كتاب العملي ادارة 2024 PDF

Faculty of Nursing -Damietta University Prepared by Dr. Samah Mohammed Abdel Rahiem an Nursing administration 4th year 2023-2024 Prepared by Dr. Marwa Talaat Abd Alghany Dr. Hagar Farouk Shahin 2023...

Faculty of Nursing -Damietta University Prepared by Dr. Samah Mohammed Abdel Rahiem an Nursing administration 4th year 2023-2024 Prepared by Dr. Marwa Talaat Abd Alghany Dr. Hagar Farouk Shahin 2023-2024 Nursing administration Clinical Practicum work book 4th year 1 Goal: By the end of this year the student should be able to integrate nursing administrative theoretical part with practical one. The manual developed based on the first &second term course spec. of fourth year nursing administration theoretical part. Intended learning outcomes: Upon satisfactory completion of this course the student will be able to: 1. Evaluate the philosophy and objectives of the ward and hospital where assigned, and make a new philosophy for the assigned clinical area. 2. Evaluate hospital policies as they apply to nursing staff. 3. Evaluate the organizational structure of the hospital and ward where they assigned and draw organizational hierarchy perfectly. 4. Distinguish the differing roles of various nurse administrators 5. Participate in medical and nursing rounds. 6. Order and account for supplies and equipments. 7. Display communicative competence with both patients and the health care team. 8. Be familiar with proper channels forms, modes, and media while interacting with others. 9. Recognize common forms of oral and written message that are used by nurse manager to effectively use them in direct or indirect interaction with the staff. 10. Supervise the other students’ works. 11. Demonstrate competence in completing selected hospital forms. 12. Document patient's care completely by utilizing nursing notes for the assigned patients. 13. Identify leadership styles in selected clinical areas. 14. Complete a one month staffing plan for a theoretical unit when given pertinent data. 15. Critically evaluate nursing care given to a group of patients. 16. Provide positive suggestions for improving nursing services at assigned unit. 2 PRINCIPLES FOR DEVEL OPING A POSITIVE LEARNING ENVIRONMENT Arrive to clinical prepared and ready to work Communicate what learning activities would be most helpful to you Be willing to do everything that is within your scope of practice Engage and connect while on the unit. Do not focus on written assignments while on the unit Be sensitive to the pressures on the staff nurses you work with Use staff/faculty expertise appropriately-learn from both sources Value the wisdom of staff nurses, and share what you are learning in support of evidence- based practice Act as though you are a member of the health care team on the unit and help whoever needs it Express appreciation often and with sincerity 3 Course Content: - 1. Planning 2. Organization 3. Time management 4. SBAR communication tool 5. Patient classification system 6. Scheduling 7. Patient care delivery models 8. Documentation (reporting & recording) 9. Leadership styles and powers 10. Decision making process 11. Total quality management 4 Policy & procedures 5 Intended learning outcomes: At the end of this session, the student will be able to: Differentiate between management and administration Discuss management process Evaluate different types of policies Meaning of administration Administration comes from the latin word (administer) means to care for people to manage their affairs Definition administration It is the process concerned with determining goals objectives, policies and plans for which the organization and its management operate Definition of management Is a process that involves Planning, Organizing, Staffing, Directing and Controlling an organization to achieve goals while using human, financial, and material resources. Planning  Is the basic and prime function of nursing management  It involves setting objectives, policies strategies and programs for the nursing services. Also it involves budgeting, managing time and making decision. Organizing  It means developing a system. It involves preparing job descriptions, assigning job roles, creating hierarchy of authority and lines of communication, identifying relationships among departments for achieving the organizational objectives. 6  Staffing  Staffing process includes recruitment, selection, orientation, staff development activities and Work schedules Directing  It is concerned with encouraging staff, and creating productive work environment. Controlling  It is the measuring and evaluate the performance Purpose of planning ❖ Provides sense of direction ❖ Encourages innovation and creativity ❖ Helps in co-ordination ❖ Focuses attention on organizational / units’ objectives and result ❖ helps in achieving economies. ❖ It can be used to realize the need for change ❖ minimizes risk ❖ Guides decision-making ❖ improves employee’s moral ❖ facilitates controlling 7  Principles of planning ❖ Planning must focus on purposes ❖ Planning should be a continuous and repeated process ❖ Planning should be simple and flexible ❖ Planning must be precise in its objectives ❖ Planning should be time-bound. ❖ Planning must be documented Mission ✓ is a brief statement identifying the reason that an organization exists. Vission ✓ statement is used to describe future goals or aims of an organization. 8  Philosophy y ✓ defines the set of values and beliefs that guide all actions of the organization Goals y ✓ End results toward which the organization operates Objectives y ✓ Identify how and when the goal is to be accomplished Policies y ✓ Are comprehensive statement ✓ derived from the organization's philosophy, goals and objectives, ✓ explains how goals will be met ✓ It is a plan reduced to statement that guide organization in their actions Procedures y ✓ Are plans of acceptable ways to accomplishing a specific task ✓ Steps of required action Principles of policy  Known by the staff  Present (verbal or written)  Directive not confusing  Clear Content  Content Complete 9  Applicable  Objective  Legally Obvious  Flexible  Consistent  Formal  Have well established Procedure  Dated  Signed Categories of policy Personnel Policies: Are concerned with all the hospital -personnel and include:. Personnel employment policies e.g. hiring new employees, promotion of the present employees. Termination of present employees and retirement.. Arrangement of work e.g. hours of work. Vacations, holidays, sick leaves and absence and working conditions. Employees services e.g. health care programs, social and recreational activities, safety programs, health insurance, pension, housing and Reward and compensation policy.. Training policy: e.g. purpose of training, type of training needed, time and place for conduction training, authorized scope of training program, and administration and scheduling of the training program Departmental policies (regulations): Are specific personnel policies that are applied only to a specific department or individual positions, e.g. nursing service policies manual Financial policies: Are concerned with all the hospital finance (money), and include: ▪ Sources of capital budget. ▪ Uses of capital budget. ▪ Protection of capital budget. ▪ Distribution of earnings 10  Patient Related Policies ▪ Patient Rights ▪ Patient Admission ▪ Patient Transfer ▪ Patient Discharge ▪ Patient Death ▪ Visiting Hours ▪ Patient and Family Education ▪ Patient Rights Nursing staff Related Policies ▪ Nurse role in Unit Round ▪ Nurse role in Endorsement ▪ Staff Development ▪ Staff Communication ▪ Staff reporting of medical errors Administrative Policies ▪ Hiring System ▪ Job Description ▪ Attendance ▪ Punctuality ▪ Leave ▪ Termination ▪ Disciplinary ▪ Dress Code 11 ▪ Promotion ▪ Performance Appraisal ▪ Documentation ▪ Authority Delegation ▪ Supplies & Equipments ▪ Utility ▪ Maintenance ▪ Incident Reports ▪ Safety and Risk Management ▪ Crush Carts ▪ Fire and Evacuation ▪ Infection control universal precautions 12 Time management 13  To-do list By the end of this presentation every student should be able to: - Define to –do list. Discuss the benefits of to-do list. Enumerate steps to fill to –do list. Apply to-do list in hospital. Outlines: Definition of to –do list. Benefits of to do list. Steps to fill to do list. Application of to do list in hospital. Definition of to-do list: - ❑ It is a time planning tool used to record the daily tasks to be done to make sure that every daily goal is achieved on time. ❑ Is a list of tasks that need to be completed, typically organized in order of priority Benefits of to-do list: - 1. Creates order: A to do list is an orderly way to organize how to do the things you want to do 2. Prioritize: manage tasks effectively 3. Accountability 4. Rescheduling and organizing your time 5. Feeling productive 6. Relieves stress 14  To-do list checklist Student name: Group: Hospital: Unit: Date: Items Score Done Not Comments done 1. Check your calendar to determine thedays before entering all tasks. 2. Write all tasks to be accomplished in thisday. 3. Break down large tasks. 