Final Nursing Management

Final Nursing Management - Presentation Transcript
1. PUT YOUR NOTES IN ONE LONG BOND PAPER NOT FOLLOWING INSTRUCTION
MEANS NO OPEN NOTES DURING THE QUIZ INSTRUCTION FOR THE QUIZ
2. PREPARED BY: Michael Bonito G. Tamayo, RN NURSING MANAGEMENT PROCESS
3. NURSING MANAGEMENT
o Is the process of working through staff members to be able to provide

comprehensive care to the patient
o This includes planning, organizing, directing and controlling
o The task of the nurse manager is to plan, organize, direct and control available
financial, material, and human resources in order to provide effective, economic care to groups
of patients
4. NURSING MANAGEMENT PROCESS
5. NURSING MANAGEMENT PROCESS
6. Purpose of the Nursing Management Process
o To achieve scientifically – based, holistic, individualized care for the patient
o To achieve the opportunity to work collaboratively with patients and others
o To achieve continuity of care
7. Characteristics of the Nursing Management Process
o Systematic
o Dynamic
o Interpersonal
o Goal Directed
o Universally Applicable
8. MANAGEMENT FUNCTION NURSING MANAGEMENT PROCESS PLANNING
9. PLANNING
o Is deciding in advance what to do, how to do a particular task, when to do it, and
who is to do it.
o Is predetermining a course of action in order to arrive at a desired results. It is the

continuous process of assessing, establishing goals and objectives and implementing and
evaluating them, which is subject to change as new facts are known
10. COMPONENTS OF PLANNING PLANNING: PREDETERMINED ACTION WHO IS TO

DO IT: -professional, non-professional HOW TO DO IT: -technique, principles WHAT TO DO:
-nursing activities
11. Nursing management -planning-
o PRINCIPLES OF PLANNING
o 1. Planning is always based and focused on the vision, mission, philosophy, and
clearly defined objectives of the organization.
o 2. Planning is a continuous process.
o 3. Planning should be pervasive within the entire organization covering the various
departments, services and the various levels of management to provide maximal cooperation
and harmony.
o 4. Planning utilizes all available resources.
o 5. Planning must be precise in its scope and nature.
o 6. Planning should be time bounded.
o 7. Projected plans must be documented for proper dissemination to all concerned

for implementation and implementation as to the extent of its achievement.
12. PLANNING
o It leads to success in the achievements of goals and objectives
o It provides meaning to work
o It provides for the effective use of available personnel and facilities
o It helps nurses cope with crises and problems calmly and efficiently
o It is cost effective
o It is based on past and future activities

o It reduces the element of change
o It is necessary for effective control
13. Characteristics of a GOOD PLAN
o It should have a clearly worded objectives, including results and methods for
evaluation
o Be guided by policies and/or procedures affecting the planned action
o Indicate priorities
o Develop actions that are flexible and realistic in terms of available personnel,
equipment, facilities and time
o Develop a logical sequence of activities
o Select the most practical methods for achieving each objective
14. PLANNING
o TYPES OF PLANNING:
o 1. STRATEGIC OR LONG-RANGE PLANNING
o “ what are the right things to do”
o - usually extending 3 to 5 years into the future.
o 2. OPERATIONAL OR SHORT-RANGE PLANNING
o “ how does one do things right”
 - deals with day to day maintenance activities.
 3. CONTINUOUS OR ROLLING PLANS
 - similar to operating plans, involves mapping out the day-to-

day activities.
15. ELEMENTS OF PLANNING
o Forecasting or Estimate the future
o Set Objectives/Goals and Determine Results Desired
o Develop and Schedule Strategies, Programs/Projects/Activities; Set the Time

Frame
o Prepare the Budget and Allocation of Resources
o Establish Policies Procedures and Standards
16. Elements of Planning -Forecast or Estimate the Future-
o Forecasting is looking into the future
o Refers to estimation of time series, cross sectional or longitudinal data
o In making forecast, the planner should consider 3 things:
 Agency
 Community affected
 Goals of care
o Forecast must be supported by facts, reasonable estimates and accurate reflection

of policies and plans
17. Elements of Planning Set Objectives/Goals and Determine Results Desired
o GOALS are broad statements of intent derived from the purposes of the
organization
 Is a desired aim or condition toward which one is willing to work
 Individual goals- are personal goals; based on one’s desired in life
 Group goals- may refer also to organizational goals although on a

smaller scale
 Organizational goals- management goals of an organization that are

established to justify its existence
 Short term goals and long term goals
18. Objectives
o The objectives of the Nursing Department is congruent to its vision as well as to

the 11 key areas of responsibilities to nursing practice:
o To observe ethical principles and standards that govern nursing practice . (ethico-
moral-legal responsibilities)
o To establish well coordinated referral system for the continuity of patient’s/

client’s care. (communication)
o To assure the application of acceptable performance of functions, duties, and
responsibilities of every position in the nursing department. (safe & quality nursing care,
management of resources)
o To encourage its nursing personnel to participate in nursing research for improving

nursing care. ( research)
o To utilize media for information campaign to intensify health education program.

