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Principles & Practice of Nursing Management & Administration (for BSc & MSc Nursing)
Jogindra Vati
UNIT 1: FRAMEWORK OF NURSING MANAGEMENT AND ADMINISTRATION
CHAPTER 1:
Concept of Nursing
COMPETENCIES
INTRODUCTION
EVOLUTION OF NURSING
Civilian Nursing
Military Nursing
Missionary Nursing
THE CONCEPT OF MODERN NURSING
Care, Core and Coordination Concept
Care
Cure
Coordination
Nursing as an Intellectual Activity
Nursing as a Collection of Tasks
Nursing as a Kind of Interpersonal Interaction
DEFINITIONS OF NURSING
NURSING AS A PROFESSION
What Defines a Profession?
Commitment by the Professionals
Profession as an Occupation
Profession as Non-competing Group with Normative Control
Profession as a Vocational and Occupational Group
Profession as a Disciplined Group of Individuals
Profession with Scientific and Philosophical Bases
Profession and Vocation
Characteristics of Profession
Viewpoint of Southern Illinois University
Viewpoint of Burbules and Densmore
General Characteristics of Profession
Regulation
Autonomy
Status and Prestige
Power
Skill based on Theoretical Knowledge
Professional Association
Extensive Period of Education
Criteria of a Profession
In General
William Shepherd's Criteria
Kelly's Dimensions of Profession
Is Nursing a Profession?
NURSING AS AN ACADEMIC DISCIPLINE
Characteristics of Discipline
Areas that Identify Nursing as a Distinct Discipline
NURSING AS A PRACTICE SCIENCE
NURSING AS A HUMAN SCIENCE
LANDMARKS IN HOSPITAL NURSING SERVICES IN INDIA
CHAPTER 2:
Nursing Management and Administration
COMPETENCIES
MANAGEMENT
Concept of Management
Traditional Concept
Modern Concept
Management is for Effective Utilization of Resources
Importance of Management
NURSING MANAGEMENT
Concept of Nursing Management
Nursing Management Parallels Nursing Process
Nursing Management—A General System Theory Approach
LEVELS OF NURSING MANAGEMENT
Top Level
Middle Level
Operative Level
PRINCIPLES OF MANAGEMENT IN NURSING
Application of Fayol’ 14 Principles in Nursing
FUNCTIONS OF NURSING MANAGEMENT
Planning
Organizing
Staffing
Directing and Leading
Controlling
Coordination
ADMINISTRATION
Meaning of Administration
Nature of Administration
Scope of Administration
Importance of Administration
Types of Administration
Similarities
Differences
NURSING SERVICE ADMINISTRATION
MANAGEMENT vs ADMINISTRATION
NURSING MANAGEMENT vs NURSING ADMINISTRATION
VISION AND MISSION STATEMENT
VISION AND VALUE STATEMENT
How to Create Vision Statement?
Vision Statement Guidelines
Benefits of a Vision Statement
Vision Killers
Vision Statement
MISSION STATEMENT
Characteristics of a Mission Statement
Benefits of a Mission Statement
How to Create Mission Statement?
CHAPTER 3:
Applications of Management Theories
COMPETENCIES
THEORIES AND MODELS
What is Theory?
What is Model?
EVOLUTION OF THEORIES IN NURSING
CLASSIFICATION OF NURSING THEORIES
Meta Theory
Grand Theories
Middle Range Theories
Practice Theories
Developmental Theories
LIST OF MANAGEMENT THEORIES AND MODELS APPLICABLE IN NURSING
APPROACHES TO MANAGEMENT THOUGHT AND RELATED THEORIES
THE CLASSICAL APPROACH
Scientific Management Theories
Frederick Taylor's Principles of Management
Time and Motion Studies
The Gantt Chart by Henry Gantt
Bureaucracy/Organizational Theory
Max Weber Theory of Bureaucracy
General Administrative Management Theories
Henri Fayol's Principles of Management
Luther Gulick and Lyndall Urwick's Theory of Administrative Management
Mary Parker Follett and Management Theory
NEOCLASSICAL approach
Human Relations Management Theories
Elton Mayo's Hawthorne Effect
Chester Barnard Theories
Strategic Planning
Acceptance Theory of Authority
Human Relations Management Theories
Motivational Theories
Content Theories of Motivation
Maslow's Theory of Motivation-hierarchy of Needs
Maslow's Hierarchy of Needsmodel
1970's adapted hierarchy of needs model, including cognitive and aesthetic needs
1990's adapted hierarchy of needs including transcendence needs
Herzberg's Motivation-Hygiene theory and job enrichment
McGregor theory X and theory Y
X theory (Authoritative Management Style)
Y theory (Participative Management Style)
Theory Z
Alderfer's E-R-G Theory
Existence needs
Relatedness
Growth needs
Achievement-motivational or Three Needs Theory
The Need for Achievement (nAch)
The need for authority and power (nPow)
The need for affiliation (nAff)
Process Theories of Motivation
BehaviourModification Model
Locke's Goal Setting Theory
Expectancy (Three Factors) Theory
Equity Theory
Leadership Theories
Great Man and Trait Theories
Behavioural Theories
Lewin, Lippitt and White Theory
Autocratic Style
Laissez-faire Style
Leadership Continuum Behaviour Model
Ohio State University Research
University of Michigan Research
Managerial Grid
Leader-Member Exchange Theory
Contingency Theories of Leadership
The Fiedler Contingency Theory of Leadership or Fiedler's Least Preferred Co-worker (LPC) Theory (1967)
Likert's System 4 Management
System 1 Exploitive autocratic
System 2 Benevolent authoritative
System 3 Consultative
System 4 Participative
Path-Goal Theory
Directive style
Supportive style
Achievement oriented style
Situational Leadership Theory
Management / Transactional Theories
Transformation Leadership Theory
Idealized Influence
Inspirational Motivation
Intellectual Stimulation
Individual Consideration
Burns’ Leadership Theories
Transactional Leaders
Transformational Leaders
Relationship Theories
Charismatic leadership: Transformational Leadership
Emotional Intelligence Leadership Theory
Self awareness
Social skills
Self regulation
Motivation
Empathy
Social skill
Leadership styles
Leader-Participation Model
Decision Making Models
Herbert A. Simon’ Decision Making Model
Intelligence activity
Design activity
Choice activity
Vroom and Jago decision-making model
Autocratic I
Autocratic II
Consultative I
Consultative II
Group II
Modern Approach
Systems Theory
Contingency Theory
Internal environment
External environment
CHAPTER 4:
Ethics and Ethical Issues in Nursing
COMPETENCIES
INTRODUCTION
CONCEPT OF ETHICS
VALUES
TYPES OF ETHICS
General Ethics
Meta-ethics
General Normative Ethics
Applied Ethics
Employee Ethics
Work Related Ethics
Organizational Related Ethics
Health Care Ethics
Nursing Ethics
THEORETICAL FRAMEWORK OF APPLIED ETHICS
Deontology
Utilitarianism
Ethical Rights Theory
Casuist Ethical Theory
Virtue Ethical Theory
Autonomy
Beneficence
Confidentiality
Equality
Finality
Justice
Nonmaleficence
Understanding/Tolerance
Publicity
Respect for Persons
Universality
Veracity
The Ethics of Care Theory
Principles of Ethics
Principles of Personal Ethics
Principles of Professional Ethics
The Florence Nightingale Pledge
Principles of Global Ethics
Principles Based Ethics
Autonomy
Informed Consent
Justice
Beneficence
Nonmaleficence/Do No Harm
Fidelity
Veracity
Accountability
Confidentiality
Rights of Patients Supported by Ethics
Ethical Rights of Patients
NURSING CODE OF ETHICS
What is ‘Code’?
Why?
The Code of Ethics for Registered Nurses
Code of Ethics for Nurses followed by Developed/Developing Countries
International Council of Nurses–Code for Nurses
American Nurses Association Code of Ethics
Canadian Nurses Association Code of Ethics
The Code of Ethics for Nurses in Australia
The Code of Ethics for Nurses In India
Indian Nursing Council, Code of Ethics and Professional Conduct (2006)
Code of Ethics
Code of Professional Conduct
Code of Ethics for Supervisors of Nursing Service Personnel
ETHICAL DILEMMAS
What it is?
Emerging Issues
How to Resolve Ethical Dilemma?
ETHICAL DECISION-MAKING
ETHICAL DECISION-MAKING MODELS
The PLUS Model
A General Model
Thompson & Thompson Model
Establish sound data base
Identify value conflicts
Outlines course of action and outcome
Determine who owns the problem and define nurse's objectives
‘MORAL’ Model
American School Counselor Association Model 1996
Josephson Institute of Ethics (1999) Model
Putnam Decision-making Model
Arthur Decision-making Model
DECISION-MAKING PROCESS TO RESOLVE ETHICAL DILEMMA
ROLE OF NURSE MANAGERS IN ETHICAL ISSUES
CHAPTER 5:
Legal Foundation of Nursing Practice
COMPETENCIES
INTRODUCTION
CONCEPT OF LAW
Meaning of Law
Difference between Law and Morality
PURPOSES OF LAWS
TYPES OF LAW
Public Law
Introduction
Constitutional law
Administrative law
Criminal Law
Civil Law
Tort Law
Contract Law
CRIMES vs TORTS
CONSUMERS PROTECTION ACT
Basic Rights of Consumers
Who is Consumer?
Grievance Redressal Mechanism under CPA
Who can file a Complaint?
Grounds to file a Complaint
Categories of Patients as Consumers
Patients of Government Hospitals
Patients of Charitable Hospitals
Patients of Nursing Homes and Private Practioners
THE JUDICIAL PROCESS
Judicial Branch
The Supreme Court of India
The High Court
District and Session Courts
IMPORTANCE OF LAW IN NURSING
LEGAL LIABILITY IN NURSING
Unintentional Torts
Negligence
Concept
Elements of negligence
Common acts of negligence in nursing
Example of a negligence case
Malpractice
Concept
Case
Examples
Safety Measures
Goal: Identify Patients Correctly
Intentional Torts
Assault and Battery
Criminal Battery
Civil Battery (Tort)
False Imprisonment
Restraints
Quasi-intentional Torts
Defamation
Slander and Libel
Fraud
Invasion of Privacy
Why Nurses are being Sued?
New Rights-oriented Patients
New Litigation-oriented Patients
Greater Expectations
Expanded Nursing Roles
Guide for Legal Responsibility and Safe Guards in Nursing Practice
Licensure
Standards of Care
Standing Orders
Consent
Correct Identity
Documentation
Drug Maintenance
NURSING CHECKLIST TO REDUCE THE RISK OF LIABILITY
Legal Issues in Nursing Practice Area
Controlled Substances
Caring Patients with AIDs (Acquired Immuno Deficiency Syndrome)
Deaths and Dying
Autopsy and Organ Donation
Living Wills and Health Care Surrogates
Patient's Property
LEGAL ISSUES IN OTHER SPECIALTY PRACTICE AREAS
LEGAL RESPONSIBILITIES OF NURSES
At Administrative and Supervisory Level
Responsibilities of Appointing and Assigning and Floating
Responsibility in Quality Control
Responsibility in Relation to Material Management
Responsibility towards Proper Documentation System
Responsibility for Maintaining Public Relation
Responsibility at the Time of Disaster Management
Responsibility towards the Staff Management
At Operational Level (Fig. 5.4)
Responsibilities related to Physician's Orders
Responsibility for Verbal Orders
Do not Resuscitate Orders
Responsibility to Prevent Burn, Fall of the Patient
Responsibility for Administration of Medications
Responsibility towards Maintaining Safe Environment
Responsibility of Nurses for the Use of Equipments
Responsibility towards Maintaining Proper Records
Responsibility towards Short Staff
Responsibility towards Use of Controlled Substances
Responsibility towards Death and Dying Patients
Responsibility towards Correct Identity of Clients
Responsibility towards Absconding Patient
MEDICO-LEGAL CASES AND PROCEDURES
What are Medico Legal Cases?
Legal Implications in Medico Legal Cases (MLCs)
CHAPTER 6:
Trends and Issues in Nursing
COMPETENCIES
INTRODUCTION
MEANING
Trends
Trends in Nursing
TRENDS IN NURSING
Historical Perspective
Before Independence
After Independence
Nursing Service Trends
Emerging Trends in Nursing Practice
Factors Affecting Trends in Nursing
Changing Scenario of Government Towards Health Care-healthy People 2010
Computers and Technology Change Health Care Delivery
Informatics and Efforts to Standardize and Unify Nursing Language
Case Management, Disease Management, and Telehealth Care Expand
Diverse Responsibilities
Educated Consumers
Changing Role of Women in Society
Changes in Medical, Paramedical and Allied Professions
International Influence and Contribution of International Organizations
Expanding Nursing Roles
Nurses Must Prove Value
Nurse's Roles as Leaders and Managers Essential
Shared Governance and Collaborative Decision-making
Nursing Shortage Threatens Patient Care
Nursing Education Goes Online
Standards and Practice Guidelines
Evidence-based Care and Best Practices are Emphasized
New ethical Concerns
Wellness Centers, Holistic and Alternative Therapies
Nursing wellness and Healthy Working Environment is Stressed
Life Long Learning is Required
CURRENT ISSUES IN NURSING SERVICE
Issues at the Districts/State Level
Issues Related to Nursing Administration and Services
According to Henery Lorensen and Hirchfield
According to Korniewicz DM & Palmer MH
HOW TO MEET THESE CHALLENGES?
FUTURE ISSUES IN NURSING
Future Issues and Nursing Practice
Differentiated Nursing Practice
Implementing Differentiated Nursing Practice
Defining Competencies and Competency Models
Competencies Reported by Institute of Medicine
Competencies Identified by Pew Health Professions Commission
According to Utley-Smith
Essential Competencies required by Nurses
Nursing Practice Models
A Nursing Nomenclature (Classification)
CHAPTER 7:
Quality Assurance and Quality Management
COMPETENCIES
INTRODUCTION
HOW QUALITY ASSURANCE BEGAN?
WHAT IS QUALITY?
QUALITY IN HEALTH CARE
Definitions
PURPOSES OF QUALITY
QUALITY ASSURANCE TO QUALITY IMPROVEMENT/MANAGEMENT
Quality Assurance (QA)
Definitions and Meaning
Quality Control
Quality Improvement
Concept
Steps of Quality Improvement
Basic Tenets of Quality Improvement
The Tools of Quality Improvement
Flow Charts
Fishbone Diagram
Histogram
Pareto chart
Continuous Quality Improvement (CQI)
Quality Management
TOTAL QUALITY MANAGEMENT (TQM)
Objectives of TQM
Key Principles of TQM
Tools and Techniques for TQM
MODELS OF QUALITY ASSURANCE AND QUALITY MANAGEMENT
American Nurses’ Association (ANA) Model
Donabedian Model
Wilson's Model
Quality Health Outcome Model
Quality Management Model
Focus – PDCA Model (Quality Management Model)
Joint Commission 10 – Step Process Model
Performance Management System Paradigm
Quality Caring Model
Marker's Umbrella Model
QUALITY CIRCLE
Bases of Quality Circle
Principles of Quality Circle (QC)
Importance of QCs
Elements of Quality Circle Programme
Its People Building Philosophy
It's Voluntary
Employees Help Others to Develop
Everyone Participate
Training is Emphasized
Creativity is Encouraged
Management has to be Supportive
Secrets to Develop a Successful Quality Circle Programme
Factors that Influence Quality Measurement and Improvement
QUALITY EVALUATION SYSTEMS IN HEALTH CARE
Specific Approaches
Regulatory Approaches
SIX-SIGMA IN HEALTH CARE
What is Six-Sigma?