4. Set tasks in priority orders. 5. Determine time allowed and divided itinto hours. 6. Mark on the tasks which completed. 7. Allocate certain for emergencies. 8. Evaluate your list periodically. 9. Rewrite your list in priority order. 10. Draw out your timetable. 1. Total NB: Start at the beginning of the day. Student's signature: Demonstrator signature: 15  Time-log By the end of this presentation every student should be able to: - 1- Define time-log. 2- List the uses of time-log. 3- Enumerate the steps of time-log. 4- Apply time-log. Outlines: ▪ Definition of time-log. ▪ The uses of time-log. ▪ The steps of time-log. ▪ Apply time-log. Definitions of time-log:- ✓ Is record that monitor the time spent on completing the tasks, and they are a good way to know how spend the time. ✓ It is a comprehensive record of the tasks, the date and time taken to complete these tasks. These logs are sequentially ordered and displayed. A time log can be used for all of the following: 1. Determine how you’re spending your time. 2. Identify time wasters. 3. Become better at estimating how long a task will take you to complete. 4. Identify how you’re procrastinating. 5. Make better use of your leisure time so you can start setting aside an hour a day to achieve your dreams. 6. Come up with strategies to make better use of your time. 7. Measure the results of your efforts to become more productive. 16  Time log Checklist Student name: Group: Hospital: Unit:. Date Time Items Score Done Not done Comments 1-Record time for beginning and endingshift hours. 2-Proritize tasks and activities 3- Record tasks and activities as written in to do list 4-Determine tasks which can be delegated. 5-Record time of starting and ending task. 6-Track details of each task 7- log time of emergencies. 8- Write comments related to each task ifoccur 9- Check to do list to ensure all tasks andactivities recorded. 10-Comparing between task whichachieved 11-Compairing between tasks which notachieved if can be posted A –Posponed b- losted Total Student's signature: Demonstrator signature 17  2023- 2024 Nursing Administration Clinical Practicum Book Job description 18  2023- 2024 Nursing Administration Clinical Practicum Book Intended learning outcomes: At the end of this session, the student will be able to: Differentiate between job description and job specification Discuss purposes of job description Explain different components of job description Meaning of job description  A broad, general, and written statement of a specific job, based on the findings of a job analysis.  It includes duties, purpose, responsibilities and working conditions of a job along with the job's title, and the name of the person to whom the employee reports.  Job description usually forms the basis of job specification.  It is a contract that should include the jobs functions and obligations and specify the person to whom the employee is responsible Purposes of job description  To identify the duties, essential functions and requirements of the position.  Analyzing employee’s duties  Developing job specification  Orienting new employees  Establishing a rational for salary structure  Defining the organizational structure  Evaluating job performance.  Identifying potential training needs.  Clarifying relationship among jobs 19  2023- 2024 Nursing Administration Clinical Practicum Book Information in job description Job identification  Job title  Location of the job in terms of department, division or section.  May also include immediate supervisor’s title  Information regarding salary and /or pay scale  grade/level of the job Job summary Brief one or two sentence statements describing the purpose of the job and what outputs are expected from the employees Describes general nature of the job and includes only the major functions of the job or activities e.g. the marketing managers job is to plan, direct and coordinate the marketing Relationships Shows job holders’ relationship with others inside and outside the health care organization. Includes :  reporting to  Supervises  Works with  Outside the health care organization. 20  2023- 2024 Nursing Administration Clinical Practicum Book Responsibilities and duties List each of the job major responsibilities separately, and describes it in a few sentences Responsibilities and duties include: - Description of the job duties, responsibilities, and behavior performed on the job. This section should also define the limits of the job holders’ authority, including his or her decision-making authority, direct supervision of other personnel and budgetary limits. Describe the social interaction associated with the work (for example, size of the work group, amount of dependence in the work) Includes general statements like “perform other assignments as required” purpose is to give supervisor more flexibility in assigning duties Standard of performance List the standard the employee is expected to achieve under each of the job descriptions main duties and responsibilities Environmental conditions Environment/conditions – description of the working conditions of the job, the location an environment such as hazards and noise levels Meaning of job specification ❖ It is a written statement that describes the knowledge, skills, e0ducation, experience, and abilities that are essential to performing a particular job. ❖ -It describes the person you want to hire for a particular job. ❖ It is developed from the job analysis also it developed from a detailed job description ❖ It can be used to realize the need for change 21  2023- 2024 Nursing Administration Clinical Practicum Book ❖ minimizes risk ❖ Guides decision-making ❖ improves employee’s moral ❖ facilitates controlling Components of job specification Experience Number of years of experience in the job you are seeking to fill. Education: State what degrees, training, or certifications are required for the position Required Skills, Knowledge and Characteristics State the skills, knowledge, and personal characteristics of individuals who have successfully performed this job. End results toward which the organization operates Personal characteristics: y Such as education, job experience, age, sex, and extra activities. 22  2023- 2024 Nursing Administration Clinical Practicum Book Physical characteristics y such as height, weight, chest, vision, hearing, health, voice poise, and hand and foot coordination, (for specific positions only). Mental characteristics y such as general intelligence, memory, judgment, foresight, ability to concentrate, etc. Social and psychological characteristics such as emotional ability, flexibility, manners, drive, conversational ability, interpersonal ability, attitude, values, creativity etc Purposes of job specification It helps candidates to analyze whether they are eligible for a particular job or not. It helps recruiting team to understand what qualifications, qualities and characteristics should be present in a candidate. It helps in selecting the most appropriate candidate for a particular job. 23  2023- 2024 Nursing Administration Clinical Practicum Book Organizational chart 24  2023- 2024 Nursing Administration Clinical Practicum Book Intended learning outcomes: At the end of this session, the student will be able to: Define organizational chart Explain advantages of organizational charts Categorized types of organizational charts Discuss principles of drawing organizational charts Once the plans are formulated, the next step is to organize the activities and resources, preparing job descriptions, assigning job roles, creating hierarchy of authority, and allocation of resources. Definition of organization Organization is a collection of people working together under a defined structure for the purpose of achieving predetermined outcomes through the use of financial, human and material resources. Definition of organizational chart It is visual picture of an organization entity. It is the visual representation of an organizational structure showing how resources, departments, and personnel are grouped horizontally and vertically into lines of authority, communication, delegation, and decisions. Advantages of Organizational Charts  Maps lines of decision making and authority  Helps people understand their assignments (orient the employee to the organization).  Show formal lines of communication.  It shows clearly the various Show positions and how they relate to one another.  It provides guidance to outsiders to whom they should contact 25  2023- 2024 Nursing Administration Clinical Practicum Book Types of organizational chart Vertical charts: It shows high-level management at the top and the lower level management at the bottom 26  2023- 2024 Nursing Administration Clinical Practicum Book A left-to-right (horizontal) charts It shows the high-level management at the left with lower positions to the right 27  2023- 2024 Nursing Administration Clinical Practicum Book Circular charts It shows the high-level management in the center with successive positions in circles Principles for drawing an accurate organizational chart  The chart should have a clear title.  It should be dated and signed.  