lOMoARcPSD|12569633

LMR
Atty. Arlene Carampel-Capili
LEADERSHIP AND MANAGEMENT

Management
 art of getting things done with and through people so that the
goals of the organization can be achieved.

Leadership
 The use of one’s skills to influence others to perform to the best of
their ability toward goal achievement

Different influence tactics

(aircubes) > leader > use conciously and unconciously

 Assertiveness - sending direct messages standing up for your

own rights without stepping the rights of others
o therapeutic communication
 Ingratiation - making others feel good or look good before
making a request / uto
 Rationality - the use of reasoning
 Coalition - backing up the a request together with your co-
members
 Upward appeal - using the name of a superior formally or
informally
 Blocking - threatening somebody to damage his opportunity for
advancement or not being friendly to another person until he
grants the request. blackmail
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 Exchange - reminding somebody of a previous favors or returns

of favors
 Sanction - either giving or preventing incentives, benefits or
promotions

2 Types of Leaders
 Formal Leaders - a possition in the organization
3 levels
o Top Leaders - monitor entair org. ex. cheif
nurse ,
o Middle Leaders - coordinates w/ the top
level and first level leaders. ex. supervisors,
coordinator, dept head
o First level - focuses on the operations. ex.
head nurse/ unit managers
 Informal Leaders - they dont hold position but can motivate
members to perform
Ex. senior stuff, charge nurse

3 Common Styles of Leaders

 Autocratic - leader focused
best used in emergency situation and crisis
 Democratic - members of a voice in desicion making, leader
acts as facilitator.
best to used when you need compliacnce from the members
 Laisse-Faire - member focused, leader ay parang decoration
best used when members are matured enough
leader acts like monitor/ new leader
Authority
 legitimate right to give command and to act on the interest of an
organization
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 an officially sanctioned responsibility

 Power
 ability to obtain, retain and motivate people and to organize
informational and material resources to accomplish a task
 a demonstrated ability to get results

Sources of Power
 Legitimate Power - people who holds a position in the org.
 Reward Power - ability to give incentive and benifits
 Coercive Power - ability to give fear and punishments
 Connection Power - are the people you know
 Referent Power - pertains to charisma
 Information Power - are the people who knows (taong maraming
alam consider as powerful)
 Expert Power - are the people who have special skills and abilities
 Self Power - power that eminates from self due to maturity,
experience or gender. self confidence, self esteem

Functions of Management
 Planning -
 Organizing -
 Directing/delication -
 Controlling/evaluation -

Planning- knowing where you are and where you want to be -

inaalam mo kung ano gusto mong mangyare, assessment ex.
NCP

2 types of planning
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 Strategic / long term plan: implemented within 3 to 5 year --> type

of plan that benefits the organization (top leader)
 Operational / short term plan: type of plan that usually change
anually (operations) (1st level like head nurse)

SWOT analysis (Strength, Weaknesses, Opportunities, Threats)

Planning Formula: Meeting --> Automtic Planning
1. what action is necessary?
2. where will it take place?
3. when will it take place?
4. who will do it?
5. how will it be done?

Hierarchy of Planning/tools
 Mission and Vision (mission - reason for exsistance) provide full
care and affordable health care (vision- wants to achieve)
 Philosophy - statement of beliefs values and principles
 Goals - general statement of aim and purposes
 Objectives - specifics statements of aim and purposes that are
used to carry out the goals
 Policies - plan reduced to statement
 Procedures - step-by-step instructions
 Rules - guidelines for action and non-action

Budget - systematic way of meeting in the expenses

revenues & expenses
income costs

Types of Budget
 Capital Budget - usually expensive ( long term used)
 Operational Budget - the day today expense (ginagamit araw
araw) ex. kuryente
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 Personnel Budget - salary of full time employee (prepared a head

of time)
 Cash Budget - always available/cash on hand (emergency)c

Organizing purpose is for work distribution

Organizing
• Involves establishing a formal structure that provides the
coordination of resources to accomplish objectives and
determine position qualification and description

3 Elements of Organizational Structure

1. Levels of Authority
do we always have 3 levels of authority? no, it depends on the
size of the org.
2. Lines of Communication
a. solid line - direct relationship
o unity of command - only one can give orders - immediate
superior
Cheif Nurse

supervisor supervisor

HN HR HN HN HN HN

b. broken/dotted line - indirect relationship - coordinating

relationship
c.
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3. Span of Control - number of workers that directly work to a

superior - limited

Major Forms of Organizational Structure

1. Centralized Models
o responsibility is assumed and confined only to one authority
o only one for dsicion making
 advantages
– highly cost-effective
– makes management easier
 disadvantages
– as the organization becomes bigger and complex,
the hierarchical arrangement becomes
cumbersome
– the attention of manager becomes diluted due to
his many responsibilities
– the arrangement does not readily adapt to
change
– obtaining quick decisions or actions is not easy