Goals of Six-Sigma
Benefits of Six-Sigma
Six-Sigma Methodologies
Training in Six-Sigma Quality System
Principles of Six-Sigma
Characteristics of Six-Sigma
The Six-Sigma Model
Key Tools Used in Six-Sigma System
Steps involved in implementing Six-Sigma in a Hospital
Keys to Six-Sigma Success
Administrative and Leadership Support
Align Goals with Six-Sigma Activities
Establish Six-Sigma Infrastructure
Ensure Execution and Accountability
Challenges in Launching Six-Sigma
CHAPTER 8:
Nursing Service Standards
COMPETENCIES
INTRODUCTION
DEFINITIONS OF STANDARD
COMPONENTS OF STANDARDS
CHARACTERISTICS OF STANDARDS
ADVANTAGES OF ADOPTING STANDARDS
IMPORTANCE OF STANDARDS
TYPES OF STANDARDS
TAXONOMY OF STANDARDS
Dimension One
Dimension Two
1. Nursing Service Standards
2. Standards of Nursing Practice
3. Standards of Governance
DEVELOPMENT OR SETTING QUALITY STANDARDS
The Basis or Prerequisite for Setting Standards
Questions Need to be Considered in the Development Process of Standards
Steps for the Development of Nursing Standards
General Steps
A seven-step methodology:
Techniques used in Preparation of Standards in Nursing
Professional Standards Techniques
Comprehensive Review Systems
Process Appraisal Technique
STANDARDS FOR NURSING SERVICES
American Nurses Association Standards
ANA Standards of Care/Practice:
Canadian Nurses Association (CNA) Standards
In Indian Scenario ‘Practice Standards’
Professional Responsibility and Accountability
Nursing Practice
Communication and Interpersonal Relationships
Management
Professional Development
Standards and Evaluation
Self-assessment
Inspection
Accreditation
ROLE OF NURSE ADMINISTRATORS IN DEVELOPING STANDARDS FOR NURSING PRACTICE
Barriers and Constraints in Development of Standards for Nursing Service
Related to Policies
Related to Nursing Manpower
Related to Equipment and Other Materials
Related to Physical Facilities
Related to Finance
Related to Monitoring System
SAMPLE FOR STANDARDS AND NORMS IN NURSING SERVICES
CHAPTER 9:
Regulatory Bodies
COMPETENCIES
INTRODUCTION
REGULATORY SYSTEM
PROFESSIONAL BODY
REGULATORY BODY
Meaning and Definition
Aims of Regulatory Bodies of Nursing
Objectives of Regulatory Bodies of Nursing
Role of Professional and Regulatory Bodies (PRBs)
Functions of Regulatory Bodies
TYPES OF REGULATORY BODIES OF NURSING
Indian Nursing Council (INC)
Introduction
INC Regulations
Aims and Objectives of Indian Nursing Council
Main Purposes of INC
Functions of Indian Nursing Council
Organization Structure
Committees
Activities of INC
Nursing Educational Institutions
State Nursing Councils
Introduction
Size
Functions
Coordination with INC
Examination Boards and Universities
Recognized Qualifications
TRAINED NURSES ASSOCIATION OF INDIA
Introduction
Affiliation of TNAI
Philosophy
Objectives
Aims
Functions
Activities
Benefits
Recent Activities
HEALTH VISITOR LEAGUE
MIDWIVES AND AUXILLARY NURSE MIDWIVES ASSOCIATION
CHRISTIAN NURSES LEAGUE OF THE CHRISTIAN MEDICAL ASSOCIATION OF INDIA
STUDENT NURSES ASSOCIATION OF INDIA
Introduction
Objectives
Activities
CHAPTER 10:
Accreditation
COMPETENCIES
INTRODUCTION
MEANING AND DEFINITIONS OF ACCREDITATION
Characteristics of Accreditation
According to Harvey 2004
According to INQAAHE
SCOPE OF ACCREDITATION
Concerning Service Areas
Concerning Education
AIMS OF ACCREDITATION
BENEFITS OF ACCREDITATION
ACCREDITATION PROCESS
Hospital Accreditation
Process
Accreditation Standards
Support Services
Management
Human Resources
Management of Information
MODELS OF ACCREDITATION
TYPES OF ACCREDITATING AGENCIES IN INDIA FOR EDUCATION
NATIONAL ASSESSMENT AND ACCREDITATION COUNCIL (NAAC)
Introduction
Procedure for Assessment and Accreditation by NAAC
Institutional Eligibility for Quality Assessment (IEQA)
Preparation of the Self-Study Report
Peer Team Visit
Criteria for Assessment
THE INDIAN NURSING COUNCIL AND ACCREDITATION
Objectives
Process of Accreditation
Criteria for Assessment
Guidelines for Conducting Inspection
How to make Programme Evaluation/Accreditation Successful?
Inspections
First Inspection
Reinspection
Periodical Inspections
Inspection for Enhancement of Seats
ACCREDITING AGENCIES FOR ACCREDITING NURSING PROGRAMMES IN OTHER COUNTRIES
In United State
Commission on Collegiate Nursing Education (CCNE)
National League for Nursing Accrediting Commission (NLNAC)
ACCREDITATION OF HOSPITALS
Umbrella Organizations
The International Society for Quality in Health Care (ISQua)
The United Kingdom Accreditation Forum, or UKAF
The Society for International Healthcare Accreditation, or SOFIHA
Internationally Acclaimed Healthcare Accreditation Organizations
Development of Accreditation System in Different Countries
America
Canada
Australia
United Kingdom
China
Latin America and the Caribbean
Hospital Accreditation System in India
NATIONAL ACCREDITATION BOARD FOR HOSPITALS AND HEALTHCARE PROVIDERS (NABH) AND QUALITY CONTROL OF INDIA (QCI)
Introduction
Aim
Composition
Focus
Activities
NABH Accreditation Hospitals
CHAPTER 11:
Nursing Audit
COMPETENCIES
INTRODUCTION
Historical Perspective
Early Contribution
Before Year 1955
Year 1955 and Later
CONCEPT OF NURSING AUDIT
DEFINITIONS OF NURSING AUDIT
CLINICAL AUDIT
OBJECTIVES OF NURSING AUDIT
IMPORTANCE OF NURSING AUDIT
ADVANTAGES OF NURSING AUDIT
DISADVANTAGES OF NURSING AUDIT
Bases of Nursing Audit
Debit Items
Credit Items
Nursing Auditors
Quality
Nursing Standards
Activities
Resources
Types of Nursing Audit
According to Methodology to be Adopted for Auditing
According to Type of Auditors
CLINICAL AUDIT CYCLE
NURSING AUDIT PROCESS
Describing Phase
Identify Topic or Issue or Problem
Identify Core Group and Form an Audit Team or Committee
Set Audit Criteria and Standards
Develop an Audit Protocol
Preparing and Implementing Phase
Define Criteria and Prepare Audit Tools
Make a Plan for Gathering Information
Get Ethical Approval from Ethical Committee
Gather Data
Analysis and Concluding Phase
Analyze Data and Compare Results with Criteria and Standards
Make an Audit Summary
Plan and Implementing Change
Re-audit
GOLDEN TIPS TO PRACTICE NURSING AUDIT
UNIT 2: PLANNING
CHAPTER 12:
Fundamentals of Planning
COMPETENCIES
INTRODUCTION
CONCEPT OF PLANNING
DEFINITIONS OF PLANNING
NATURE OF PLANNING
Approaches to Planning
Planning: A Rational Approach
Planning: Open System Approach
Planning: Pervasiveness Approach
Objectives of Planning
To Set the Objectives
To Focus on Meaningful Activities
To Economizes the Time and Effort and Other Resources
To Maintain Coordination
To Reduce Risk and Uncertainty
To Ensure Proper Control
To Achieve the Organizational Effectiveness
Planning Promotes Creativity
To Improve Efficiency
PRINCIPLES OF PLANNING
IMPORTANCE OF PLANNING
Planning Process
Identification of Situation
Formulation or Setting of Objectives
Developing Premises or Conditions (Forecast Future)
Identification of Alternatives
Evaluation of Alternatives
Selection of the Best Possible Alternative
Formulation of Supporting Plans
Defining Various Activities and Preparation of Action Plans
Communication of Plans and Securing Cooperation
Follow up and Review
Types of Planning
Long Term and Short Term Planning
Proactive and Reactive Planning
Formal and Informal Planning
Strategic and Operational Planning
Management (Corporate) and Functional Planning
TYPES OF PLANS
Management Point of View
Standing and Single Use Plans
Strategic and Operational Plans
Short Range or Long Range Plans
Hierarchical Nature of the Plans
Purposes or Mission
Statement of Philosophy
Objectives or Goals
Strategies
Policies
Protocols
Procedures
Rules
Standards of Care
Standards of Nursing Practice
Budgets
Components of Sound Organizational Planning
A Written Statement of Purpose and Objectives of Nursing Services
A Plan of Organization
Development of Policies and Administrative Manuals
Setting of Nursing Standards
Nursing Procedure Manual
A Nursing Service Budget
A Master Rotation Plan
Plans for Appraising Nursing Care
Nursing Service Administrative Meetings
Adequate Facilities, Supplies and Equipments
Written Job Descriptions and Job Specifications
Personnel Records
In-service Education of Nursing Personnel
Meetings with Other Personnel from Other Departments
CHAPTER 13:
Mission, Philosophy and Objectives
COMPETENCIES
INTRODUCTION
MISSION AND PURPOSE
Meaning and Definition of Mission and Purpose
Mission or Statement of Purpose
Elements of Mission Statement
Purpose Statement
The Business or Activities Statement
Values
Dimensions of Mission Statement
Formulation of Mission
Characteristics of Mission Statements
Nursing Mission or Purpose
PHILOSOPHY
Meaning of Philosophy
Nursing Philosophy
Bases for Developing Nursing Philosophy
Standards for Evaluating Nursing Philosophy
OBJECTIVES OF NURSING SERVICES
Introduction
Definitions of Objectives
Importance of Objectives
Nature of Objectives
Objectives form Hierarchy
Multiplicity of Objectives
Objectives have Time Limit
Objectives are Inter-related and Inter Dependent
Objectives have Different Priorities
Formulation of Nursing Objectives
On the Basis of National Health Policy
Needs of the Population
Priority Areas for Improvement of Basic Nursing and Midwifery
Resources Available
Active Participation
Philosophy of Nursing Services
Accepted or Approved by the Administrators
Characteristics of Nursing Objectives
Effective Objectives are Stretching but Achievable
Classification of Nursing Objectives
Levels of Objectives
Types of Objectives
Based on Hierarchy or Operational Objectives
Nursing Objectives Specific to Hospital Nursing Services
CHAPTER 14:
Strategic Planning and Plans
COMPETENCIES
INTRODUCTION
STRATEGY
Meaning and Definitions
Types of Strategies
How to Develop Strategies?
STRATEGIC PLANNING
What is Strategic Planning?
Concepts of Strategic Planning
Strategic Planning has three Concepts of Planning
Planning is an Intellectual Process
Planning is a Social Process
Purposes of Strategic Planning
Steps of Strategic Planning
Getting Ready
Articulating Mission and Vision
Assessing the Situation
Evaluating Programs’ Impact on Clients
Developing Strategies, Goals, and Objectives
Completing the Written Plan
Guiding Principles to Successful Strategic Planning
How Strategic Planning can be used to Improve the Nursing Management?
STRATEGIC PLANS
Requirements of a Good Strategic Plan
Defining the Strategic Framework
Standard Format for a Strategic Plan
Introduction by the President of the Board
Executive Summary
Mission and Vision Statements
Organization Profile and History
Critical Issues and Strategies
Program Goals and Objectives
Management Goals and Objectives
Appendices
How to Make a Strategic Plan Implementation Successful?
Process Elements
Content Elements
Usage Elements
OPERATIONAL PLANS
Introduction
What is an Operational Plan?
Content of Operational Plan
Purposes of Operational Plan
Formulation of Operational Plans
How to Evaluate Operational Plans
Characteristics of an Effective Annual Operating Plan
Operational Plans and Strategic Plans
Relationship
Differences
CHAPTER 15:
Business Plan and Planning New Venture
COMPETENCIES
INTRODUCTION
BUSINESS PLAN
What is a Business Plan?
Purposes of the Business Plan
Features of a Business Plan
Importance of the Business Planning Process
How to Develop a Business Plan?
A Start up Business Strategy
Before Writing a Business Plan
Develop Business Plan
Checklist for Writing a Business Plan
PLANNING NEW VENTURE
Concept of New Venture
Management of the Venture-building Process
Steps to Starting a Successful Small Business
Before Starting up
Identify Market/Demand
Evaluate the Feasibility of Chosen Business
Consider Start-up Requirements
Develop a Business Plan
Develop Financing Request and Obtain Initial Capital
Finalize All Start-up Requirements
Risks in a New Venture
How to Overcome these Risks?
CHAPTER 16:
Qualitative Planning Methods
COMPETENCIES
INTRODUCTION
What is a Network?
Major Techniques for Time Event Network Analysis
Gantt Chart
Construction
Uses of Gantt Chart
Advantages
Milestone Budgeting
Programme Evaluation and Review Technique (PERT) and Critical Path Method (CPM):
Critical Path Method (CPM)
Programme Evaluation and Review Technique (PERT)
Definition of Terms used in CPM and PERT Programme or Project
Purposes of CPM and PERT
Steps in CPM and PERT
Applications
General Problems in Use of Network Analysis
CHAPTER 17:
Management By Objectives
COMPETENCIES
INTRODUCTION
WHAT IS MBO?
FEATURES OF MBO
OBJECTIVES/ PURPOSES OF MBO
Ultimate Objective
Process of MBO
Setting of Objectives at the Top
Identifying Key Result Areas (KRAs)
Clarifying Organizational Roles
Setting Subordinates Objectives
Holding Periodical Meetings
Assess Strengths and Weaknesses of Key Resources
Evaluation of Results or Performance Appraisal
Recycling or Reevaluating the Process
ADVANTAGES OF MBO
LIMITATION OR DISADVANTAGES OF MBO
IMPLICATIONS OF MBO IN NURSING
CHAPTER 18:
Decision-making
COMPETENCIES
INTRODUCTION
DEFINITIONS OF DECISION-MAKING
BASIC ELEMENTS OF DECISION-MAKING
FEATURES OF DECISION-MAKING
OBJECTIVES OF DECISION-MAKING
Bases of Decision-making
Intuition
Facts
Experience
Authority
Decision Levels
Strategic Level
Tactical Level
Operational Level
Decision-making Process
Specific Objectives
Identification of Problem
Generate Alternatives
Evaluation of Alternatives
Choice or Selection of an Alternative
Action
Results
Types of Decisions
Programmed and Non-programmed Decisions
Organizational and Personal Decisions
Routine or Tactical and Strategic or Basic Decisions
Policy and Operative Decisions
Individual or Group Decisions
Techniques of Decision-making
Operational Research (OR)
Decision Tree
Linear Programming
Gaming or Game Theory
WHO MAKES THE DECISIONS?