The higher management should be shown at the top, while most junior positions at the end of the chart.  Positions of equal seniority should be shown at the same level.  For clarity, details should be well spaced.  Solid lines ‫ الخطوط الصلبة‬must be used to indicate flow of authority; staff relationships can be shown by a dotted line.‫الخط المنقط‬  Colors may be used to distinguish between departments 28  2023- 2024 Nursing Administration Clinical Practicum Book Communication 29  2023- 2024 Nursing Administration Clinical Practicum Book ISBAR communication tool Intended learning outcome At the end of the lecture the student will able to: 1- Define of communication 2- Discuss Purpose of communication. 3- List Element or component of communication process 4- Enumerate types of communication. 5- List Principles of Effective Communication. 6- Know Barriers of communication. 7- Define of organizational communication 8- Describe Channels of managerial communication 9- Define SBAR communication tool. 10- Apply SBAR communication tool to nursing practice. Out lines 1- Definition of communication 2- Purpose of communication. 3- Element or component of communication process 4- types of communication. 5- Principles of Effective Communication. 6- Barriers of communication. 7- Define of organizational communication 8- Channels of managerial communication 9- Define SBAR communication tool. 10- Apply SBAR communication tool to nursing practice. 30  2023- 2024 Nursing Administration Clinical Practicum Book Definition:- Communication is an exchange of facts, feeling and information by two or more persons. Purpose of communication:- 1. Promotes clear thinking. 2. Increases the knowledge brings change in the behavior among learners. 3. Acquires new skills. 4. Sharing of information and ideas. 5. Provides instructions. 6. Builds human relationship. 7. Obtain feedback from the learners about the effectiveness of the session. The communication process:- It begins with the sender who encodes an idea (message), which can be sent in oral \written\visual\ in some or other form to the receiver.The receiver decodes the message and gains an understanding of what the sender wanted to communicate, this in turn may result some change or an action in their behavior. Components of communication process:- 1-sender\ encoder\communicator: 2-The message 1- Channel 4-The receiver 5- The feedback 6- The effect 1- Sender: A sender is a person who encodes & sends the message to the expected receiver through an appropriate channel. 2- Message: The message is the content of communication & may contain verbal or non-verbal language. 3- Channel: A channel is a medium through which a message is sent or received between two or more people. Several channels can be used to send or receive the message, i.e seeing, hearing, touching, and smelling, writing &feeling. 4- Receiver: A receiver is an individual or a group of individuals intended to receive, decode & 31  2023- 2024 Nursing Administration Clinical Practicum Book interpret the message sent by the sender/source of message and give feedback. 5- Feedback: It is a return message sent by the receiver to the sender. It is most essential element of the communication process as it shows that the receiver has understood the primary message sent by the sender. 6-Effect : The effect of communication is the end results of the communication process Which could be emotional, cognitive or physical. Types of communication 1- verbal communication 2- non-verbal communication 1-Verbal communication (35%): - Verbal communication involves the spoken or written words. For Example:- - oral - written 2- Non -verbal communication (65%): - Non - verbal communication is transmission of messages without use of words. For Example:- 1-Personal appearance 2-Facial expression 3-Eye contact 5-gesture 32  2023- 2024 Nursing Administration Clinical Practicum Book Principles of Effective Communication :- 1. Clarity 2. Conciseness 3. Objectivity 4. Consistency 5. Completeness 6. Relevancy 7. Audience Knowledge Communication Barriers:- 1- Language Barriers 2- Psychological Barriers 3- Physiological Barriers 4-Cultural barriers Definition of managerial communication: Organization communication was defined as the process by which manager, use the established system to receive and relay information to people within the organization as well as to relevant individuals and group outside it. Levels of managerial communication There are four levels of managerial communication: 1) Downward communication. 2) Upward communication. 3) Lateral communication. 4)Diagonal communication. ❖ Downward Communication It is occurring when someone sends a message to a person at a lower level. I-e, a supervisor is receiving a downward communication when listening to instruction or an evaluation from his or her manager. 33  2023- 2024 Nursing Administration Clinical Practicum Book The supervisor is sending a downward communication when he or she discusses a problem with a nurse or tells a nurse how to perform a task. Common forms of downward communication are employee handbooks, operating manuals, job description sheets, performance appraisal interviews, employee counseling, and letters. ❖ Upward communication: Upward communication in the management levels from staff, lower and middle management personnel and continuous up to the organizational hierarchy. It provides a means for motivating satisfying personnel by encouraging employee input. i-e, a supervisor is receiving an upward communication when a nurse asks a question or reports a problem. Another means of encouraging upward communication is to establish a formal way, as a suggestion box for nurses to provide comments and suggestions. Common means of upward communication include progress reports, budget reports, profit and loss statements. ❖ Lateral communication: Lateral or horizontal communication refers to the communication which takes place between the departments or personnel on the same level of the hierarchy. I- e, it is most frequently used to coordinate activities, committees, conferences, and meetings are often used to facilitate horizontal communication. ❖ Diagonal communication: Diagonal communication occurs between two individuals or departments that are not on the same level of the hierarchy. Informal in nature. Multidirectional communication, which is common when communications often flow in all directions at the same time. I-e this type of communication is used to speed information flow, to improve understanding and to coordinate efforts for the achievements of organizational objectives. 34  2023- 2024 Nursing Administration Clinical Practicum Book ❖ ISBAR ❖ Introduction: ISBAR: - technique provides a framework for communication between members of the health care team about a patient's condition. ISBAR is an easy-to remember, concrete mechanism useful for framing any conversation, especially critical ones, requiring a clinician’s immediate attention and action. It allows for an easy and focused way to set expectations for what will be communicated and how between members of the team, which is essential for developing teamwork and fostering a culture of patient safety. ❖ What is ISBAR? The ISBAR framework represents a standardized approach to communication which can be used in any situation. It stands for Introduction, Situation, Background, Assessment and Recommendation. ❖ What are the advantages of ISBAR? 1. The ISBAR framework Ensures completeness of information and reduces likelihood of missed data. 2. Is an easy and focused way to set expectations for what will be communicated? 3. Ensures a recommendation is clear and professional. 4. Gives confidence in communication. 5. Focuses not on the people who are communicating but on the problem itself. Why would I use ISBAR? Key reasons for using ISBAR are 1. It is portable, memorable and easy to use 2. Can be used to present information clearly in any situation 3. Helps you to organize what you’re going to say 4. Standardizes communication between everyone What are the elements of the ISBAR Framework? The ISBAR framework is simple. It consists of 5 elements that focus a conversation to relevant detail. This helps to focus the information and eliminate irrelevant information. These elements are 35  2023- 2024 Nursing Administration Clinical Practicum Book I – Introduction Who you are, your role, where you are and why you are communicating S – Situation what is happening at the moment? B – Background what are the issues that led up to this situation? A – Assessment what do you believe the problem is? R – Recommendation what should be done to correct this situation? Where can ISBAR are used? The ISBAR format can be used in all forms of communication: Clinical Handover Referrals Reports (Ward etc) Protocols, memos and emails Personal interactions For example: Shift changes Discharge to community services Inter-hospital transfers Intra-hospital transfers Time-critical situations such as medical emergencies or evacuations Procedure documents Reports, memorandums and briefings. Who can use ISBAR? Because it focuses on the issue at hand, it means that those of different discipline and seniority will speak the same language. This allows more effective communication. ISBAR creates a shared mental model for the transfer of relevant, factual, concise information between clinicians. It flattens the hierarchy and so eliminates the power differences that may inhibit information flow. Doctor to Doctor, Nurse to Nurse, 36  2023- 2024 Nursing Administration Clinical Practicum Book Nurse to Doctor, Doctor to Allied Health To and between ward staff, housekeeping and clerical staff). Key tips for preparing for ISBAR:- 1. Preparation is vital , with the reason of the referral being absolutely clear 2. Having written, prepared questions will assist. 