2. Decentralized or Participating Approach

o a behavioral system whereby the large structures are broken
down to small units and authority is delegated to those
closer to the majority of workers

Decentralized or Participating Approach

 Advantages
 Reflects the interest of the workers and have a voice in decision
making
 Promote better interpersonal relationship
 communication departmentally and interdepartmentally
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 Allows problem to be solved with greater imagination and

creativity

Decentralized or Participating Approach

 Disadvantages
 Not cost-effective
 Communication breakdown
 Problems with role communication can occur

Job Description
 Also termed performance responsibility
 Spell out the precise job content including duties, activities to be
performed, responsibilities and results expected from the various
roles of the agency

Staffing
 Process of assigning competent people to fill the roles designed for
the organizational structure through recruitment, selection and
development of personnel

Employment Procedure
 Recruitment
o filling up of vacancies and selection of personel
 Induction
o employee becomes a formal part of the org.
 activity during induction
1. make sure you are included in the payroll
– CONTRACT SIGNING
2. arrange for deductions
3. Submit necessary requirements and documents
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 Orientation - employee familiarizes themselves to the organization

o to know: organization; most important: job descrption

The Staffing Process

 4 Methods
o Conventional -manage can either do centralized or
decentralized
 centralized and stuffing - isa lang
 decentralized - madami
o Cyclic - schedule repeats itself ( ang sched ay paulit ulit lang)
o Forty hours - work 8 hrs a day x 5 days a week, 2 days off
(R.A 5901 private and public hosp.) - prepandemic
 labor code(private hosp) but if exigency arrives may
work at a 6 days provide that the 6days will be
overtime (only in health care provider)
o Seven days - 10 hrs a day for 7 days a week followed by 7
days off (pandemic)

Nursing Care System - system that is used to deliver nursing

care ( modalities of nursing care/ patterns of nursing care)
 Case Nursing/case method - oldest method - total care nursing
(1:1) 1nx 1pt
 Functional - task are deligated among the staff (kanya kanya ng
trabaho)
 Team Nursing - group of nurses assign to a group of pt wherein
there is a team leader
ex. student nurses the c.i is the team leader
 Primary Nursing - ideal to the ward
24 hr continuous coordinated comprehensive service of 5 to 6 pt
from admission to discharge (1:5 or 1:6) (rn:pt)
primary nurse needs to create NCP
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(off-duty primary - associate cant change the NCP except if there is

a sudden change in the pt. condition provide that he will report it
to the primar) 1 nurse per shif
will you have the came set or nurses from admission to discharge?
yes
 Modular Nursing - combination of team and primary nursing but
there is geographical assignment of patient
 Case Management / nursing case management - utilizing health
care delivery system wherein the gaols are to deliver quality care,
promote quality of life, decrease fragmentation(dec isolation)-
(fragment-small peel of a whole) and to contain costs
ex. nursing home-found within community ( music and art
therapy)

Directing
Directing /Delegation -The issuance of assignments, orders and
instructions that permits the employees to know what is
expected of them so that they can contribute to the attainment
of the goals and objectives of the organization
 The “doing phase” of management

2 aspects of delegation - problem

1. Technical - task, procedures, materials and equipments
o show how to do task/ teach/
demonstrate/supervise/ do or perform it
with the nurse
2. Interpersonal - attitudes, behaviour and styles of derection
giving
o verbalization of feelings
o assertiveness as a style of direction/style of
communication
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4 pointers of delegation
1. position of the staf - licensed or unlicensed
2. ward - san galing or san pupunta
3. capabilities of the staff - depend in the position in the ward
4. condition of the patient -
questions: telementry(tele-monitor, metry-measurement-
patient with cardiac problems) leaders assign in the
pediatric ward
what type of pt can be assigned to you?