MODELS OF DECISION-MAKING
Optimizing Model
Ascertain the Need for Decision
Identify the Decision Criteria and Allocate Weighs to the Criteria
Develop the Alternatives
Evaluate the Alternatives
Select the Best Alternative
ALTERNATIVE MODELS
The Satisfying Model
The Implicit Favorite Model
Intuitive Model
Rational Decision-making Model
Political-Behavioral Approach
PROBLEMS IN DECISION-MAKING
DECISION-MAKING IN HEALTH CARE
ROLE OF NURSE ADMINISTRATORS IN DECISION-MAKING
Seven Steps for Successful Decision-making in Nursing Services
Identify a Clear Objective
Gather the Necessary Data
Get Others Involved as Soon as Possible
Convey the Urgency of a Situation
Value Your Experience and Intuition
Don't Let Circumstances Decide
Evaluate the Outcome and the Process
CHAPTER 19:
Problem-solving
COMPETENCIES
INTRODUCTION
Problem-solving
DEFINITIONS AND MEANING OF PROBLEM-SOLVING
DECISION-MAKING AND PROBLEM-SOLVING
TYPES OF PROBLEMS
NATURE AND CHARACTERISTICS
PRINCIPLES OF PROBLEM-SOLVING
PROBLEM-SOLVING APPROACH
MAIN STEPS OF PROBLEM-SOLVING
APPROACHES OF PROBLEM-SOLVING PROCESS
Problem-solving Process Model
Problem-solving for Better Health Nursing (PSBHN) Model
OBSTACLES IN PROBLEM-SOLVING
Basic Guidelines to Problem-solving and Decision-making
Define the Problem
Look at Potential Causes for the Problem
Identify Alternatives for Approaches to Resolve the Problem
Select an Approach to Resolve the Problem
Plan the Implementation of the Best Alternative is
Monitor Implementation of the Plan
Verify if the Problem has been Resolved or Not
UNIT 3: HEALTH CARE DELIVERY SYSTEM AND PLANNING PROCESS
CHAPTER 20:
Indian Administrative System
COMPETENCIES
INTRODUCTION
EVOLUTION OF THE INDIAN ADMINISTRATIVE SYSTEM
Impact of Britishers on Indian Administrative System
Federal System
Parliamentary System
Independent Recruiting Body
Neutrality of Civil Servant
District was Considered as a Unit of Administration
Hierarchical System
Democratic System
Local Self Government Institutions
Red Tapism
INDIAN CONSTITUTION
THE PREAMBLE
Elections
Administrative System of India
Administrative Structure of Government: Government of India
The Legislature
The Lok Sabha
The Rajya Sabha
The Executive
The Judiciary
Administrative Structure of State Government
District Administration
Local Self Government
Rural: The Panchayati Raj
At Village Level
At Block Level
At District Level
Urban Area
CHAPTER 21:
Health System in India
COMPETENCIES
INTRODUCTION
Evolution of Modern Health System
Phase I (1947-83)
Phase II (1983-2000)
Phase III (Post-2000)
ORGANIZATION OF THE HEALTH SYSTEM IN INDIA
ORGANIZATION OF HEALTH SYSTEM AT THE CENTRE
Union Ministry of Health and Family Welfare
Departments
Department of Health
Department of Family Welfare
Department of AYUSH
The Directorate General of Health Services
Functions
The Central Council of Health
ORGANIZATION OF HEALTH SYSTEM AT STATE LEVEL
State Ministry of Health
State Health Directorate
REGIONAL LEVEL
ORGANIZATION OF HEALTH SYSTEM AT DISTRICT LEVEL
Sub-Divisional/Taluka Level
Community level
Primary Health Centres (PHC) Level
Sub-centre Level
PUBLIC VS PRIVATE HEALTH SECTOR
Public Health Sector
The Private Health Sector
NATIONAL HEALTH SYSTEM
Goal and Activities of National Health System
Activities
Characteristics of an Ideal Health System
Functions of Health System
Challenges for the Health System in India
HEALTH CARE DURING THE TENTH PLAN
HEALTH CARE SERVICES
Human Resources for Health
Current Problems Faced by the Health Care Services
India's Share in Global Health Problems
Future Trends in Indian Health System
CHAPTER 22:
Fundamentals of Health Planning
COMPETENCIES
INTRODUCTION
CONCEPT OF HEALTH PLANNING
NATIONAL HEALTH PLANNING
Planning Process
Elements in a Health Planning Process
Purposes of Health Planning
Steps in Health Planning
Step One - Analysis of Health Situation
Step Two - Setting Directions, Objectives and Goals
Step Three - Assessment of Resources in Term of Health Problems and Challenges
Step Four - Range of Solutions and Setting of Priorities
Step Five - Selection of Best Alternative Solution(s) and Preparation of Plans
Step Six - Implementation of Prepared Plan
Step Seven - Monitoring
Step Eight - Evaluation
Step Nine - Re-planning
PLANNING COMMISSION
Structure of the Planning Commission (Fig. 22.1)
Functions of the Planning Commission of India
FIVE YEAR PLANS
Introduction
Objectives of the Health Programme during Five Year Plans
Sub Health Sectors under Five Year Plans
Details of Five Year Plans
The First Five Year Plan (1951-56)
The Second Five Year Plan (1956-61)
The Third Five Year Plan (1961-66)
Three Annual Plans (1966-68)
The Fourth Five Year Plan (1969-74)
The Fifth Five Year Plan (1974-79)
Rolling Plan (1978–80)
The Sixth Five Year Plan (1980-84)
The Seventh Five Year Plan (1985-89)
Annual Plans (1990 and 1991)
The Eighth Five Year Plan (1992-97)
The Ninth Five Year Plan (1997-2002)
The Tenth Five Year Plan (2002-2007)
The Eleventh Five Year Plan (2007-2012)
NATIONAL HEALTH COMMITTEES
Bhore Committee, 1946
Short-term Measure
Mudaliar Committee, 1962
Chadah Committee, 1963
Mukherjee Committee, 1965
Mukherjee Committee, 1966
Jungalwalla Committee, 1967
Kartar Singh Committee, 1973
Shrivastava Committee, 1975
Bajaj Committee, 1986
National Health Programmes
During First Five Year Plan
During Second Five Year Plan
During Third Five Year Plan
During Fourth Five Year Plan
During Fifth Five Year Plan
During Sixth Five Year Plan
During Seventh Five Year Plan
During Eighth Five Year Plan
During Ninth Five Year Plan
During Tenth Five Year Plan
NATIONAL HEALTH POLICIES
Introduction
NATIONAL POLICIES RELATED TO HEALTH
National Health Policy (NHP) 2002
Goals of NHP 2002
Objective of the NPH Policy
Major NPH Policy Prescriptions
Policy Prescriptions Related to Nursing Personnel
Norms for Health Care Professionals
Elements of NHP
National Rural Health Mission (2005-2012)
Objective of NRHM
Mission
Aim
Strategies of NRHM
Core Strategies
Supplementary Strategies
Strategies for Meeting the Human Resource for Health Needs
1. Numeric Adequacy
2. Ensuring Availability of Doctors in Rural Areas
Concerns
Implementation of National Rural Health Mission
Purposes
Objectives
Janani Suraksha Yojana
National Policy on AYUSH
Main Objectives
The Infrastructure
Subordinate Offices
• Pharmacopoeial Laboratory for Indian Medicine (PLIM)
• Homoeopathic Pharmacopoeial Laboratory (HPL)
• Ayurved Hospital, Lodhi Road, New Delhi
Public Sector Undertaking, Ayurveda and Unani Drugs Manufacturing Unit
Statutory Regulatory Councils
Research Councils
National Institutes
National Medicinal Plants Board
Drugs Regulation
Budget
Implementation
National Population Policy of India
The Long-term Objective
The Immediate Objective
The Medium-term Objective
Goals
Strategic Themes
UNIT 4: ORGANIZING
CHAPTER 23:
Fundamentals of Organizing and Organization
COMPETENCIES
INTRODUCTION
ORGANIZING
Meaning of Organizing
Steps of Organizing
Division of Activities
Creation of Jobs and Departments
Assignment of Duties to Suitable Individuals
Establishing Authority Relationships
Coordination of Activities
ORGANIZATION
Meaning of Organization
Organization as a Structure
Organization as a Group of People
Organization as a Process
Definitions of Organization
Characteristics of Organization
Organizing is a basic Function of Management
It is based on Common Objectives
Organization Create a Structure of Relationships
Organization is a Process
IMPORTANCE OF ORGANIZATION
ORGANIZATION AS A SYSTEM
What is System?
Inputs
Throughput
Outputs
Outcomes
Feedback
Characteristics of a System
Characteristics of Organization as a System
Organization as a Social System
HEALTH CARE ORGANIZATIONS AS COMPLEX OPEN SYSTEM
Characteristics
System Model for Organizational Analysis
Inputs
Transformation Process
Output
Subsystem within Health Care System
The Required Sub-system
The Personal Sub-system
The Emergent Sub-system
HOSPITAL AS AN OPEN SYSTEM
Sub-systems in Hospital
Environment of Hospital
Nursing Department as a System
Power Authority Sub-system
Communication Sub-system
Work Flow Sub-system
Rewards and Punishment Sub-system
Role Sub-system
Social Sub-system
Individual Personality Sub-system
Elements in Organizational Process
Departmentation
Delegation
Decentralization
Principles of Nursing Organization/Organizing
Unity of Objectives
Hierarchy or Scalar or Chain of Command Principle
Span of Control
Authority and Responsibility
Delegation of Authority
Integration vs Disintegration
Centralization and Decentralization
Unity of Command
Coordination
Division of Work and Specialization
Principle of Flexibility
Principle of Simplicity
Principle of Balance and of Continuity
Principle of Leadership and Efficiency
FUNCTIONS OF Nursing ORGANIZATION
FEATURES OF NURSING ORGANIZATION
Hierarchy or Scalar Principle
Merits
Demerits
Unity of Command
Span of Control
Factors Affecting Span of Control
Division of Labor and Specialization
For Managerial Functions
Nursing personnel management
Material management
Equipment and drug supply management
For supervisory activities
For nursing care
Authority
Authority: Meaning and Definitions
Features of Authority
Types and Sources of Authority
Delegation of Authority
Elements of Delegation
Barriers to Effective Delegation
Superior-related factors
Subordinate related factors
Organizational related factors
How to Make the Delegation Effective?
Responsibility
Ultimate Responsibility
Operating Responsibility
Delegation of Responsibility in Nursing Services
Accountability
Characteristics of Accountability
Accountability of Nursing Personnel in the Hospitals and their Views
Centralization
Meaning and Definitions
Advantages of Centralization
Limitation of Centralization
Decentralization
Meaning and Definitions
Implications of decentralization
Advantages of decentralization
Factors determining degree of decentralization
CHAPTER 24:
Organization Structure
COMPETENCIES
INTRODUCTION
ORGANIZATION STRUCTURE
Concept of Organization Structure
Basic Parts of An Organization
Operating Core
Strategic Apex
Middle Line
Elements of Organization Structure
Elements of Structure that Differentiate the Work of an Organization
Elements of Structure that Integrate the Work of An Organization Coordinate and Control Work
ORGANIZATION CHARTS
What is Organization Chart?
Structure of an Organization Chart
Features of Organization Chart
Advantages of Organization Chart
Limitations of Organization Chart
Types of Organization Chart
Hierarchical Organizational Chart
Matrix Organizational Chart
Flat or Horizontal Organizational Chart
DESIGN OF ORGANIZATION STRUCTURE
Formal Organization
Features of Formal Organization
Benefits and Advantages of Formal Organization
Disadvantages of Formal Organization
Informal Organization
Features of Informal Organization
Functions of Informal Organization
Disadvantages of Informal Organization
Comparison of Formal and Informal Organizations
Structure
Focus
Major Concepts
Purpose
Nature
Formation
Source of Power
Rigidity
Interdependence
Size and Tenure
Communication
Leadership
Source of Control
DEPARTMENTATION
Objectives of Departmentation
Advantages of Departmentation
Methods of Departmentation
Departmentation by Persons (Purpose)
Departmentation by Product
Departmentation by Process
Departmentation by Place (Territory)
Departmentation by Customers
Factors Affecting Departmentation
DIVISIONAL ORGANIZATION Structure
Advantages of Divisional Structure Organization
Disadvantages of Divisional Structure
MATRIX ORGANIZATION STRUCTURE
Advantages
Disadvantages
FORMS OF FORMAL ORGANIZATION STRUCTURE
Line Organization Structure
Features of Line Organization
Merits of Line Organization
Demerits of Line Organization
Line and Staff Organization Structure
Characteristics of Line and Staff Organization
Merits of Line and Staff Organization
Demerits of Line and Staff Organization
Functional Organization Structure
Characteristics of Functional Organization Structure
Merits of Functional Organization Structure
Demerits of Functional Organization Structure
CHAPTER 25:
Committees
COMPETENCIES
INTRODUCTION
CONCEPT OF COMMITTEES
CHARACTERISTICS OF COMMITTEES
TYPES OF COMMITTEES
According to Authority
Line Committee
Staff Committee
According to Delegation of Authority
Formal
Informal
According to its Existence
Permanent Committees
Temporary Committees
PURPOSES, COMPOSITION AND TERM OF COMMITTEES
Purposes of Committees
Decision-making
Informational
Coordination
Advisory
Composition of Committees
Term of Committees
ADVANTAGES AND DISADVANTAGES OF COMMITTEES
Advantages of Committees
Pooling of Knowledge and Experience
Promotes Coordination and Cooperation
It Encourages a Comprehensive and Democratic Approach
It Brings Effective Face to Face two Way Communication
It is Device or Tool for Management Development
Avoidance of Action
Disadvantages of Committees
Delay in Execution
Ineffective Decision
Indecisive
Economy
Divided Responsibility
Misuse of Committee
WHEN TO USE COMMITTEES?
How to Make Committee Effective?
Members
Chairperson
Vice Chairperson
Convener or the Secretary
Ways to Build Committee Meetings Effective
Pre-meeting
One Day Before the Meeting
On the Day of Meeting
After Meeting
CHAPTER 26:
Coordination
COMPETENCIES
INTRODUCTION
MEANING OF COORDINATION
DEFINITIONS
Features of Coordination
Group Effort
Essence of Management
Conscious Activity
Responsibility of Management
Continuous and Dynamic Process
Unity of Actions
Unity of Purpose
Integration of Activities
Pervasive Function
Common Purpose
COORDINATION AND COOPERATION
PURPOSES OF COORDINATION
NEED AND IMPORTANCE OF COORDINATION
Elements of Coordination
Balancing
Timing
Integrating
Principles of Coordination
Direct Personal
Early Beginning
Reciprocity
Continuity
TYPES OF COORDINATION
On the Basis of Scope
On the Basis of Hierarchy
Preconditions to Coordination
Participation
Impartiality
Transparency
Barrier of Effective Coordination
Loss of Ad hoc Communication
Lack of Contact among Employees
Time to Initiate Contact or Communication
Communication Differences or Preferences
Lack of Trust
Personal Work Style Differences
Different Backgrounds of Members
Not Realizing there is a Need to Communicate
Skills to Achieve Effective Coordination
Sound Planning
Effective Communication
Effective Leadership and Supervision
Proper Delegation
Voluntary Coordination
Evaluation Skills
Coordination Through Committees
Meetings
CHAPTER 27:
Organizational Climate
COMPETENCIES
INTRODUCTION
DEFINITION AND MEANING OF ORGANIZATIONAL CLIMATE
EVOLUTION OF THE CONCEPT
WHY TO MEASURE ORGANIZATIONAL CLIMATE
AREAS OF MEASURING ORGANIZATIONAL CLIMATE
FACTORS INFLUENCING ORGANIZATION CLIMATE
Dimensions of Organizational Climate
Orientation
Interpersonal Relationships
Supervision
Problems
Management of Mistakes
Conflict Management
Communication
Decision-Making
Trust
Management of Rewards
Risk Taking
Innovation and Change
IMPORTANCE OF ORGANIZATIONAL CLIMATE
HOW TO DEVELOP SOUND ORGANIZATIONAL CLIMATE
CHAPTER 28:
Organizational Effectiveness
COMPETENCIES
INTRODUCTION
CONCEPT OF ORGANIZATIONAL EFFECTIVENESS
DEFINITIONS
HISTORICAL BACKGROUND OF ORGANIZATIONAL EFFECTIVENESS
DETERMINANTS OF ORGANIZATIONAL EFFECTIVENESS
Managerial Characteristics
Strategies, Policies and Practices
Standards
Leadership Skills
Decision Making
Effective Communication
Human Resource Management
Staff Training and Development
Rewards and Incentives
Performance Management
Organizational Characteristics
Structural Design
Methods
Size
Organizational Culture
Environmental Characteristics
Internal
Complexity
Public Opinion
Employees Characteristics
Individual Goals
Skills
Motives
Attitudes
Values
MODELS OF DETERMINING ORGANIZATIONAL EFFECTIVENESS
Competing Values Model
The Contradictions Model of Organizational Effectiveness
Assumptions
Seven Models Concept
Rational Goal Model
The Systems Resource Model
Bargaining Model
The Managerial Process Model
The Organizational Development Model
The Structural Functional Approach
Functional Approach
Strategic Constituencies Model
The Fault-driven Model
High Performing System Model
HOW TO DEVELOP ORGANIZATIONAL EFFECTIVENESS?
