PRINCIPLES AND CONCEPTS

of
CONTROLLING
in the NURSING PRACTICE
 It is the use of formal authority to assure the
attainment of purpose of action to the fullest
extent possible.

 On going function of management which

occurs during planning, organizing and
directing phases
Reasons for Conducting an
Evaluation
• Ensures that quality care is provided

• Allows for the setting of sensible objectives and

ensures compliance with them

• Provides standards for establishing comparisons

• Promotes visibility and a means for employees to

monitor their own performance
Reasons for Conducting an
Evaluation
• Highlights problems related to quality care and
determines the areas that require priority attention

• Provides an indication of the cost of poor quality

• Justifies the use of resources

• Provides feedback for improvement

• Evaluation must be based on the
behavioral standards of
performance which the position
requires

• There should be enough time to

observe the employee’s behavior
• The employee should be given a copy of
the job description, performance
standards and evaluation form before
the scheduled evaluation conference

• The employee’s performance appraisal

should include both satisfactory and
unsatisfactory results with specific
behavioral instances
 Areas needing improvement must
be prioritized to help the worker
upgrade his/ her performance

 Evaluation conference should be

scheduled and conducted at a
convenient time for the rater and
the employee
 Evaluation report and
conference should be
structured in such a way
that it is perceived and
accepted as a means of
improving job
performance.
 1. Developing Performance Evaluation Tool

 Characteristics of an Evaluation Tool

 1. Objectivity
 2. Reliability
 3. Validity
 4. Sensitivity
1. Structure
Standard
 Focuses on the
structure or
management
system used by
the agency to
deliver care
2. Outcome Standard
• Focuses on
demonstrable changes
in the client’s health
status as a result of
nursing care
• Usually compared with
the nursing care plans
3. Process Standard
• Focuses on how the
care was given and the
manner in which the
nursing process is
applied to various
patients
Performance Appraisal

 Comparing the results of performance with the

standards, objectives and identifying strengths and areas
of correction or improvement
 Determine the salary standards and merit
increases

 Select qualified individuals for promotion or

transfer

 Identify unsatisfactory employees for

demotion or termination
 Make inventories of talents within the
institution

 Determine training and developmental needs

of employees

 Improve the performance of work groups by

examining, improving, correcting
interrelationships between members
 Improve communication between supervisors
and employees and reach an understanding on
the objectives of the job

 Establish standards of supervisory performance

 Discover the aspirations of employees and
reconcile these with the goals of the
institutions

 Provide “employee recognition” for

accomplishments; and

 Inform employees “where they stand”

 III. MEASURING
PERFORMANCE
1. Essay or Free Response Report
- strengths, weaknesses and potentials
2. Checklist
- compilation of all nursing performance expected of a worker
3. Ranking
- ranks employees according to how he/ she fared with co-
workers with respect to certain aspects of performance or
qualifications
 II. MEASURING PERFORMANCE

4. Rating Scale
- series of items representing the different
tasks or activities in the nurse’s job
description
5. Forced Choice Comparison
- evaluator is asked to choose the statement
that best describes the nurse being
evaluated.
6. Anecdotal Recording
-describes the nurse’s experience with a
client or a group of client
 II. MEASURING PERFORMANCE

7.Job dimension scales

- rates the performance on job
requirements

8. Peer review
- assessment of work performance
carried out by peers
 II. MEASURING PERFORMANCE
9. Management by
objectives
-Employee and management
agree upon goals of
performance to be reached

10. Self – appraisal – appraisal

of performance by the
employee
 II. MEASURING PERFORMANCE

11. Nursing Audit

- official examination of records, physical
facilities and personnel involved in patient care
for the purpose of evaluation, verification and
improvement.
- composed of a nursing audit
committee
 1. Depending on when is the audit done, it can
be:
 A. Retrospective audits – performed after the patient
receives service

 B. Concurrent audits – performed while the patient is

receiving service

 C. Prospective audits – attempt to identify how future

performance will be affected by current interventions.
 2. Depending on what is audited, it can be:
 A. Outcome audits – determine what results occurred as a
result of specific nursing intervention for patients.

 B. Process audits – used to measure the process of care or

how care was carried out.

 C. Structure audits – assumptions that a relationship

exists between quality care and appropriate structure;
includes resource inputs such as the environment in which
health care is delivered.
 II. MEASURING PERFORMANCE

12. Quality Assurance Tool

- ongoing systematic process designed to evaluate and
promote excellence in health care provided to clients

- primary purpose: to ensure that each client receives the

highest level of care

- done by visiting and assessing clients and review of

charts
 Also referred to as continuous
quality improvement.

 The quest for quality is an ongoing

process and there is always room for
improvement
IV. TAKING CORRECTIVE
ACTIONS
DISCHARGE/ DISMISSAL

PENALTY SUSPENSION

PREVENTIVE SUSPENSION

WRITTEN REPRIMAND

VERBAL REPRIMAND

COUNSELING