3. It is important to gather all patient information before handover e.g charts, ECG, CXR. 4. Take notes and record any instructions. 5. ISBAR works best when both parties are using the same framework. 37  2023- 2024 Nursing Administration Clinical Practicum Book 38  2023- 2024 Nursing Administration Clinical Practicum Book ISBAR case scenario: Emergency nurse using SBAR framework regarding a pediatric patient admitted with vomiting and abdominal pain Here is how the nurse would quickly provide information to the pediatrician I I am miss Mona, specialized nurse, from emergency unite, are u Identify doctor ahmed ? My patient name is Sara has 9 yrs. old at emergency unit room 3 S (Situation): sara was brought to the E.R. by her father two hours ago complaining of abdominal pain and experiencing nausea, vomiting, and diarrhea. I would like to update you on her condition and clarify orders. B (Background): sara’s father reports that complaints of abdominal pain started this morning and she refused food. Since being admitted her pain has gotten worse (now rated as an 8 out of 10) and is now radiating to the right lower quadrant. Oral fluids were ordered and her fever is 38.5 C orally. A (Assessment): sara looks pale, is fever, and is experiencing increased pain, vomiting, and diarrhea since her time of admission. R I believe that sara should be given intravenous fluids and that an (Recommendation): ultrasound should be considered in order to determine whether she has appendicitis. 39  2023- 2024 Nursing Administration Clinical Practicum Book Patient classification system 40  2023- 2024 Nursing Administration Clinical Practicum Book Intended learning outcomes: At the end of this session, the student will be able to: Define patient classification system Explain purpose of patient classification system Apply one method of patient classification system to determine staffing needs Determining the right number and type of nursing staff required to meet patient care needs historically is viewed as the foundation of workforce management systems. The term Patient Classification Systems refers to measurement systems in nursing that reflect actual patient care needs for staffing purposes. The term also is referred to as Acuity Systems, although the concept of “Acuity” denotes unidimensional illness severity in the medical sense. Operational Definition A Patient Classification/Acuity System (PCAS) is defined as “the methods and processes of determining, validating and monitoring individual patient care requirements over time in order to assist in such determinations as: unit staffing, patient assignments, case mix analysis, budget planning and defense, per patient cost of nursing services, variable billing and the maintenance of quality assurance standards”  Includes critical system elements as well as various ways the resulting data can be used. confirms that a tool or measure with rules and definitions is used to determine patient care requirements includes processes for validating and monitoring the measure and its outcomes over time PCAS data can be used for: ✓ unit staffing ✓ equal workload distribution 41  2023- 2024 Nursing Administration Clinical Practicum Book ✓ quality of care maintenance ✓ budget development ✓ costing out care ✓ organizational processes Patient Classification System ✓ Focuses on patient needs. ✓ Patients are grouped according to the acuity of their needs and the degree of their dependency on nurses. Patients grouped according to their nursing needs into 4 groups: Purpose of patient classification system 1. Determine the required nursing hours needed to provide safe and efficient patient care based on standards of care and practice 2. Determine the number and category of staff (skill mix) needed for providing quality of patient care. 3. Enhance staff satisfaction through stress free work environment 4. Categorize patients according to their needs and the time and skill needed to satisfy each category needs. 5. Determine work load and nursing care requirements. 42  2023- 2024 Nursing Administration Clinical Practicum Book Time Scheduling 43  2023- 2024 Nursing Administration Clinical Practicum Book Intended learning outcomes: At the end of this session, the student will be able to: Define time scheduling Explain objectives of time scheduling Apply one method of patient classification system to determine staffing needs Definition of time scheduling It means the distribution of working hours for each employee in a particular unit for a given period of time. It is a planning pattern of on-off duty hours for employees Objectives of time scheduling  To ensure patient`s care needs without over or under staffing  To maximize the use of nursing staff power and to optimize the use of professional expertise  To know well in advance what individual schedules are.  To ensure fair treatment of nursing staff in their distribution  To achieve balanced distribution of days off  To satisfy personnel both as to work hours and as to perceive sense of equity  To consider the unique needs of the staff as well as the patient Principles of time scheduling 1. Provide schedule for 4-8 weeks at a time. 2. Head nurse (HN) never has off duty on Saturday which is the beginning of the week. 3.One day off must be planned between of the HN and the assistant head nurse for adequate reporting. 44  2023- 2024 Nursing Administration Clinical Practicum Book 4. Do not give night shift to the head nurse 5. Night shifts should be followed by days off (sleeping days) before working any other shifts (morning, or afternoon shifts) 6. No accumulation of days on to insure adequate rest and relaxation for staff members. 7. Slight overlapping time should be kept between shifts to provide chance for shift report. 8. Ensure flexibility to overcome personnel needs such as sick leaves, vacations, and holidays. 9. Equal distribution of desirable and undesirable work hours. 10. Special requests should be granted if reasonable. 11. Provide a professional nurse on duty at all times during 24 hours period. 12. After completing schedule; changes should be more limited. 13. Notify staff regarding schedule changes before having duty hours with sufficient time. Hospital policies related to time schedule Hospital scheduling policies must be identified at the time of employment. ❖ Who is responsible for scheduling (by title) ❖ Time covered by each schedule. ❖ Dates for posting schedule. ❖ Day beginning the work week. ❖ Beginning and ending time for shifts. ❖ Length of meal or break time. ❖ Identify number of nurses in the unit ❖ Numbers of work hours per month. ❖ Numbers of sequential works days. ❖ Numbers of sequential days off ❖ Numbers of weekends off per month. ❖ Number of nurses in morning shift should be more than afternoon and night shift because of the work overload in the morning shift than other shifts ❖ No. of paid holidays / year. 45  2023- 2024 Nursing Administration Clinical Practicum Book Systems of developing time scheduling Centralized scheduling It done by top manager for all nurses in all departments usually manually or by computer Decentralized scheduling It planned at the unit level, usually by the head nurse. Self-scheduling It is a process by which nurses and other staff develop and implement hospital policies related to time scheduling and variables affecting it. So, staff nurses set their wishes on schedule and wait for response from head nurse Approaches of Time scheduling There are two basic approaches for scheduling: - The manual approach One or several persons prepare a schedule for a specified time for a group of personnel on one nursing unit, several divisions or an entire institution. The Computerized approach Computerized scheduling allows for maintaining the patterns to be used and the choice of employee and the planning of holidays, days off and vacations. All data necessary for time scheduling are fed to the computer and a program for scheduling is designed based on the fed data. The computerized scheduling is more effective than the other types. Types of time scheduling Block scheduling Means that the work schedule for a unit is planned in a “block” of week, i.e. days to be worked by staff are blocked together. 