Plan Process of Change
Develop Leadership Skills for Organizational Change
Use of Improvement Processes and Tools
Develop Individual Effectiveness
CHAPTER 29:
Conflict Management
COMPETENCIES
INTRODUCTION
MEANING AND DEFINITIONS OF ORGANIZATIONAL CONFLICT
Nature of Organizational Conflict
ORGANIZATIONAL CONFLICT PROCESS
Pondy's Model (1967) of Conflict Development
Stage 1: Latent Conflict
Stage 2: Perceived Conflict
Stage 3: Felt Conflict
Stage 4: Manifest Conflict
Stage 5: Conflict Aftermath
Stephen P Robbins Model
Emergence
Escalation
Crisis
Negotiation
Resolution or Outcome Stage
The Process Model of Conflict
Conflict Potential
Dependence (or power)
Conflict Perception
Resultant Force
Conflict Aftermath
Structural Model
TYPES OF ORGANIZATIONAL CONFLICT
Interpersonal Conflict
Intra-group Conflict
Intergroup Conflict
Inter-organizational Conflict
FORMS OF ORGANIZATIONAL CONFLICT
Cognitive, task-related Conflicts or Substantive Conflict
Affective Conflict or Relationship-focused Conflicts
Process Conflict
DIMENSIONS OF CONFLICT
Negative Emotionality
Importance
Acceptability
Resolution Potential
Group Communication Norms
The Size or Scope of the Conflict Issue
IMPACT OF DIFFERENT TYPES OF CONFLICT
Impact of Task Focused Conflict: Positive Effect
Impact of Relationship Conflict: Negative Effect
ELEMENTS OF CONFLICT
ORIGIN OF CONFLICT IN HEALTH CARE SETTINGS
HOW TO PREVENT CONFLICT: AT INDIVIDUAL LEVEL
Get Education and Training in Conflict and Conflict Management
Improve your Communication Skills
Recognize that Men and Women have different Communications Styles and Responses to Conflict
Adopt an AVID Approach to Others
Behavioral Approach
MANAGING ORGANIZATIONAL CONFLICT
Thomas Model of Conflict-handling Modes
Competing
Collaborating
Compromising
Avoiding
Accommodating
Borisoff and Victor Theory
Assessment
Acknowledgement
Attitude
Action
Analysis
CONFLICT RESOLUTION STRATEGIES
Acting at the Level of Structure
Change of Organizational Structures
Increasing Integration
Flattening the Hierarchy and Decentralizing Authority
Acting at the Level of Attitudes and Individuals
‘Four Rs’ of Conflict-resolution
Reasons
Reactions
Resolution
Considerations in Selecting Conflict Management Style
Decide on a SMART Agreement
LEADERSHIP AND CONFLICT RESOLUTION
Develop an Organizational Process
Skills-based Training and Coaching
Meditation
EMOTIONAL INTELLIGENCE (EI) AND CONFLICT RESOLUTION
EFFECTIVE COMMUNICATION AND CONFLICT RESOLUTION
CHAPTER 30:
Organizational Change
COMPETENCIES
INTRODUCTION
MEANING OF CHANGE
ORGANIZATIONAL CHANGE MANAGEMENT Vs CHANGE MANAGEMENT
ORGANIZATIONAL CHANGE AS PLANNED CHANGE
What it is?
The Dimensions of Change
When the Organization is viewed as a Multivariate System
Technology Related Changes
Task related Changes
Structure related Changes
People related Changes
When the Organization is viewed as an Integral System
Two Dimensions of Change are Viewed
The Seven Dimensions of Change
Purposes of Planned Change
Essential Elements of Organizational/ Planned Change
Vision
Guiding Principles/Shared Values and Belief
Mission
Organizational Structure/Culture
Situational Analysis
Goals and Objectives
Project Work Plans (Actions plans)
Financial Plan
Communications Plan
Evaluation Plan
PRINCIPLES OF CHANGE MANAGEMENT
THEORIES AND MODELS OF CHANGE MANAGEMENT
Planned Change Theory
Lewin's Change Model
Unfreezing
Changing
Refreeze
Kotter and Cohen's Model of Change
The ADKAR Model
Bridges’ Transition Model
The Ending
Shifting to Neutral
Moving Forward
TQM — Total Quality Management
McKinsey 7-S Model
The Change Curve Models
The Change Curve
The Change Curve Model
The Lewis-Parker ‘Transition Curve’
Synergy Model of Nursing
The Trans Theoretical Model of Behaviour Change
Pre Contemplation Stage
Contemplation Stage
Preparation Stage
Action Stage
Maintenance Stage
Relapse Stage
STRATEGIES FOR CHANGE
PROCESS OF PLANNING CHANGE
Identify Need for Change
Identify Areas for Change
Assessing the Situation
Planning for Change
Clear Goals
Scope
Communication
Participation
Provision of Resources and Support
Minimize Resistance
Assess Change Forces
Actions for Change/ Implementing Change
Monitoring and Evaluating the Change Process
Feedback
PLAN FOR THE BUSINESS (ORGANIZATION STRUCTURE) DIMENSION OF CHANGE
Inclusion of Project Elements
Prepare for People for Dimension of Change
Plan Common Action Steps for Managing Change
HUMAN RESPONSE TO CHANGE
Responses of Change
Management Viewpoint
Staff Viewpoint
Resistance to Change
Anxiety
Happiness
Fear
Threat
Guilt
Depression
Disillusionment
Hostility
Denial
Factors for Resistance to Change
Resistance Management
Proactive Resistance Management
Reactive Resistance Management
Qualities of a Change Agent
Role of a Nurse Manager in Change Management
UNIT 5: HUMAN RESOURCE MANAGEMENT AND STAFFING
CHAPTER 31:
Human Resource Management
COMPETENCIES
PERSONNEL Management
Meaning and Definitions
Personnel Administration
Personnel Management
Principles of Personnel Management
Characteristics of Personnel Management
Functions of Personnel Management
Objectives of Personnel Administration and Management
Manpower Management and Development
Phase I: Manpower Planning
Phase II: Manpower Production
Phase III: Manpower Management
HUMAN RESOURCE MANAGEMENT
Introduction
What is Human Resource Management (HRM)?
Features of Human Resource Management
Human Resource Management: Scope
Human Resource Management: Objectives
Components of HRM
Human Resource Utilization
Human Resource Development
Human Resource Management: Functions
CHAPTER 32:
Fundamental of Staffing
COMPETENCIES
INTRODUCTION
MEANING AND DEFINITIONS OF STAFFING
SAFE STAFFING
NATURE OF STAFFING
FEATURES OF STAFFING
NEED FOR STAFFING
IMPORTANCE OF SAFE STAFFING
Related to Patients
Related to Nurses
Cost Effective
PHILOSOPHY OF STAFFING IN NURSING
Principles of Nursing Staffing
Patient Care Unit Related
Staff Related
Institution/Organization Related
SYSTEM APPROACH TO STAFFING
Components/Steps of Staffing Process
Manpower Planning
Job Analysis
Recruitment
Selection
Placement
Induction and Orientation
Training and Development
Remuneration
Performance Appraisal
Promotion and Transfer
STAFFING PATTERNS
Purpose
Factors Influencing Staffing Pattern
Types of Nursing Services
Number of Patients
Standard of Care
Role Defined by Profession
Qualification and Job Specification
Supply of Personnel
Patients; Condition
Fluctuation of Work Load
Method of Assignment
Geography of Nursing Unit
Supporting Staff
Type of Hospital
Personnel Policies
Budget
ANALYSIS FOR WORKING ON STAFFING PATTERN
Determination of Services Provided Per Year
Working Days per Nurse per Year
Staff available for Nursing Service
Time available for Nursing Services in a Year
Daily Activities
Time Required per unit of Activity
Services Provided
Enumeration of Service Requirements
Staff Required for Intended Service
STAFFING NORMS
METHOD OF CALCULATION
I. Method of Calculating the Working Hours per Week per Nurse
II. Method of Calculating Nurse Patient Ratio or Number of Patients per Bedside Nurse
III. Method of Calculating Maximum Nursing Time available per Patient per Nurse per Shift
Utilization of Available Nursing Time
Availability of Written Ward Policies
Clear, Concise and Written Assignments
Admission and Discharge Policies
Equipments and Supplies
Professional Preparation
Planned Programme of Periodic Appraisal of Performance
Group Conferences
Supervision
Visitor Control
Emphasis on Research and Utilization
CHAPTER 33:
Manpower Planning
COMPETENCIES
INTRODUCTION
MANPOWER/HUMAN RESOURCE PLANNING: MEANING AND DEFINITIONS
ASPECTS OF NURSING MANPOWER PLANNING
Quantitative Aspect
Qualitative Aspect
NEED FOR MANPOWER PLANNING
AIMS AND OBJECTIVES OF NURSING MANPOWER PLANNING
IMPORTANCE OF NURSING MANPOWER PLANNING
Manpower Planning Process
Wickstrom, National Industrial Conference Board USA
Hall's Viewpoints
Roberfroid et al, 2009 Viewpoints
Una V Reid View Points
NURSING MANPOWER PLANNING AT NATIONAL LEVEL
MANPOWER PLANNING AT ORGANIZATIONAL LEVEL
DETERMINATION OF NURSING SERVICE OBJECTIVES
FORECASTING NURSING MANPOWER REQUIREMENTS
Concept of Demand/Requirement
Demand
Need
Requirements
Factors Affecting Demand
Demographic Factors
Economic Factors
Social and Cultural Factors
Health Status
Accessibility of Health Services
Resources Availability and Productivity
Health Care Technology
Sources for Demand Forecast
Methods of Estimating the Nursing Manpower Requirement or Demand
Need Based Approach
Assumptions
Advantages
Limitations
Utilization Based Approach
Health Workforce to Population Ratio Approach
Service Target-based Approach
Adjusted service target approach
The Economic Demand Approach
Effective Demand based Approach
Lomas J, Stoddart G Model
O'Brien-Pallas's Dynamic System-based Framework
Benchmarking Approach
Normative Approach
NTTP (Needs, Service Targets, Time and Productivity) Approach
Delphi Method
Measurement of Actual Time
Modeling Strategies
Regression Modeling
A Simulation Model
A Markov-population Model
Econometric Models
Macro models
Micro models
Taxonomy of Nurse Demand and Method
Consensus Approaches
Consultative method
Top-down Management Approaches
Staffing norms or normative method
Staffing formulae
Using expert opinion
Population Benchmarking Database
‘Bottom-up’ Management Approaches
Timed-task/activity method/nursing intervention method
Patient dependency methods
Nurses per occupied bed
Dependency-activity-quality (acuity-quality) method
Regression-based systems
SUPPLY ESTIMATES
Concept
Supply Forecasting
Determining Internal Supply of Workforce
Determining the External Supply of Manpower
Action Based on Supply and Demand Analysis
Supply and Demand Analysis
Establish Specific Objectives & Formulation of Requirement/Action Plans
PLANNING MANPOWER MANAGEMENT METHODS
According to Trent Health (1991)
Short Term
Medium Term
Long Term
Operational
According to Audit Scotland (2001)
Developing a Partnership Culture
Assessing Staffing Needs for Service Delivery
Retaining and Recruiting the Staff as per Need
Managing Performance
Improving Employee Performance
CHAPTER 34:
Recruitment, Selection and Retaining Employees
COMPETENCIES
INTRODUCTION
MEANING OF RECRUITMENT
PURPOSEs AND IMPORTANCE OF RECRUITMENT
RECRUITMENT PROCESS
Identify Vacancies
Preparing Job and Person Specification
Physical Specification
Mental Specification
Emotional and Social Specification
Behavioral Specification
Advertising Vacancies
Managing Response
Short Listing and Identifying the Prospective Candidates
Arranging the Interview with the Shortlisted Employees
Conducting the Interview and Decision Making
SOURCES OF RECRUITMENT
Recruitment from Internal Sources
Transfers
Promotion
ADVANTAGES OF RECRUITMENT THROUGH INTERNAL SOURCES
Recruitment from External Sources
Methods
Advertisement
Employment Agencies
Deputation
On the Campus Recruitment
Online Recruitment
Telecasting
Advantages
Disadvantages
Difference between Internal and External Sources
THE RECRUITMENT POLICY
Components of the Recruitment Policy
Characteristics of the Recruitment Policy
Factors Affecting Recruitment Policy
SELECTION: MEANING AND DEFINITIONS
SIGNIFICANCE OF SELECTION
SELECTION PROCESS
Pre Selection
Interview
Assessment
Screening of Application Forms
Selection Tests
According to Merit System
Selection by Evaluation of Qualification and Experience
Achievement and Aptitude Tests
Intelligence Tests
Neuropsychological Tests
Occupational Tests
Personality Tests
Interview
References Checks
Physical/medical Examination
Approval by the Appropriate Authority and Issuing of Appointment Letter
Orientation and Placement
RECRUITMENT vs SELECTION
Similarities
Retaining Employees
Selecting and Training
An Effective Orientation
Job Satisfaction
Creating Trust
Empower Each Nursing Personnel
Build Relationship with Subordinates
Recognize Employees
Stress Management
CHAPTER 35:
Job Analysis, Design and Evaluation
COMPETENCIES
INTRODUCTION
JOB ANALYSIS WHAT IS JOB ANALYSIS
Types of Job Analysis
Qualitative Job Analysis
Quantitative Job Analysis
Purposes of Job Analysis
Manpower Planning
Recruitment
Selection
Placement and Induction
Determining Training Needs
Compensation
Counseling
Employee Safety
Performance Review
Job Evaluation
Job Design and Redesign
Process of Job Analysis
Organizational Analysis
Selection of Strategic Choices
Collection of Job Analysis Data and Information Processing
