CENTRAL LUZON DOCTORS’ HOSPITAL

EDUCATIONAL INSTITUTION, INC.

Romulo Highway, San Pablo, Tarlac City
 (045) 982-5019/982-5052/982-0264  (045) 982-0780/982-2757
Department of Graduate Studies

COURSE TITLE:  NURSING ADMINISTRATION

PREPARED BY: MARIA ANGELICA L. JALOS, MSN 1-C
COURSE CONTENT: ROLES AND FUNCTIONS IN CONTROLLING
A. QUALITY CONTROL
B. PERFORMANCE APPRAISAL
C. PROBLEM EMPLOYEES

CONTROLLING is the function of management that involves, setting standards, measuring

performance against those standards, reposting the results and taking action.

QUALITY CONTROL is a specific type of controlling, which refers to activities that evaluate,
monitor or regulate services rendered to consumers.

QUALITY CONTROL HAS THREE BASIC STEPS

1. Criterion or standard is determined

2. Information is collected to determine if the standards has been met.
3. Educational or corrective action is taken if the criterion has not been met.

STEPS IN QUALITY CONTROL

1. Identify the information relevant to criteria.

2. Determine ways to collect the information.
3. Collect and analyze the information.
4. Compare collected information with established criteria.
5. Make judgement about quality.
 6. Provide information and if necessary, take corrective action regarding findings of
appropriate sources.
7. Determine ways to collect the information.

STANDARDS AS A DEVICE FOR QUALITY CONTROL

Types of standards the most organization must establish ( Koont & Weitrich; 1988) :

 PHYSICAL STANDARDS – which include patient activity ratings to

established nursing care hours per patient per day.
 COST STANDARDS – which include the cost per patients per day.
 CAPITAL STANDARDS – which include the review of monetary
investment of new programs.
 PROGRAMME STANDARDS – which guide the development and
implementation of programs to meet client needs.
 INTANGIBLE STANDARDS – which include staff development or
personnel orientation cost.
 GOAL STANDARD – which outline qualitative goals in short and
long term planning.
 STRATEGIES PLAN STANDARD – which outline check points in
developing and implementing the organization’s strategic plan.

AUDIT AS A TOOL FOR QUALITY CONTROL

 An audit is a systematic and official examination of a record, process or account

to evaluate performance.

TYPES OF AUDIT

OUTCOME AUDIT – end results of care. Example; length of stay, morbidity,

mortality.
 PROCESS AUDIT – used to measure process of care or how the care was carried out.

STRUCTURE AUDIT – monitors the structure or setting in which patient care

occurs, such as the finances, nursing services, medical records, and environment.

NURSE MANAGER’S ROLES IN QUALITY CONTROL

 Encourage staff to be actively involved in the quality control process.

 Clearly communicate standards of care to subordinates.
 Encourage the setting of high standards to maximize quality instead of setting
minimum safety standards.
 Implement quality control proactively instead reactively
 Use control as a method of determining why goals were not met.
 Be positively active in communicating quality control findings.
 Act as role model for followers in accepting responsibility and accountability for
nursing action.

FUNCTIONS OF NURSE MANAGER IN QUALITY CONTROL

 In union with other personnel in the organization establish clear cut, measurable
standards of care and determine the most appropriate method for measuring if
those standards have been met.
 Select and use process, outcome and structure audits appropriately as quality
control tools.
 Assesses appropriate sources of information in data gathering for quality control.
 Determine discrepancies between care provided and unit standards and seeks
further information regarding why standards were not met.
 Use quality control findings as a measure of employee performance and reward,
coach, counsel or discipline employees accordingly.
  Keep abreast of current government and licensing regulations that affect quality
control.

TOTAL QUALITY MANAGEMENT

This is a philosophy developed by Dr. Edward Deming.

PRINCIPLES:

 Creates a constancy of purpose for the improvement of the products and service.
 Adopt a philosophy of continual improvement
 Focus on improving processes, not on inspection of products.
 End the practice awarding business on price alone, instead minimize total cost by
working with a simple supplier.
 Improve constantly every process off planning, producing and service.
 Institute job training and retraining.
 Develop leadership in the organization.
 Drive out fear by encouraging employees to participate actively in the process.
 Foster inter – departmental cooperation, and breakdown barriers between
departments.
 Eliminate slogans, exhortations and targets for the workforce.
 Focus on quality and not just quantity.
 Promote team work rather than individual accomplishments.
 Educate employees to maximize personal development.
 Charge all employees with carrying out total quality management package.

NURSING AUDIT is the assessment of the quality of nursing care and uses records as an aid in
evaluating the quality of patient care. It is an evaluation of the nursing service.
PURPOSES OF NURSING AUDIT

 Evaluating nursing care given

 Achieves deserved and feasible quality of nursing care.
 Stimulant to better records
 Focuses on care provided and not on care provider.
 Contributes to research.

METHODS OF NURSING AUDIT

 RETROSPECTIVE VIEW - This type of nursing audit is conducted after

the discharge of the patient from the healthcare facility wherein the auditor
determines the quality of patient care based on clinical records.
 CONCURRENT REVIEW - This nursing audit method is conducted
while the patient is currently undergoing treatment at the healthcare
facility. It involves staff interviews and patient assessment in addition to
the review of the patient’s records.

ADVANTAGES OF NURSING AUDIT

 Can be used a method of measurement in all areas of nursing.

 Scoring system is fairly simple.
 Results are easily understood.
 Assesses the work of all those involved in recording care.
 May be useful tool as part of quality assurance programme in areas where
accurate records of care are kept.

DISADVANTAGES OF NURSING AUDIT

 Appraises the outcomes of the nursing process, so it is not so useful in

areas where the nursing process has not been implemented.
 Many of the components overlap making analysis difficult.
 Is time consuming.
 Requires a team of trained auditors.
 Deals with a large amount of information.
 Only evaluates record keeping. It only serves to improve documentation,
not nursing care.