(health education)
19. 11 key areas of responsibilities to nursing practice
o Safe and quality nursing care
o Management of resources and environment
o Health education
o Legal responsibility
o Ethico-moral responsibility
o Personal and professional development
o Quality improvement
o Research
o Record Management
o Communication
o Collaboration and teamwork
20. Nursing management - ELEMENTS OF PLANNING-
o MISSION OR PURPOSE
o - The mission statement outlines the agency’s reason for existing ( whether
hospital or health care), who the target clients are ( the poor, the needy, the middle or upper
class), and what services will be provided ( in-patient, out-patient, emergency).
o - reason for the existence of the organization (Nursing service exist to promote and
maintain health)
21. Vision
o The Board of Nursing under the guidance of the Almighty, with its unquestionable
integrity and commitment, envisions itself to be the ultimate authority in regulating the nursing
profession in the Philippines and to lead nursing development to its highest level of excellence.
22. Mission
o The BON shall unwaveringly pursue the advancement of nursing development in

the country by:
o 1. providing leadership, information, options,
o scenarios and lobby efforts to targeted
o decision makers and stakeholders
o 2. ensuring adherence to professional, ethical
o and legal standards as mandated by existing
o regulatory laws
o 3. unifying the nursing sector through good
o governance
o 4. fostering linkages with the domestic and
o international stakeholders
o PHILOSOPHY
 - Philosophy is the sense of purpose of the organization and the reason

behind its structure and goals.
 - Philosophy states the beliefs that influence nursing practice and beliefs
about health care.
24.
o POLICIES
o Policies in general, they are guidelines to help in the safe and efficient achievement
of organizational objectives
o PROCEDURES
o Procedures are specific directions form implementing written policies
o Develop and Schedule Strategies, Programs/Projects/Activities; Set the Time

Frame
o Strategy is the techniques, methods, or procedure by which the overall plan of the
higher management achieve desired objectives.
o Programs are activities put together to facilitate attainment of some desired goals.
26. Nursing management PLANNING
o Time Management is a technique for allocation of one’s time through the setting of
goals, assigning priorities, identifying and eliminating time wastes and use of managerial
techniques to reach goal s efficiently
o Principles of Time Management
o Planning for contingencies-planning anticipates the problem that will arise from
actions without thought
o Listing of task-task to be accomplished should be done in sequence which are

prioritized according to importance
o Inventory
o Sequencing
o Setting and keeping deadlines- and adhering to deadline is an excellent exercise in

self discipline
o Deciding on how time will be spent
o Time Saving Techniques, Devices and Methods to Better Use of Time
o Conduct an inventory of your activities.
o Set goals and objectives and write them down.
o With the use of calendars, executive planners, logs or journals, write what you
expect to accomplish yearly, monthly, weekly or daily.
o Break down large projects into smaller parts.
o Devote a few minutes at the beginning of each day for planning.
o Organize your work space so it is functional.
o Close your door when you need to concentrate.
o Learn to delegate.
o In a meeting, define the purpose clearly before starting.
o Take or return phone calls during specified time.
o Develop effective decision-making skills.
o Take rest breaks and make good use of your spare time.
o Multitasking
 Trying to get more things done in less time
 Examples: answering phone calls while driving, sending e-mails while

in the meeting
o DEVELOPING AND SCHEDULING PROGRAMS
o Programs are predetermined, developed and targeted within a time frame to reach
the set goals and objectives.
o The Planning Formula
o WHAT
o WHEN
o WHERE
o HOW
o WHO
o WHY
o CAN
o PREPARING THE BUDGET
o A budget is the annual operating plan, a financial “road map” and plan which
serves as an estimate for future costs and a plan for utilization of manpower, material and other
resources to cover capital projects in the operating programs.
o A nursing budget is a plan for allocation of resources based on preconceived needs

for a proposed series of programs to deliver patient care during one fiscal year.
o A hospital budget is a financial plan to meet future service expectations.
32. Factors in BUDGET planning
o Type of patient, length of stay in the hospital and acuteness of illness
o Size of hospital and bed occupancy
o Physical lay out of the hospital, size and plan of the wards, units, nurse’s station,
treatment rooms, etc
o Personnel policies
 Salaries paid to various type of nursing personnel including