 kawasaki disease - inflamation of lining of the blood

vessels

Communication - sending of messages from sender thru

reciever vice versa and hoping that it is being understood
 Elements of Communication - sender and receiver are missed
conception of elements of communication
o Message -
o Encoding -
o Transmitting (channels of communication)/mode of
transmission - send(through text)
o Decoding - reading
o Feedback/Action - reply (always vary depending on the
receiver)
 3 Barriers in Communication
1. Physical Barriers - evironmental ( madalas nakikita sapaligid.
ex. noise), distance (1km usap ex. prison in other country
needs phone)
2. Social-Psychologic Barriers - lack of trust
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3. Semantic Barriers

verbirization - repeating words

echolalia - repeating what you are hearing (echo ex. parrot)
echopracia - repeating what other are doing
perseveration - repeating same ideas
duphaston? periodic hypokalemia
Conflict - missed understading /hindi pagkakaunawaan
 Conflict – Resolution Strategies
1. Avoidance - let us not talk about it(iniiwasan ang
problema)
2. Dominance and Suppression (i am the manager here you
have no choice)
3. Restriction/power - manager will solve the probalem ( i
am the manager here, i will do what is neccessary)
4. Majority Rule - let us divide the house (voting)
5. Smoothing - ang mali ay ginagawang tama (unacceptable
appears to be acceptable)
6. Compromise - meeting halfway
7. Collaboration - working hand in hand in solving problem
o Brainstorming - #1 rule: all ideas are
welcome
reporting - conflict - resolution strategies

4 approaches
manager 1. win - lose (able to solve problem at the expense of thers)
or you 2. lose - win (able to solve the problem at your own expense)
3. lose - lose (both parties sacrifice in the solution of the problem)
(both parties compromise)
4. win - win (both parties benefit from the soluti0on of the problem)
=collaboration
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Change Management
– Any alteration in the status quo (present situation)
3 stages of change
 Unfreezing
 Moving
 Refreezing

The Change Process

 Perceive the need for change - determine the problem (madalas
ang problema nakasulat na sa situation
 Initiate a group interaction - key to problem solving
o Identify internal and external forces
o State the problem
o Identify the constraints
o List change strategies
o Develop plan for implementation
o Select or develop tools for evaluation
 Implement plan one step at a time - do it gradually to prevent
resistance
 Evaluate over-all results
o if there is resistance, go back to 2 aspects of directing

Controlling
Controlling/ Evaluating/ Reviewing/ Checking/
Comparing/Determiting
 Seeing to it that what is planned is done
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4 Basic Steps
1. Develop standards (predetermined level of care) and criteria
(charactheristics used to meet the level of care) - basis for
evaluation (ex. surgical hand washing) tip in the board exam any
question in controling is standards
3 types of standard
 Structure - facilities, equipments, materials and
management system (manager)
 Process - plans and procedures (nurse)
 Outcome - results

2. Determine compliance to standards and criteria (pagsunod)

2 types of evaluation
 Nursing Audit - pt. focused
 Performance Appraisal - staff focused

Nursing Audit
2 Types of Nursing Audit
 Concurrent - (present) - evaluate as the care is given
 Retrospective - (past) - source of evaluation is patient chart

Performance Appraisal
2 Types
 Informal – incidental performance appraisal (walang balak
mag evaluate si manager pero dahil may nangyari kaya sya ng
evaluate)
 Formal – systematically done based on the procedure, usually
ends up in review sessions
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3. Identify strengths and weaknesses

4. Act to reinforce strengths and to take corrective actions on the
weaknesses (weaknesses we need to delegate) go back to 2 aspects
of

RESEARCH
 Scientific Method
– informal application of problem identification, hypothesis
formulation, observation, analysis and conclusion
 Research
– more formal, systematic and intensive method of analysis for
the purpose of discovery and development of an organized body
of knowledge
 Nursing Research – clinical problems
 Research in Nursing
 Broader study of people and the nursing profession including
historical, ethical and policy studies
 Evidence-Based (Nsg) Practice
 Conscious and judicious use of the current “best” evidence in
the care of patients and delivery of health care services

Importance of Research in Nursing

 Professionalism
 Accountability
 Social Relevance of Nursing
 Research and decision making
 Ultimate Goal
 To improve the practice of its members so that the services
provided to its clientele will be maximally effective
Sources of Human Knowledge
 Tradition
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 Authority
 Logical Reasoning
 Experience and trial and error
 Scientific Research

Major Steps in the Process of Research

 Phase I: The Conceptual Phase
 Phase II: The Design and Planning Phase
 Phase III: The Empirical Phase
 Phase IV: The Analytic Phase
 Phase V: The Disseminating Phase