46  2023- 2024 Nursing Administration Clinical Practicum Book Block scheduling is done for 4-8 weeks at a time. Day S S M T W T F S S M T W T F S S M T W T F S S M TW T F h h h h Staff A x xx x ox x xx x o x x x xxxo x x xxo x xx x o B x xx x xo x xx x x x o x xxxx x o xxx x xx o x C x xx x ox x xx x x o x x xxxx o x xxx x xo x x Cyclic scheduling It is a technique for assigning days and time off in a pattern that repeats itself regularly, while taking in consideration the need for the proper number and mixes of personnel and continuity of care. Cyclic time scheduling is done for “four to eight weeks.” Example of cyclic time scheduling Week (1) (2) (3) (4) Day S S M T W Th F S S M T W Th F S S M T W T F S S M T W T F Staff h h Charg D D D D D D - D D D D D D - D D D D D D - D D D D D D - e 1 N N N N - - - E E E - - D D N N N N - - - E E E - - D D 2 D D - - N N N - - - E E E E D D - - N N N - - - E E E E 3 E E E - - D D N N N N - - - E E E - - D D N N N N - - - 4 - - - E E E E D D - - N N N - - - E E E E D D - - N N N Week (5) (6) (7) (8) Day S S M T W Th F S S M T W Th F S S M T W T F S S M T W T F Staff h h Charg D D D D D D - D D D D D D - D D D D D D - D D D D D D - e 1 N N N N - - - E E E - - D D N N N N - - - E E E - - D D 2 D D - - N N N - - - E E E E D D - - N N N - - - E E E E 3 E E E - - D D N N N N - - - E E E - - D D N N N N - - - 4 - - - E E E E D D - - N N N - - - E E E E D D - - N N N 47  2023- 2024 Nursing Administration Clinical Practicum Book How to implement time scheduling ✓ Determine schedule type, pattern of on-off duty hours, staff capabilities and experience. ✓ Consider the percentage of staff per shift. ✓ A skeleton plan is made in pencil to allow alterations. ✓ Write schedule data and list staffing in order of seniority. ✓ Distribute night shift first then evening shift then morning shift and finally off duty hours. ✓ Check completed schedule for principles and errors e.g. (Name omitted, requested and approved holidays and improper mix of personnel). ✓ Sign completed schedule with your full name. ✓ Secure through take an approval on your schedule from nursing director. ✓ Post schedule to notify employee about assigned duty hours several weeks in advance. ✓ Update the schedule daily if needed. Criteria for scheduling evaluation 1-Coverage: The number of nurses by skill class assigned to be on duty is in relation to some minimum number on nurses required. 2-Quality: It is a measure of a schedules desirability as judged by the nurse who will have to work it. 3-Stability: Measure of the extent to which nurses know their future days on and days off in relation to hospital policies. 4-Flexability: Ability of scheduling system to handle changes to work and to nurses. 5-Fairness: Measure of the extent to which each nurse perceives the same chances and influences in the schedule 6- Cost: The resources consumed in making the schedule 48  2023- 2024 Nursing Administration Clinical Practicum Book Nursing care delivery models 49  2023- 2024 Nursing Administration Clinical Practicum Book Intended learning outcomes: At the end of this session, the student will be able to: Define Nursing care delivery models Explain purposes of Nursing care delivery models Discuss characteristics of good assignment Evaluate principles of patient assignment Differentiate between different types of Nursing care delivery models Apply functional and case method for nursing care delivery in the clinical unit Definition of Nursing care delivery models Nursing care delivery models refer to the organization and structure of how nursing care is provided Show detail assignments, responsibility, and authority to accomplish patient care Determine who is going to perform what tasks, who is responsible, and who makes decisions Match number and type of caregivers to patient care needs It is a framework that describe how organizations approach the care delivered to their patients. Purposes of Nursing care delivery models To delegate the work to be done by nursing personnel Suggest appropriate procedure for nursing care with maximum efficiency with minimum effort Gain the cooperation of workers in the acceptance of work to be done Serve as work plan 50  2023- 2024 Nursing Administration Clinical Practicum Book Assignment refers to “a written delegation of duties to care for a group of patients by trained personnel assigned to the unit.” Characteristics of Good Assignment Meet employee and patients' needs and preferences. Written clearly, concisely and legibly. Posted in a place easily accessible. Should be related to previous assignments, in order to provide for Progressive learning experience. Done on weekly basis and adjusted daily to meet changes in patients ’needs or changes in nursing personnel. Principles of patient assignment Assignment must be made by first line manager It is based on nursing needs of patients, and approximate time required in order to fulfill those needs It is based on job description. It is planned for at least one week to assure continuity of care. It considers the capabilities of the staff nurses, skill levels and experience. It considers all direct and indirect unit activities. It considers that each task is the responsibility of one nurse. Consider the geographical location of the unit and the assigned duties to save nurses' time and effort. Must be balanced among nursing staff. Never to assign the same task to more than one nurse. 51  2023- 2024 Nursing Administration Clinical Practicum Book Classic Nursing Care Models 1 Case Method (total patient care) 2.Functional nursing The Case Method (Total patient care) ▪ It is the oldest patient care delivery method. ▪ In this method one professional nurse assumes total responsibility of providing complete care for one or more patients (1-2) while she is on duty according to working conditions, patient acuity and hospital policy. ▪ Nurses responsible for planning, organizing, and performing all care, including personal hygiene, medications, treatments, emotional support, and education required for their assigned patients. ▪ In this method no gaps exist because the nurse knows what have been done and what should be done for the assigned patient. ▪ The hospital needs large number of staff nurses to use this method of assignment. ▪ This method preferred to use in critical care units as coronary and intensive care units. Advantages of case model: 1. High degree of autonomy 2. Lines of responsibility and accountability are clear 3. Patient receives holistic, unfragmented care 4. Consistency in carrying out the nursing care plan. 5. Patient needs are quickly met as high number of nursing care hours are spent on the patient 6. Relationship based on trust is developed between the nurse and the patient's family Disadvantages of case method: 1. Each RN may have a different approach to care 2. Not cost-effective 3. Lack of RN availability 52  2023- 2024 Nursing Administration Clinical Practicum Book The Functional Method : ▪ In this method, the nursing care is divided into tasks and each staff member is assigning to perform one or two tasks for all patients in the unit according to the level of skill required for performance as follows: Registered professional nurses: Responsible for administering medication to all unit patients, another for changing dressings and administering ordered treatments for all patients. Technical nurses: Responsible for taking vital signs and recording intake and output for all patients in the unit. Nurse aide: Responsible for making beds for all ambulatory patients and assisting patients to move in bed or walk in the hall. Advantages of functional method 1. Care is provided economically and efficiently 2. Minimum number of RN are required 3. Tasks are completed quickly 4. Save time, effort, and cost. 5. More specialization to nursing duties ensure quality nursing care. 6. Each nurse become highly skillful, she developed speed and efficiency in doing her assigned task. 7. Each nurse become more independent and needs less supervision. 8. Few numbers of nurses can provide nursing care to large number of patients. Disadvantages of functional method 1. Care may be fragmented Patient may be confused with many care providers 2. No one nurse knows or evaluates patient care. 3. It is difficult to define responsibility of patient care. 4. poor nurse- patient communication. 5. The nurse become less skillful in other tasks. 6. Lack of holistic understanding of the patient Problems with follow-up. 53  2023- 2024 Nursing Administration Clinical Practicum Book Modern Nursing Care Models 1. Case management 2. Clinical Pathways Case Management ▪ First introduced in the 1970s by insurance companies ▪ Hospitals adopted the model in the 1980s ▪ Value demonstrated through research ▪ Components include : ▪ Assessment, planning, implementation, evaluation, and interaction ▪ Variations are found in most health care organizations ▪ Reserved for chronically ill patients, seriously ill patients, or long term, expensive cases ▪ RN assumes a planning and evaluative role; usually not responsible for direct-care duties ▪ Supplemental form of care delivery; does not replace direct-care model ▪ Coordinates the patient’s care throughout the course of an illness from a payer or facility perspective Employee of the payer (external case management) Employee of the health care facility (internal case management) Clinical Pathways ▪ Delineate a predetermined written plan of care for a particular health problem ▪ Specify desired outcomes and transdisciplinary intervention ▪ Address a common medical diagnosis ▪ Dictate the type and amount of care given and thus have financial implications Clinical Pathways essential Components Consults Laboratory and diagnostic tests 54  2023- 2024 Nursing Administration Clinical Practicum Book Treatments Medications Safety Self-care activities Nutrition Patient and family education Discharge planning Triggers Choosing a nursing care delivery model 1.What staff mix is required ? 