OT pay or shift differential
 Extent of VL, SL, holidays
 Provision for staff development programs
o Grouping of patients such as those in specialized areas
o Standards of nursing care: kind and amount of care to be given as it affects the
number of hours of bedside care
o The method of performing nursing care whether simple or complex; the method of
documentation
o Proportion of nursing care provided by the professional nurses and those given by
non-professionals
o Amount and quality of supervision available and provided; the efficiency of job
description and job classification
o Method of patient assignment whether functional, case, team or primary
o Amount and kind of labor-saving devices and equipments
o Amount of centralized service provided: sterile supply , central o2 supply, linen

supply
o Nursing service requirements of the ancillary departments: clinics, admitting

office, ER
o Reports required by administration whether simple or complex
o Affiliation of nursing students or medical students
35. Establishing Nursing Standards, Policies and Procedures
o Nursing Standards
 Standard- a practice that enjoys general recognition and conformity

among professionals or an authoritative statement by which quality of practice or
education can be judged
 Nursing Care Standard – a descriptive statement desired quality against

which to evaluate nursing care
 Purpose of nursing standards
 Improved quality of care
 Decrease the cost of nursing care
 Determine nursing negligence
 Sources of nursing standards
 DOH, BON, Professional Organization, Nursing Programs
o Nursing Service Policies
 Policies in general are guidelines to help in safe and efficient

achievement of organizational objectives
 There are 3 general areas in nursing which requires policy formulation.

These are:
 Areas in which confusion about the locus of responsibility
might result in neglect or malperformance of an act necessary to a patient’s welfare
 Areas pertaining to the protection of patients’ and families’

rights as right to privacy and right to property
 Areas involving matters of personnel management and

welfare
o Nursing procedures
 Procedures are specific directions for implementing written policies
 Procedures are more specific guide to action than policy
38. NURSING MANAGEMENT FUNCTION NURSING MANAGEMENT PROCESS

ORGANIZING
39. Nursing management - ORGANIZING -
o ORGANIZING is the process of establishing formal authority
o Involves setting up the organizational structure through identification of groupings,

roles and relationships
o Determines staff needed through developing and maintaining staffing patterns and
distributes them in the various areas as needed
o Develops job descriptions by defining the qualifications and functions of personnel
40. Organizing
o Organizing is one way which nursing management coordinates the various

activities of a department or a unit so that the staff can get its work done in an orderly fashion
o Organizing means having qualified people and the right materials, information and
equipment needed to deal with contingencies
o PRINCIPLES OF ORGANIZATION:
o Communication: effective and open communication in all forms; thread that binds
the organization together
 Directions of communication:
 Downward
 Upward
 Lateral/Horizontal
 Grapevine
o Unity of Command
o Span of Control
o Delegation of authority
o Similar Assignments
o Unity of Purpose
42. ORGANIZATIONAL DESIGN
o Organizational design is a formal, guided process for integrating the people,

information and technology of an organization.
43. PRINCIPLES OF ORGANIZATIONAL DESIGN
o Division of labor
o Unity of command
o Authority and responsibility
o Span of Control
o Contingency Factors
o ELEMENTS OF ORGANIZING
o Organizational Structure
o Staffing
o Scheduling
o Developing job descriptions
45. Importance of organizational structure

o It enables members what their responsibilities are so that they may carry them out
o It frees the manager and the individual workers to concentrate on their respective
roles and responsibilities
o It coordinates all
o ORGANIZATIONAL STRUCTURE
o The organizational structure refers to the process by which a group is formed its
channel of authority, span of control and lines of communication.
o It is the formal structure, the official arrangement of positions or working

relationships that will coordinate efforts of workers of diverse interest and abilities
47. Patterns of Organizational Structure
o Tall or Centralized Structure
o Flat or Decentralized Structure
48. TALL OR CENTRALIZED STRUCTURE
o Responsible for only a few subordinates, so there is a narrow span of control
o Because of the vertical nature of the structure, there are many levels of
communication
49. TALL OR CENTRALIZED STRUCTURE
o Advantage
o It makes use of expertise, and allows close communication between the workers.
o Supervisory individuals screen the communication.
o Disadvantage
o Transpires that the most skilled individuals end up doing nothing while actual tasks
are done by those less capable.
o Communication from bottom to top is often difficult, and messages do not get to
the top
o Workers tend to be very “boss-oriented “ because of the close contact with their
supervisor .
50. Flat or Decentralized Structures
o Refers to an organizational structure with few or no levels of intervention between

