Leadership Management and Research

LEADERSHIP AND
MANAGEMENT
SRG Integrals 2nd Ed. Leadership Management and Research 624

LEADERSHIP AND MANAGEMENT
I. LEADERSHIP
• the process of influence in which the leader influences others toward goal achievement
• is the effort to envision and inspire change
• Process of influencing the behavior or actions of a person or group to attain desired objectives
• A dynamic, interactive process that involves three dimensions: leader, follower and the situation
Leader - the one who leads, conducts or guides the process

Lead- to go with or ahead of so as to show the way; guide
“A Leader is one
others follow
willingly and
voluntarily”
A. TYPES OF LEADERS:
• Informal leader
▪ Does not have official sanction to direct activities of others; chosen by the group itself
▪ Usually become leaders because of age, seniority, especial competencies, an inviting personality or
ability to communicate with and counsel others
• Formal or appointed
▪ Chosen by administration, and given official or legitimate authority to act
Example: The elected and appointed officers
B. THEORIES OF LEADERSHIP
(a) TRAIT THEORY
• leaders have traits that must be enhanced by experience

• envisioning goals, affirming values, serving as a symbol
QUALITIES/TRAITS OF A LEADER
▪ Intelligence: judgment, knowledge and fluency of speech
▪ Personality: adaptability, alertness, creativity, cooperativeness, personal integrity, self confidence,

emotional balance and control, independence
▪ Abilities: ability to enlist cooperation, popularity and prestige, sociability/interpersonal skills, social
participation, tact and diplomacy
* Trait Theory : Early works in this area maintained that traits are inherited, but later theories suggest that the traits
can be obtained through learning & experience
LEADERSHIP TRAITS:
▪ Task-Oriented : Behaviors include planning, scheduling, & coordinating activities.
▪ Relationship-Oriented : includes being friendly & considerate, showing trust & confidence, expressing
appreciation & providing recognition
▪ Participative Leadership: enlists associates participation in making decisions

(b) GREAT-MAN THEORY
• Leaders are born and not made
• Great leaders will arise when there is a great need
Ex. King of Spain
*Great Man Theory argues that few people are born to be great leaders who are well rounded & simultaneously
instrumental & supportive
Many finds this theory unattractive because of the premise that leaders are born not made, which suggests that
leadership cannot be developed
“Leaders are
(c) CONTINGENCY THEORY
born, not
• Leaders’ ability to lead is contingent upon situation.
created.”
a.leadership member relation
b.task structure
c.position power
*Contingency Theory leadership style will be effective & ineffective depending on the situation
(d) TRANSACTIONAL LEADERSHIP

• People are motivated by reward and punishment
(e) TRANSFORMATIONAL THEORY

Empowerment is the key factor
• People will follow a person who inspires them
• A person with vision and passion
• Value based leadership
(f) INTEGRATIVE LEADERSHIP MODEL

• Obviously there is no one best leadership style. Leaders are rarely totally people oriented or task oriented.
• One should be aware of his own behavior & learn to adapt.
1. BEHAVIORAL THEORY
▪ Successful leadership is based in definable, learnable behavior
2. PARTICIPATIVE LEADERSHIP
▪ People are more committed to actions
3. SITUATIONAL LEADERSHIP THEORY
▪ Depends on the level of the maturity of individual
▪ Situational Theory Used task behavior & relationship behavior in relation to the follower’s
readiness, called maturity to emphasize the importance of the maturity level of the followers, & the
leader needs to adapt leadership styles accordingly
▪ Predicts the most appropriate leadership style from the level of maturity of the followers
▪ The best action of leader depends on range of situational factors
o motivation
Integrative Leadership Model
o capability of followers
Obviously there is no one best
o performance of leader and follower
leadership style. Leaders are
o attitudes, needs and expectations
rarely totally people oriented or
task oriented.
One should be aware of his own

behavior & learn to adapt.

(g) PATH-GOAL THEORY
Leaders have certain objectives and initiate their followers to attain their own objectives
• derived from the expectancy theory where people act as they do because they expect their behavior to
produce satisfactory results
• In path-goal relationship, the leader facilitates task accomplishment by minimizing obstruction to the goals
(structured activity), & by rewarding followers for completing their task
• Staff associates are introduced as a variable where in staff associates with high need for achievement
probably will prefer a task oriented leader, but people with high need for affiliation will prefer a
considerate leader
• Transactional Leadership an exchange posture that identifies the needs of the followers & provides reward
in exchange for expected performance
• a contract for mutual benefits that has contingent rewards
• Jay Conger & Kanungo (1998) -They found out that charisma is more of an attributional phenomenon
(h) STRATEGY THEORY

BASED ON HUMAN HANDLING SKILLS OF LEADERS
Strategy 1 – attention thru vision “Charm is an
Strategy 2 – meaning thru communication inspirational
Strategy 3 - trust thru positioning quality”
Strategy 4 - deployment of self thru positive self-regard
(i) CHARISMATIC THEORY

• Charm and grace are needed to create followers
• Self belief
▪ Charismatic theory leader inspires others by obtaining emotional commitment from followers and by
arousing feelings of loyalty & enthusiasm
▪ Robert House - found that this leaders have strong conviction & high self confidence & followers has
the similar belief with the charismatic leader thus showing signs of unquestioning acceptance &
obedience
▪ Bernard Bass - it sometimes leads into blind obedience but a transformational leaders use it to
motivate members
C. STYLES OF LEADERSHIP
1. AUTHORITARIAN/AUTOCRATIC
- Strong control over the group or directive approach
- Concern with task accomplishments
• Autocratic involves centralized decision making, with the leader making the decision & using
power to command & control others
2. DEMOCRATIC OR PARTICIPATIVE
- Leaders focuses on involving subordinates in decision making
- People-oriented
• Democratic is participatory, with the authority delegated to others, influential by having close and
personal relationship with the subordinates
3. LAISSEZ – FAIRE OR PERMISSIVE

- Delegating approach
- Little or no direction is provided to subordinates
• Laissez-Faire Is passive & permissive, nondirective, inactive. Chaos is most likely to develop because
members may work independently
4. MULTICRATIC/ SITUATIONAL
- The leader identify which style of leadership a particular situation requires
5. CHARISMATIC
- Obtains emotional commitment from followers and by arousing feelings of loyalty & enthusiasm
inspires others to follow
D. POWER & AUTHORITY

• Authority - Legitimate power to direct others
• Power - It is one’s capacity to influence others
Sources of power:
• Expert power – it is derived from the knowledge & skills one possess
• Legitimate power – is derived from the position one holds in a group & indicates authority but not sufficient as
one’s only source of power
• Referent power – derived from respect & trust coming from any individual group or organization
• Reward power – it comes from the ability to recognize others for complying
• Coercive power – is based on fear of punishment if one fails to conform
• Connection power – it comes from coalition & interpersonal relationship
• Informational power – it comes from knowledge & access to information
Bases of Power For Leaders

• Legitimate/authority – power granted by an official position
• Referent – potential influence one has because of the strength of relationships between leaders and followers
• Expert – gained thru the position of special knowledge, wisdom, sound judgment, good decision skills, skills or
ability
• Informational power – exists when an individual have information that others must have to accomplish
particular goals
• Connection power – based on having connections or associations with others who are powerful
• Coercive power or punishment power – manager control the groups through fears, threats and sanctions
• Reward power – this is achieved through influencing others because of one’s control over desired resources
LEADERSHIP MANAGEMENT
Motto Do the right things Do things right
Challenge Change Continuity
Focus Purpose Structures & procedures
Time Frame Future Present
Methods Strategies Schedules
Questions Why? Who, What, When, Where & How?
Outcomes Journeys Destinations
Evaluate Human Potential Performance
Table 1.1 Comparison of Leadership and Management
Components of Effective Leadership

• Understanding of the individual strength, weaknesses and potential
• Knowledge of basic ingredients for leadership and management
• Systematic use of self to get things done at the right time
“Leadership is the essence of professionalism and

should be considered an essential component of
all nurses and other professional roles”
Joyce Clifford
II. MANAGEMENT
• Art of getting things done thru people

• Process that involves guidance, direction of a group of people toward organizational goals or objectives
• Process thru which the objectives of an organization are accomplished by utilizing human, physical and technical
resources.
• the act of planning, organizing, directing (leading), controlling (evaluating).
• is a process of coordinating and allocating resources to achieve organizational goal
Manager
• a person that creates and maintains an internal environment in an enterprise in which individual work
together as a group
Managing
• accomplishing the goals of the group through effective and efficient use of resources
A. MANAGEMENT ROLES
• Information role – monitor, disseminator, spokesperson
• Interpersonal role- figurehead, leaders, liaison
• Decisional roles – entrepreneur, disturbance handler, resource allocator, negotiator
B. MANAGEMENT LEVELS
• FIRST LEVEL – Supervises the operative employee
• MIDDLE LEVEL – plan and coordinate activities of the organization.
• TOP LEVEL – manages the organization as a whole.
C. MANAGEMENT THEORY
Purposes of Theory:
• Provide a stable focus of understanding what we experience
• Enable us to communicate freely Scientific Management
• Challenge us to keep learning of our work “Focused on the best
way to do a task”
PRINCIPLES
OF
MANAGEMENT
(MODERN ERA)
Scientific
Classical
Human Relations
Behavioral
Efficiency provided information on:

