bad. Close and informal

relations may not be possible.

There may be problems of team work because there

are many subordinates under one manager.

Flat organization structure may create problems of

coordination between various subordinates.
http://kalyan-city.blogspot.com/2011/05/what-is-coordination-meaning-and.htmlhttp://kalyan-city.blogspot.com/2011/05/what-is-coordination-meaning-and.html


48/90

SAMPLE OF FLAT


49/90

SAMPLE OF FLAT

ORGANIZATION STRUCTURE

TYPES OF ORGANIZATIONAL


50/90

TYPES OF ORGANIZATIONAL

STRUCTURE

1. LINE ORGANIZATION/ BUREAUCRATIC/

PYRAMIDAL

This structure shows each position generalauthority over the lower position in the hierarchy.

Commonly found in large health care facility.

Clearly defined superior-subordinate relationship

ARA and power are concentrated at the top

2 FLAT ORGANIZATION/


51/90

2. FLAT ORGANIZATION/

HORIZONTAL

It is a decentralized type.

Flattened scalar chain and fewer levels of

position Used for less complex organizations with

authority decentralized and with several

managers supervising large work groups. Applicable only in smaller organizations or

units within larger organizations


52/90

3. STAFF ORGANIZATION

is by nature purely advisory to the linestructure with no authority to place

recommendations into action.

4. FUNCTIONAL ORGANIZATION permits aspecialist to aid line position within a limited

and clearly defined scope of authority.

5. AD HOC ORGANIZATION modification of thebureaucratic structure and is used as a

temporary basis to facilitate completion of a

project within a formal line organization.


53/90


54/90

7. SHARED GOVERNANCE ORGANIZATION one

of the most radical and idealistic type of

organizational structure developed in 1980s

as an alternative to traditional pyramidal/

centralized structure.

8. LATERAL ORGANIZATION is one of

coordination & colaboration between and

among nursing staff and hospital staff.


55/90


56/90

STEPS IN STAFFING

Determine the number & types of personnel

needed.

Recruit personnel Interview

Induct or orient the personnel

Job offfer


57/90

PATIENT ACUITY f i


58/90

PATIENT ACUITY measurement of nursing

workload that is generated for each patient.

PATIENT CARE CLASSIFICATION1. SELF CARE OR MINIMAL CARE PATIENTS

are capable of carrying activities of daily

living ( ADL)2. INTERMEDIATE OR MODERATE CARE

requires some help from nursing staff with

special treatment or certain aspects ofpersonal care


59/90


60/90

NURSING CARE MODELS

Is the framework for nursing care delivery in

any setting or design that meets the particular

needs of a group of health care givers &

clients.

1. THE CASE METHOD OR TOTAL PATIENT CARE

- original model of nursing care delivery- RN is responsible for all aspects of care of

one or more patients.


61/90


62/90

DISADVANTAGES:

RN spend more time doing tasks that could be

done more cost effectively by less skilled

person.


63/90


64/90

2. THE FUNCTIONAL METHOD

Also called as task Nursing

Developed in response to national shortage in

1940s This gave way to widespread use of LPN &

UAP to deliver nursing care.

Needs of a group of patients are broken downinto taks, which are assigne to RNs, LPNs,

UAPs.


65/90


66/90


67/90

DISADVANTAGES:

Patients cannot identify who their nurse is

CHARGE NURSE

PATIENTS ASSIGNED TO THEM

RN ADMISSIONNURSE

LPN TREATMENTNURSE

RN MEDICATIONNURSE


68/90


69/90


70/90


71/90


72/90


73/90


74/90


75/90


76/90

6 PRACTICE PARTNERSHIP


77/90

6. PRACTICE PARTNERSHIP

In this model, the RN & assistant agree to be

practice partners.

They work together with the same scheduleand the same group of patients.

It is an efficient way of using a mixture of skills

of professionals & non- professional staff with

differing levels of expertise.


78/90


79/90


80/90


81/90


82/90


83/90

FORTY HOUR/ WEEK for personnel working

in hospitals with 100 bed capacity or over or

which are located in a 1 Million population in

the community.

48 HOURS / week for personnel who work in

agencies with lesser bed capacity or which are

located in communities with less the 1 M

population.


84/90


85/90


86/90


87/90

5. Find the total number of nursing personnelneeded.

a. Total NCH /yr = 280, 593.75

working hrs./ yr. 1, 704 = 165

b. Reliever x total nsg. personnel

Divide 33( ave. Number of days an

employee is absent per year) by the number

of working days per year that each employee

serves.


88/90


89/90


90/90

ncm 107-a lecture 2012 - copy

Documents