2.Who should make work assignments ? 3.Work assigned by task? By patient ? 4.How will communication be handled ? 5.Who will make decisions ? 6.Who will be responsible and accountable ? 7.Fit with unit/facility/organization management ? Evaluation of nursing care delivery models 1.Timely, cost-effective outcomes achieved ? 2.Patient and families happy with care ? 3.Team members satisfied with care ? 4.Good communication among all team members ? 5. RNs utilized and challenged appropriately? 55  2023- 2024 Nursing Administration Clinical Practicum Book Decision making 56  2023- 2024 Nursing Administration Clinical Practicum Book Intended learning outcomes: At the end of this session, the student will be able to: Define decision, decision making, clinical decision making Explain Characteristics of good decision maker Describe guidelines for general decision making Differentiate between different types of decision making Apply decision-making process Discuss decision-making models Critique common decision-making mistakes Evaluate the nurse manager role in decision making Decision-making is a crucial part of good business. The question then is ‘how is a good decision made. One part of the answer is good information, and experience in interpreting information. There are also aids to decision- making, various techniques which help to make information clearer and better analyzed, and to add numerical and objective precision to decision- making (where appropriate) to reduce the amount of subjectivity Decision s It is a solution chosen from among alternatives. Decision making The process of examining your possibilities, options, comparing them, and choosing a course of action. Clinical decision making Clinical decision making is a complex process in which nurses combine theoretical with practical experience to make judgments regarding client care. 57  2023- 2024 Nursing Administration Clinical Practicum Book Clinical decision-making process requires thoughtful reasoning so that the best options for the client are chosen on the basis of the client’s condition and priority of the problem — So, remember……… ✓ Take particular positions on social issues. ✓ Determine how one presents himself or herself or to others ✓ Evaluate and judge to give praise on self and others ✓ Persuade and influence others ✓ Maintain and enhance self esteem Decision makers: They are individuals who have the ability and willing to take a decision. Characteristics of good decision maker: ▪ great leaders understand how to balance emotion with reason and make decisions that positively impact themselves, their employees, their customers and stakeholders, and their organizations. ▪ great leaders also know when to move quickly and proceed with the available information, versus when to take more time and gather additional information. ▪ knowledgeable ▪ critical thinker ▪ problem solver ▪ ability to take risk ▪ have adequate experience. Guidelines for general decision making Categorical interpretation The problem should be defined properly in more than one way Application of limiting factor Limiting factor should be considered in order to analyze the external strength &weakness. Adequate information 58  2023- 2024 Nursing Administration Clinical Practicum Book More quantity of reliable information leads to effective decision making. Considering other views Various views at the same point are considered for quality decision. Timeliness Decision should be, made at proper time to meet the competitive advantages Types of decision making Individual decision making  Decision making without a group's input or a decision made regardless of the group's opinion is, naturally, an individual decision. This is the more traditional decision-making approach and can work effectively for a manager when the group's input is not required or in certain cases, desired.  Advantages: ❖ An individual generally makes prompt decisions ❖ Individuals do not escape responsibilities. ❖ Individual decision-making saves time. ❖ Saving money ❖ Saving energy as individuals make prompt and logical decisions generally ❖ More focus and rational  Disadvantages: ❖ Minimal collecting more and full information ❖ An individual while making any decision uses his own intuition and views. ❖ No discover to the group members talents and ideas ❖ An individual will not take into consideration every member interest Group decision making  There are several models of group decision making that you can put to use. Two examples are consensus and consultation. Consensus decision making involves posing several options to the group and using the most popular option to make a decision.  Advantages: ❖ Easy way to share information ❖ Opportunities for face to face communication 59  2023- 2024 Nursing Administration Clinical Practicum Book ❖ Opportunities to become connected to social unit ❖ Access to larger resource base ❖ Serve in problem solving ❖ Support group ❖ Promotion of ownership of problem and solution  Disadvantages: ❖ Individual opinion influenced by others ❖ Individual identity obscured ❖ Formal and informal role and status position ❖ Time consuming ❖ Personality conflicts Decision-making process Step 1 - identifying a problem Problem - discrepancy between an existing and a desired state of affairs Step 2 - identifying decision criteria Decision criteria - what’s relevant in making decision Step 3 - allocating weights to the criteria Must weigh the criteria to give them appropriate priority in the decision Step 4 - developing alternatives List the viable alternatives that could resolve the problem without evaluating them Step 5 - analyzing alternatives Each alternative is evaluated against the criteria Step 6 - selecting an alternative Choosing the best alternative from among those considered Step 7 - implementing the decision Implementation - conveying the decision to those affected by it and getting their commitment to it Step 8 - evaluating decision effectiveness Determine whether the problem is resolved 60  2023- 2024 Nursing Administration Clinical Practicum Book Decision making models  The process for concluding which decisions need to be made and how to find alternatives for each decision 1. The rational decision-making model ✓ The rational model proposes that people follow a rational, four step sequence when making decisions. The four steps are:  Identifying the problem  Generating solutions  Selecting a solution  Implementing and evaluating the solution ✓ It is organized around selecting the most logical and sensible alternative that will have the desired effect. Detailed analysis of alternatives and a comparative assessment of the advantages of each is the order of the day. ✓ The rational model is the first attempt to know the decision-making-process. It is considered by some as the classical approach to understand the decision-making process. 2. The normative model ✓ this model based on premise that decision making is not rational ✓ Simons suggests that decision making is characterized by:  Limited information processing - there is a limit to how much information a person can manage.  Judgmental heuristics - shortcuts are used to simplify decision making.  Satisfying - choosing solutions that meet minimum requirements and are "good enough." 