▪ standards
▪ time & motion studies
▪ task analysis
▪ job simplification
▪ productivity incentives

(a) FREDERICK TAYLOR (1856-1915) “Father of Scientific Management”
• Used stopwatch studies & applied the principles of:

▪ observation
▪ measurement
▪ scientific comparison to determine the most efficient way to accomplish a task;
▪ Reduced wasted effort
▪ Set standard for performance
▪ Encourage specialization
▪ Stressed the selection of qualified workers who could be developed for a particular job.
(b) FRANK GILBRETH(1868-1924) LILIAN GILBRETH(1878-1972)
• Pioneers in time and motion studies

• Emphasized the benefits of:
▪ job simplification
▪ establishment of work standards
▪ effects of the incentives wage plan
▪ fatigue on work performance
• First to use motion picture films to analyze worker’s emotions
• Developed a micro chronometer
(c) HENRY GANTT (1861-1919)
• Disciple of Taylor, was concerned w/ problems of efficiency

• Refined previous work rather than introduce new concepts
• Developed a task and bonus remuneration plan
• Argued for more humanitarian approach and placed emphasis on service rather than profit objectives
recognize useful non-monetary incentives
• views the organization as a whole rather than focusing solely on production Classic Organization
• focused on: planning “Deductive rather
organizing than inductive”
controlling
(d) HENRY FAYOL (1841-1925) “Father of Management Process School”
• Studied the functions of managers and concluded that management is universal

• A believer of in the division of work , he argued that specialization increases efficiency.
• Believed that workers: should be allowed to think implement plans be adequately remunerated for their
services
• Encourage dev’t of group harmony through equal treatment and stability of tenure for personnel
• “a place for everything and everything in its place.”
FAYOL’S MANAGEMENT PRINCIPLES
• Division of Labor – the more people specialize, the more efficient they can perform
• Authority – management needs to be able to give orders so that they can get things done.
• Discipline – members in an organization need to respect the rules and regulation that govern the
organization
• Unity of command – subordinates should receive orders from only one superior
• Unity of direction – member of any organization should have only one objectives
• Subordination of Individual Interest to the Common Good – give way for the interest of everybody.
• Remuneration – workers should be paid according/commensurate to the work they perform.
• Centralization – managers should retain the final responsibility but should at the same time give their
subordinate enough time and authority to do their job.
• Hierarchy – the line of authority in an organization runs in order of rank.
• Order – materials and people should be at the right time and at the right place.
• Equity – people in the organization should be treated with equity and justice
• Stability of Staff – the greater the turn-over rate, the less workers are efficient
• Initiative – subordinate should be given the freedom to do their work/conceive plans even though some
mistakes occur
• Espirit de Corps – good relationship must be maintain in the organization.
(e) MAX WEBER (1864-1920) “Father of Organizational Theory”
1. Conceptualized bureaucracy w/ emphasis on rules instead of individuals and competency over favoritism as the
most efficient basis of organization
2. Conceptualized a structure of authority that would facilitate the accomplishment of the organizational
objectives
Human Relations
Basis Of Authority “Stresses the
Social
• Traditional Authority Environment”
• Charisma
• Rational/Legal Authority
-focused on the effect individuals have on the success or failure of an organization
(f) CHESTER BARNARD (1886-1961)
1. Studied the functions of executives while he was a manager for the New Jersey bell telephone system
2 . He defined the manager’s responsibilities
• Defining Objectives- Acquiring Resources

• Coordinating Activities
• Stressing the importance of cooperation b/w management and labor, he noted that the degree of
cooperation depends on the non-financial inducement
• Stressed the role of informal organization for:
▪ aiding communication
▪ meeting individual’s needs
▪ maintaining cohesiveness
(g) MARY PARKER FOLLETT (1868-1933) “Mother of Modern Management”
• Stressed the importance of coordinating the psychological and sociological aspect of management
• Perceived the organization as a social system and management as social process
• She considered subordination “offensive”

• Distinguished between power w/ others and power over others and indicated that legitimate power is
produced by a circular behavior whereby superior and subordinates mutually influence one another.
• The law of the situation dictates that a person does not take orders from another person but from the
situation
(h) ELTON MAYO (1810-1949)
• Author of “The Hawthorne Studies”

• Though criticized for poor research methods, the “Hawthorne Studies” stimulated considerable interest in
human problems on the job
• “lighting had little effect on production”
• Work norms obviously had more influence than wage incentive
(i) KURT LEWIN (1890-1974)
• Study of “Group Dynamics”

• maintained that groups have personalities of their own; composite of the member’s personalities
• advocated democratic supervision
• Identified the three types of leaders
▪ Authoratarian
▪ Democrat
▪ Laissez-Faire
(j) JACOB MORENO (1892-1979)
• Developed “Sociometry” to analyze group behavior

• Claimed that people are either:
▪ attracted to
▪ repulsed by
▪ indifferent towards others
• Developed the sociogram to chart pairings of preferences for others
• Contributed to:
• psychodrama (individual therapy)
• sociodrama ( related to social and cultural roles)
• and role playing techniques for the analysis of interpersonal relations
D. BEHAVIORAL SCIENCE
• emphasizes the use of scientific procedures to study the psychological, sociological, and anthropological
aspects of human behavior in organization
(a) ABRAHAM MASLOW (1908-1970)
• “Hierarchy of Needs Theory”- Initiated the Human Behavioral School in 1943

• He outlined a hierarchical structure for human needs classified into five categories:
1. Physiological
2. Safety
3. Belonging
4. Esteem
5. Self-actualization
(b) FREDERICK HERZBERG(1923-2000)
• Factors in the job can raise the level of performance and meet the higher order needs
• Job-content (factors in the job) ex: achievement, recognition, growth = motivators
• Job-context (surrounding environmental factors) ex: supervision, company policy, working conditions =
hygiene factors
(c) DOUGLAS MCGREGOR (1906-1964)
•“Theory X and Y”
•Developed the managerial implications of Maslow’s Theory
•Notes that ones style of management is dependent on one’s philosophy of humans
•Theory X – manager’s emphasis on the goal of the organization
▪ People dislike & will avoid work
▪ Workers must be directed, controlled, coerced, threatened
• Theory Y – emphasis is on the goal of the individual
▪ People do not inherently dislike work
▪ Work can be a source of satisfaction
▪ Workers have self direction, self-control, responds to rewards for the accomplishment of goals
(d) WILLIAM OUCHI
• “Theory Z”
• Published Theory Z: How American Business Can Meet the Japanese Challenge in 1981
• Japanese organization
▪ “lifetime employment”
▪ Slow evaluation & promotion- Non-specialized career paths
▪ Implicit control mechanisms
▪ Collective decision-making & responsibility
▪ Wholistic concern
• US organization
▪ Short-term employment—Rapid evaluation & promotion

▪ Specialized career paths—Explicit control mechanisms
▪ Individual decision-making
▪ Individual responsibility—Segmented concern
(e) ROBERT BLAKE (1918) & JANE MOUTON (1930)
• Maintained that there are 2 critical dimensions of leadership

1. Concern for people
2. Concern for production
• They depicted these on a 9 x 9 or 81 square managerial grid. The vertical axis represents the managers concern
for people, & the horizontal axis represents concern for production. The 5 basic styles are to each corner & in
the middle
(a) Impoverished Manager - lack of concern for both people & production

(b) Country Club Manager - thoughtful & friendly but lack concern for production
(c) Organization Man Management - represents a moderate concern for both people & production but not at
the same time
(d) Authority-Obedience - efficiency in operation but lacks concern for human element
(e) Team Management - the optimal managerial style. These managers integrate their concern for people &
production
E. SKILLS OF A MANAGER:
(a) According to Robert Katz:
• Technical skills – knowledge and proficiency in activities involving methods, procedures and process. It also
involves working w/ tools and specific techniques to achieve the desire result.
• Human skills – the ability to work w/ people. It is the creation of work environment in w/c people feel
secure and free to express their opinion.
• Conceptual skills – the ability to see the over-all pictures to identify important elements in a situation and to
understand the relationship among the elements
• Summer emphasized
▪ Knowledge factors
▪ Attitude factors
▪ Ability factors
F. ROLES OF MANAGERS
(a) INTERPERSONAL ROLE
▪ Symbol
▪ Leader
▪ Liaison
(b) INFORMATIONAL ROLE
▪ Monitors Information
▪ Disseminates Information
▪ Spokesperson or Representative
(c) DECISIONAL ROLE
▪ Entrepreneur or Innovator
▪ Troubleshooter
▪ Negotiator

G. STEPS IN MANAGEMENT
1. PLANNING
Planning,
• Forecasting or setting the broad outline of work to be done Organizing,
• Why it will be done? What action is necessary? Staffing
• Where it will be done? When it will be done? Directing (leading),
• Who will do it? How it will be done? Controlling (evaluating).
(a) SCOPE OF PLANNING STEPS: P.O.S.D.C.
• Strategic planning - based on mission of the institution
Supervisors
• formulate policies, rules and regulations, methods and procedures

• oordinates nursing activities
• translate strategies and procedures into specific objectives and program
Head nurses
• schedule daily and weekly plans for the administration of patient care for his or her unit
• directly responsible for the actual production of nursing services
(b) CHARACTERISITCS OF GOOD PLAN
• Based on clearly defined objectives

