Professional Documents
Culture Documents
NCM 107 Module 2F: Controlling (Compiled Notes)
NCM 107 Module 2F: Controlling (Compiled Notes)
Characteristics:
■ Cyclical- continuous, never finished
■ Lead to behavior change
■ Anticipatory and retrospective
● anticipate problems
● preventive actions
■ Views control as responsibility- because you care for employees
■ Employees think its negative, but there will be changes
○ Principles
- There must be only a few people
● this shows best results because when there is less people, there is better
control
- There must be a defined point of control
● There should be 1 authorized leader
1
- Self Control / Discipline
● Personal acceptance of responsibility and accountability
○ Types
● Pre Action
- Focuses on the prevention of deviation through personal supervision
- Rules and regulations, policies, training
● Post Action/ Concurrent
- This is when materials are prepared
- There is monitoring and adjustments of activities to make sure everything is
correctly done
● Feedback
- End result
- Reports are done
● Purpose
- Improves quality of nursing care
- It decreases the cost of nursing care
- Provides a basis for determining nursing negligence
- Control Process:
1. Establishes performance objectives and standards
2. Measure actual performance
3. Compare actual performance with the objectives and standards
4. The necessary action
○ Steps:
1. Setting performance standard
2. Measuring performance
3. Making comparison
4. Corrective action
○ Elements
1. Performance Appraisal
➢ How well employees carry out the duties of their assigned job
➢ Who evaluates:
■ Co worker
■ Patient
■ Supervisor
➢ Tools:
➢ Common Errors:
● Error of central tendency: all employees are rated average
● Leniency/strictures error: unusually high/low rating (over/underrating)
2
● Recency error: based largely on employees most recent behavior; performance should be good
● Contrast error: comparison with another employee just previously evaluated
● Halo effect: overrated based on good first impressions (traits)
● Stereotyping: generalizing employee; performance based on group
● Focusing on first impression: logical error
● Horn’s effect: very low rating d/t error committed
● Ambiguous rating: opposite of how rater perceives
● Proximity error
● SRating by position: rating supervisor (high grade)
● Grapevine: based on “chikka”/what people tell you, not performance
● Hawthorne effect: people do good when being watched so rating goes up
3. Development of Standards
■ Predetermined level of excellence as guide for practice
■ Purpose
● Improve quality
● Decrease cost of nursing care
○ Minimizes supplies, materials
● Basis for determining negligence (no problem if you follow standard)
● Provides potential solutions to issues
■ Significance
● Guides nurses to professional responsibilities
■ Types:
3
● Structure
● Process (nurse-oriented)
● Outcome (end result, patient-oriented)
3. Variance Report
- document comparing planned financial outcomes with actual outcomes
4. Discipline
- ensure employee compliance
- form of self control
- individual acts in code of behavior
Principles:
● manager should improve as a correction, not punishment
● progressive oral counseling, written warning
According to Hersey
● Regulating, curbing and restraining organization’s activities
According to Swansburg:
● Seeing that everything is being carried out in accordance with the plan
● Significance
○ assures consistent and continuous performance and quality of an organizational service or product
4
○ Controlling assesses achievement of objectives
○ Controlling involves sets of standards
○ Recycling process
Functions of Control
● Serves both as a means and an end - Cyclical process, overlapping, continuous
● Promotes effective use of resources - all resources are evaluated and maintained
● Provides professional reinforcements - given discipline and different reinforcements
● Maintains activity and expectations
Principles of Controlling
1. A critical few - fewer people involved in control
2. defined point of control- centralized or decentralized
3. Self Control nor Discipline - personal acceptance, responsibility, and accountability
STEPS OF CONTROL
A. Establish and Specify Criteria and Performance Standards
● Setting Standards and Determining Criteria
○ Standards: is a descriptive statement of desired level of performance
■ Basis for measuring
■ Statements of desired level of performance
■ Must be updated and reflect a higher level of desired performance
■ Are temporary
● Can be altered or abandoned, working model
5
○ Nursing Care Standard: is a descriptive statement of desired quality of performance
○ Standards are created during the steps of planning
○ Policies and procedures are set
○ Job descriptions are set when standards of nursing are set
1. Standards
1.1 Purposes of Standards
● improve quality of nursing care
○ By publication of these standards, everyone should know it bc this motivates to work harder
● Decrease the cost of nursing care
○ It can eliminate non essentials that serve no use for goals
○ Lessens the mistakes by following standards
● provide a basis for determining nursing negligence
○ Not reaching standards may cause harm to patients
2. Resource Controls
● Time Control
○ Deadlines and time constraints
● Material Control
○ Inventory of supplies and materials
● Equipment Control
○ ?
● Cost Control
○ ?