Preparation of Job Description
Preparation of Job Specification
Approaches to Job Analysis
Duties and Tasks
Work Environment
Equipment, Articles, and Monitors
Interpersonal Communication
Competencies
Physical Characteristic
Credentials and Experience
Other Characteristics
METHOD OF COLLECTING JOB ANALYSIS DATA
Observation Method
Direct Observation
Work Methods Analysis
Critical Incident Technique (CIT)
Interviews
Panel of Experts
Diary Method
Use of Questionnaire
Technical Conferences or Committees
JOB DESCRIPTION
What is Job Description
Job Content of Job Description
Job Title and Location
Job Summary
Job Activities/Duties
Working Conditions
Work Environment
Performance Standards
IMPORTANCE AND PURPOSES OF JOB DESCRIPTION
WRITING JOB DESCRIPTION
HOW TO DEVELOP JOB DESCRIPTION
PRINCIPLES IN PREPARING THE JOB DESCRIPTION
JOB SPECIFICATION
What is Job Specification
Advantages of Job Specification
Characteristics of Job Specification
Design of Job Specification
JOB DESIGN
What is Job Design
Factors Affecting Job Design
Organizational Factors
Environmental Factors
Behavioral Factors
Techniques of Job Design
Job Simplification
Job Rotation
Job Enlargement
Job Enrichment
JOB EVALUATION
What is Job Evaluation
Method of Job Evaluation
Job Ranking
Job Grading System
Point System
Factor Comparison Method
CHAPTER 36:
Placement, Allocation and Assignment System
COMPETENCIES
INTRODUCTION
PLACEMENT
Definition
Significance
ALLOCATION:STAFF ALLOCATION
WORK ALLOCATION
Concept of Work Assignment
Purposes of Work Assignment
Principles of Work Assignment
Characteristics of an Effective Assignment
Methods of Assignments or Assignment Pattern
Factors Affecting Assignment Pattern
Patient Characteristics
Nursing Resources
Organization Support
The Type of Nursing Care Delivery System
NURSING CARE DELIVERY SYSTEM
Meaning and Definition
Purposes of Nursing Care Delivery System
Elements of Nursing Care Delivery System
Factors Influencing Nursing Care Delivery System
The Availability of Nursing Manpower
The Complexity and Variability within the Health Care Setting
The Severity of Illness of Patients
The Financial Health of the Institution
The Physical Design of the Patient Care Areas
Assistance from Ancillary Staff
Experience and Competency of the Personnel
Recommendation of Accrediting Body
Measurements of Nursing Care Systems
NURSING CARE DELIVERY MODELS
Traditional Methods/Models
Private Duty Nursing Model
Method of Assignment
Advantages
Disadvantages
Total Patient Care or Case Method
Method of Assignment
Advantages
Disadvantages
Functional Method or ‘Efficiency’ Method
Method of Assignment
Advantages
Disadvantages
Team Method
Method of Work Assignment
Advantages
Disadvantages
Modular Nursing
Features and Method of Work Assignment
Advantages
Disadvantages
Primary Nursing Method
Method of Work Assignment
Advantages
Disadvantages
Case Management Method
Features of Case Management
Prerequisite
Elements of Successful Implementation of Case Management
Management Tools and Coordination Methods in Case Management
Integrated Care Pathways (ICP)
CHAPTER 37:
Scheduling
COMPETENCIES
INTRODUCTION
DEFINITIONS
IMPORTANCE OF SCHEDULING
OBJECTIVES
PRINCIPLES OF SCHEDULING /DUTY ROTAS
In General
Office for Health Management (2003) Model
Queensland Health (2003) Model
TYPES OF SCHEDULING
Centralized
Decentralized
TYPES OF SCHEDULE PLANS
Master Schedule Rotation Plan
Operational/Ward Schedule/Rotational Plan
FACTORS TO BE CONSIDERED IN PREPARING SCHEDULE
I In General
II As per Objectives
SCHEDULING VARIABLES
STEPS FOR DETERMINING SCHEDULING
POINTS TO BE KEPT IN MIND WHILE PREPARING SCHEDULE PLAN
SCHEDULING OF SHIFT WORK/SHIFT DUTY PATTERN
Three 12 Hours Shift Per Week
Benefits
Disadvantages
10 Hours Shift x 4 Days Schedule/ The 40 Hours, 4 Days Week Work Schedule
Advantages
Disadvantages
Combination of Four-eight-ten and Twelve Hours Shift
Advantages
Disadvantage
8 Hours Straight Shift
Advantages
Five Days, 40 Hours Week
7-70 Staffing Pattern Plan
Advantages
METHODS OF ROSTERING OR PREPARING SCHEDULE PLAN
Scheduling by Nurse Administrator/Supervisor
Self Scheduling
Advantages
Disadvantages
Computerized Rostering: Scheduling Software Automated scheduling software
Schedule pro
On line scheduling software
ROLE OF NURSE MANAGER IN SCHEDULING
TIME SCHEDULING PRACTICES IN NORTH INDIA
Duty Timings
Day Offs
SCHEDULE PLAN
For Bedside Nurses
Morning Shift Coverage
Evening Shift Coverage
Night Shift Coverage
For Nurse Supervisors
Morning Shift Coverage
Evening Shift Coverage
Night Shift Coverage
CHAPTER 38:
Turnover and Absenteeism
COMPETENCIES
INTRODUCTION
DEFINITION AND MEANING
THE MEASUREMENT OF STAFF TURNOVER
The Staff Turnover Rate (LTR)
Interpretation
Median Length of Service (MLOS)
Interpretation
Percentage Voluntary Resignation (%V)
Other Measurements of Staff Turnover
THEORETICAL MODELS OF TURNOVER DETERMINANTS
Price and Mueller Model (1981)
Hiushaw and Atwood's Model (1983)
Parasuraman Model (1989)
Irvine and Evans Model (1995)
Krausz et al Model (1995)
Alexander's Model (1998)
DETERMINANTS OF TURNOVER
IMPACT OF STAFF TURNOVER
Negative Impact
Direct and Indirect Costs
Cost of Lost Performance
Disruption in the Psycho-social Environment
Decline in Morale
Damage the Reputation of the Organization
Health and Safety of Nurses
Quality of Patient Care
Potential Positive Impact
RETENTION STRATEGIES
ROLE OF NURSE MANAGER TO REDUCE STAFF TURNOVER
ABSENTEEISM INTRODUCTION
DEFINITIONS
TYPES OF ABSENTEEISM
As per the Cause
Innocent
Culpable
As per Authorization
Authorized Absence
Unauthorized Leave
Planned Time out and Unplanned Absenteeism
COMPUTATION OF ABSENTEEISM
ASSOCIATED FACTORS OF ABSENTEEISM
Social Factors
Employees’ Related Factors
Employer Related Factors
Workplace Factors
Miscellaneous Groups of Causes
IMPACT OF ABSENTEEISM
ABSENTEEISM MANAGEMENT STRATEGIES
Preventive Measures
Keeping Absenteeism to a Minimum
Taking a Negative or Punitive Approach
Change Management Style
Change Work Environment
Provide Incentives
Develop an Attendance Policy
Terry R George Point of Views
RESPONSIBILITY OF NURSE SUPERVISORs TO MANAGE ABSENTEEISM
PROCEDURE TO DEAL WITH ABSENTEEISM
Stage 1: Counseling Interview
Stage 2: First Formal Review (Verbal Warning Stage)
Stage 3: Second Formal Review (Written Warning Stage)
Stage 4: Temporary Suspension from Work
Stage 5: Termination of Employment
CHAPTER 39:
Personnel Policies
COMPETENCIES
INTRODUCTION
DEFINITIONs OF PERSONNEL POLICY
IMPORTANCE OF PERSONNEL POLICY
NEED FOR PERSONNEL POLICIES
TYPES OF PERSONNEL POLICIES
According to Source
Originated Policies
Appealed Policies
Imposed Policies
According to Scope
General Policies
Specific Policies
According to Forms
Implied Policies
Within Policies
CHARACTERISTICS OF PERSONNEL POLICIES
ORGANIZATION OF PERSONNEL POLICIES
FORMULATION OF PERSONNEL POLICIES
Identification of Need
Collecting Facts
Find out Alternatives
Approval of Policy
Evaluate the Policy
CHAPTER 40:
Promotion and Transfers
COMPETENCIES
INTRODUCTION
PROMOTION MEANING OF PROMOTION
PURPOSES OF PROMOTION
IMPORTANCE OF PROMOTION
BASES OF PROMOTION
Seniority
Advantages of seniority
Disadvantages of seniority
Merit System
Methods of Testing Merit
Advantages of Merit System
Disadvantages of Merit System
Seniority cum Merit System
PROMOTIONAL POLICY
Features of Promotional Policy
TRANSFER
Meaning and Definitions of Transfers
Purposes of Transfer
Benefits of Transfer
Types of Transfer
Production Transfer
Shift Transfers
Replacement Transfers
Remedial Transfer
Versatility Transfer
Panel Transfer
Transfer Policy
CHAPTER 41:
Staff Development: Training and Development
COMPETENCIES
INTRODUCTION
CONCEPT AND MEANING OF STAFF DEVELOPMENT
IMPORTANCE AND NEED OF STAFF DEVELOPMENT
PHILOSOPHY OF STAFF DEVELOPMENT
GOAL OF STAFF DEVELOPMENT
OBJECTIVES OF STAFF DEVELOPMENT
ADVANTAGES OF STAFF DEVELOPMENT
STAFF DEVELOPMENT PROCESS
STAFF DEVELOPMENT MODELS
The RPTIM Model
Readiness Stage
Planning Stage
Training Stage
Implementation Stage
Maintenance Stage
Iowa Professional Development Model
The Planning Stage
Ongoing Component
Programme/summative Evaluation
Dennis Sparks Models
Individually Guided Professional Development Model
Observation/Assessment Model
Involvement Model
Training Model
Inquiry Model
STAFF DEVELOPMENT METHODS
On the Job
Off the Job Methods
STAFF DEVELOPMENT ACTIVITIES
Induction Training
Orientation
In Service Education
Continuing Education
Continuing Education is Distinguished from Academic Pursuits
Continuing Education is Different from in Service Education
Continuing Education Differs from Continuing Learning
Outcomes of Continuing Education
Patient Related
Personal
Professional (individual)
Professional (interpersonal)
Personnel (organization)
Professional
OBJECTIVES AND AREAS OF TRAINING PROGRAMMES
Objectives
Identified Areas
PLANNING OF EDUCATION/TRAINING PROGRAMMES
Assessment
Design
Implementation
Evaluation and Follow up
CHAPTER 42:
Performance Appraisal
COMPETENCIES
INTRODUCTION
DEFINITIONs OF PERFORMANCE APPRAISAL
CHARACTERISTICS OF PERFORMANCE APPRAISAL
PURPOSES OF PERFORMANCE APPRAISAL
For Employees: Individual based
It is one of the Criteria for Promotion
Job Performance Measurement
Job Improvement
Helps to Identify Training Needs and Planning for Training Programmes
Helpful in Compensation Administration
Important Tool for Motivational Force to the Employees
Basis for Counseling
Organizational Control
Feedback to Employees
Periodic Review of Progress
Self Examination
For Organization: Institutional based
Measurement of Organizational Objectives
Measurement of Work Standards
Information Generation
Reduces Grievances of the Employee
Helps for Manpower
Specific Uses
Promotion Decisions
Training and Development Programmes
Evaluation of Supervisors and Managers
Compensation Decisions
Performance Feedback
Personal Development
PRINCIPLES OF PERFORMANCE APPRAISAL
Criteria Considered for Performance Appraisal
Determine What is to be Appraised
Who are going to be Appraised and by Whom?
Why to Appraise?
When to Appraise?
How to Appraise?
APPROACHES TO PERFORMANCE APPRAISAL
Traditional Approach
Modern Approach
PERFORMANCE APPRAISAL PROCESS
METHODS OF PERFORMANCE APPRAISAL
Individual Evaluation Methods
Confidential Reports
Essay Appraisal Method
Critical Incidence Technique
Checklists and Weighted Checklists
Graphic Rating Scales
Behaviorally Anchored Rating Scales
Forced Choice Method
Management by Objective Method
Multiple-person Evaluation Methods
Ranking Method
Paired Comparison
Forced Distribution Method
Other Methods
Assessment Centres
Group Appraisal Method
Field Review Method
360-degree Feedback Appraisal
GUIDELINES FOR EFFECTIVE PERFORMANCE APPRAISAL
CHAPTER 43:
Discipline and Grievance Procedure
COMPETENCIES
INTRODUCTION
DISCIPLINE
Definitions of Discipline
Purposes of Discipline
Prerequisite for Discipline
Self Discipline
Orderly Behavior
Punishment
Types of Discipline
Positive Discipline
Negative Discipline
Characteristics of a Sound Disciplinary System
DISCIPLINE/CONDUCT RULES
Why Discipline Rules?
Principles of Discipline
INDISCIPLINE
Causes of Indiscipline
Consequences and Symptoms of Indiscipline
DISCIPLINARY PROCESS
Progressive Discipline
Oral Reprimands
Written Reprimands
Steps of Progressive Discipline
Informal Feedback-Verbal Warning
Letter of Counsel-Written Warning
Letter of Reprimand
Suspension-final Warning
Termination
PENALTIES FOR MISCONDUCT/INDISCIPLINE
Major Penalties
Procedure for Major Penalties/Punishment
Minor Penalties
Procedure for Minor Punishment
ROLE OF NURSE ADMINISTRATOR IN MAINTAINING DISCIPLINE
EMPLOYEE GRIEVANCEs
Meaning
Features
Why Grievances?
Economical
Work Environment
Supervision
Work Group
Work Organization
Faulty Systems
Lack of Appropriate Codes and Processes
FORMS OF GRIEVANCES
Factual
Imaginary
Disguised
EFFECTS OF GRIEVANCES
INVESTIGATING A GRIEVANCE
GRIEVANCE HANDLING PROCEDURE
Essential Ingredients for Grievance Procedure
Steps in Grievance Handling Procedure
Identify/acknowledge the Grievance
Define the Grievance Correctly
Gather the Facts
Analyze the Data and Finding the Cause of Grievance
Decision Making
Prompt Redressal
Implementation and Follow up
Guidelines during Grievance Handling Procedure
CHAPTER 44:
Occupational Health and Safety
COMPETENCIES
INTRODUCTION
OCCUPATIONAL HEALTH AND SAFETY
Occupational Health
Occupational Safety
Occupational Health and Safety
Why Occupational Health and Safety is Important?