• It should be simple
• It should provide for the proper analysis and classification of action
• It should be flexible
• It should be balance
• It should make use of all available resources
(c) REASONS FOR PLANNING
• Increases the chance of success by focusing on results not activities

• Forces analytic thinking and evaluation of alternatives
• Establish a framework for decision making
• Orient people to action than reaction
• Includes day to day and future focused managers
• Helps avoid crisis management and provide decision making flexibility
• Provide a basis for managing organizational and individual performance
• Increases employee involvement and improves communication
• Cost effective

(d) STAGES OF PLANNING
1. Develop the purpose or mission statement, goals, objectives, philosophy

• Mission – purpose of existence and reason behind organizational structure
• Philosophy – statements of shared values and beliefs
• Goals – statement of intent derived from the purposes of the organization, usually stated broadly and
generally
• Objectives – specific aims, purposes or targets that will have to be accomplished
2. Collect and analyze data - external and internal forces
3. Assess for the strength (opportunities that will facilitate effectiveness and achievement of goals and
weaknesses (threats that will impede achieving goals and objectives)
4. Write realistic and general statements of goal
5. Identify strategies to achieve specified goals
6. Develop a timetable for accomplishing each objective
7. Provides guideline for developing operational and functional plans
8. Put plans to work/implement
9. Provide for formative evaluation reports before, during and after the plan is implemented
H. BUDGET (AS A TOOL FOR PLANNING)
Budget - operational management plan related to income and expenses for division of time; allocated resources
necessary for future expenditures
(a) PREREQUISITES TO BUDGETING

• Sound organizational structure with clear line of authority and responsibility
• Managerial support
• Formal policies and procedures must be reflected in the budgetary manual
(b) PURPOSES OF BUDGETING IN NURSING SERVICE
• To plan the objective, programs, activities of the nursing service and finance to accomplish them.
• To motivate nursing workers through analysis of actual experience.
• To serve as standards.
(c) TYPES OF BUDGET
• Capital
• Operational
• Personnel or Manpower
• Flexible
• Cash flow
• Fixed ceiling
I. COSTS
Fixed cost - not related to volume and remain constant.

Variable cost - related to volume and varies according to different factors.
Direct cost - related to providing product service.
Indirect cost - incurred in support of providing products service.

(a) COST CONTAINMENT
• Cost Awareness
• Cost Fairs
• Cost Monitoring – focuses on how much will be spent, where, when, and why.
• Cost Management – what can be done to manage cost
• COST INCENTIVES – motivation and rewards
• Cost Avoidance – not buying supplies, technology or services not necessary needed.
• Cost Reduction – spending less for goods or services
• Cost Control – effective use of available resources through careful planning, forecasting, reporting and
monitoring.
2. ORGANIZING
• Grouping of activities, providing assignments, supervising, defining means of coordinating activities to

accomplish goals and objectives
(a) PURPOSES
• To sustain the philosophy, achieve the mission and vision and objectives of the organization
• Show the part each person shall work in the organization
(b) CHARACTERISTICS OF ORGANIZATIONAL STRUCTURE
Division of work in which each boxes represent an individual responsible for a given part of the organization’s
workload
Chain of command, with lines indicating who reports to whom and why what authority
The type of work performed, indicated by the labels or description for each boxes
The grouping of work segments shown by the cluster of work groups
The level of management, which indicate individual and entire management hierarchy
(c) BASIC TYPES OF O.S.
Informal – consists of the personal and social relationship of the members in the organization
Formal – describes the positions, responsibilities and those occupying the positions and their relationships
among them
(d) FORMAL ORGANIZATIONAL STRUCTURES

COMPONENTS OF ORGANIZATIONAL
Hierarchic or bureaucratic model STRUCTURE
Adaptive or organic model
1. Freeform People
2. Collegial
3. Project management Purpose
4. Task force
5. Matrix Structure

(e) ORGANIZATIONAL CHART
• Diagrammatic representation of the organizational structure
Types according to depiction
1. Positional – position is indicated

2. Functional – duties and responsibilities
3. Structural – agency is shown
3 General Types of Organizational Chart:
1. Line Organization
• Is the simplest and most direct type of organization in which position has general authority over the lower
position in the hierarchy
ADVANTAGES DISADVANTAGES
1. Maintain simplicity. 1. Neglects special planning
2. Makes clear division of authority. 2. Overworks key people
3. Encourage speedy action 3. Depends upon retention of a few key

people
Table 2. 1 Advantages and Disadvantages of Line Organization
2. Functional Organization
• Is one where each unit is responsible for a given part of the organization’s workload. There is a clear delineation
of roles and responsibilities which are actually interrelated
DIRECTOR
TRAINING OFFICER
CHIEF NURSE
SN SN SN

1. Relieves line executive of routine specialized decision 1. Makes relationship more complex
2. Provides frameworks for applying expert knowledge 2. Makes limits of authority of each specialist a difficult
coordination
3. Relieves press of need for large number of well-rounded
personnel 3. 6. Teach toward centralization of organization.
Table 2.2 Advantages and Disadvantages of Line Organization
3. Staff Organization
• Is purely advisory to the line structure w/ no authority to put recommendations into action.
1. Enables specialist to give expert advise 4. Continues in organization even if its function are not
clear
2. Frees the line executive of detailed analysis
5. Reduces expert power to place recommendation into
3. Affords young specialist a mass training action
6. Tends towards centralization of the organization
Table 2.3 Advantages and Disadvantages of Line Organization
(a) FORMS OF ORGANIZATIONAL CHART
1. Vertical or Tall Chart
- Depicts the Chief Executive at the top with line of authority flowing down the hierarchy.
2. Horizontal or Flat Chart
- Depicts the manager at the top w/ a wide span of control.
3. Concentric or Circular Chart
- Shows outward flows of communication from center.
SN
CN
SN SN

3. STAFFING
• Is the process of determining and providing the acceptable number and mix of nursing personnel to produce a
desired level of care to meet the patient’s demand.
• The Hospital Nursing Service Administration Manual of the Department of Health has recommended the
following nursing care hours (NCH) for patients in the various nursing units of the hospital.
CASES NCH/Pt/day Prof. to Nonprof ratio

1. General Medicine 3.5 60:40
2. Medical 3.4 60:40
3. Surgical 3.4 60:40
4. Obstetrics 3.0 60:40
5. Pediatrics 4.6 70:30
6. Pathologic Nursery 2.8 55:45
7. ER/ICU/RR 6.0 70:30
8. CCU 6.0 80:20
Table 2.4 Nursing Care Hours / patient / day according to classification of patients by units.
A. PATIENT CLASSIFICATION SYSTEM
…quantify the quality of nursing care by matching patients’ needs to numbers and kinds of nursing personnel
using time as the unit of measure.
A nurse manager must determine the following:
• Number of categories in which the pt should be divided

• Characteristics of pts per category
• Type & number of care procedures that will be needed by a pt per category
• Time needed to perform these procedures that will be required
(a) PURPOSES:
1. For staffing
2. Program costing and formulating budget
3. Track changes in patient care methods
4. Determine values for productivity equation
5. Determine quality

Levels of care NCH/pt/ day Ration prof to non-prof
L1 self care or minimal care 1.5 55:45
L2 moderate or intermediate 3.0 60:40
L3 total or intensive care 4.5 65:35
L4 highly specialized or critical care 6.0 70:30
7 or higher 80:20
Table 2.5 Levels Of Care Of Patients, NCH/Pt/Day & Ratio Or Prof & Non-Prof
*Period of NCH at each levels of care depends on the setting in which the care is being given.
Type of hospital Minimal care Moderate care Intensive care Highly Spl. care
Primary 70 25 5 -
Secondary 65 30 5 -
Tertiary 30 45 15 10
Special T. 10 25 45 20
Table 2.6 Percentage of Nursing Care Hours
(b) COMPUTING FOR THE NUMBER OF NURSING PERSONNEL
When computing for the nursing personnel, one should ensure that there is sufficient staff to cover:
1. All shifts
2. Off-duties
3. Holidays
4. Leaves
5. Absences
6. Time for Staff Development

*ACCORDING TO R.A. 5901 OTHERWISE KNOWN AS “THE FORTY-HOUR WEEK LAW”, EMPLOYEES WILL WORK FOR
40HRS/WK:
1. FOR HOSPITALS WITH 100-BED CAPACITY OR MORE

2. COMMUNITY POPULATION OF AT LEAST 1 MILLION
*HOWEVER, A NURSE WILL RENDER 48HRS/WK WITH ONLY 1 OF-DUTY A WEEK IF:
1. HOSPITALS WITH LESS THAN 100-BED CAPACITY

2. COMMUNITIES WITH LESS THAN 1 MILLION POPULATION
*THERE ARE BENEFITS ENJOYED BY THE PERSONNEL REGARDLESS OF THE WORKING HOURS. AS PER CIVIL SERVICE
COMMISSION MEMORANDUM CIRCULAR NO. 6, SERIES OF 1996, GOVERNMENT EMPLOYEES ARE GRANTED 3 DAYS
WHICH MAY BE SPENT FOR:
1. Birthdays
2. Weddings
3. Anniversaries
4. Funerals (mourning)
5. Relocation
6. Enrolment/graduation leave
7. Hospitalization
8. Accident leaves
Rights & privileges given each personnel/year Working hr/wk Working hr/wk
48 hrs 40 hrs
1. Vacation leave 15 15
2. Sick leave 15 15
3. Legal holidays 10 10
4. Special holidays 2 2
5. Special privileges 3 3
6. Off duties/ R.A. 5901 104 52
7. Continuing Education Prog. 3 3
Total Non-working days/year 152 100
Total Working days/ year 213 265
Total Working hours/ year 1,704 2,120
Table 2.7 Total number of working hours and non-working days and hours of nursing personnel per year.