● Employee Performance
○ Ex: absences, tardiness, accidents
● Financial Control
○ Facilitates achievement of organizational profits
6
● Operations Control
○ How efficient and effective the organizational task formation process is
○ TQM (Total Quality Management)
● Statistical Process Control
○ Physics, mathematical methods to determine where production operations are performed
● Just-in-Time System
○ Timely application of medication for patients and purchasing of patients
○ Communication of supervisors and staff
ELEMENTS OF CONTROLLING
A. Performance Appraisal
- Evaluation of an employee conducted at regular intervals by an employer persons in line positions.
8
- Methods of
- Employees performance are recorded against the standards
DISCIPLINE
● Manager’s standpoint : the process of ensuring employees compliance with institutional rules and regulations
○ Basis: institutions rules and regulations
○ Official employees standards of conduct
● Employees standpoint : a form of self-control through which the individual acts in accord with the institutions code of
behavior
*disciplining is not a punishment
Principles of Discipline
● Manager should improve disciplinary action for the purpose of correcting rather than punishing a wayward employee
○ It is not for punishing but more on correction
○ Sanctions may be given and is usually thought of as punishments
● Discipline should be administered from promptly, privately, and consistently
○ You don’t give different sanctions to same offense, only have the gravity of offense
● Discipline should be progressive in nature and preceded by counselling
○ Starts with a friendly or informal talk advice
○ Oral reprimand → firm
○ If committed again → Written
10
○ No improvement → suspension
○ Commits again → staff will be discharged from office
○ Should be preceded by counselling
● Uses cautions in instituting disciplinary procedures
○ Since problems can be very severe
● The same reprimand is given to all offenders
○ Same mistakes, base it on gravity of offense
○ Hoarding grievances → promote a blow up
○ Sweetened forms of criticism → employee will not recognize mistake
○ Instituting discipline unfairly
Absenteeism
- Any time away from work
● Contributory Factors
○ Staff has double jobs
● Distance between home and workplace
○ Online issues (slow internet)
○ Early shift
○ Gender
■ more absences in females due to menstruation
■ Mondays absent for males cuz they have a nightlife (hungover)
○ Accidents
● Emotional Causes
○ Mental and emotional disorders
○ Low self-esteem
○ Job dissatisfaction because of long shift - so kapoy
○ Monotonous tasks
● Effects
○ Increase cost → call other people to do the work
○ Inefficiencies and errors → work is left behind and mistakes are committed
○ Demoralization of other workers → bc others always present others always absent
○ Poor quality of care d/t exhaustion of nurse or understaffing
● Types
○ Voluntary
■ employees control
○ Involuntary
■ Unavoidable situations
● Measures to reduce:
○ Keep records of attendance
○ “Call in” policy
■ Fill in absent slip at the station, get a medical certificate from the ER and send them to
the nursing office
● Needs to be completed before you go back on work
○ Home visits - they visit the students in their homes
○ Improve work environment
○ Incentive plans
■ For complete attendance
○ Negative sanctions - deduction from pay
2 Factors that affect absenteeism:
1. Ability to attend
11
2. Motivation to attend
Turn Over
- Separation of employees from their jobs
- Hospitals have fast turnovers bc many are going out of the country
● Types
- Voluntary - individual leaves on own accord
- Involuntary - individual is asked to leave
● Causes
- Lack of conduit between institutions needs and manpower
● Consequences
- Negative effect on hospital
- Increased costs
- Undesirable effect on patients (from mistakes)
- newbies still learning how to perform procedure with big responsibility
● Measures to improve
- Job description, recruitment, and selection should be evaluated
- Methods of assignment
- Increase salary
Extra discussion:
● Directions must come across as requests, not commands - TRUE
○ As nurse managers, you should give your directions nicely
● Any conflict causes dysfunction - TRUE
● A win-lose strategy in a conflict resolution, represses rather than resolves a conflict - TRUE
● Anything that can be planned can be controlled - TRUE
● A standard control system must be applied only to nursing units - FALSE
○ Not only in nursing units but in all units of hospital
● The control process is a continuous flow between measuring and actual performance and compare with standards -
FALSE
● Collegial evaluation - PEER REVIEW
● No such thing as performance assessment or performance audit
12
● Providing feedback
○ When you give a feedback report, you use surveys, progress notes ?? did she give an answer for this
● Measuring nursing performances: nursing rounds, quality assurance and nursing audit
● 1 characteristic of effective control is any of the:
○ Stops once the problem is resolved - NO
○ Anticipate organizational problems - YES
○ Compare performance with standards - NO
○ Assess appropriateness and effectiveness of services - YES
● If performance is found to have deviation from standards, the nurse may take action to minimize the costs, or attend
trainings or seminars - YES
○ Take corrective action is the first step, needs to have due process
● When giving disciplinary measures, you are into this area of nursing management - HUMAN RESOURCES
● This is an error in appraisal where the rater rates the staff to average: ERROR OF CENTRAL TENDENCY
● The tendency to rate a person due to an error committed: HORN’S EFFECT
● Discipline is given only to offenders: NO
13