Phase I: The Conceptual Phase

1. Formulating and delimiting the problem
2. Reviewing the related literature

3. Undertaking a clinical fieldwork

4. Defining the framework and develop conceptual definitions
5. Formulating the hypothesis

Phase II: The Design and Planning Phase

6. Selecting a research design
7. Developing protocols for the intervention
8. Identifying the population to be studied
9. Designing the sampling plan
10. Specifying the methods to measure the research variables
11. Developing methods for safeguarding human/animal rights
12. Finalizing and reviewing the research plan
Phase III: The Empirical Phase
13. Collecting data
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14. Preparing the data for analysis

Phase IV: The Analytic Phase
15. Analyzing the data
16. Interpreting the results
Phase V: The Disseminating Phase
17. Communicating the findings
18. Utilizing the findings in practice

The Problem
Sources of Research Problems
 Nursing literature
 Ideas from external sources
 Theory
 Experience and clinical field work
 Social issues
 Scientific Research
Criteria of Good Research Problems
 S - significance of the study
 A – availability of the subjects
 L – limitation of subjects
 T – time allotment and research ability
 L – limitation of tools

 I – interest of the researcher

 N – novelty /newness/ freshness of idea
Major Types of Data Collection Method
 Use of existing data
 Self reports – interview, questionnaire
 Observation – participant or non-participant
 Biophysiologic measures – use of equipments or gadgets

Downloaded by mei geum (mingeum3822@gmail.com)

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1. In Vivo
2. In Vitro

Phenomena Amenable to Observations

 Characteristics and condition of the individual
 Activities and behavior
 Skill attainment and performance
 Environmental characteristics
 Verbal communication
 Non verbal communication
o

Criteria used to Know Effectivity

 Validity
o degree to which an instrument measures what is supposed
to be measured.
 Reliability
o repeatability/consistency yields the same result upon
repeated use of the instrument.
 Sensitivity
o ability to detect fine differences.
o

 Related literature -synthesis of previous studies

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Steps/Strategies for Searching Lit.

 Determine concept/issues/topics
 Identify variables/terms
 Conduct computer search
 Weed out irrelevant resources before printing
 Organize resources from print out for retrieval
 Retrieve relevant sources
 Copy articles
 Conduct preliminary reading and weed out irrelevant sources
 Critically read each source
 Synthesize critical summaries of each article
o

Hypothesis
 Tentative prediction or explanation of the relation between 2 or
more variables

Parts of Hypothesis
 Independent Variables
 Dependent Variables
 Relationship
 Population to which it applies

Types of Research Accdg to Motive

 Basic Research – to gain new knowledge
 Applied Research – to make new knowledge useful and practical
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According to Levels of Investigation

 Level I Exploratory
o identifying the variables
 Level II Descriptive
o finding out whether the variables are associated / related
a. Descriptive
b. Correlational
c. Comparative
 Level III Experimental
o finding out the effects of variables to each other

According to Approach / Design

 Non-Experimental
 Historical
 Survey
 Case Study
 Methodological
 Analytical
 Experimental
 True Experiment
 Quasi

According to Time Frame

 Cross sectional study
 Longitudinal study
 Retrospective
 Prospective
Sampling Designs
 Population
 The entire aggregation of cases that meet a designated set of
criteria
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 Eligibility Criteria
 The exact criteria by which it could be decided whether an
individual would or would not be classified as a member of the
population in question
 Accessible Population
 The aggregate of cases that is within the reach of the researcher.
 Target Population
 The aggregate of cases about which the researcher would like to
make generalizations
Sampling Designs
 Sampling
 Refers to the process of selecting a portion of population to
represent the entire population
 Sample
 Consists of the subsets of the units that comprise the population
 Sampling Plans
 Non-probability sampling (Non random)
 Probability sampling (Random)
Non-probability Sampling
 Convenience or accidental sampling
 Quota sampling
 Purposive /Judgmental sampling
 Snowball sampling
Probability Sampling
 Simple random sampling
 Stratified random sampling
 Cluster sampling
 Systematic sampling

4 Basic Rights of Research Subject

 Right not to be harmed
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 Right to full disclosure

 Right to privacy, anonymity and confidentiality
 Right to self-determination
Levels of Measurement
 Nominal data
 Used to classify objects or numbers according to categories
 Ordinal data
 Used to show relative ranking of objects or events
 Interval Data
 Shows ranking of events with equal intervals and the no. zero is
not absolute
 Ratio
 Shows ranking of events with equal intervals and absolute zero
Descriptive Analysis
 Frequency distribution
 Measures of central tendency
 Mean, median, mode
 Measures of variability
 Simple rank, range, variance, standard deviation
Inferential Statistics
1. ANOVA
2. Chi-square
3. T-tests
1. Student T-test
2. Paired T-test
• Pearson Product Moment of Correlation
(Pearson r)