(c) CLASSIFICATION CATEGORIES
• Level I- SELF CARE or MINIMAL CARE

▪ patients can take a bath on his own, feed himself and perform his ADL.
▪ patients about to discharge, those non-emergency, newly admitted do not exhibit unusual symptoms,
and requires little treatment/observation or instruction.
▪ NCH/ 55:45 ration prof and non prof
• Level II- MODERATE CARE or INTERMEDIATE CARE

▪ patients under this level need some assistance.
▪ extreme symptoms of their illness must have subside or have not yet appeared.
▪ slight emotional needs, w/ V/S ordered up to 3x/shift, intravenous fluid or blood transfusion, are
semiconscious and exhibiting some psychological or social problems; periodic treatment, observation &
instructions.
▪ 3 NCH / 60:40 ration prof & non-prof
• Level III- COMPLETE or INTENSIVE CARE

▪ patients in this category are completely dependent upon the nursing personnel.
▪ they are with marked emotional needs, w/ V/S more than 3x/ shift, may be on continuous O2 therapy,
w/ chest or abdominal tubes.
▪ require close observation at least 30 mins for impending hemorrhage, w/ or w/o hypo or hypertension
& cardiac arrhythmia.
▪ 6 NCH / 65:35 Ration prof & non-prof
• Level IV- HIGHLY or SPECIALIZED CARE

▪ Need maximum nursing care.
▪ patients need continuous treatment & observation; w/ many medication, IV piggy banks; V/S q 15-
30 mins; hourly output.
▪ 6-9 NCH / 70:30 to 80:20

To compute for relievers needed, the following should be considered:
1. Ave. number of leaves taken each year 15

Vacation Leave 10
Sick Leave 5
2. Holidays 12
3. Special Privileges 3
4. Continuing Education Program for Professionals 3
Total Average Leaves 33
To determine the relievers needed:

33 (ave # of days an employee is absent)
213 or 265
(# of working days/year that each employee serves)
= 0.15 (15%) for persons who work 40hrs/wk
= 0.12 (12%) for persons who work 48hrs/wk
To distribute the staff by shifts:
Morning shift = 45 – 51% (0.45 – 0.51)
Afternoon shift= 34 – 47% (0.34 – 0.47)
Night shift = 15 – 18% (0.15 – 0.18)
**NOTE: In the Philippines, the distribution usually followed is 45% (0.45) for the morning shift, 37% (0.37) for the
afternoon shift and 18% (0.18) for the night shift.
STAFFING FORMULA
1. Categorize the patients according to levels of care. Multiply the total # of patients by the % of patients at each
level of care.
Ex. Find the # of nursing personnel needed for 250 bed capacity in a tertiary hospital
250 (pts) x .30 = 75 pts need L1
250 (pts) x .45 = 112.5 pts need L2
250 (pts) x .15 = 37.5 pts need L3
250 (pts) x .10 = 25 pts need L4
2. Find the # of nursing care hrs (NCH) needed by patients at each level of care/ day.
75 pts x 1.5 (NCH at L1) =112.5 NCH/day
112.5 pts x 3 (NCH at L2) =337.5 NCH/day
37.5 pts x 4.5 (NCH at L3)=168.75 NCH/day

25 pts x 6 (NCH at L3) =150 NCH/day
Total = 768.75 NCH/day
3. Find the total NCH needed by given number of patients or bed capacity/year.
768.75 x 365 (days) = 280,593.75 NCH/year
4. Find the actual number of working hours rendered by each nursing personnel/year.
8 (hrs/day) x 213 (working days/year) = 1,704 (working hrs/year)
5. Find the total # of nursing personnel needed. (immediate, reliever, total personnel)
Total NCH/year = 280,593.75 = 165
working hrs/yr 1,704
Relief x total immediate nursing personnel
165 x 0.15 = 25
Total Nursing Personnel needed
165 + 25 = 190
Categorize the nursing personnel into professional and non-professional.
190 x .65 = 124 professional nurses
190 x .35 = 66 nursing attendants
190 nursing personnel
Distribute by shift
124 x .45 = 56 nurses on AM shift
124 x .37 = 46 nurses on PM shift
124 x .18 = 22 nurses on Night shift
124 nurses
66 x .45 = 30 nursing attendants on AM shift
66 x .37 = 24 nursing attendants on PM shift
66 x .18 = 12 nursing attendants on Night shift
66 nursing attendants

B. SCHEDULING
SCHEDULE
• It is a timetable showing planned work days and shift for nursing personnel.
• Is to assign working days and days off to the nursing personnel so that adequate patient care is assured.
(a) ASSESSING A SCHEDULING SYSTEM
1. Ability to cover the needs of the unit.
2. Quality to enhance the nursing personnel’s knowledge, training and experience.
3. Fairness to the staff
4. Stability
5. Flexibility
• Cyclic staffing- sets a basic time pattern that is repeated in cycles.
• Modified workweeks- include systems of scheduling personnel such as 10-hour and 12-hour shifts, weekend
alternative, team rotation, and flexible hours.
• Self-scheduling- is a method of scheduling in which the nurse manager determines the needs per day and shift
and the nursing staff schedule themselves to meet these needs.
PRODUCTIVITY
• is a system of measuring worker output and is commonly defined as outputs divided by inputs.
• Temporary workers- are contract workers hired from a staffing agency for a period of time that may be for
one to several days or weeks. They are not employees of the health care agency where they work.
• Manager behavior- oversees staffing activities through human resource management that includes use of a
patient classification system and provision of qualified nursing personnel in adequate numbers to meet
patient care needs.
• Leader behavior - uses input from employees to develop and implement a staffing philosophy and staffing
policies that inspire personnel to work to their maximum level of productivity.
• Basic to planning for staffing of a division of nursing is the fact that qualified nursing personnel must be provided
in sufficient numbers to ensure adequate, safe nursing care for all patients 24 hours a day, 7 days a week, 52
weeks a year. Each staffing plan must be tailored to the needs of the agency and cannot
be determined with a simple worker-patient ratio or formula.

(b) COMPONENTS OF PATIENT CLASSIFICATION SYSTEM
Classification categories
- Factor
- Prototype
Modified approaches to nurse staffing and scheduling
1. 10-hour shift
2. 12-hour shift
3. Weekend alternative
4. Flex time
5. Others
Productivity- is commonly defined as output / input
Percent productivity - required staff hours / provided staff hours x 100
Staffing activities- include recruitment, hiring, assignment, scheduling, calculating turnover, preparing payroll,
developing and administering policies, and related activities.
C. HUMAN RESOURCE DEPARTMENT
• involves tasks like interviewing, hiring, coaching, retention of state and performance evaluation/appraisal
Personnel- are persons employed in an agency or department
Recruitment- the process of enlisting personnel for employment; the process of hiring
Selection- the process of choosing or selecting candidates according to their qualifications to the job; the process of
elimination
Retention- capacity to retain employees once they are hired
(a) MODES OF RECRUITMENT
Employee recommendation Posters
Word of mouth Career Days
Advertisement Job Fairs
Flyers Placement
Newsletter
Bulletin
(b) SCREENING POTENTIAL STAFF
Philosophies in the screening process:
• The manager should screen out applicants who do not fit the agency’s image.
• The manager should try to fit the job to a promising applicant.
• Usually the manager should try to fit the applicant to the job.
Application Forms and Resumes
• Determine whether the applicant meets minimal hiring requirements.
• Furnish background data useful in planning the selection interview.
• Obtain names of references who may be contacted for additional information about
the applicant’s work experience and general character.
• Collect information for personnel administration (SSN, # of dependents etc.).
D. LETTER OF REFERENCE
(a) INTERVIEW
• Face to face contact between the job seeker and a person with full authority to fill the
position under discussion.
• The purpose of the interview is to obtain information, to give information, and to

determine if the applicant meets the requirements for the position.
• Types of Interview
Directive interview – uses closed-ended question

Non-directive interview – the applicant narrates himself.
Structure interview – the interviewer uses pre-prepared guidelines for interview.
Group interview – several applicants or interviewees are interviewed together.
Board interview – conducted by selected member of the personnel to an applicant.
• Test Used in Selection of Applicant
Aptitude Test – measures capacity on potential ability to learn

Psychomotor – measures strength and coordination
Job knowledge
Proficiency – measures how well the applicants can do a simple work
Psychological test – measures personality characteristics

