Nursing management - Directing and Controlling

Supervision

begins once the task is delegated to a member of the staff.

Delegation

is getting work done through others by transferring accountability for the activity

DIRECTING

is the act of issuing of orders, assignments, instructions to accomplish the organization's goals and objectives

SUPERVISION

is the active process of directing, guiding, and influencing the outcome of an individual's performance of an activity or task

Nursing Care Plan

is the primary tool in directing

DIRECTING

it entails explaining what to be done, to whom and by whom, at what time, how, and why it is to be done

STAFF DEVELOPMENT

planned experience to help employees perform effectively and efficiently to enrich their competence in practice, education, administration and research

Common delegation ERRORS:

• Underdelegating • Overdelegating • Improper delegating

Critical Few

▪ only a few people involved in the control process bring about the best result

Direct supervision

▪ the supervisor observes and directs the staff member through each step of the task. ▪ this may occur when the nurse is performing a procedure for the first time or when performing complex procedures

Self-control or Discipline

▪ translates to personal acceptance of responsibility and accountability

EVALUATION Importance:

✓ Develop fair employment practice and performance appraisal process ✓ Identify the strengths and weaknesses of each staff ✓ Recognize and further develop strengths ✓ Provide security for patients, personnel, agency, and community ✓ Provide constructive feedback ✓ Determine the progress and worthiness of individual nurse ✓ Basis for promotion

General Rule of Supervision

✓ Has potential for serious harm to the patient ✓ If the task is complex ✓ May require steps other than those that are normally followed ✓ May have unpredictable outcome ✓ Is not performed frequently

Purposes of Nursing Audit

✓ It prioritizes nursing care by promoting optimum nursing care ✓ It can identify differences in the organization and administration of nursing care, and may be used to correct such deficiencies through continuing education and administrative change.

PROCESS OF CONTROL

✓ Material controls relate to inventory and materials needed. ✓ Cost controls help ensure that cost standards are met. ✓ Employee performance control focuses on the actions and behaviors of individuals and groups of employees. ✓ Budget control - refer to cost or expense related standards. * Identify the quantity of materials used and production output

Taking Remedial or Corrective Actions

❑ Correction of deviations or errors • Better selection and training of subordinates • Changing the number of personnel • Adding more materials or resources to minimize or eliminate errors ❑ Use of the master control plans depicting its functions, goals and objectives ❑ Take necessary action • Supervisor takes immediate corrective action

Performance Appraisal

❖ Is a major responsibility in the controlling function ✓ is a method of acquiring and processing information needed to improve the individual's performance and accomplishment ✓ it consists of setting standards and objectives, reviewing progress having ongoing feedback between the appraiser and the one who is being appraised, planning for reinforcement, and deletion of identified behavior as necessary ❖ the purpose of the appraisal is to assess the appropriateness, adequacy effectiveness and efficiency of the services.

Feedforward/Predictive Control

➢ Focus on operations before they begin. This type of control helps to foresee problem ahead of its occurrence

Peer review

➢ a collegial evaluation of the performance done to promote excellence in practice and offer information, support, guidance, criticism and direction to one another

Standards

➢ any guideline established as basis for measurement ➢ precise, explicit statement of expected results for a product, service, machine, individual or organizational unit

Operations Control

➢ assess how efficiently and effectively an organization's transformation processes create goods and services. ➢ This includes TQM (Total Quality Management), and inventory management control.

Hawthorne Effect

➢ behavior of the ratee changes simply because he is observed by the rater.

Checklist

➢ composed of behavioral statements that represent desirable job behavior. A weighted scale is commonly used

Nursing Audit

➢ consist of documentation of the quality of nursing care in relation to the standards established by the nursing department

Program Evaluation and Review Technique (PERT)

➢ employ a matrix that uses a network of activities represented in a chart, including time management, budget, goals or product desired

Financial Control

➢ facilitates achieving the organization's profit

Feedback control

➢ focus on the result of operations which guide future planning, inputs, and process designs. (weekly, monthly, annual reports)

Behaviorally Anchored Rating Scale (behavioral expectation scale)

➢ focuses on desired behaviors to improve performance

Structure Evaluation

➢ goal is to obtain feedback on the system

Statistical Process Control

➢ is the use of statistical method and procedures to determine whether production operations are being performed correctly

Job dimension

➢ it focuses on job requirements/job description performance and the quality of work

COORDINATION

➢ links the different components of an organization ➢ creates harmony in all activities to facilitate the success of work

Quality Assurance

➢ monitors compliance of nursing personnel with established standards in terms of nursing care given to patients

Nursing Rounds

➢ nurses pay particular attention to issues of patient care and nursing practice ➢ this will also find out if the needs and problems of the patient are met or unmet.