Aims and Objectives of Occupation Health and Safety
OCCUPATIONAL HAZARDS
Meaning of Occupational Hazards
Common Occupational Hazards in Hospitals
Biological Hazards
Airborne and Droplet Aerosol Exposure
Skin Contact Exposure
Exposure to Infectious Fluids via broken Skin, Eyes, Mucous Membranes, and Parenteral Exposure
Physical Hazards
Chemical Hazards
Occupational Cancers
Reproductive Hazards
Mechanical Hazards
Psychological Hazards
Occupational Hazards in Emergency Unit
Blood, and Blood-borne Infectious
Hazardous Chemicals Exposure
Slips/Trips/Falls
Latex Allergy
Equipment Hazards
Workplace Violence
Tuberculosis
Workplace Stress
Methicillin-Resistant Staphylococcus Aureus (MRSA)
GENERAL METHODS OF PREVENTION OF OCCUPATIONAL DISEASES
The Constitutional Aspects of Employees’ Right to Health
Occupational Health Laws
Health Provisions under the Factories Act, 1948
The Employees’ State Insurance (ESI) Act, 1948
National Safety Council of India (NSCI)
Occupational Safety and Health Act, 1989
Occupational Safety and Health Institutions
IS 18001:2000 Occupational Health and Safety Management Systems
National Policy on Safety, Health and Environment
Objectives
India and International Labour Organization (ILO)
Develop a Successful Health and Safety Programme at Local Level
Nosocomial Infection Control
Patient Safety
Food Safety
Disaster Management
Waste Management Issues
Community based Programmes
NURSES’ ROLE IN PREVENTION OF OCCUPATIONAL HAZARDS/DISEASES
At administrative and managerial level, the nursing personnel should:
UNIT 6: DIRECTING
CHAPTER 45:
Fundamentals of Directing
COMPETENCIES
INTRODUCTION
MEANING OF DIRECTING
FEATURES OF DIRECTING
ROLES AND FUNCTIONS OF DIRECTING
Principles of Directing
Harmony of Objectives
Unity of Command
Appropriate Techniques
Direct Supervision
Effective Leadership
Understanding and Comprehension
Effective Communication
Use of Informal Communication
Utilization of Maximum Individual Efforts
Clear Orders
Follow up
Elements of Directing
Supervision
Motivation
Leadership
Communication
Order Giving
Direction and Organizational Behavior (Ob) Models
Autocratic Model
Custodial Model
Supportive Model
Collegial Model
System Model
CHAPTER 46:
Effective Supervision
COMPETENCIES
INTRODUCTION
MEANING AND DEFINITION OF SUPERVISION
OBJECTIVES OF SUPERVISION
Main Objectives
Specific Objectives
Purposes of Supervision
Getting the Work Done in an Organization
Observing, Assessing, Checking and Amending
Improvement of Staff Efforts Individually and Collectively
Self Direction
Sense of Security and Confidence
Help in Solving the Problems
Team Work
Bridging the Gap between Personal and Organizational Goals
PRINCIPLES OF SUPERVISION
TIPS FOR EFFECTIVE SUPERVISION
PROCEDURAL STEPS FOR SUPERVISION
Preparation
Actual Supervision
Follow up of Supervision
CONTENT FOR SUPERVISION
TECHNIQUES OR METHODS OF SUPERVISION
Selection of Technique
Methods
Direct Methods
Indirect Methods
Other Methods
Tools of Supervision
Observation Check List
Rating Scale
FUNCTIONS OF SUPERVISION
Normative Functions
Formative or Educational Functions
Restorative or Supportive Functions
Other Functions
Communicative
Evaluative
FUNCTIONS OF A SUPERVISOR
In General
Towards Superiors
Towards Subordinates
In Terms of Cooperation
QUALITIES OF A SUPERVISOR
Categories of Supervision
Clinical Supervision
Managerial Supervision
Personal Supervision
Professional Supervision
CHAPTER 47:
Motivation
COMPETENCIES
INTRODUCTION
DEFINITIONS OF MOTIVATION
Motivation Process
TYPES OF MOTIVATION
MOTIVATION AND PERFORMANCE
Factors that Influence Nurses Motivation
Hygiene and Motivational Factors
Valence, Expectancy, and Instrumentality
Self Esteem, Job Enrichment
Attribution
Causes of de-motivation
Workplace Hazards
Shift Duty Pattern and Long Working Hours
Night Duty
Shortage and Turnover
Feeling of Underpaid
Lack of Recognition and Appreciation
General Demotivating Factors
Theoretical MODELS OF MOTIVATION
MARS Model of Individual Behavior
Four Drive Model of Employee's Motivation
Acquire and Achieve
Belong and Bond
Challenge and Comprehend
Define and Defend
MOTIVATIONAL THEORIES
Hierarchy Needs of Abraham Maslow's Theory of Need
Physiological Needs
Safety Needs
Social Needs
Esteem Needs
Self-Actualization Needs
ERG (Existence, Relatedness, and Growth) Theory
Existence
Relatedness
Growth
Two-Factor Theory of Fredrick Herzberg
Hygiene Factors
Motivator Factors
Acquired-Needs Theory of David McClelland's
Need for Achievement (nAch)
Need for Affiliation (nAff)
Need for Power (nPow)
Process Theories of Motivation
HOW TO CREATE MOTIVATING CLIMATE?
CHAPTER 48:
Communication
COMPETENCIES
INTRODUCTION
MEANING OF COMMUNICATION
FEATURES OF COMMUNICATION
PURPOSES OF COMMUNICATION
COMMUNICATION PROCESS
IMPORTANCE OF COMMUNICATION
TYPES OF COMMUNICATION
Types of Communication according to Channel or Relationship
Formal Communication
Informal Communication or Grapevine
Disadvantages
Types of Communication according to Direction or Flow
Downward Communication
Upward Communication
Lateral/Horizontal Communication
Diagonal Communication
External Communication
Types of Communication according to Method of Expression
Verbal Communication
Oral Communication
Advantages
Disadvantages/Limitations
Written Communication
Merits
Demerits
Non-verbal Communication
Facial Expression
Blinking of Eyes
Gestures
Coughing
Body Position
Silence
NETWORK CHANNELS OF COMMUNICATION
Chain Network
Circular Network
Wheel Communication
Free Flow Communication
Inverted V
Network Channel of Informal or Grapevine Communication
EFFECTIVE COMMUNICATION
BARRIERS AND PROBLEMS IN COMMUNICATION
Semantic Barriers
Psychological Barriers
Stress
Unjust Assumptions
Barrier of Allness
Snap Reactions
Apathetic Listener
Sophisticated Role
Defensiveness
Fear
Organizational Barriers
Personnel Barriers
Environmental Barriers
Mechanical Barriers
MAKING COMMUNICATION EFFECTIVE
Elements of Effective Communication
Clarity of Massage
Clarity of Objectives of Communication
Use of Two Way Communication
Understanding the Receiver and Physical Setup
Adequacy and Completeness
Consistency
Timing
Appropriate Language and Symbols
Credibility
Good Listener
Eliminating Differences in Perception
Use of Simple Language
Noise Reduction
Control over Emotions
Avoid Overloading of Messages
Constructive Feedback
Select Appropriate Channel
Flexibility in Meeting the Targets
Use of Multiple Channel of Communication
Use Informal Channel of Communication
Maintain Transparency with Team Members and Subordinates
Be Confident
Essential Ingredients for Effective Written Communication
COMMUNICATION PATTERN IN NURSING
Communication of Nurse Administrator with Medical Administrators
Communication of Nurse Administrator with Subordinates
Communication Pattern of Nurse Supervisors
Communication Pattern of Bedside Nurses/ Operational level nurses
CHAPTER 49:
Public Relations
COMPETENCIES
PUBLIC RELATIONS
Introduction
Definitions of Public Relation
General Consideration
Aims of Public Relation
Functions of Public Relation
Advantages of Public Relation
Elements of Public Relation
Factors Affecting Hospital Public Image
Factors Responsible for Successful Public Relation Programme
PUBLICITY OR PUBLIC EDUCATION
Definitions
Significance of Positive Publicity
Objectives of Publicity
Characteristics of Publicity
Why Public Education
Means of Publicity
Written Words
Spoken Words
Visual Medias
Combinations of Means
NURSES ROLE IN IMPROVING HOSPITAL PUBLIC RELATIONS
CHAPTER 50:
Human Relation
COMPETENCIES
INTRODUCTION
DEFINITIONS OF HUMAN RELATIONS
Goals and Areas of Human Relation
Self-Esteem
Mutual Respect
Self-awareness and Self-disclosure
ELEMENTS OF HUMAN RELATION
PRINCIPLES OF HUMAN RELATION
BASIC PRINCIPLES OF HUMAN RELATIONS APPROACH
ADVANTAGES OF GOOD HUMAN RELATION
PREREQUISITES FOR GOOD HUMAN RELATION
INGREDIENTS FOR EFFECTIVE HUMAN SKILLS
ROLE OF NURSE MANAGERs TO DEVELOP HUMAN RELATION
CHAPTER 51:
Collective Bargaining
COMPETENCIES
INTRODUCTION
COLLECTIVE BARGAINING
What is Collective Bargaining
Objectives of Collective Bargaining
Collective Bargaining and Nursing
Characteristics of Collective Bargaining
Process of Collective Bargaining
Preparatory Phase
Discussion Phase
Possible Alternatives or Proposal Phase
Bargaining Phase
Settlement Phase
Formalizing the Agreement
Enforcing the Agreement
Merits
Demerits
Types of Collective Bargaining
Role of TNAI in Bargaining and Policies for Strike
HEALTH CARE Labour LAWS
What are Laws
Health Care Laws
Indian Health Care Improvement Act, 1976
Labour Laws
EMPLOYEES UNIONS
Trade Union
Features of Unions
Objectives of Unions
Purposes of Unions
Associations
Legal Status and Growth of Associations in India
Features of Associations
Objectives of Professional Associations
Usually the associations are formed with the objectives:
UNIT 7: LEADERSHIP
CHAPTER 52:
Nursing Leadership
COMPETENCIES
INTRODUCTION
SIGNIFICANCE OF LEADERSHIP
MEANING OF LEADERSHIP
CHANGING DEFINITIONS OF LEADERSHIP
DEFINITIONS OF NURSING LEADERSHIP
FEATURES OF LEADERSHIP
LEADERSHIP AND MANAGEMENT
Difference between Leadership and Management
Background and Classical Studies on Leadership
The Iowa Leadership Studies
The Ohio State Leadership Studies
The Early Michigan Leadership Studies
THEORETICAL APPROACHES IN LEADERSHIP
LEADERSHIP FOR HEALTHCARE PROFESSIONALS
LEADERSHIP STYLES
Meaning of Leadership Style
Types of Leadership Styles
According to Dimensions of Leadership
Leader's Approach to Influence: Transformational versus Transactional Leadership
Leader's Approach to Decision making and Problem solving: Autocratic versus Participative Leadership Styles
Following Style Emerges from Autocratic vs Participative Leadership
Leader's Balance between the Influence and Maintenance Functions: Socio-Emotional versus Task Style
According to the Way the Leaders Exercise their Authority
Leadership Styles Exhibited by Nurses
Relationally Focused Leadership Styles
Task Focused (non-relationally focused) Leadership Styles
EFFECTIVE LEADERSHIP
Need for Effective Leadership in Nursing
Importance of Effective Leadership
Leadership Styles and their Outcomes
Staff Satisfaction with Work, Role and Pay
Staff Relationships with Work
Healthy Work Environment
Organizational Productivity and Effectiveness
CHARACTERISTICS/QUALITIES OF AN EFFECTIVE LEADER
Qualities of an Effective Leader
Knowledge of Self
Personality Characteristics
Managerial Competencies
Competencies and Skills for Nurse Managers
LEADER DEVELOPMENT AND LEADERSHIP DEVELOPMENT
Definitions
Leader Development
Leadership Development
Difference between Leader and Leadership Development
Factors Influencing Leadership Development
Methods of Leadership Development
Leadership Training Programmes
Competencies to be Taught
Educational Activities
Phases of Training
360-degree Feedback
Coaching
Mentoring
On the Site Programmes
Using Human Relation Theory
Team Building
Using Feedback Model
Use of Three-circle Model of Strategic Leadership
CHAPTER 53:
Group Dynamics
COMPETENCIES
INTRODUCTION
GROUPS AND GROUP DYNAMICS
What is a Group
What is Group Dynamics
Focus Areas of Group Dynamics
Group Dynamics: Historical View
Need for a Group
Criteria and Attributes of a Group
Characteristics of Groups
Characteristics of Effective Groups
Types of Groups
Formal Groups
Task Groups
Informal Groups
Purposes of Groups
Organizational Functions
Individual Functions
GROUP FORMATION
Group Development: Theoretical Bases
Classic Theory
Social Exchange Theory
Social Identity Theory
Schutz's Three Stage Model (1958, 1966)
Inclusion
Control
Affection
Tuckman's Stages Model
Forming
Storming
Norming
Performing
Adjourning
Fisher's Theory of Decision Emergence in Groups (1970)
Bass and Ryterband's Model (1979)
Poole's Multiple-Sequences Model
McGrath's Time, Interaction, and Performance (TIP) Theory
Wheelan's Integrated Model of Group Development (1990, 1994)
Tubbs's System Model, 1995
Systematizing the Person Group Relation (SPGR) Theory on Group Development (Sj⊘vold 1995, 2006, 2007)
Control Function
Nurture Function
Opposition Function
Dependence
Group Size
Group Functions
Task Functions
Maintenance Functions
Self-interest Functions
GROUP NORMS
What are these
Why Group Norms
Types of Norms
Performance Norms
Reward-allocation Norms
The Norm of Equality
Equity Norms
Social Responsibility Norms
Behavior Norms
Characteristics of Norms
GROUP COHESIVENESS
What is Group Cohesiveness
Importance of Group Cohesiveness
Types of Group Interaction
Unorganized Social Interaction
Collaborative Group Interaction
Logical Group Interaction
Factors Influencing Group Cohesiveness
Effects of Group Cohesiveness
Positive Effects
Negative Effects
Indicators of Group Cohesiveness
Advantages of Group Cohesiveness
ROLE OF GROUP LEADER IN GROUP PROCESS
APPLICATIONS OF GROUP DYNAMICS IN NURSING MANAGEMENT
CHAPTER 54:
Power and Politics
COMPETENCIES
INTRODUCTION
POWER
Meaning and Definitions of Power
Sources of Power
Types of Powers
Legitimate Power
Reward Power
Coercive Power
Expert Power
Referent Power
Other Types of Power
Consequences of Powers
Using Legitimate Power
Using Reward Power
Using Coercive Power
Using Expert Power
Using Referent Power
Contingencies of Power
Substitutability
Centrality
Discretion
Visibility
Perspectives of Organizational Power
The Functionalist Perspective
The Critical Perspective
ORGANIZATIONAL POLITICS
Historical Perspective of Organizational Politics
Definitions
Characteristics of Organizational Politics
Techniques Used in Organizational Politics
Controlling Information
Controlling Lines of Communication
Controlling the Agenda
Attacking and Blaming
Using Outside Experts
Game Playing
Image Building
Building Coalitions
Factors/Conditions influencing Political Behavior
Ambiguous Goals
Scarce Resources
Changes in Technology and Environment
Non-programmed Decisions
Organizational Change
Personal Characteristics
Managing Organizational Politics
Knowledge about Political Behaviour
Eliminate the Factors Causing Organizational Politics
Provision of Sufficient Resources
Introduce Clear Rules
Free Flow Information
Quick Action
Manage Change Effectively
Remove Political Norms
Hire Low Political Staff
Have Peer Pressure against Politics
CHAPTER 55:
Team Management
COMPETENCIES
INTRODUCTION
CONCEPT AND MEANING OF TEAM
Meaning of Team
DIFFERENCE BETWEEN TEAM AND WORKING GROUP
IMPORTANCE OF TEAM APPROACH
Composition and Type of Teams
Task Force or Cross Functional Teams
Problem Solving Teams
Self Managed Work Teams
Committees
Work Group
Quality Circle
SIGNIFICANCE OF TEAM WORK