4. DIRECTING
• Issuance of assignments, orders and instructions that permits the worker what is expected of
the to achieve organizational goals and objectives
A. DELEGATING
• is getting the work done through employees.
• Is the process by which a manager assigns specific task/duties to workers with commensurate
authority to perform the task.
- The worker in return assumes responsibility & is held accountable for its result.
(a) 2 Important Criteria in Delegation
1. Ability of the worker to carry out the task.
2. Fairness not only to the employee but to the team as a whole.
(b) Principles of Delegation
• Select the right person
• Delegate both interesting & uninteresting task
• Provide staff with enough time to learn
• Delegate gradually
• Delegate in advance
• Consult before delegating
• Avoid gaps & overlaps

B. NURSING CARE ASSIGNMENTS/ MODALITIES OF NURSING CARE OR SYSTEM/PATTERN OF NURSING CARE
1. PRIMARY
• Extension of principle of decentralization
• Nursing process driven
• Primary nurses and associate nurses
• 24-hour coverage
• Greater patient and staff satisfaction
1) patient & family are able to develop 1) high cost because there is a higher RN skill;
trusting relationship with RN 2) proximity of patient assignment;
2) there is defined accountability & 3) overlapping of staff functions;
responsibility;
4) nurse patient ratio must be realistic.
3) there is holistic/continuity of care.
Table 2.7 Advantage and Disadvantages of Primary Nursing
2. CASE METHOD
• 1:1 nurse/patient ratio
• Examples include private duty, ICU, Community Health Nurse
• Similar to Primary, however, no Associate RN
• The nurse is responsible for the total care of the patient for the shift she’s working
1) consistency of one individual caring for 1) the nurse may not have the same patient the
the patient for the whole shift; next day;
2) more opportunity to observe & 2) it does not serve the purpose of
monitor the patient. decentralization.

3. FUNCTIONAL NURSING
• divides the work to be done & every member is responsible for his actions
• best system that can be used if there are many patient & professional nurses are fe
1) work is done fast; 1) fragmentation of nursing care therefore
2) workers learn to work fast; holistic care is not achieved;
3) they gain skill faster in that particular 2) patient cannot identify who their “real
task. nurse” is;
3) nurse-patient relationship is not fully
developed;
4) evaluation of nursing care is poor &
outcomes are rarely documented, and
5) it is hard to find a specific person to answer
the relative’s questions.
4. JOINT PRACTICE (TEAM NURSING / MODULAR NURSING )
• More than modality
• Involves nurses and physicians collaborating as colleagues
• Agreed upon protocols to manage care in primary settings
• Modular nursing is a kind of team nursing that divides the area into modules of patient, with
each module cared by a team of nurses.
1) work is shared with others 1) patient receives fragmented,
depersonalized care;
2) communication is complex;
3) accountability & responsibility is shared
which can cause confusion;
4) these factors affects RN’s dissatisfaction.

5. CASE MANAGEMENT
• Clinical system with accountability for individual or group through continuum of care
• Negotiating
• Procuring
• Coordination of services and resources
C. RESPONSIBILITIES IN DIRECTING
1. Promotive “improve systems”
2. Preventive “anticipate problems & difficulties”
3. Corrective “institute measures to correct problems”
4. Regulatory “preserve existing assignments”
D. CHANGE PROCESS
Change – purposeful, designed effort to bring about improvements in a system, with the assistance
of change agent
(a) THEORIES OF CHANGE
• REDDINS THEORY – suggested seven techniques by which change can be accomplished
1. Diagnosis
2. Mutual setting of objectives
3. Group emphasis
4. Maximum information
5. Discussion of implementation
6. Use of economy and ritual
7. Resistance interpretation

• LEWIN’S THEORY
▪ Unfreezing stage – the nurse is motivated by the need to create change
▪ Moving stage – the nurse will gather information
▪ Refreezing stage – changes are integrated and stabilized as part of the value system
• ROGERS’ THEORY
1. awareness
2. interest
3. evaluation
4. trial
5. adoption
E. MOTIVATION
• Forces that make or propels one to act in a certain way.
• Individual’ desire and responses to events which prompts extraordinary effort to attain goal and
enthusiasm
(a) LEVELS OF MOTIVATION
EXTRINSIC MOTIVATION – anticipated rewards or avoidance of negative consequences in the

performance of action
INTRINSIC – satisfaction derived from the action itself
TRANSCENDENTAL – recognition of the usefulness of action to some other person
• CONTENT THEORY – motivation factors or needs within a person
1. Maslow’s Needs Theory
2. Alderfer’s theory – (Existence, Relatedness, Growth) ERG
3. Herzberg’s Theory – two factor theory

a. Disatisfiers or hygienic – (extrinsic) salary, job security, working condition, relationships
b. Satisfiers or non hygienic – (intrinsic) achievement, recognition, reward,

advancement, work itself
4. McClelland theory – affiliation, achievement and power
5. Monistic/scientific theory – salary as the best motivating factor
• PROCESS THEORY
1. Arousal theory – focuses on internal process that mediate the effect of work performance
2. Expectancy theory – focuses on people’s expectation that their efforts will result in good
performance and valued results
3. Equity theory – focuses on fair treatment
F. DECISION MAKING
• A systematic, sequential process of choosing among alternatives & putting those choices into action
STEPS
1. Identify problem
2. Prioritize problem
3. Gather and analyze situation related to problem
4. Evaluating all alternatives
5. Select an alternative for implementation
5. CONTROLLING
• The process by which managers attempt to measure if actual activities conform to planned
activities
• A process wherein the performance is measured and corrective action is taken to ensure the
accomplishment of organization goal

(a) STEPS IN CONTROL PROCESS
Establish standards and criteria
Measure performance
Compare results with standards
Match with standards?
If YES – do nothing or improve
If NO - take corrective action
(b) PERFORMANCE APPRAISAL/EVALUATION SYSTEM
• Process of evaluating employee’s performance against standards
• To determine job competence
• Enhance staff development and motivate employee
• discover employee’s aspirations and recognize accomplishments
• Improve communication
• Aid managers in counseling and coaching
• Determine training and dev. needs of staff
• Inventories of talent
• Legal purposes

(c) METHODS OF EVALUATION
Anecdotal records/ critical incidents– objective Critical incident – describe effective and effective
description of behavior behavior of employee
Ranking or rank order Self appraisal/self rating
Peer review Paired comparison method
Forced - choice distribution method Subordinates/ Team evaluation – multiple raters
Behavior – anchored – list specific description of good, Narrative Essay Evaluation – describe strength and
average and good performance weaknesses of employee
Table 2.11 Methods of Evaluation
(d) PROBLEM AREAS OF EVALUATION
• Subordinates have not been motivated to want to change
• People are unable to make change
• Subordinates become resentful and anxious when merit system is applied
(e) COMMON ERRORS OF EVALUATION
• Halo error – allowing one trait to influence the evaluation of others or rating of all traits on
the basis of first impression
• Horn error – the evaluator is hypercritical
• Contrast error – managers rate the nurse opposite the way they perceive themselves
• Leniency of error
• Central tendency error
• Racial bias
• System design and operating problems – focuses on the method (system) and process

(operating) of evaluation
• Overgeneralization
• Recency of Events error
(f) TOTAL QUALITY MANAGEMENT
• Systematic process to improve outcomes based on customers’ needs
• Doing the right thing
• Meeting the needs of the customer
• Building quality performance into the work process
• Employ scientific approach to assessment and problem solving
(g) QUALITY ASSURANCE PROGRAM
• Process of establishing a standards of excellence of intervention and taking steps to ensure

that each patient receives the expected level of care
• Fulfillment of social contract between society and professions
QUALITY NURSING CARE
• Presence of all elements/characteristics specified in the standards.
(h) FRAMEWORK OF QUALITY ASSURANCE
1. Structure – instrumentalities in the delivery of care (personnel, supplies etc)
2. Process – how the service was delivered
3. Outcome – results expected of the service
(i) NURSING AUDIT
• Official examination of: nursing records, physical facilities, personnel involved in patient care
• Tool to analyze and evaluate nurses’ bedside records and physical facilities
• Serves as a means of improving nursing care by revealing existing deficiencies

nursing research

NURSING RESEARCH
I. DEFINITIONS:
A. NURSING RESEARCH
• A systematic search for and validation of knowledge about issues of importance to the
nursing profession (Polit & Hungler)
• Research concerned with knowledge that directly or indirectly influences clinical nursing
practice
• Systematic, objective process of analyzing phenomena of importance to nursing.
RESEARCH ETHICS
(a) Ethical Codes and Guidelines in Research
a. Nuremberg Code – stemmed from the Nuremberg Trials on war atrocities after WWII. It
includes the following:
i. Researcher must inform the subjects about the study
ii. Research must be for the good of society
iii. Research must be based on animal experiments, if possible
iv. Researcher must try to avoid injury to research subjects
v. Researcher must be qualified to conduct the research
vi. Subjects or the researcher can stop the study if problems occur
*ANA Research and Studies Commission (1968).
*Later revised in ’75 and ’85 as Human Rights Guidelines for
Subjects must be:
• protected from harm,
• privacy should be ensured,
• dignity preserved.