management and staff.
51. Flat or Decentralized Structure
o Advantages
o Lower likelihood of messages being distorted
o Workers develop own abilities and autonomy and able to see the organization as
humanistic resulting in greater job satisfaction
o The principle of “shared governance” produces maximum potential for

professional growth
o Disadvantages
o Supervisor spend less time with each worker
o Supervisors may lack expertise in the variety of operations and may end up making
inappropriate decisions
o Types of Organization Classified by Nature of Authority
o Line Organization- each position has general authority over the lower positions in
the hierarchy. (also known as Bureaucratic/Pyramidal)
o Informal Organization- refers to horizontal relationship rather than vertical.(Flat or

horizontal organization)
o Staff Organization- purely advisory to the line structure with no authority to put
recommendations into action.
o Functional Organization – each unit is responsible for a given part of the

organization’s workload.
53. TYPES OF ORGANIZATIONAL STRUCTURE
o Line Organization/ Bureaucratic/ Pyramidal
o - shows that each position has general authority over the lower position of the
hierarchy.
o - ARA and power are concentrated at the top.
o 2. Flat Organization
o - refers to an organizational structure with few or no levels of intervention between

management and staff.
o 3. Staff Organization
o - purely advisory to the line structure with no authority to place recommendations

into action.
o 4. Functional Organization
o - permits a specialist to aid line position within a limited and clearly defined scope
authority.
57. ORGANIZATIONAL RELATIONSHIP
o FORMAL RELATIONS
o INFORMAL RELATIONS
o FORMAL RELATIONS
o - represents by uninterrupted lines between units, showing who reports to whom.
o 2. INFORMAL RELATIONS
o - represented by a broken or dotted line, where power relationships are

coordinated.
o ORGANIZATIONAL CHART
o - Organizational chart is a line drawing that shows how the parts of an organization
are linked.
o Characteristics of an Organizational Chart
o Division of Work
o Chain of Command
o Type of Work to be performed
o Grouping of Work Segment
o Levels of Management
o STAFFING
o Staffing is the process of determining and providing the acceptable number and
mix of nursing personnel to produce a desired level of care to meet the patients’ demand.
o The process of assigning competent people to fill the roles designated for the
organizational structure through recruitment, selection and development.
63. - STAFFING -
o FACTORS AFFECTING TIME REQUIREMENT OF NURSING CARE
 Patient’s acuteness of illness
 Degree of dependence
 Communicability of ailment
64. Steps in Staffing
 Determine the Number and Types of Personnel Needed
 Recruitment
 Interview
 Induct or Orient the Personnel in Organization
 Job Offer
65. Centralized Staffing
o Staffing decisions for all units are made by a central office or computer.
o Tends to be fairer to employees, because policies are implemented more
consistently and impartially.
o Frees manager to complete other functions.
o Most cost effective, because it maximizes use of human resources organization-

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

inconsistently.
o Time-consuming for unit manager.
67. NURSING CARE MODALITIES
o TOTAL CARE or CASE NURSING
o One nurse is assigned to one patient for totality of care during his or her time on
duty
o PDN
o Isolation nurse
o Nursing student
68. NURSING CARE MODALITIES
o FUNCTIONAL Nursing
o Task-oriented
o Particular nursing function is assigned to each nurse
o Time saving
o Worker learns w/ mastery

o -Medication nurse
o -Charge nurse
o -Nursing attendant
69. Nursing Care Modalities
o PRIMARY Nursing
o Nurse is responsible for the total care of a small group of clients from admission to
discharge
70. Nursing Care Modalities
o TEAM Nursing
o The team leader assigns patients & tasks according to job descriptions
71. PATIENT CLASSIFICATION SYSTEM
o “ Self care” or Minimal Care Patients
o Intermediate or Moderate Care
o Total Care Patients
o Intensive Care Patients
o “ Self care” or Minimal Care Patients
o capable of carrying activities of daily living (ADL) Convalescing, no longer