CHARACTERISTICS OF A SUCCESSFUL TEAM
FACTORS INFLUENCING EFFECTIVENESS OF TEAM
How to Design a Team Based Organization
Consensus Building
Trust
Communication
Achieving Potential
Skills and Role Clarity
Diversity
Rewarding Performance
Adapting to Change
Training a Team
Make Team Members Emotionally Intelligent
Empower Team
Positive Reinforcement
Stages to Develop Teams
Forming Stage
Storming Stage
Norming Stage
Performing Stage
FACTORS HINDERING IN DEVELOPMENT OF TEAM
STRATEGIES FOR TEAM MANAGEMENT
CHAPTER 56:
Time Management
COMPETENCIES
INTRODUCTION
WHAT IS TIME MANAGEMENT
BASIC TIME MANAGEMENT PRINCIPLES
Be on Time
Adjust your Attitude
Be Goal Oriented
Prioritize
Divide Large Tasks
Plan your Activities
Be Organized
Manage your Workload
Follow a Routine
Delegate Effectively
Documentation
Manage Meetings
Control Interruptions
Manage your Health
Organize your Home Life
Track What You Do
IMPORTANCE OF TIME MANAGEMENT IN NURSING
EFFECTS OF TIME MANAGEMENT
Effects on the Proximal Outcomes Time Estimation and Spending Time on High Priority Tasks
Effects on Performance in Work and Academic Settings, Job Performance, Academic Performance
Effects on Attitudinal and Stress-related Outcomes
Effect on Completion of Work
Self Awareness about the Work
Improves Quality of Life
COMMON TIME WASTERS AND REMEDIES
Feeling of Overwhelmed and Anxious
Procrastination
Putting off Starting a Task
Perfectionism
Day Dreaming
Poor Planning
Interruptions
Socializing Idle Conversation
Unclear Objectives and Priorities
Stress
Inability to Say ‘No’
Leaving Tasks Unfinished
BARRIERS IN UTILIZING EFFECTIVE TIME MANAGEMENT BY NURSES
Disorganization
Distraction
Perfectionism
Procrastination
Rigidity
Poor Planning or Unrealistic Planning
EFFECTIVE TIME MANAGEMENT
How to Prioritize
Four Generations of Time Management
First generation
Second generation
Third generation
Fourth generation
The Pickle Jar Theory
Time Management Matrix or the Urgent/Important Matrix
Quadrant 1 - Urgent and Important
The Quadrant of Necessities
Quadrant 2 - Important but not Urgent
The Quadrant of Quality
Quadrant 3 - Urgent but not Important
The Quadrant of Deception
Quadrant 4 - Neither Urgent nor Important
The Quadrant of Waste
Other Prioritization Tools
Paired Comparison Analysis
Grid Analysis
The Action Priority Matrix
The Ansoff Matrix and the Boston Matrices
Pareto Analysis
Nominal Group Technique
Criteria of a Good Time Management System
Time Management Techniques
Time Management Building Blocks
Step 1: Goal Setting
Step 2: Review Time Utilization
Step 3: Match Time Utilization Patterns with Goals
Step 4: Planning and Priotizing
Step 5: Self monitoring: Battling the Major Time Wasters
Step 6: Time Shifting and Adjustment
Time Management Tips for Nurses
L-E-A-P-S Approach
‘Plan, Pick and Play’ Approach
Scheduling the Tasks and Activities
CHAPTER 57:
Stress Management
COMPETENCIES
INTRODUCTION
WORK STRESS
What is Stress
What is Work Stress
NATURE OF STRESS
Types or Levels of Stress
Eustress
Distress
Burnout
STAGES OF STRESS
The Alarm Stage
Resistance Stage
Exhaustion Stage
SOURCES OF STRESS
Organizational Factors
Workload
Inadequate Staffing
Job Content
Working Hours
Shift Duty Pattern
Role Ambiguity and Role Conflict
Lack of Task Autonomy, Accountability and Feedback
Lack of Career Development
Physical Facilities/Environment
Social Environment
Ineffective Communication
Nature of Profession
Caring for Suffering and Death and Dying Patients
Difficult Patients and their Family Members
Working with Psychiatry Patients
Exposure to Occupational Hazards
Personal Characteristics
Demographic Characteristics
Personality
Belief in External Locus of Control
Competency
Lack of Preparation
Outside Work Environment Sources
Consequences of Workplace Stress
Cognitive Effects
Biological or Physiological Effects
Emotional and Psychological Effects
Behavioral Effects
Occupational Effects
EFFECTS OF LONG TERM STRESS
Physical and Physiological
Cardiovascular Disease
Musculoskeletal Disorders
Cancer, Ulcers, and Impaired Immune Function
Workplace Injury
Psychological Disorders
Mental Problems
Substance Abuse and Suicide
APPROACHES TO STRESS MANAGEMENT
Individual Coping Strategies
Time Management
Relaxation/Meditation
Physiologically oriented methods
Cognitive oriented method
Biofeedback
Other Individual Coping Strategies
Cognitive Restructuring Strategies
Stress Inoculation Training
Employee Assistance Programmes (EAP)
Organizational Coping Strategies
Organizational change
Stress Management Training Program
NURSE MANAGERS’ ROLE IN STRESS MANAGEMENT
TIPS FOR REDUCING STRESS AT WORKPLACE
UNIT 8: MATERIAL MANAGEMENT
CHAPTER 58:
Material Management: Concept, Principles and Procedures
COMPETENCIES
INTRODUCTION
MATERIALS
Meaning and Definition of Materials
Classification of Materials
MATERIAL MANAGEMENT
Concept and Definitions of Material Management
Concept of Integrated Material Management
AIM OF MATERIAL MANAGEMENT
OBJECTIVES OF MATERIAL MANAGEMENT
PURPOSES OF MATERIAL MANAGEMENT
IMPORTANCE AND ADVANTAGES OF MATERIAL MANAGEMENT
BASIC NEEDS OF MATERIAL MANAGEMENT
FUNCTIONS OF MATERIAL MANAGEMENT
FUNCTIONS OF MATERIAL MANAGEMENT DEPARTMENT
STOCKS IN THE HOSPITALS
PRINCIPLES OF MATERIAL MANAGEMENT
Effective Management and Supervision
MANAGEMENT TECHNIQUES USED FOR MATERIAL MANAGEMENT
PROCEDURE OF MATERIAL MANAGEMENT SYSTEM
Planning and Budgeting / Demand Estimation
Pre-requisites
Cost Balance
Material Specification
Value Analysis
Procurement
Receipt and Inspection
Inventory Control or Storage, Issue and Distribution
Storage
Issue and Distribution
Maintenance and Repair
Accounting and Information System
Disposal and Condemnation
CHAPTER 59:
Procurement and Purchasing
COMPETENCIES
INTRODUCTION
PROCUREMENT
Definitions
Procurement
Procurement Process
Objectives of Procurement System
Procurement Process
Step 1: Need Recognition
Step 2: Specific Need
Step 3: Source Options
Step 4: Price and Terms
Step 5: Purchase Order
Step 6: Delivery
Step 7: Expediting or Follow Up
Step 8: Receipt and Inspection of Purchases
Step 9: Invoice Approval and Payment
Step 10: Record Maintenance
Flow of Procurement Decision
Need Assessment
Finding the Budget
Prioritization of Purchase of Equipment, Machinery, etc.
Standards and Specification Development
Placing of Indent by the Head of Department
Consideration of Indent
Choose Procurement Method
Risk Purchase
Receipt of Tenders
Opening of Tenders
Evaluation of Tenders
Placement of Orders
Follow up of Orders
Receipt and Inspection of Material
Invoice Approval and Payment
Procurement process for consumable items
Process Flow for Consumable Items
PURCHASING
Meaning
Key Steps of Purchasing
Principles of Purchasing
Points to Remember while Purchasing
Points to Remember while Purchasing Equipment
CHAPTER 60:
Inventory Control
COMPETENCIES
INTRODUCTION
WHAT IS INVENTORY
IMPORTANCE OF MAINTAINING INVENTORY
INVENTORY CONTROL
INVENTORY SYSTEM
INVENTORY MANAGEMENT SYSTEM
OBJECTIVES OF INVENTORY CONTROL
IMPORTANCE OF INVENTORY CONTROL
Types of Inventory Costs
Ordering Cost
Inventory Carrying (holding) Cost
Out of Stock/Shortage Cost
Other Costs
HOW TO ACHIEVE CONTROL
MAJOR ACTIVITIES OF INVENTORY CONTROL
FACTORS IN INVENTORY CONTROL DECISION MAKING PROCESS
Setting up of Various Stock Levels
Minimum Level
Maximum Level
Reorder Level
Reserve Stock
Basic Principles of Inventory Control
Safety Stock SS
Lead Time (LT)
Average Inventory: INVAVG
Reorder Point
TECHNIQUES OF INVENTORY CONTROL
INVENTORIES CLASSIFICATION
ABC ANALYSIS
What it is?
Pareto's Theory
‘A’ Items
‘B’ Items
‘C’ Items
Principles of ABC Analysis
How to Carry Out Actual Analysis?
Procedural Steps
Advantages of ABC Analysis
Disadvantages of ABC Analysis
Applicability
VED ANALYSIS
Meaning
Advantages of VED Analysis
COMBINATION OF ABC AND VED ANALYSIS
Advantages
FSN ANALYSIS
Meaning
Method
Analysis
Advantages
SDE (SCARCE, DIFFICULT, EASY TO OBTAIN) ANALYSIS
Meaning
Criteria
Advantages
HML (HIGH, MEDIUM, LOW) ANALYSIS
Criteria
Analysis
Advantages
XYZ ANALYSIS
Criteria
Advantages
GOLF ANALYSIS
Criteria
Method
SOS ANALYSIS
INVENTORY MODEL FOR QUANTITY & INVENTORY REPLENISHMENT
Economic Order Quantity (EOQ)
Steps for Calculation of EOQ
Assumptions of EOQ
EOQ Model
Weaknesses of EOQ Formula
Advantages
ROL (Reorder Limit) method
Periodic Ordering Method
Optimum Review Period
Safety Stocks
INVENTORY ACCOUNTING SYSTEM
Perpetual Inventory System
Meaning
Features
Bin Card
Store Ledgers
Continues Stock Taking
Periodic Inventory System
Features
CHAPTER 61:
Planning Equipment and Supplies
COMPETENCIES
INTRODUCTION
MEANING OF EQUIPMENT AND SUPPLIES
EQUIPMENT MANAGEMENT
Aspects of Medical and Nursing Equipment Management
Planning Phase
Procurement Phase
Incoming Inspection
Equipment Inventory and Documentation System
Commissioning and Acceptance
Monitoring of Use and Performance
Maintenance
De-commissioning
WORKING OF DEPARTMENTS RELATED TO EQUIPMENT AND SUPPLY
Purchase and Store Department
Equipment Maintenance and Repair Department
PROCESS OF STOCK VERIFICATION AND CONDEMNATION OF EQUIPMENTS, ARTICLES
Annual Physical Stock Verification
Condemnation of Equipments, Articles
Nurses Activities in Equipment and Supply Management
Procurement
Receiving and Inspection
Storing
Issuing, Distribution and Maintaining Inventory
Maintenance of the Associated Paperwork and Records
Repairing and Disposal
ROLE OF NURSE MANAGERS IN MAINTAINING EQUIPMENT AND SUPPLY
Input
Process
Objective
Output
Objective
UNIT 9: FISCAL MANAGEMENT
CHAPTER 62:
Financial Administration and Management
COMPETENCIES
INTRODUCTION
FINANCIAL MANAGEMENT/ADMINISTRATION
Meaning of Financial Management/Administration
Objectives of Financial Administration/Management
Elements of Financial Management
Investment Decisions
Financial Decisions
Dividend Decision
Functions of Financial Management
Scope of Financial Management
WHAT IS FINANCE
NURSING FINANCE
Meaning
Scope of Nursing Finance
HEALTH CARE FINANCING
Meaning
Health Service Finance Sources
FINANCIAL/FISCAL PLANNING
Meaning
Objectives of Fiscal Planning
To determine capital requirements
To determine capital structure
To frame financial policies
To utilize financial resources adequately
Importance of Fiscal Planning
Steps in Fiscal Planning
Factors Affecting Financial Planning
Features of Sound Financial Plan
FINANCIAL MANAGEMENT TRIAD IN NURSING SERVICES
Planning
Budgeting
Evaluation
FINANCIAL ACCOUNTABILITY FOR THE NURSE MANAGERS
Definitions of Finance Terms
Revenue
Expenses
Variance
Fiscal Year
Contribution Margin
CHAPTER 63:
Budget and Budgetary Process
COMPETENCIES
INTRODUCTION
BUDGET
Historical Background
Definitions of Budget
Importance of Budget
Purposes of Budget
Principles of Budget
Characteristics of Budget
Features of Budget
Terminology of Budget
Union Budget
Revenue Budget
Revenue Receipts
Capital Budget
Plan and Non-plan Expenditure
Fiscal Policy
Fiscal Deficit
Hospital Budget
Budget and Nursing Service
Typology of Budget
Capital Expenditure Budget
Operating Budget
Manpower or Direct Labour House
Fixed Budget
Variable or Flexible Budget
Open Ended Budget
Historical Budget
Forecast or Statistical Budget
Trended Budget
Zero based Budgets
Revenue and Expense Budget
Roll over Budget
Cash Budget
Program Budget
Performance Budget
Time, Space, Material and Product Budgets
BUDGETING
Definitions
Principles of Budgeting
Purposes of Budgeting
Main Purpose
Specific Purposes
BUDGETARY PROCESS
What is Budgetary Process
Prerequisite of Budgetary Process
Features of Budgetary Process
Principles of Budgetary Process
Steps in Budgetary Process
Budget Estimate Preparation
Budget Approval
Budget Allocation and Appropriation
Budget Monitoring
PREPARATION OF COUNTRY BUDGET
NURSING BUDGET
Meaning
Advantages of Nursing Budgeting
Steps of Nursing Budgeting
ZERO-BASED BUDGETING
Meaning
Steps
Advantages
Disadvantages
PERFORMANCE BUDGETING
Meaning
Steps
Tools Used in Performance Budgeting
Preparation of Budget under Performance Budgeting
Allocation of Resources
Budget Execution
Appraisal and Evaluation
MID TERM APPRAISAL
What is MTA
An Overview of Mid Term Appraisal of the Eleventh Plan (2007-08 to 2011-12)
PROGRAMME PLANNING BUDGETING SYSTEM (PPBS)
Introduction
Meaning
History
PPBS as a Process
Planning
Programming
Budgeting
Evaluation and Control
Steps for Programme Planning Budgeting System (PPBS)
Aim of PPBS
Purposes of PPBS
Principles of PPBS
Elements of PPBS
A Program Structure
Program Document
A Decision Making Process
The Analysis Process
Information System
Characteristics of PPBS
Advantages
Disadvantages
CHAPTER 64:
Cost Accounting and Audit
COMPETENCIES
INTRODUCTION
CONCEPT OF COST
Defining Cost/s
Elements of Cost
Material Cost
Labour Cost
Expenses or Overhead Cost
COST CLASSIFICATIONS
Basic Cost Classifications
According to Elements of Costing
According to Nature of Cost
Direct Costs
Indirect Costs
According to Cost Behavior
Fixed Costs
Variable Costs
Semi-variable Costs
Standard Costs (SC)
Classification According to Functions
Production Costs
Administrative Costs
Selling and Distribution Costs
Research and Development Costs
According to Time
Historical Costs
Predetermined Cost
Management Decision Making Point of View
Average Cost
Marginal Cost
Differential Costs
Opportunity Costs
Relevant Costs
Replacement Costs
Abnormal Costs
Controllable Costs
Shutdown Cost
Capacity Costs
Urgent Costs
Calculation of Total Cost
Major Classification System of Costs
WHO Classification
As per Intervention Activities
According to Programme Cost Sheet
Recurrent Cost
Capital Cost
According to Analysis of Program
Program Costs
Cost of Participants
Costs to Others
TYPES OF COSTS IN HEALTH CARE
Direct Costs
Direct Health Care/Medical Costs
Direct Non Health Care/Medical Costs
Indirect Cost
Intangible Costs
ACCOUNTING
What is Accounting?
Types of Accounting Systems
National Accounting Systems
Gross Domestic Product
Gross National Product
Per Capita GDP or GNP
Net National Product (NNP)
Net Income
Financial Accounting Systems
Balance Sheet
Shareholder's Equity
Income Statement
Cash Flow Statement
Management or Cost Accounting Systems
COST ACCOUNTING
Definitions
Objectives of Cost Accounting
Scope of Cost Accounting
Cost book-keeping
Cost System
Cost Ascertainment
Cost Analysis
Cost Comparisons
Cost Control
Cost Reports
Importance of Cost Accounting
Limitations of Cost Accounting
Difference between Financial Accounting and Cost Accounting
Purpose
Nature
Documentation of Data
Information Users
Analysis
Term
Presentation of Report
AUDIT
Introduction
What is An Audit?