* Nurses who are asked to participate in research should be fully informed about the research.
(b) Elements of Informed Consent in Research Studies
a. Researcher is identified and credentials presented. Nurse researchers must inform clients
that they are acting in their capacity as researchers and not as nurses.
b. Subject selection process is described.
c. Purpose of the study is described
d. Study Procedures are discussed.
e. Potential risks are described
f. Potential benefits are described
g. Compensation, if any, is discussed
h. Alternative procedures, if any, are disclose
i. Anonymity or confidentiality is assured
j. Right to refuse to participate or withdraw from study without penalty is assured.
k. Offer to answer all questions is made
l. Means of obtaining study results is presented.
(c) Nurse Researcher as a Patient Advocate
a. Protect the privacy and dignity of the people involved in research and to protect them from
harm.
b. The nurse researcher must assume responsibility for study conditions and avoid undue
physical or psychological risks to the subjects.
(d)Types of Nursing Research According to Purpose
Basic Research – to generate new knowledge, to test or generate new theories
Applied Research – to use knowledge/research findings to solve immediate problems
Important Goals:
1. Production of evidence-based practice
*Research is the most reliable means of obtaining knowledge

2. Credibility of the nursing profession
*Profession requires the existence of a body of knowledge that is distinct from that of other
disciplines.
3. Accountability for nursing practice
*Increasing accountability for actions among nurse
4. Documentation of cost-effectiveness of care
The most important goal is to improve quality of client care
The Specific Aims of Research is to: (D.E.E.P)
Describe a phenomenon which relates to nursing profession
E xplore a phenomenon by observing and recording events. (answers “What?”)
Explain and clarifies a prevailing situation (answers “Why?”)
Predict and control possible psychological and physiological reactions to nursing interventions
(e) Characteristics of Research (G.E.C.O)
Generalized statements after due analysis of an adequate number of cases.
Empericism that is consist of concepts, processes and phenomena which are learned through
the use of human senses.
C ontrol of constraints or limitations to ensure validity of results.
Orderly and systematic investigation.
(f) Classification of Nursing Research According to Design:
1. Quantitative – objective, has tight controls, can generalize findings
2. Qualitative – studies the subjective meaning of an experience to a person

QUANTITATIVE QUALITATIVE
• hard, replicable, reliable • rich, real, deep, valid
• manipulation and control of phenomena • in-depth description of people or events-

verification of results using empirical data data gathered thru unstructured
interviews and participant observation
• testing of hypothesis concerned with patterns and themes
• Deductive • Inductive
• Limited by existing theories • Must be open to new theories
• Does not have clear-cut guidelines, and are
actually harder to do for novice researchers
Table 1.1 Comparing Quantitative and Qualitative Research
(g) Roles of Nurses in Research
• Principal investigator – demands preparation beyond BSN l
• Member of research team – data collector, administers experiments
• Identifier of researchable problems
• Evaluator of research findings – determines the usefulness of findings
• User of research findings
• Patient/Client Advocate
• Subject of Studies

B. QUALITATIVE RESEARCH Focuses on
gaining insights
• Phenomenological Studies and
understanding of
▪ “Lived experiences”. events
▪ Examines human experiences through descriptions provided by the people involved.
▪ Bracketing – the researcher releases expectations and biases prior to doing the research
▪ End purpose: to determine themes and patterns of behavior, etc.
• Ethnographic Studies
▪ Collection and analysis of data about cultural groups
▪ End purpose – to develop cultural theories
▪ Method – participant observation and interviews with “key informants
• Case Study
▪ In-depth examination of people or institutions
• Grounded Theory Studies
▪ Data are collected and analyzed and then a theory is developed that is grounded on the
data.
▪ Method : purposeful sampling, done in field/naturalistic setting
▪ Concerned with theory generation rather than testing of hypothesis. Uses purposeful
sampling
• Historical studies
▪ Identification, location, evaluation, &synthesis of data from the past
▪ End purpose: to relate the past to the present and the future
(a) SOURCES OF DATA FOR HISTORICAL RESEARCH:
1. Documents – oral history, written research, diaries, eyewitness accounts, pictorial sources
2. Relics and artifacts – items of physical evidence

(b) CLASSIFICATION OF SOURCES CAN BE:
• Primary – an account of the event from the person himself
• Secondary – summarized or retold by another
(c) EVALUATION OF DATA SOURCE:
• External Criticism – authenticity or genuineness of the source
• Internal Criticism – accuracy of the data in the source
(d) EVALUATION OF QUALITATIVE RESEARCH
• Focuses more on whether the data was able to provide the answer to the research question.
• Are the researcher’s conceptualizations clearly based on the data?
C. QUANTITATIVE RESEARCH
Step 1: Identify the Problem
A. Broad topic, narrowed down
B. May be the most difficult and will take the most amount of time
C. Sources of study problems
• Personal experiences
• Literature sources
• Previous research
• Testing of theories
(a) CHARACTERISTICS OF A GOOD PROBLEM STATEMENT
1. Stated as a question
2. Specifies the population and the variables
a. One-variable studies (aka Univariate)
Example: What is the primary motivation of student nurses in passing the NLE?

b. Two-variable studies (Bivariate)
• Most frequently used in nursing research
• Can be cause and effect in experimental studies.
c. Multiple-variable studies (Multivariate)
Example.: Why do nursing students fail on the NLE?
3. Empirically testable
• Variables can be measured by the researcher.
• Hearing, sight, taste, smell, touch
• Problem Statement Format:
B. CORRELATIONAL STATEMENT :
• Is there a correlation between X and Y in the population?
Example: Is there a relationship between anxiety levels (X) and test performance (Y) among
graduating nursing students (Population).
C. COMPARATIVE STATEMENT
(a) Descriptive Study
• Is there a difference in Y between people in the population with X characteristics and those who
do not have X characteristics.
Example: Is there a difference in nationwide test performance (Y) between high school students
(population) who study in private schools (X characteristic) and those who do not study in private
schools?
(b) Experimental Study
• Is there a difference in Y between group A who received X treatment and group B who did not
receive X treatment.
Example: Is there a difference in the average weight (Y) between Group A who received a
specialized diet regiment (X treatment) and Group B who did not receive the specialized diet
regimen?

D. RESEARCH PROBLEM CONSIDERATIONS
1. Ethical issues
2. Significance to nursing
3. Personal motivation
4. Researcher qualifications
5. Feasibility of the study:
• Time, Cost, Equipment and Supplies,
• Administrative support, Peer support, Availability of Subjects
Step 2: Determine the purpose of the study
a. Defines why the study is being made (often mistakenly interchanged with problem statement)
*Problem statement tells you WHAT will be studied. Purpose will tell you WHY the study is
being done.
b. Must state the significance and use of the study results in order to get approval
Step 3: Review of Related Literature
(a) Purpose:
• To determine what knowledge already exists on the topic to be studied
• To develop a conceptual and theoretical framework for the study
• To help the researcher plan the study methods (eg. Instruments or tools)
Literature Sources can be classified as:
Primary Source – Written by the original researcher. Seen in Nursing Journals
Secondary source – summary of the research as written by someone other than the researcher.
*Review of related literature must be done on a continuous basis so as to ensure that researcher’s info
are up to date.

Step 4: Develop a Theoretical or Conceptual Framework
• To assist in the selection of the study variables and in defining them
• “Research without theory provides a set of isolated facts.”
E. DEFINITION OF TERMS:
1. Theory – set of related statements that describes or explains phenomena in a systematic way (eg.
Newton’s Theories of Motion, Orem’s Self-Care Deficit Theory, Lewin’s Change Theory)
• Composed of concepts and the relationship between these concepts.
2. Concept – a word picture or mental idea of a phenomenon. May be concrete or abstract. The
building blocks of a theory.
3. Construct – highly abstract, complex phenomenon. Cannot be directly observed but must be
inferred by certain concrete or less abstract indicators (Eg. Wellness, mental health, self-esteem)
4. Proposition – statement or assertion of the relationship between concepts. May be derived from
theories or empirical data.
• Eg: Bacteria causes disease.
• There is a relationship between anger and increase in BP”.
5. Empirical Generalization –generalization based on similar pattern of events found in the

empirical data of a number of different studies.
6. Hypothesis – researcher’s expectations about the study. Predicts the relationship between two
variables. A means for the researcher to test the theory.
7. Model – symbolic representation of some phenomenon or phenomena. (Eg. Flowchart or

diagram)
8. Conceptual model / Paradigm– made up of concepts and propositions that state the relationship
between the concepts
THEORY GENERATION AND DEVELOPMENT
• Deductive reasoning – proceeds from general to specific. Theory -> Propositional Statement ->
Hypothesis -> Empirical Data

• Inductive reasoning – proceeds from specific to general. Empirical data -> Empirical
Generalization -> Propositional Statement -> Theory
THEORETICAL FRAMEWORK CONCEPTUAL FRAMEWORK
• broad, general explanation of the • explains relationships between

relationships between concepts of concepts but links concepts selected
interest in a research study. Based on from several theories, from previous
one existing theory research results, and from the
researcher’s own experience.
Table 1.2 Theoretical Vs. Conceptual Framework
Step 5: Identify the Study Assumptions
Assumptions – beliefs that are held to be true but have not necessarily been proven.
Three types of assumptions:
1. Universal assumptions
2. Assumptions based on theory or research findings
3. Assumptions necessary to carry out the study
Step 6: Acknowledge the Limitations of the Study
A. Limitations – uncontrolled variables that may affect the study results and limit the generalizability of
the findings.
• Perceived weaknesses of the study findings.
Extraneous/Confounding/Uncontrolled Variables – variables over which the researcher either

has no control or chooses not to control.
*In experimental studies, extraneous variables are referred to as threats to internal and external validity
B. Delimitations – limitations placed on the research by the researcher himself.
C. Scope – the extent to which the study will be made.