Process Evaluation

➢ nursing actions are examined, to determine if the client's goal is met or not met

Horn's'Effect

➢ occurs when rating an employee very low because of error committed

COLLABORATION

➢ participation in the decision-making process

Concurrent Control

➢ refers to processes as they are happening and also known as the real-time control.

Time Control

➢ relates to deadlines and time constraints.

Benchmarking

➢ seeks out the best so as to improve its performance. ➢ provides a standard or point of reference in measuring or judging such factors as quality, values and costs.

Outcome/Product Evaluation

➢ takes note on the responses of patients after nursing care is done

Halo Effect

➢ tendency to overrate the staff based on the rater's first impression. ➢ evaluation is based on the good traits or good things one sees in a person

Logical Error

➢ the first encounter may provide the rater the qualities or specific traits which serves as bar to the quality of performance of the ratee

EVALUATION

➢ the process of determining how far or how many of the organization's objectives were accomplished

The Just-in-time System

➢ the timely application of materials for use in case nurses need it for patient care. ➢ communication, coordination, and cooperation are required from supervisors and employees to deliver the smallest possible quantities at the latest possible date at all stages

COMMUNICATION

➢ the transmission of message from sender to receiver using shared symbols that needs to be properly understood

Leniency Error

➢ there is the propensity to overlook or observe the weaknesses and mistakes of the person being evaluated leading to an inaccurate picture of the job performance

Trait Rating

➢ this method of rating a person against a set standard which may be the job description, desired behavior, and personal trait

Central Tendency Error

➢ this rates the staff average, used by the rater when the feedback tools are inadequate and there is no sufficient time for the rater to observe the ratee.

Self-Appraisal

➢ this tool allows the employee to evaluate his own performance, this will remind your boss of all the good things you did

CONTROLLING

➢ use of formal authority to assure the achievement of goals and objectives ➢ seeing that everything is being carried out in accordance with the plan which has been adopted

Characteristics of Control Process

1. Control process is cyclical which means it is never finished 2. Controlling often leads to management expecting employees to change 3. Control is both anticipatory and retrospective 4. Ideally, each person in the healthcare delivery views control as his or her responsibility 5. Controlling builds on planning, organizing, and leading

3 Principles of Controlling:

1. Critical Few 2. Defined Point of Control 3. Self-control or Discipline

Types of supervision

1. Direct supervision 2. Indirect supervision

Types of Control

1. Feedforward/Predictive Control 2. Concurrent Control 3. Feedback control

Common Errors in Appraisal

1. Halo Effect 2. Logical Error 3. Central Tendency Error 4. Leniency Error 5. Hawthorne Effect 6. Horn's'Effect

Techniques for monitoring and measuring service

1. Nursing Rounds 2. Quality Assurance 3. Nursing Audit

Types of Evaluation

1. Outcome/Product Evaluation 2. Process Evaluation 3. Structure Evaluation

Comparison of actual Performance

1. Program Evaluation and Review Technique (PERT) 2. Benchmarking

Performance Appraisal Tools

1. Trait Rating 2. Job dimension 3. Behaviorally Anchored Rating Scale (behavioral expectation scale) 4. Checklist 5. Peer review 6. Self-Appraisal

PROCESS OF CONTROL

A. Establishment of Standards B. Measurement of Actual Performance of Nursing Care Services C. Comparison of actual Performance D. Taking Remedial or Corrective Actions

qoute:

Being a Nurse is more than a job, it's a way of life.

Elements of Directing

DELEGATION SUPERVISION STAFF DEVELOPMENT COORDINATION COLLABORATION COMMUNICATION EVALUATION

Quote:

You're not just a nurse. Take pride in what you do. You're saving lives and making a difference in someone's life.

CONTROLLING Importance:

▪ It is a critical determinant of organizational success. ▪ Promotes effective use of resources, provides professional reinforcements and maintains activity and expectations.

Guide for the delegation of Tasks

▪ Nursing Practice Act (RA 9173) ▪ Job description ▪ Patient needs ▪ Policies and procedures

World Health Organization (WHO)

▪ Universal Health Coverage (UHC) ▪ R.A 11223 ➢ UNIVERSAL HEALTHCARE ACT (UHC)

Defined Point of Control

▪ centralization or decentralization of authority

Indirect supervision

▪ occurs when the supervisor/nurse manager oversees the performance of a task delegated to a staff member who is then responsible to manage each step of the task independently of the nurse supervisor.