Purposes of Audit
Types of Audit
External Audit
Importance of External Audit
Features of External Audit
Purposes of External Audit
Types of External Audits
Internal Audit
Role of Internal Audit
Purpose of Internal Audit
Objectives of Internal Audit
Importance of Internal Audit
An Internal Audit Plan
Characteristics of Internal Auditor
CHAPTER 65:
Health Economics
COMPETENCIES
INTRODUCTION
HISTORICAL VIEW
DEFINING HEALTH ECONOMICS
What is Economics?
What is Health?
Definitions of Health Economics
CONCEPTS IN HEALTH ECONOMICS
Resources
Scarce Resources
Scarcity
Opportunity Cost
Efficiency
Technical Efficiency
Allocative Efficiency
Demand
Supply
The Production of Health
Market
Health Care Market
Buyer
Seller
Price
Macroeconomics
The Economy Level of Outputs
Level of National Income
Level of Employment
General Price Level
Macroeconomic Health Care Market
Microeconomics
Health Microeconomics
COMPONENTS OF HEALTH ECONOMICS
HEALTH ECONOMICS MAP
NEED FOR HEALTH ECONOMICS
IMPORTANCE OF HEALTH ECONOMICS
Major Tasks of Economics In Health (Care)
Descriptive Quantification
Explanatory or Predictive
Evaluative
FEATURES OF HEALTH ECONOMICS
AREAS OF HEALTH ECONOMICS
FACTORS INFLUENCING HEALTH ECONOMICS
Tools Used in Economic Analysis
Economic Variables
Relationships between Economic Variables
Graphical Representation of Relationships
The Direction of the Relationships
ECONOMIC EVALUATION
Introduction
Steps in Economic Evaluation
Deciding Upon the Study Question
Assessment of Costs
Assessment of Health Effects
Adjusting for Timing
Adjustment for Uncertainty or Sensitivity Analysis
Types of Economic Evaluation
CHAPTER 66:
Economic Evaluation Techniques
COMPETENCIES
INTRODUCTION
COST ANALYSIS
Definition
When to Use Cost Analysis?
Objectives of Cost Analysis
Purposes of Cost Analysis
Principles of Cost Analysis
Framework of Cost Analysis
Basic Steps in Cost Analysis
Health Valuation Methods
Cost-of-Illness Method (COI)
Non Market Valuation Methods
Revealed Preference Method (RPM)
Stated Preference or Contingent Valuation Method (CVM)
Types of Cost Analysis
Cost-of-Illness Analysis
Cost-benefit Analysis (CBA)
Cost-effectiveness Analysis (CEA)
Cost-utility Analysis (CUA)
Cost-minimization Analysis
Cost-consequence Analysis
COST-BENEFIT ANALYSIS
Meaning
Direct Benefits
Indirect Benefits
Intangible Benefits
Historical Background
Importance of Cost Benefit Analysis
Features of Cost Benefit Analysis
Purposes of Cost Benefit Analysis
Principles of Cost Benefit Analysis
Advantages of Cost Benefit Analysis
Drawbacks of Cost Benefit Analysis
Approaches of Cost Benefit Analysis
Procedural Steps in Cost–Benefit Analysis
Defining the Problem
Identifying Interventions
Defining the Audience
Defining the Perspective
Defining the Time Frame and Analytic Horizon
Defining the Discount Rate
Identifying Intervention Outcomes
Health Outcome
Non-health Outcome
Intangible Outcome
COST EFFECTIVENESS ANALYSIS
Definitions
Aim of Cost Effectiveness Analysis
Objectives of Cost Effectiveness Analysis
Historical Background
Purposes of Cost Effectiveness Analysis
Drawbacks of Cost Effectiveness Analysis
Benefits of Cost Effectiveness Analysis
Measures for Cost-Effectiveness
Cost Effectiveness Ratio
Net Health Benefits (NHB)
Elements of CEA
Procedural Steps in Cost–Effectiveness Analysis
Defining the Problem
Adopting a Research Strategy
Specify Audience
Define Perspective
Specify the Time Frame Work
Prepare the Analytic Horizon
Decide the Type of Study Design
Identify the Outcome Measures or Variable
Search for Available Alternatives
Identify the Types of Costs to be included in CEA
Analysis
COST UTILITY ANALYSIS (CUA)
Meaning
Measures of CUA
The Quality-Adjusted Life-Year (QALYs)
Components of QALY
Methods of QALY
Instruments Commonly used in QLAYs
Disability-Adjusted Life Years
Definitions
Goal of DALY
Measures of DALY
Advantages of CUA
Advantage of CUA over CEA
Cost Utility Ratio
COST MINIMIZATION ANALYSIS
COST CONSEQUENCES ANALYSIS
Definitions
Advantages
Disadvantage
CHAPTER 67:
Critical Pathways and Health Care Reforms
COMPETENCIES
INTRODUCTION
CRITICAL PATHWAYS
Definitions
History
Goals of Critical Pathways
Purposes
Characteristics of Critical/Clinical Pathways
Benefits of Critical Pathways
Steps in Developing and Implementing Critical Pathways
Phase 1: Focus and Recognition
Phase 2: Evaluation and Analysis
Phase 3: Development
Phase 4: Implementation and Evaluation
HEALTH CARE REFORMS
Definitions of Health Care/sector Reform
Basis of Indian Health Policy
Nature of Health Sector Reform
Purposes of Health Care Reforms
Importance of Health Sector Reforms
Principles of Health Sector Reforms
The Indicators of Health Sector Reform
Reform Strategies
Ownership of Reform
Factors Affecting the Design of Health Care Reforms
Implications for Equity in Access and Utilization
Sustainability of Reforms
Problems in Having Health Reforms in India
Consequences of Health Sector Reforms
UNIT 10: NURSING INFORMATICS
CHAPTER 68:
Concept of Nursing Informatics
COMPETENCIES
INTRODUCTION
HISTORICAL TRENDS IN NURSING INFORMATICS
History of Nursing Informatics
DEFINITIONS
GOAL OF NURSING INFORMATICS
PURPOSES OF NURSING INFORMATICS
BASES OF NURSING INFORMATICS
ESSENTIALS OF NURSING INFORMATICS
INFORMATIC COMPETENCIES REQUIRED FOR NURSES
COMPONENT STANDARDS OF NURSING INFORMATICS
IMPORTANCE OF INFORMATICS
BENEFITS OF INFORMATICS IN GENERAL
BENEFITS OF NURSING INFORMATICS
FUNCTION OF NURSING INFORMATICS
APPLICATIONS OF NURSING INFORMATICS
Nursing Clinical Practice
Nursing Administration
Nursing Education:
Nursing Research
IMPLICATIONS FOR INFORMATICS
DIFFERENCE BETWEEN NURSING INFORMATICS AND EVIDENCE BASED PRACTICE
LIMITATIONS OF NURSING INFORMATICS
CHAPTER 69:
Information Technology: Use of Computer in Nursing
COMPETENCIES
INTRODUCTION
WHAT IS INFORMATION TECHNOLOGY (IT)?
PURPOSES OF INFORMATION TECHNOLOGY
INFORMATION SYSTEMS IN THE CLINICAL SETTING
TYPES OF INFORMATION TECHNOLOGY
Administrative and Financial Systems
Clinical Systems
Computerized Provider Order Entry (CPOE)
Electronic Health Record (EHR)
Clinical Decision Support System (CDSS)
Infrastructure
Bar Coding
Automated Dispensing Machines (ADMs)
Advance Applications of Information Communication Technology (ICT) in Nursing
Advances in Education and Collaborative Learning
Telenursing/Telehealth
Wireless and Handheld Technologies
Knowledge Based Systems
Interoperable Electronic Health Record System (EHRS)
Knowledge Management and Knowledge Generation
BARRIERS IN ADOPTION OF INFORmaTION TECHNOLOGY
USE OF COMPUTERS
What is Computer?
What is Computer System?
I Hardware
II Software
Purposes of Use of Computers
Administrative Purposes
Clinical Purposes
In Community and Home Health Nursing Practice
Computers in Nursing Research
Computers in Nursing Education
Importance of Computers
Advantages on Use of Computers in Nursing
Computer Network
Applications of Computers
TELECOMMUNICATIONS
Email Communication
What is e-mail?
Uses of e-mail in Clinical Setting
Disadvantages of e-mail
Advantages of e-mail
Wireless Nurse Communication
The Voice Communications System
Benefits
Cellular Telephony
Videoconferencing and Teleconferencing
FAX (Facsimile Transmission)
Internet
E-learning
CHAPTER 70:
Documentation System: Nursing Records and Reports, Correspondence
COMPETENCIES
INTRODUCTION
DOCUMENTATION SYSTEM
What is Documentation?
Purposes of Documentation
To Facilitate Communication
Coordination of Care
To Promote Continuity of Care
To Promote Quality Nursing Care
To Meet Professional and Legal Standards
Accountability
Security
Providing Quality Improvement
Facilitating Evidence-based Practice
TYPES OF DOCUMENTATION SYSTEMS
I Paper–Based Documentation System
Source-oriented Record
Advantage
Disadvantage
Problem-Orientated Medical Record (POMR)
Advantages
Disadvantages
Components of POMR
Formats
Charting by Exception (CBE)
Graphic Sheets and Flow Sheets
Variance Charting (VAR)
II Electronic Documentation
ELECTRONIC MEDICAL RECORDS (EMRS)
Definitions
Types of EMR
Departmental EMR
Inter-departmental EMR
Hospital EMR
THE ELECTRONIC HEALTH RECORD (EHR)
Types of Electronic Health Record (EHR)
Structure of EHRs
Usability of EHRs
Users of EHRs
Components of EHRs
Medical Data Components
Nursing Data Components
Other Electronic Record Devices
Personal Digital Assistants
Computer Automated Cancer Detection
Computerized Theatre Management Application
Tools for Documentation
General Guidelines for Recording
Date and Time
Timing
Legibility
Permanence
Correct Spelling
Signature
Accuracy
Use Specific Descriptions
Don't Erase, or Use Corrective Fluid
Sequence
Appropriateness
Completeness
Conciseness
Accepted Terminology
Legal Prudence
RECORD
Definition
Record
Hospital Records
A Medical Record
A Nursing Record
Objectives of Hospital Records
Purposes of Medical Records
To Patients
To the Hospital
Purposes of Patient Records
Value of Nurses Clinical Records
Functions of Records
Principles of Good Record Keeping
Characteristics of Good Recording
Steps for Designing the Record
Records Available in Nursing Units
REPORT
Definition
Objectives of Reports
Purpose of Reporting
Types of Reporting
Change-of-shift Report
Meaning
Types of Change-of-Shift Reports
Telephone Report
Telephone Orders
Transfer Report
Incident Reports or Occurrence Reports
Conferring
Intra-divisional
Among Nursing Staff
Between Nursing Sisters and Staff Nurses
Between Nursing Sister and Matron
Between Nursing Sisters and Doctors
Intra Departmental Reports
CORRESPONDENCE
Meaning
Importance of Correspondence
Characteristics of Correspondence
The Format of the Correspondence
Components of Official Letter/Correspondence
CHAPTER 71:
Information System: Management Information and Evaluation System
COMPETENCIES
INTRODUCTION
INFORMATION SYSTEM
What is Information?
What is a System?
What is Information System?
Characteristics of Information System
Operating Elements of an Information System
MANAGEMENT INFORMATION SYSTEM (MIS)
What is Management Information System?
Classification of Management Information Systems
Databank Information System
Predictive Information System
Decision-Making Information System
Decision-Taking Information System
Objectives of Management Information System
Purposes of Management Information System
Advantages of Management Information System
HEALTH CARE INFORMATION SYSTEM
Types of Health Information System
Admission, Discharge and Transfer (ADT)
Accounting or Financial System
Order Entry
Ancillary Systems
Clinical Documentation System
Scheduling
Acuity
Specialty Systems
Communication Systems
How to Develop a System?
Step 1: Need Assessment and Analysis
Step 2: Planning
Step 3: Implementation Stage
Step 4: Maintenance/evaluation Stage
NURSING INFORMATION SYSTEM (NIS)
Meaning
Uses of Nursing Information System
Benefits of Nursing Information System
Application of Nursing Information System
Designing and Implementing Nursing Information System
Planning Phase
Analysis Phase
Design Phase
Development Phase
Implementation Phase
Evaluation Phase
Upgrade Phase
Computer-Based Nursing Information Systems
Bases of a Computerized Nursing Information System
Nursing Minimum Data Set (NMDS)
Elements of Nursing
Demographic Elements
Elements of Care
Uses of Nursing Management Minimum Data Set (NMMDS)
CHAPTER 72:
Communication Technology: E-Nursing, Telemedicine, Telenursing
COMPETENCIES
INTRODUCTION
E-Learning
Definitions of E-Learning
Development of e-Learning
E-LEARNING IN NURSING/E-NURSING
Modalities of e-learning
Individualized Self-paced e-learning online
Individualized Self-paced e-learning offline
Group-based e-learning Synchronously
Group-based e-learning Asynchronously
Learning Preferences and Styles in e-Learning
Offline and Online Activities
Synchronous and Asynchronous Activities
Different Multimedia Assets
Different Didactical Interactions
Different Ways of Delivering the Content
Self Study and Collaborative Learning
Formal and Informal Learning
Types or Forms of e-Learning
Elements of e-Learning Material
Importance of e-Learning
To Organization
To Learners/Employees
To Organization and Community
Theoretical Bases of e-Learning
Andragogy
Constructivism
Benefits of e-Learning
Advantages of e-Learning
Disadvantages of e-Learning
Designing of Programme Through e-Learning
Strategic Planning
Course Development
Faculty Development
Learner Needs
Assessment and Evaluation
Tools and Skill Required
Skills Required for e–Learning
Basic Computing and Communication Skill
Use of Pre-designed Packages
Assembling Internet Resources
Designing Courses, Modules or Session Materials
TELEMEDICINE
Introduction
Definitions
Telemedicine
Telecommunications
Telehealth
Telehealth Care
e-Health
IsfTeH
mHealth or Mobile Health
uHealth or Ubiquitous Health Care
Endeavors in Telemedicine
Success Stories of Telemedicine in India
Benefits of Telemedicine, eHealth and Health IT
TELENURSING
Introduction
Definitions
Telephone Nursing
Types of Telecommunication Tools
Teleservices
Telehealth
Requirements for Telenursing
1. Hardware
2. For Telehealth Monitoring
3. Software
4. Software Programme
Advantages of Telenursing
Provide Remote Care
Decrease Patient Visit
Transcending Miles and Borders
Data Sharing
Rapid Response Time
Improve Access, Costs, and Outcomes
Enhances Patient's Voice in Decisions
Other Advantages of Implementation of Telenursing
Applications of Telenursing
Benefits of Telenursing
Uses of Telenursing
Evidence Based Uses of Telenursing
Implications of Telenursing
Delivery, Management, Coordination of Care
Multi-disciplinary Teams
Disease Management
Obstacles in Telenursing
Disadvantages of Telenursing
Dehumanizing Effects
Cost
Inability for Patient to Use Equipment
Knowledge Base of the Nurse
Equipment Malfunction
Problems in Implementing Telenursing
Understanding of Software
System Errors
Patient Understanding
Cost
Issues in Telenursing
Societal
Technical
Safety Standards
Regulatory Issues
Professional Liability
Professional
Legal Issues
Reimbursement.
Who should be Telenurse?
Competencies for Professional Practice in Telenursing
Competencies for Telehealth Technologies in Nursing
Telenursing Practice Standards
Bases
Guidelines
INDEX
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Index
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