require intensive, moderate, or maximum care
o Require dx studies,
o Minimal therapy
o Awaiting elective surgery,
o Home environment temporarily makes discharge undesirable
o 2. Intermediate or Moderate Care
o requires some help from the nursing staff with special treatments.
o Given to moderately ill
o Recovering from immediate effects of a serious illness or operation
o May be ambulatory for short periods (needs assistance)
o 3. Total Care Patients
o those who are bedridden and who lack strength and mobility to do average daily
living.
o Needs close attention
o Requires nurse to initiate, supervise, and perform most of the activities
o Requires frequent medication
o 4. Intensive Care Patients
o those who are critically ill and in constant danger of death or serious injury.
Acutely ill patients w/ high level of nurse dependency
o Unstable condition w/c requires frequent evaluation with adjustment of therapy
76. Nursing management - STAFFING -
o STAFFING FORMULA
 Requirements:
 STANDARD VALUE OF NURSING CARE
Cases / Patients NCH/pt/day Prof. to Non-Prof Ratio

o Surgery
o General Ward
o Pediatric
o Pathologic Nursery
o Medical
o OB
o ICU/ER/RR
o CCU
3.4 3.5 4.6 2.8 3.4 3.0 6.0 6.0 60:40 60:40 70:30 55:45 60:40 60:40 70:30 80:20
o Distribution Per Shift
SHIFT PERCENTAGE AM PM NIGHT 45 % 37% 18%

o CATEGORIES OF PATIENT
Levels of Care NCH Needed /pt./ day Prof: Non Prof Level I Self-Care or Minimal Care Level II
Moderate or Intermediate Care Level III Total or Intensive Care Level IV Highly Specialized or
Critical Care 1.50 3.0 4.5 6.0 7.0 or higher 55:45 60:40 65:35 70:30 80:20
o PERCENTAGE OF PATIENTS IN VARIOUS LEVELS OF CARE
Type of Hospital Minimal Care Moderate Care Intensive Care Highly Spl. Care Primary Hospital
Secondary Hospital Tertiary Hospital Special Tertiary Hospital 70 65 30 10 25 30 45 25 5 5 15 45 - -
10 20
o TOTAL NUMBER OF WORKING AND NON-WORKING DAYS AND

HOURS OF NURSING PERSONNEL PER YEAR
Right s and Privileges Given each Personnel/Yr Working Hours per Week 40 hours 48 hours
o Vacation Leave
o Sick Leave
o Legal Holidays
o Special Holidays
o Special Privileges
o Off Duties as per R.A. 5901
o Continuing Education Program
o Total Non-Working Days/Year
o Total Working Days/Year

o Total Working Hours / Year
o RA 5901 = 40H WK LAW
15 15 15 15 10 10 2 2 3 3 104 52 3 3 152 100 213 265 1,704 2,120

o Steps for Computing the Staff Needed in the in-patient Unit of the Hospital
o COMPUTATION:
o CASE: 250 BED CAPACITY TERTIARY HOSPITAL. HOW MANY STAFF

NURSES DO WE NEED?
o 1. CATEGORIZE PATIENT ACCDG. TO LEVEL OF CARE
o 250 X 30% = 75 minimal care
o 250 X 45% = 112.5 moderate care
o 250 X 15% = 37.5 intensive care
o 250 X 10% = 25 highly specialized nursing care
o 2. FIND THE NURSING CARE HOURS (NCH) NEEDED
o 75 X 1.5 (NCH @ Level I) = 112.5 NCH/day
o 112.5 X 3 (NCH @ Level II) = 337.5 NCH/day
o 37.5 X 4.5 (NCH @ Level III) = 168.75NCH/day
o 25 X 6 (NCH @ Level IV) = 150 NCH/day
o ------------------- 768.75 NCH/DAY
o 3. FIND NCH PER YEAR
o 768.75 X 365 (DAYS/YEAR) = 280,593.75 NCH/YEAR
o 4. FIND ACTUAL WORKING HOURS NEEDED BY EACH NURSING

