FACTORS INFLUENCING WARD MANAGEMENT

Ward management is one of the prerequisites for good nursing

care. There are many factors involved in good ward
management, which the nurse manager/supervisor needs to
understand thoroughly for good management of the ward as
follows.
1.
Knowledge of the ward means that knowledge of all the
duties and activities to be performed in ward.
2.
3.
Planning the schedule of the ward refers to a planned
program for each day's work to save time and use available
time in a useful way for nursing the clients.
4.
5.
Starting the work on time: Proper arrangements are made so
that all nurses do their job in right time as assigned promptly.
6.
7.
Preventing interruptions: Good management requires
avoidance of interruption whenever possible, e.g. changing
assignments are anticipated.
8.
9.
Establishment of ward routines: These provide a plan for
delegation of duties and getting the work done in an efficient
way. Policy manuals of the institution help to establish ward
routines which include handling orders, writing and giving
reports, checking medicine cards, summarizing charts,
handling telephone calls, checking and ordering, supplies,
keeping cupboards stocked distributing linen, collecting
specimens, there is more time left for individualized nursing,
supervision and teaching.
10.
11.
Use of democratic method in establishing ward policy: When
ward objectives are to be determined and policies to be
established or changed, better co-operation are achieved if
participation of the entire staff is encouraged.
12.
13.
Orientation of new personnel: Well developed orientation
program helps good ward management. When new staff has
entered the hospital, they must be oriented to hospital as well
as the ward, which helps new nurses develop desirable
understanding and attitudes.
14.

8A. Orientation of hospital will include the type of hospital,
organization of hospital, aim of nursing service, relationship of
hospital with medical/nursing schools or colleges, doctors,
different departments in relation to nursing services, health
services for nurses, meal hours, plans for periodical
conferences and staff development. 3



8B. Orientation of ward/unit will include the introduction of
new nurses to ward personnel. Services represented on the
ward (medical, surgical, gynecology, etc), methods of
assignment working schedule of the day (patients time of
awakening, taking JPR, meal timings, etc.) resting hours,
visiting hours, etc. duties of non-professional workers,
methods of obtaining daily assignments (Handling orders,
charting, etc.), ward tour/rounds. Location of equipment.
Location of existing and emergency equipments, and other
sources of information such as procedures routines, and ward
policy book, etc. and also introduction of required special
experiences.


1.
Maintenance of suitable environment: Elements which help
maintain suitable environment in the ward include prevention
of noise, good ventilation, cleanliness of ward, well
functioning equipments, good housekeeping, etc. Because,
noise hampers relaxation and rest; improper ventilation is
harmful to health. A sanitary, safe, restful environment is
necessary to the patient's welfare and comfort as well as that of
all members of the ward personnel. Cleanliness and order
improve morale and tend to make workers careful and neat in
their habits. Maintenance of building and equipment in good
repair is economical as well as safe and efficient.
2.
3.
Providing supplies and equipment in a hospital: There
should be provision for proper supplies and equipment for
efficient work supplies are expendable items or those articles
which are used up and must be recorded periodically such as
soap, and detergents, paper towels, stationery, food, sterile
goods, etc. Equipments include more permanent articles and
may be classified as fixed or movable. Fixed equipment is not
a part of the structure of the building but is attached to its walls
or floor such as sterilizers and sinks. Movable equipments
include furniture, instruments, syringes, dishes, etc.
4.
For good management, all materials (supplies and equipment)
should be adequate free from repair, accessible, and
conveniently located and should maintain the standard, in the
materials, according to their use, maintain good exchange
system, inventory and requisition (proper polices and performs
are used for material management). It is always better to
have  4 controls. Apply department in every hospital for
providing efficient nursing service.
5.
6.
Clear cut, specific orders for medical therapy and
nursing: Good ward management needs a clear cut doctor's
orders and nursing orders, which are very essential to
safeguard the patient welfare. They help prevent errors and
thus they protect the doctor, the nurse and the hospital. It is
always better that orders be written and signed by the doctor.
There are some standing orders that also should be written in
the policy book of the hospital, and then only the nurses are
able to carry out the standing orders. Nursing orders, given by
the nurse supervisor, should be specific and easily
communicated to the concerns nurses to carry out and the same
which avoid confusion and other odd events.
7.
8.
Record keeping, maintaining accurate records is essential
for good management: They might be patient clinical records,
administrative records, all have legal and scientific value, so
that recording competence should be maintained. Records will
include administrative records. Doctor's orders, nursing orders,
nurse's notes, record of treatment, etc. While using records
proper instruction to be followed by proper use of clinical
records. In addition proper maintenance of records of
equipments losses and replacements, records of personnel
performance are also a part of good management.
9.
10.
Reporting: Reports are of prime importance both to good
ward management and to a well-functioning hospital. Many
reports are oral and are concerned mainly with the immediate
functioning of the ward such as reports between nurses and
reports to doctors and supervisors. Reports are written as they
may be needed for legal purposes, when they are to serve as a
source of reference, or to be used by several people.
11.
Written reports include day, evening and night reports and
those relating to accidents and unusual condition which may
reflect the quality of care the patient has received, Reports to
other departments in the hospital and to agencies outside the
institution are usually written. A report to be of the greatest use
and to save time and duplication of efforts must be prompt,
complete, accurate and objective. Reports which have
legal  5 significance, especially those describing accidents and
mistakes, are written by the individuals involved and should
include all identifying information, which in any way may
have contributed to the situation.
12.
13.
Maintenance of high morale among all members of the staff.
14.
15.
Establishment of good relationship: Establishing good
working relationship within the ward and with other associates
is an essential factor in good work management. In the hospital
where every individual and every department exists for its
contribution to the patient and his well-being, there are
interdependencies and interrelationships which must be
understood and respected. When good relationship exists,
people are enthusiastic about their work. They feel themselves
to be a part of the institution. A warm, friendly atmosphere
prevails; the hospital. The attitude of nurses and other
employees is reflected to the patients.
16.
17.
Delegating responsibility: Whenever an individual is
responsible to another person, delegation of duties is essential.
In a hospital ward the bedside care o the patients is delegated
to the staff and student nurses, housekeeping duties are
assigned to other personnel. The delegation of responsibility
will be made in accordance with the ability of individuals
within the frame of policy of the hospital.
18.
19.
Assigning duties and responsibility: Well-planned
assignments of duties and responsibilities have following
objectives.
20.
1.
To provide the patient with the best possible nursing care.
2.
3.
To plan assignment which are interesting and stimulating to
professional growth?
4.
5.
To provide a well rounded educational experience for student
nurses.
6.
7.
To achieve good ward management.
8.