61  2023- 2024 Nursing Administration Clinical Practicum Book Principles of ethical decision making Decision makers should use the moral and ethical principles to assist them the making the decision Autonomy The individual’s right to make a choice about one’s course of action Beneficence. The obligation to do good not harm Paternalism The individual to assume the authority to make a decision for another one Utility To reflect the belief that what is the best for the common good outweighs what is the best for the individual Justice To be fair in treating all people. Factors influence ethical decision making  The patient right’s  Social and culture attitudes  Science and technology  Judicial decisions  Funding  Personal religious, philosophic view points Common decision-making mistakes 1. Relying too much on "expert “information 2. Over estimating the value of information received from others 62  2023- 2024 Nursing Administration Clinical Practicum Book 3. Under estimating the value of information received from others 4. Only hearing what you want to hear or seeing what you want to see 5. Not listening to your feelings or gut reaction, 6. Procrastination – deciding too slowly Waiting too long to get more information Losing an option because of delaying Waiting so long someone else decided for you Deciding tomorrow when you could have decided today 7. Impulsiveness – deciding too fast Adopting an alternative too soon Rejecting an alternative too soon Deciding before you know all the facts 8. Miscalculating control Assuming you have more control than you have Assuming you have less control than you have Believing it was your decision when it was not Not being able to carry out a decision after you made it 9. Misinterpreting information Over or under estimating the significance of information Failing to consider certain alternatives Failing to consider certain outcomes Using biased information Forgetting to consider risks 10. Unclear values Letting others’ values influence you Not realizing what you wanted most Minimizing serious negative consequences Being unclear about you values–what is important to you 63  2023- 2024 Nursing Administration Clinical Practicum Book Nurse manager role in decision making 1- The nurse manager must use critical thinking: It can see in 3 perspectives': A-thinking ahead (the ability to be proactive to prevent the problem arise). B-thinking in action (the ability to think and react quickly toward problem) C-thinking back (reflecting what we can do better by looking for good rational) 2- Reflective thinking: it does by evaluating the actions done in the past experience. 3- Nurse manager should follow problem solving process: 1- define and identify the problem 2- analyze the problem 3- identifying possible solutions 4- selecting the best solutions 5- evaluating solutions 6- develop an action plan 7- implement the solution 4-nurse manager should decide which problem need immediate attention and which can wait involve the ability to prioritize one’s actions. 5-nurse manager should promote climate the encourage critical thinking and innovative problem solving and decision making. 6- nurse manager should consider the ethical consequences when take decision. 7- nurse manager should knowledgeable about themselves and other individuals in the health care setting: -possess technical expertise. -know weakness and strength and others needs and be able to take decisions. -always benefit from study and practice. -maintain self-development by reading and attending workshop. 64  2023- 2024 Nursing Administration Clinical Practicum Book Documentation (reporting & recording) 65  2023- 2024 Nursing Administration Clinical Practicum Book Reporting Intended learning outcomes from the lecture: After the student has studied this lecture, he/ she should be able to: -Discuss what is meant by reporting. List the purpose of reporting. -Describe the characteristics of effective reports. -Distinguish between the intradepartmental and interdepartmental reports. -Differentiate among the different types of reports that could be used in the nursing department. -Define what is meant by shift report. -State the content of shift report. -Discuss what is meant by daily conditional report. - Define what is meant by incident report. -Demonstrate the procedures for using the incident report. Outlines: -Introduction. -Definition of reports. -Purpose of reporting. -Characteristics of effective reports. -Types of reports. Interdepartmental report. Intra departmental report. 66  2023- 2024 Nursing Administration Clinical Practicum Book Reporting Introduction:- Reports are prepared accounts of important activities within a particular period of time. It is the supplement of fast transmission of data to ensure current information, which is critical for all caregivers to make appropriate clinical decisions for care. A report is a written and oral relay of information about a patient, usually used between health professionals. It provides an account of what is known and relevant about a patient. Meanwhile, information about patients is exchanged between health team members, the patient, and family members. Reports offer a summary of activities seen, performed, or heard. *Definition of reporting: Reporting refers to given an account of something that has been seen, heard, done, or considered. It is the oral and written, or computer-based communication intended to convey information to others. It is the verbal communication of information regarding a patient’s health status, needs, treatments, outcomes, and responses. **Purpose of reporting: 1- To communicate information to a person or group of people. 2- To convey information based on factual materials. 3- To provide better continuity of care among nursing caring for patients. 4- To give a scope of activities within the department. 5- To convey pertinent information that will help staff members or individuals (physician, family) understand the current status of the patient under discussion. 67  2023- 2024 Nursing Administration Clinical Practicum Book Characteristics of effective reporting: Accurate, clear, precise, comprehensive and concise. Appropriateness and understandable language. Use acceptable abbreviations only. Dated and timed. Oral reports should be in an unhurried, clear, and audible voice. Written reports should be clearly written in ink and signed, with full name beside signature. *Types of reports: There are two types: interdepartmental and intra departmental report. A. Inter-departmental report: Inter-departmental reports are those exchanged between nursing department and other hospital departments, e.g. admission office. B. The intradepartmental reports: Intradepartmental reports are those exchanged between members of different categories within the nursing service department, as the head nurse and the nursing service director. Intradepartmental reports includes the three types: Shift report, daily conditional report, and incident report. 68  2023- 2024 Nursing Administration Clinical Practicum Book 1. Shift report Intended learning outcome At the end of the lecture the student will able to: Define shift report. Describe the benefits of shift report. List the characteristics of special information. Enumerate the steps used to fill the shift report. Apply of shift report in hospital. Outlines: Definition of shift report. The benefits of shift report. The characteristics of special information The steps used to fill shift report. Application of shift report. Definition:- It is an oral and written report given by the head nurse on one shift to the head nurse and all members of the coming shift. It is exchanged at the beginning of the oncoming shift. Or It is written summaries of pertinent information about patient’s condition and activities related to their care. Report occurs two or three times per day. Benefits of shift report:- It is essential to provide the oncoming nurse with information about the patients he or she will be caring for. If important information is missed in the report, it can affect patient care and safety. 69  2023- 2024 Nursing Administration Clinical Practicum Book *Change of shift report: The change-of-shift report occurs two or three times a day in all types of nursing units. At the end of each shift, nurses report information about their assigned patients to nurses working on the next shift. It is should be given quickly and efficiently. Change-of-shift report is an oral report usually given by the on-duty charge nurse to all nursing personnel coming on duty. The face-to- face report allows the listener to ask questions during the reporting. The more detailed report is often given at bedside, and patients, as well as nurses, may participate in the exchange of information. 70  2023- 2024 Nursing Administration Clinical Practicum Book Shift report checklist Items Score Done Not Comments done Fill / complete basic : information 3 - Date. - Shift. - Unit name. - Patient census - Number of Admissions - Patients’ names. - Patient's Diagnosis. - Number of deaths. - Number of critical cases. - Number of discharges. - Number of transfers. - Number of operations. List patient’s personal information, including: 2 age medical history details current condition Latest symptoms. Provide summary on patient’s reaction to treatment/care, 2 with any other important observations you make during your shift. List all recommended actions the incoming nurse should 2 take during his /her shift. Sign name / title with ink 1 Total 10 NB. Receiving of the report between head nurse and head nurse and nurses of the oncoming shift. 71  2023- 2024 Nursing Administration Clinical Practicum Book Incident Report Intended learning outcome By the end of this lecture the student should be able to:- 1- Define incident report. 2- Enumerates the uses of the incident report. 3- List importance of the incident report. 4- Discuss the steps incident report. 5- Apply incident report. Outlines: Definition of the incident report. The uses of the incident report. The importance of the incident report. The steps of the incident report. Application of the incident report. 