PERSONNEL / YEAR
o 8 ( hrs/day ) X 213 (WORKING DAY/YEAR)=

o 1,704 ( working hrs/year )
o 5. FIND THE TOTAL NUMBER OF NURSING PERSONNEL NEEDED.
o a. TOTAL NCH/ YEAR = 280,593.75 = 165
 WORKING HRS / YEAR 1,704
 b. RELIEF x TOTAL NSG PERSONNEL
 165 X 15%=25
o ( CONSTANT: 15% FOR 40 HRS/WK & 10% FOR 48 HRS/WK)
o c. TOTAL # OF NURSING PERSONNEL NEEDED + RELIEVERS
o 165 + 25 = 190 TOTAL PERSONNEL NEEDED
o
o 6. DETERMINE PROF FROM NON PROF PERSONNEL
o e.g. tertiary hospital
o 190 X 65% = 124 PROFESSIONAL
o 190 X 35% = 68 NON PROFESSIONAL
o 7. DISTRIBUTE PER SHIFT
o PROFESSIONAL(124) NON PROFESSIONAL(66)
o AM (45%) 56 30
o PM (37%) 46 24
o NIGHT (18%) 22 12
o Placement of Staff
o proper placement:
o a. fosters personal growth
o b. provides a motivating climate for the employee
o c. maximizes productivity
o d. organizational goals have better chances of being met
o inappropriate placement:
o a. frustration
o b. poor quality of work
o c. reduced organizational efficiency
o d. rapid turn-over
o e. poor image for the agency
o RA 9173 nurses with Master’s degree in Nursing are easily placed in position
o SCHEDULING
o A schedule is a timetable showing planned work days and shifts for nursing
personnel.
o Factors to Consider in Making a Schedule
o Different levels of the nursing staff
o Adequate coverage for 24 hours, 7 days a week
o Staggered vacations and holidays
o Weekends
o Long stretches of consecutive working days
o Evening and night shifts
o Floating
o Assessing a Scheduling System
o Ability to cover the needs of the shift

o Quality to enhance the nursing personnel’s knowledge, training and experience
o Fairness to the staff.
o Stability
o Flexibility
o Types of Scheduling
o Centralized Schedule
o Decentralized Schedule
o Cyclical Schedule
o SCHEDULING VARIABLES
o Length of scheduling period whether 2 or 4 weeks
o Shift rotation
o Week-ends off
o Holiday off
o Vacation leave
o Special days
o Scheduled events in the hospital , training programs, or meetings
o Job categories
o Continuing professional education (CPE) programs
o DEVELOPING JOB DESCRIPTION
o Job Description is a statement that sets the duties and responsibilities of a specific
job.
o Contents of a Job Description
o Identifying Data
o Job Summary
o Qualification Requirements
o Job Relationships
o Specific and Actual Functions and Activities
o Uses of Job Description
o For recruitment and selection of qualified personnel
o To orient new employees to their jobs
o For job placement, transfer or dismissal
o As an aid in evaluating the performance of an employee
o For budgetary purposes
o For determining departmental functions and relationships to help define the

organizational structure
o For classifying levels of nursing functions according to skill levels required.
o To identify training needs
o As basis for staffing
o To serve as channel of communication.
94. Nursing management - DIRECTING -
o DIRECTING
 Plan put into action
 Activities
 Delegation – transferring responsibility
 Updating policy
 Utilize the policy updates
 Supervision
 Roles in Supervision
 Guides
 Direct
 Facilitates
 Motivates
 Teaches
o Principles of Delegation
o Select the right person to whom the job is to be delegated.
o Delegate both interesting and uninteresting tasks.
o Provide subordinates with enough time to learn.
o Delegate gradually.
o Delegate in advance.
o Consult before delegating.
o Avoid gaps and overlaps.
o What Cannot be Delegated
o Overall responsibility, authority and accountability for satisfactory completion of

all activities in the unit.
o Authority to sign one’s name is never delegated
o Evaluating the staff and or taking necessary corrective or disciplinary action.
o Responsibility for maintaining morale or the opportunity to say a few words of

encouragement to the staff especially the new ones.
o Jobs that are too technical and those that involve trust and confidence.
o Four Rights of Delegation
o 1. task
o The right task should be within the scope of the person’s practice and consistent
with the job description.
o 2. person
o The right person should have the appropriate license or certificate, job description.
o 3. communication
o The right communication should be clear, concise, complete and correct.
o 4. feedback
o The right feedback should ask for input, get the person’s recommended solution to
the problem and recognize the persons effort.
o Aspects of Delegation
o 1. Responsibility – denotes obligation
o 2. Authority – the power to make final decisions and give commands.
o 3. Accountability – refers to liability
o COMMUNICATION
o Communication is the transmission of information, opinions, and intentions

between among individuals.
o Purpose of communication
o 1. facilitates work
o 2. increases motivation
o 3. effects change
o 4. optimizes patient care
o 5. increases workers’ satisfaction
o 6. facilitates coordination

o Types of Communication
o 1. Verbal Communication
o 2. Written Communication
o 3. Non-verbal Communication
o Personal appearance
o Intonation of the voice
o Facial expression
o Posture and gait
o Touch
o Lines of Communication
o UPWARD
o to superior
o HORIZONTAL OUTWARD
o to peers and to patient, family
o members of the and community
o Health Team to workers’ family
o and friends
o DOWNWARD
o to subordinates
NURSES
o DECISION MAKING
o Decision is a course of action that is consciously chosen from available alternatives