Step 7: Formulate the Hypothesis
Hypothesis – predicts the relationship between two or more variables. Problem statements asks the question
hypothesis gives a predicted answer.
(a) Characteristics of a hypothesis
i. Declarative form
ii. Written in Present Tense
iii. Reflects the problem statement
iv. Contains the population and the variables
v. Must be testable or empirically verifiable
(b) Two main types of variables:
• Independent – the cause
• Dependent – the effect
(c) Classifications of Hypotheses
• Simple vs. Complex
Simple – relationship between one independent and one dependent variable
Complex – relationship between two or more independent or dependent variables.
• Null vs. Research
1. Null – no relationship exists between two variables
2. Research – there is a relationship; states the expected relationship
• Nondirectional vs. Directional
1. Nondirectional – mere prediction that a relationship exists
2. Directional – researcher further predicts the type of relationship; direct or inverse
• There is a difference in the level of anxiety between pre-surgical patients who

receive pre-operative instructions and those who did not receive pre-operative
instructions.
• There is a more significant decrease in blood sugar levels among diabetic patients
who combine diet and exercise compared to patients who used diet alone.

• There is no significant difference in average test scores between students who had 8
hours of sleep the day before the exam and those who had less than 8 hours of
sleep before the exam.
Which types of research requires a hypothesis?
• Experimental, correlational, comparative studies, require hypothesis.
• Descriptive studies, exploratory studies
– do not necessarily require a hypothesis.
Step 8: Define Study Variables and Terms
Importance – to make terminologies and variables clearer to the researcher and the reader.
• To allow for replication of the study.
Types of Research Definitions:
1. Operational definition – indicates how a variable will be observed or measured.
2. Dictionary definition/Theoretical definition – obtained from literature sources
Step 9: Select the Research Design
Research design – the PLAN for how the study will be conducted
Research design according to amount of knowledge about the variables:
1. Exploratory – conducted when little is known about the topic of interest
2. Descriptive – phenomena is described or the relationship between variables is examined
3. Explanatory – searches for causal relationships
EXPERIMENTAL VS. NON-EXPERIMENTAL STUDIES
Experimental – concerned with cause and effect relationships.
• Highly respected in the scientific world.
• Must have: manipulation or control of independent variable random selection of

subjects presence of control group
*More control can be exercised over extraneous variables. In nursing experimental research, a nursing
intervention is usually introduced.

(d) Threats to Validity of Experimental Design.
A. Internal validity – degree to which changes in the dependent variable can be directly
attributed to the independent variable.
• Threats to internal validity:
▪ Selection bias – results are due to subject differences before the independent variable
was manipulated.
▪ History - some event other than the experimental treatment occurs during the study
that influenced the dependent variable
▪ Maturation - changes that occur within the subjects during an experimental study
influences the study results.
▪ Testing - influence of the pretest or knowledge of the baseline data on the posttest
scores. (Eg. Weight)
▪ Instrumentation change - difference between the pretest and post test measurement
caused by a change in the accuracy of the instrument or the judge’s ratings. (avoided by
trial runs, or training sessions for judges prior to rating)
▪ Mortality – subject dropout rate is different between the experimental and the
comparison group
B. External validity – degree to which the study results can be generalized to other people and
other settings.
• Threats to external validity include:
▪ Hawthorne effect – study participants respond in a certain manner because they are
aware that they are being observed.
▪ Experimenter effect – researcher characteristics or behavior influence subject behavior.
(in non-experimental research, this is called the Rosenthal effect)
▪ iReactive effects of the pre-test (measurement effect) - subjects have already been
sensitized by the pre-test and may affect post-test results.
TYPES OF EXPERIMENTAL DESIGNS
A. True Experimental – researcher has great deal of control over the research situation.
1. Pretest-Posttest Control Group Design

R O1 X O2 (experimental group)
R O1 O2 (control group)
2. Posttest only Control Group Design
R X O1 (Experimental Group)
R O1 (Control Group)
B. Quasiexperimental - missing one criteria for true experimental design.
1. Non-equivalent control group design – similar to pretest posttest control group design
but there is no random assignment of subjects. Biggest threat – selection bias
2. Time-series designs – researcher periodically observes and measures the subjects.

Experimental treatment is administered between two of the observations.
Design: O1 O2 O3 X O4 O5 O6
C. Pre-experimental design – weak design, researcher has little control over the research
1. One-shot case study – single group is exposed to an experimental treatment and observed
afterwards.
Design: X O
2. One-group pretest-posttest design – provides a comparison between a group of subjects

before and after the treatment.
Design: O1 X O2
TYPES OF NON-EXPERIMENTAL RESEARCH DESIGN
A. Correlational Studies – researches extent to which one variable (X) is related to another variable.
Correlation coefficient – magnitude and direction of the relationship between 2 variables (may
or may not be independent vs. dependent).
*Can be –1.00 (Inverse) to +1.0 (Direct)
B. Survey studies – self report data are collected from samples with the purpose of describing
populations on some variable/s of interest
* Probability sampling and adequate sample size are very important
C. Comparative Studies

– Examines the differences between intact groups on some dependent variable of interest.
- Almost similar to experimental but has no manipulation of variables.
*Retrospective studies – dependent variable identified in the present, and the

independent variable that occurred in the past is determined
*Prospective studies – independent variable is identified at the present time, and the
subjects are followed in the future to observe the dependent variable
*Ex post facto studies – data are collected “after the fact” variations in the independent
variable are studied after the variations have occurred, rather than at the time of the
occurrence.
D. Methodological Studies – concerned with the development, testing, and evaluation of research
instruments and methods.
Eg. Post partum depression screening scale.
Step 10: Identify the population
POPULATION – complete set of individuals or objects that possess some common characteristic that is of
interest to the researcher
▪ Target population (aka Universe) the group of people or objects to which the researcher
wishes to generalize the findings of a study.
▪ Accessible population – that group which is actually available for the study.
*NOTE: The accessible population must possess the characteristics similar to the target population, and vice
versa.
Step 11: Select the sample
SAMPLE – a subgroup chosen to represent the population and used to make generalizations about the
population.
SAMPLING FRAME – a listing of all elements of a population
1. Probability 2. Non-probability
• everyone in the population has a chance of • not all members of the population has a
being selected. chance to be selected
Table 1.3 Two major types of sampling
A. PROBABILITY SAMPLING METHODS

• Simple Random Sampling – ensures that each element of the population has an equal and
independent chance of being chosen.
o Identify the sample population and list all the elements of the population (sampling
frame)
o Table of random numbers
• Stratified Random Sampling – population is divided into subgroups or strata, according to some
variable/s of importance.
• After this, a simple random sample is taken from each of the subgroups.
o Proportional stratified
o Disproportional stratified
• Cluster Random Sampling – large groups or samples become the sampling units.
o Eg. Geographical area, school, etc.
• Systematic Random Sampling – sample is taken from every kth element of the population.
o Eg. 1,000 population and researcher needs 100 samples,
then: (k interval = N/n) = 1,000/100 = 10.
*Every 10th person in the list will be taken as sample
B. NON-PROBABILITY SAMPLING METHODS
– sample elements are chosen from the population by non-random methods. More likely to produce
biased samples.
• Convenience sampling (accidental or incidental) – choosing readily available people or objects

for a study.
• Snowball sampling – study subjects help refer additional subjects
• Quota sampling – similar to stratified random but selection not random. Basis of stratification is
determined by the researcher.
• Purposive/Judgmental sampling – based on a set of criteria

TIME FRAME FOR STUDYING THE SAMPLE
1. Longitudinal study – follows the subject over a period of time (6 months or more). More
accurate study of changes that occur over time.
a. cohort study – persons are studied who have been born during a particular time
period.
2. Cross-sectional study – examines the subjects at one point in time. Less expensive and easier
to conduct.
Step 12:Conduct a pilot study
Pilot study: Miniature, trial version of the planned study. Can prevent a researcher from
conducting a large-scale study that might be an expensive disaster.
Objectives – to examine issues related to the design, sample size, data collection procedures
and data analysis approaches.
- Can be used to test an instrument, evaluate the study procedures, etc.
Step 13: Collect the data
Data – pieces of information or facts that are collected in scientific investigations.
Questions that need to be asked during data collection process:
What; Who; Where; When, How
*The choice of data collection method is determined by the study hypothesis/research questions of the
study.
Criteria for selection of data Data collection methods:

collection instrument
1. Questionnaire
i. Practicality of the 2. Interview
instrument
3. Observation
ii. Reliability of the
4. Physiological measurement
instrument – consistency
and stability 5. Attitude scales
6. Psychological tests
iii. Validity of the instrument
– ability mto gather data 7. Delphi technique
that it is intended to
8. Visual analog scale
gather.
9. Pre-existing data
SRG Integrals 2iv.
nd Ed. Concerns the content of Management and Research
Leadership 675
the instrument.
DATA COLLECTION METHODS
1. Questionnaires – paper and pencil, self-report instrument. Guidelines in wording of questions:
a. Affirmative rather than negative
b. Avoid ambiguous questions
c. Avoid double negative questions
d. Neutral wording
e. Avoid Double-barreled questions
Types of questions:
a. Demographic – data on the characteristics of the subjects. Age, educational background,