72  2023- 2024 Nursing Administration Clinical Practicum Book Definitions of incident report:- An accurate and comprehensive report on unplanned or unexpected occurrence that could potentially affect a patient, family member, or staff. It is a tool used by health care agencies to document the occurrence of anything out of the ordinary, which might be harmful to a patient, employee, or visitor. Incident report can be used for: any injury, medication administration errors, Falls and burns, loss or damage to a patient, nurse, or organization’s property. Why are incident reports important? 1- They protect you. Every nurse makes mistakes. When it happens, a well- documented incident report can actually save your nursing license and career. 2- They protect your organization. If a patient or their family decides to file a lawsuit against the organization (which can also include you), it will be essential for the organization to show that policies were followed, an incident report was filed, and appropriate departments or people were notified. 3- They result in better patient care and an improved work environment. It might not seem like your simple incident report will have much impact, but it does. The only way changes can happen is if safety and operations managers recognize the need to make things safer for everyone. 73  2023- 2024 Nursing Administration Clinical Practicum Book Incidence Report Checklist Student name: Hospital : Unit: Date: Time: Group: Items Score Done Not Comment Done 1. Fill date of incident 2. Fill time of the incident (AM/ PM). 3. Fill place of the work (unit) /its phone number 4. Fill name and position of responsible person who reported incident (head nurse / witness). 5. Fill who was injured person (patient/ visitors/nursing staff /employee). 6. Fill the name of injured person. 7. Fill age/ gender of injured person. 8. Fill the phone number of injured person. 9. Fill type of incident 10. Fill diagnosis (in case if patient ) 11. Describe details of the incident objectively. 12. Fill name and position of involved personnel. 13. Fill name and position of witness. 14. Fill the comments of involved person 15. Fill the required intervention/action taken (firstaid/hospital/police/others). 16. Fill other notes or comments 17. Fill repot to quality assurance unit 18. Notes on follow up action, contact withinvolved person. 19. Fill out the report completely, clear, accurately,and based on facts. 20. After completing the incident report, all partiesmust sign with ink, includes: - Person who reported incident sign / fill position or title/ date of report. - The witness - Supervisor who received it (in case callothers). Total 74  2023- 2024 Nursing Administration Clinical Practicum Book N.B. 1- The incident report is submitted as soon as possible to the appropriate authority (supervisor/quality assurance). 2- No nurse is blamed in an incident report. 3- Follow specific documentation guidelines. 4. The report form should not be copied or placed in the client’s record. Student's signature: Demonstrator signature: 75  2023- 2024 Nursing Administration Clinical Practicum Book Recording Intended learning outcomes from the lecture: After the student has studied this lecture, he/ she should be able to: Define what is meant by recording. Discuss what is meant by patient’s clinical records. List importance of recording. Enumerate the types of records. Differentiate among the different types of records that could be used in nursing unit. Distinguish among different types of record used in the nursing office Outlines Definition of recording. Definition of patient’s clinical records. Importance of recording. Types of records. Types of records used in nursing unit. Types of records used in nursing office 76  2023- 2024 Nursing Administration Clinical Practicum Book Recording ❖ Definition Records are hospital administrative tools used in collecting data directed towards the attainment of the objective of its sections and department. ❖ Definition of patient’s clinical records A patient’s clinical record is the comprehensive collection of data that describes a patient’s condition, health care needs, health care services received, and response to care. OR An authoritative and summarized narrative of patient's hospitalization from admission to discharge (or death). OR It is a written account of all significant clinical information pertaining to a patient. ❖ Importance of records 1. Provide a basis of communication between physicians and others participating in the patient care such as nurses. 2. Serve as a basis for planning individualized patient care. 3. Provide a document for the care given to the patient during each hospitalization. 4. Serve as a basis for analyzing, studying and evaluating the quality of care given. 5. Assist in protecting the legal interests of patient, hospital physicians, and health care providers. 6. Provide clinical data for use in research and education. 7. Provide continuity of patient care on subsequent admission of the patient. ❖ Types of records: There are two types of records used in hospital I. Records in common use by nursing unit 1. Patient's record 2. Assignment record 3. Time planning record 77  2023- 2024 Nursing Administration Clinical Practicum Book 4. Census record 5. Inventory record 6. Narcotic record; medication records II. Records in common use by nursing office 1. Master record of nursing hours 2. Attendance record 3. Personnel record o Employment record o Evaluation record I. Nursing unit records 1. Patient clinical record It is an orderly written record; include comprehensive, collected data that describes Patient condition Health care needs Health care services and Response to care This record should be arranged in chronological order from the current data back to the data of admission. It includes a. Admission and discharge records, b. History of physical examination c. Progress notes. d. Physician’s orders e. Graphic records f. Other records Consultation report Test result report Transfusion record The other part of clinical record should include nursing documentation as Nursing progress notes Nurses notes and Medication administration record. 78  2023- 2024 Nursing Administration Clinical Practicum Book a. Nurse’s progress notes: It includes Patient condition; Complain; Identified problems; Interventions and Patient response to care b. Nurse’s notes Begin with the admission of the patient to the unit and should include: Date, time and manner of admission (wheel chair, crutches, etc.). Statement of apparent condition of the patient. Record of symptoms noted. Treatment initiated. Time and type of specimens Signature by nurse who rendered to service. ❖ Importance of nurse’s notes: Provide an accessible form, which may be readily consulted and followed by nurses. It transfers responsibility from the nurse to other It makes it possible to review readily and quickly the patient’s condition and all records for patient care. III. Records used in nursing office: It includes three types of records namely 1. Master record of nursing hours 2. Attendance record 3. Personnel record 1. Master record of nursing hours This record derived from the daily time record of the nursing units; should show the distribution of the hours assigned to be worked by each category of nursing personnel in the hospital. 2. Attendance record It is used to determine the attendance and absence of nursing personnel. Every nurse should sign and write the exact time of her attendance. 79  2023- 2024 Nursing Administration Clinical Practicum Book 3. Personnel record - It is concerned with information about each individual nurse. It consists of employment and evaluation record. The file should include the following Application blank Interview form Reference findings Health status – physical examination Employee performance appraisal Salary status Employment change Disciplinary action Accident and incident reports Educational achievement Staff activity 80  2023- 2024 Nursing Administration Clinical Practicum Book Medication order record The intended learning outcomes: Define the medication order record. Identify the material required to fill medication order record. Enumerate the steps used to fill medication order record. Apply the medication order record in hospital. Out lines: Definition of medication order record. The material required to fill of medication order record. The steps used to fill medication order record. Application of the medication order record in hospital. 81  2023- 2024 Nursing Administration Clinical Practicum Book Definition of medication order record: It is a legal ongoing record on which the nurse documents medications needed to all patients in the unit. Material required: Medication record sheet. Steps: 1. Write the name of the unit. 2. Write date. 3. Write the numbers of patients. 4. Write the patient name. 5. Write medication. Name Dose Route frequency 6. Write remarks of nurses about medication to pharmacy. 7. Total all patient medication. 82  2023- 2024 Nursing Administration Clinical Practicum Book kardex Intended learning outcome: At the end of the lecture the student will able to Define kardex Summarize the benefits of using kardex. List characteristics of effective kardex. List characteristics of ineffective kardex. Specify the kardex updated times. Enumerate steps on filling kardex. Summarize categories of diet on the hospital: Illustrate abbreviations in kardex. Apply