for the purpose of achieving a desired result.
 5 Steps in Decision Making

 1. definition of the problem
 “ why the problem occur”
 2. analysis of the problem
 “ getting to the cause of the problem”
 3. development of an alternative solution
 “ search for and analysis of alternatives and their possible

consequences”
 4. selection of the solution
 weighing of facts and exploring alternative solutions
 5. implementation and follow-up
o Major Management Functions in Implementing Decisions
o 1. Planning which entails consideration and selection of realistic objectives,

policies and procedures.
o 2. Organizing which means helping personnel understand the decision and the
procedures necessary for implementing the decision.
o 3. Staffing or the selection of the right person/s to carry out the decision
o 4. Controlling the environment and the group to prevent adverse effects.
o Art of Decision Making:
o Not making decision that others should make, to preserve morale and authority;
o Not deciding on problems that are not pertinent to matters at hand to prevent waste
of time and energy;
o Not deciding prematurely to prevent prujudice
o Not making ineffective decisions to avoid losing the respectability of the decision
maker.

o CONFLICT MANAGEMENT
o CONFLICTS – clash, fight, battle or struggle; it may be constructive or destructive
o Basis of the Conflict
o 1. Intrapersonal
o 2. Interpersonal
o 3. Group
o 4. Intergroup
o 5. Organizational
o Sources of the Conflict
o Cultural differences
o Different facts
o Separate pieces of information
o Different perception of the event
o Defining the problem differently
o Divergent views of power and authority
o Role conflicts
o Number of organizational levels
o Degree of association
o Parties dependent on others
o Competition for scarce resources
o Ambiguous jurisdictions
o Need for consensus
o Communication barriers
o Separation in time and space

o Accumulation of unresolved conflit
o Types of Conflict
o 1. Intrasender
o - conflict originates in the sender who gives conflicting instructions.
o 2. Intersender
o - conflict arises when an individual receives conflicting messages from two or

more sources.
o 3. Interrole
o - conflict can occur when an individual belongs to more than one group.
o 4. Person-role
o - conflict is the result of disparity between internal and external roles.
o 5. Interperson
o - conflict is common among people whose positions require interaction with other
persons who fill various roles in the same organization or other organizations.
o 6. Intragroup
o - conflict occurs when the group faces a new problem.
o 7. Intergroup
o - conflict is common where 2 groups have different goals and can achieve their
goals only at the others’ expense.
o 8. Role Ambiguity
o - a condition in which individuals do not know what is expected on them.
o 9. Role Overload
o - the person is simply unable to accomplish so much within a limited time period.

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

than to the best solution.
o 5. Competition
o - it is an assertive position that fosters conflict resolution on the part of the

subordinate.
o 6. Smoothing
o - disagreements are ignored so that surface harmony is maintained in a state of

peaceful co-existence.
o 7. Withdrawing
o - one party is resolved thereby making it possible to resolve the issue.
o 8. Forcing
o - yields an immediate end to the conflict but leaves the cause of the conflict
unresolved.
o Rules on Mediating a Conflict Between Two or More Parties:
o 1. Establish clear guidelines and make them known to all.
o 2. Do not postpone indefinitely.

o 3. Create an environment that makes people comfortable to make suggestions.
o 4. Keep two-way communication.
o 5. Stress a peaceful resolution rather than confrontation.
o 6. Emphasize shared interests.
o 7. Follow-up on the progress of the plan.
o Staff Development
o Staff development is geared ultimately to organizational development.
o Orientation
o Orientation is a planned and guided activities of an employee in the organization,

the work environment , and in his job.
113. Nursing management - CONTROLLING -
o CONTROLLING
o Controlling or evaluating is an on-going function of management which occurs

during planning, organizing, and directing activities.
o The controlling process opens opportunities for improvement and comparing

performance against set standard.
o Reasons For Conducting Evaluation
o Evaluation ensures that quality nursing care is provided.
o It allows for the setting of sensible objectives and ensures compliance with them.
o It provides standards for establishing comparisons.
o It promotes visibility and a means for employees to monitor their own

performance.
o It highlights problems related to quality care and determines the areas that require
priority attention.
o It provides an indication of the costs of poor quality.