religion
b. Open-ended questions – essay, fill-in-the blank
c. Closed-ended questions – respondent is asked to choose from given alternatives.
Must be collectively exhaustive (all possible answers provided) and mutually exclusive
(no overlap between categories)
d. Contingency questions – items that are relevant for some respondents and not for
others. Example: If yes…
e. Filler Questions – items in which the researcher has no direct interest but are included in a
questionnaire to reduce the emphasis on the specific purpose of other questions.
Cover Letter – accompanies the questionnaire disclosing the writer’s purpose, who is sanctioning the
study, deadline of returning the questionnaire, offer to inform respondents of study result.
2. Interviews – interviewer obtains responses from a subject in a face-to-face encounter or through a

telephone call.
a. Unstructured interview – interviewer given a great deal of freedom to direct the course of the
interview.
Conducted more like a normal conversation.
*Probes – additional promptimg questions that encourage the respondent to elaborate on the
topic

b. Structured interviews – asking the same questions in the same order and in the same manner
of all respondents in the study. Even subtle changes in the wording of the interview may not be
permitted.
c. Semi-structured interview – interviewers are generally required to ask a certain number of

specific questions but additional probing questions are allowed or even encouraged.
3. Observation Method – gathering data through visual observation.
Can be: psychomotor skills, habits, nonverbal communication
- Structured vs. Unstructured Observations
a. Structured – carried out when the researcher has prior knowledge about the phenomenon of
interest.
- Uses a checklist.
b. Unstructured – researcher attempts to describe events or behaviors as they occur, with no
preconceived idea of what will be seen.
Event sampling vs. Time Sampling:
a. Event – observation of an entire event.
Eg, bed making techniques of student nurses
b. Time – observation of events or behaviors during specified times.
Eg. Appetite of patients during scheduled meals
Relationship between observer and subjects:
A. Nonparticipant observer-overt – observer openly identifies himself and provides

subjects with info about the types of data that will be collected.
B. Nonparticipant observer-covert – generally not ethical. Observer does not let

participants know of his activity.
Eg: Public behavior (can be ethical)
C. Participant observer-overt – involved with the subjects openly and subjects know that
they are being observed by the same. Eg. Immersion with families while observing their day- to-
day lifestyle
D. Participant observer-covert – “plant”, “Spy”. Observer interacts with the subjects and
observes their behavior without their knowledge. Rarely ethical.
4. Physiological Measures – involve the collection of physical data from the subjects. Generally more

objective and accurate than many of the other data collection methods.
5. Attitude Scales – self-report, data-collection instruments that ask respondents to report their
attitudes or feelings on a continuum
A. Likert Scale – uses five or seven responses for each item ranging from Strongly Agree (5) to
Strongly Disagree (1).
B. Semantic Differential Scales – asks subjects to indicate their position or attitude about some
concept along a continuum between two adjectives.
a. Eg. Flexible _ _ _ _ _ Rigid
6. Psychological Tests
1. Personality Inventories – self-report measures used to assess the differences in personality

traits, needs, or values of people
2.Projective Techniques – subject is presented with an ambiguous stimuli, subject describes

what the stimuli appear to represent. Eg. Rorschach Inkblot Test
7. Delphi Technique – uses several rounds of questions to seek a consensus on a particular topic from a
group of experts. To obtain group consensus without a face-to-face meeting.
8. Visual Analogue Scale
9. Preexisting Data – use of existing information that has not been collected for research purposes.
Eg: patient’s charts.
Step 14: Organize the Data for Analysis
Tabulation and Evaluation
- Plans for organizing the data should be made prior to data collection. Plans for analyzing
the data should also be made prior to data collection.
- Determine if questionnaires have been completed correctly. What to do with missing data.
Audio tapes transcribed.
Level of Measurement of Data
1. Nominal – objects or events are named or categorized (Religion, gender, marital status)
2. Ordinal – data that can be arranged by rank (Anxiety levels)
3. Interval – “real” numbers (Temperature readings, weight)
4. Ratio – data that can be categorized,

- a true or natural zero can be specified
Step 15: Analyze the data
Measures to condense data
– statistics used to summarize and condense data
1.Frequency distribution – simply counting the occurrence of values or scores represented in the data.
If range of score is less than 20, each score can be listed individually, when the range is large you can
group them into “class intervals”.
2. Graphic Presentations – have visual appeal that may cause readers to analyze the data more closely
3. Percentages – represents the proportion of a subgroup to a total group.
*Minimum number for the computation of percentages should be at least 20.
MEASURES OF CENTRAL TENDENCY
– statistics that describe the average, typical, or most common value for a group of data.
1. Mode – category or value that occurs most often in a set of data under consideration.
2. Median – middle score or value in a group of data.
3. Mean – the average sum of a set of values found by adding all values and dividing by the total
number of values.
X = Total of all values/Number of values
MEASURES OF VARIABILITY
– measures how spread out values are in a distribution of values.
1. Range – distance between the highest and lowest value in a group of values or scores.
2. Percentile – a datum point below which lies a certain percentage of the values in a frequency
distribution.
3. Standard Deviation – Indicates the average deviation or variation of all values in a set of values from
the mean value of those data.
4. Variance – Standard deviation squared

MEASURES OF RELATIONSHIPS
– measures the correlation between variables
1. Correlation coefficients – pairing the value of each subject on one variable with the value on another
variable
2. Scatter plots (scatter diagram, scattergram) - graphic representation of the relationship between two
variables
(X and Y axis)
Step 16: Interpret the findings
- Made in light of the study hypothesis or research question and the theoretical framework
Step 17: Communicate the findings
- The final step in the research process and yet the most important one for nursing. No matter
how significant the findings may be, they are of little value to the nursing profession if not
communicated to other colleagues.

Leadership Management and Research

Uploaded by

Copyright:

Available Formats

You might also like

Leadership Management and Research

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Leadership Management and Research

Uploaded by

Copyright:

Available Formats

LEADERSHIP AND

SRG Integrals 2nd Ed. Leadership Management and Research 624

Leader - the one who leads, conducts or guides the process

(a) TRAIT THEORY

• leaders have traits that must be enhanced by experience

▪ Intelligence: judgment, knowledge and fluency of speech

▪ Personality: adaptability, alertness, creativity, cooperativeness, personal integrity, self confidence,

▪ Task-Oriented : Behaviors include planning, scheduling, & coordinating activities.

▪ Participative Leadership: enlists associates participation in making decisions

SRG Integrals 2nd Ed. Leadership Management and Research 625

(d) TRANSACTIONAL LEADERSHIP

(e) TRANSFORMATIONAL THEORY

(f) INTEGRATIVE LEADERSHIP MODEL

One should be aware of his own

SRG Integrals 2nd Ed. Leadership Management and Research 626

(h) STRATEGY THEORY

(i) CHARISMATIC THEORY

3. LAISSEZ – FAIRE OR PERMISSIVE

D. POWER & AUTHORITY

Bases of Power For Leaders

Components of Effective Leadership

“Leadership is the essence of professionalism and

• Art of getting things done thru people

Efficiency provided information on:

SRG Integrals 2nd Ed. Leadership Management and Research 629

• Used stopwatch studies & applied the principles of:

(b) FRANK GILBRETH(1868-1924) LILIAN GILBRETH(1878-1972)

• Pioneers in time and motion studies

(c) HENRY GANTT (1861-1919)

• Disciple of Taylor, was concerned w/ problems of efficiency

(d) HENRY FAYOL (1841-1925) “Father of Management Process School”

• Studied the functions of managers and concluded that management is universal

FAYOL’S MANAGEMENT PRINCIPLES

(e) MAX WEBER (1864-1920) “Father of Organizational Theory”

(f) CHESTER BARNARD (1886-1961)

2 . He defined the manager’s responsibilities

• Defining Objectives- Acquiring Resources

(g) MARY PARKER FOLLETT (1868-1933) “Mother of Modern Management”

SRG Integrals 2nd Ed. Leadership Management and Research 631

(h) ELTON MAYO (1810-1949)

• Author of “The Hawthorne Studies”

(i) KURT LEWIN (1890-1974)

• Study of “Group Dynamics”

(j) JACOB MORENO (1892-1979)

• Developed “Sociometry” to analyze group behavior

(a) ABRAHAM MASLOW (1908-1970)

• “Hierarchy of Needs Theory”- Initiated the Human Behavioral School in 1943

(b) FREDERICK HERZBERG(1923-2000)

(c) DOUGLAS MCGREGOR (1906-1964)

(d) WILLIAM OUCHI

▪ Short-term employment—Rapid evaluation & promotion

(e) ROBERT BLAKE (1918) & JANE MOUTON (1930)

• Maintained that there are 2 critical dimensions of leadership

SRG Integrals 2nd Ed. Leadership Management and Research 633

(a) According to Robert Katz:

(a) INTERPERSONAL ROLE

SRG Integrals 2nd Ed. Leadership Management and Research 634

• Strategic planning - based on mission of the institution

• formulate policies, rules and regulations, methods and procedures