o It justifies the use resources.
o It provides feedback for improvement.
o Principles of Evaluation.
o The evaluation must be based on the behavioral standards of performance which

the position requires.
o The evaluation should have enough time to observe employee’s behavior.
o The employee should be given a copy of the job description, performance

standards, and evaluation conference.
o The employee’s performance appraisal should include both satisfactory and

unsatisfactory results with specific behavioral instances to exemplify these evaluative
comments.
o Areas needing improvement must be prioritized to help the worker upgrade his/her
performance.
o The evaluation conference should be scheduled and conducted at a convenient time

for the rater and the employee.
o The evaluation report and conference should be structured in such a way that is
perceived and accepted positively as a means of improving job description.
o Characteristics of an Evaluation Tool
o Should be objective
o Should be reliable
o Should be sensitive
o PERFORMANCE APPRAISAL
o Performance appraisal is a control process in which employee’s performance is

evaluated against standards.
o Purposes of Performance Appraisal

o Determine salary standards and merit increases.
o Select qualified individuals for promotion or transfer.
o Identify unsatisfactory employees for demotion or termination
o Make inventories of talents within the institution.
o Determine training and development needs of employee.
o 6. Improve the performance of work groups by examining, improving, correcting

interrelationship between members
o 7. Improve communication between supervisors and employees and reach an

understanding on the objectives of the job
o 8. Establish standards of supervisory performance.
o 9. Discover the aspirations of employees and reconcile these with the goals of the
institution
o 10. Provide employee recognition
o 11. Inform employees where they stand.
o Methods of Measuring Performance
o Essay
o Checklist
o Ranking
o Rating Scales
o Forced-choice Comparison
o Anecdotal Recording

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2. PREPARED BY: Michael Bonito G. Tamayo, RN NURSING MANAGEMENT PROCESS

o Is the process of working through staff members to be able to provide

o This includes planning, organizing, directing and controlling

4. NURSING MANAGEMENT PROCESS

5. NURSING MANAGEMENT PROCESS

6. Purpose of the Nursing Management Process

o To achieve scientifically – based, holistic, individualized care for the patient

o To achieve the opportunity to work collaboratively with patients and others

o To achieve continuity of care

7. Characteristics of the Nursing Management Process

8. MANAGEMENT FUNCTION NURSING MANAGEMENT PROCESS PLANNING

o Is predetermining a course of action in order to arrive at a desired results. It is the

10. COMPONENTS OF PLANNING PLANNING: PREDETERMINED ACTION WHO IS TO

11. Nursing management -planning-

o 2. Planning is a continuous process.

o 4. Planning utilizes all available resources.

o 5. Planning must be precise in its scope and nature.

o 6. Planning should be time bounded.

o 7. Projected plans must be documented for proper dissemination to all concerned

o It leads to success in the achievements of goals and objectives

o It provides meaning to work

o It provides for the effective use of available personnel and facilities

o It is based on past and future activities

o It is necessary for effective control

13. Characteristics of a GOOD PLAN

o Be guided by policies and/or procedures affecting the planned action

o Develop a logical sequence of activities

o Select the most practical methods for achieving each objective

o 1. STRATEGIC OR LONG-RANGE PLANNING

o “ what are the right things to do”

o - usually extending 3 to 5 years into the future.

o 2. OPERATIONAL OR SHORT-RANGE PLANNING

o “ how does one do things right”

 - deals with day to day maintenance activities.

 3. CONTINUOUS OR ROLLING PLANS

 - similar to operating plans, involves mapping out the day-to-

15. ELEMENTS OF PLANNING

o Forecasting or Estimate the future

o Set Objectives/Goals and Determine Results Desired

o Develop and Schedule Strategies, Programs/Projects/Activities; Set the Time

o Establish Policies Procedures and Standards

16. Elements of Planning -Forecast or Estimate the Future-

o Forecasting is looking into the future

o Refers to estimation of time series, cross sectional or longitudinal data

o In making forecast, the planner should consider 3 things:

o Forecast must be supported by facts, reasonable estimates and accurate reflection

17. Elements of Planning Set Objectives/Goals and Determine Results Desired

 Is a desired aim or condition toward which one is willing to work

 Individual goals- are personal goals; based on one’s desired in life

 Group goals- may refer also to organizational goals although on a

 Organizational goals- management goals of an organization that are

 Short term goals and long term goals

o The objectives of the Nursing Department is congruent to its vision as well as to

o To establish well coordinated referral system for the continuity of patient’s/

o To encourage its nursing personnel to participate in nursing research for improving

o To utilize media for information campaign to intensify health education program.

19. 11 key areas of responsibilities to nursing practice

o Safe and quality nursing care

o Management of resources and environment

o Personal and professional development

o Collaboration and teamwork

20. Nursing management - ELEMENTS OF PLANNING-