Management شرح (1) PDF

‫‪0503327640‬‬ ‫احمد السيد‬ ‫‪01011395301‬‬ ‫‪1‬‬ 0503327640 ‫احمد السيد‬ 01011395301 Management  coordinating staff to accomplish the objectives of the facility in the most efficient, cost-effective manner Role of the nurse-...

‫‪0503327640‬‬ ‫احمد السيد‬ ‫‪01011395301‬‬ ‫‪1‬‬ 0503327640 ‫احمد السيد‬ 01011395301 Management  coordinating staff to accomplish the objectives of the facility in the most efficient, cost-effective manner Role of the nurse-manager  policy and decision making  providing adequate staffing for safe, effective patient care  evaluating patient care and documentation  supervising and guiding staff members  evaluating staff performance  planning and implementing budgets FUNCTIONS OF MANAGEMENT Planning  Determining objectives and identifying methods that lead to achievement of objectives Organizing  Using resources (human and material) to achieve predetermined outcomes Directing  Guiding and motivating others to meet expected outcomes Controlling  Using performance standards as criteria for measuring success and taking corrective action 2 0503327640 ‫احمد السيد‬ 01011395301 Types of managers Frontline managers  involved with delivery of client care  include charge nurse &team leader Middle manager  Unit manager and supervisor. Responsibilities  supervising staff, preparing budgets  preparing work schedules, writing and implementing policies Nurse executive  Top-level nurse manager.  works closely with the administrative team of the organization Leadership  Interpersonal process that involves influencing others (followers) to achieve goals. Autocratic leader  maintains strong control  not allow for staff participation  give order and instruction  makes decisions 3 0503327640 ‫احمد السيد‬ 01011395301 Democratic leader  Staff members participate in the decision-making  Most decisions are made by the group, not the manager.  Staff development is encouraged.  Positive feedback is given to staff members to encourage professional growth.  Cannot be used in emergency situation. Laissez-faire  Decision making is left to the group, with providing little , guidance, support, or feedback Situational  uses a combination of styles based on the current circumstances and events Participative  Problems are identified by the manager and presented to the staff with possible solutions.  Staff members are encouraged to provide input but the manager makes the decision.  Negotiation is key. 4 0503327640 ‫احمد السيد‬ 01011395301 Unity of command  Leader stresses the need for all the employees to follow orders and instructions from him and not from anyone else Unity of direction  Leader emphasizes to the team about the need to put their efforts together towards attainment of the goals of the program. Centralization  making of decisions done by a few individuals at the top of the organization (managers of a department or unit)  Decisions are communicated after that to the employees. Decentralization  Distribution of authority throughout the organization which allow for increased responsibility and delegation in decision making. Great man theory Leaders are born not made Charismatic Based on personal beliefs and characteristics of influence Transactional using a reward and punishment system Quantum maintaining a balance between tension and order prevents an unstable environment and promotes creativity 5 0503327640 ‫احمد السيد‬ 01011395301 Servant Based on a desire to serve others Transformational focuses on promoting change through a shared vision Power  the ability to do or act to achieve desired results Types of Power Reward Ability to provide incentives Coercive Ability to punish Referent Based on attraction Expert Based on having an expert knowledge Empowerment  interpersonal process of enabling others to do for themselves involves open communication mutual goal setting, and decision making Nurses can empower clients through teaching and Advocate Conflict  Occurs due to difference in beliefs, attitudes, values, goals. Types of conflict Intrapersonal within person Interpersonall Occurs among clients, nurses, or other staff members 6 0503327640 ‫احمد السيد‬ 01011395301 Organizational Occurs when an employee confronts the policies and procedures of the organization Modes of conflict resolution Accommodation  neglect their own needs goals, or concerns  (unassertive) while trying to satisfy others ‫ييجى علي نفسه علشان يرضي االخرين‬ Avoidance  unassertive and uncooperative  do not follow their own need goals  Postpone dealing with problem Competition  Follow their own needs and goals at the expense of others Compromise  assertive  and openly to achieve important goals and concerns SBAR  structured and standardized communication technique that improves communication among team members when sharing information on a client. Components  up-to- information about the date client’s Situation.  Background information.  Assessment data.  Recommendations such as treatments, medications, or services needed 7 0503327640 ‫احمد السيد‬ 01011395301 Delegation  Process of transferring performance of a selected nursing task to an individual who is competent to perform that specific task.  nurse who delegates maintains accountability for the task The 5 rights of delegation include the :  Right task  Right circumstances  right person  Right direction communication.  right supervision, evaluation Before delegation be sure from:  institutional policies and procedure  job descriptions of personnel provided by the institution Unlicensed assistive personnel (UAP) non-invasive interventions  bathing  ambulation  feeding patient  chest compression during cpr  change patient position 8 0503327640 ‫احمد السيد‬ 01011395301 licensed practical nurse (LPN)  perform tasks that UAP can perform certain invasive tasks  such as dressing changes, suctioning, urinary catheterization, and medication administration A registered nurse (RN)  responsible for assessment and planning care, initiating teaching, administering medications intravenously Functional nursing  Tasks being delegated by the charge nurse to individual members of the team.  Team members focus on the delegated task rather than the total client. ‫الممرضه بتكون مسؤوله عن وظيفه واحده وليس عنايه كامله للمريض‬ primary nursing  Responsible for managing and coordinating the client’s care while in the hospital and for discharge. 9 0503327640 ‫احمد السيد‬ 01011395301 Client-focused care(Case method)  Assumes total responsibility for planning and delivering care to a client Different nurses assigned during a 24hour Types of communication Upward Communication Communication from LOW authority to HIGH authority. Downward Communication from HIGH level Communication authority to LOW authority. Lateral(Horizontal) Is between department and personnel communication on the SAME level of hierarchy. Diagonal Communication Communication between managers and workers located in different functional divisions Interpersonal people communicate with same communication culture, goals, values and ethics Intrapersonal people communicate their own belief. communication. culture, goals, values and ethical Types of Evaluation Horn Effect LOW evaluation Halo effect. High evaluation and reward Central tendency average evaluation 10 0503327640 ‫احمد السيد‬ 01011395301 Vision vs Mission:  legal documents that indicate the client’s permission to perform surgery, a treatment or procedure  The client must be informed, in understandable terms, of the risks and benefits of the surgery or treatment  A consent must be signed freely by the client without threat or pressure and must be witnessed  A competent client 18 years of age or older must sign the consent.  A client may withdraw consent at any time Durable power of attorney for health care  document in which the patient designates a person to make medical decisions for him if he becomes incompetent 11 0503327640 ‫احمد السيد‬ 01011395301 o acceptable only under acute or emergency circumstance  Clearly identify the client’s name and room number.  Repeat the prescription to the primary health care provider (PHCP), and record the prescription.  Sign the prescription; begin with “t.o.” (telephone order), write the PHCP’s name, and sign the prescription  dynamic process that leads to an alteration in behaviour Three elements for successful change Unfreezing  first phase of the process  problem is identified and individuals involved gather facts and evidence supporting a basis for change. moving and changing phase  change is planned and implemented. Refreezing  the last phase of the process  change becomes stabilized A. Discharge planning begins when the client is admitted to the hospital or health care facility 12 0503327640 ‫احمد السيد‬ 01011395301  strategy used to evaluate the severity of injury of each victim as quickly as possible and to tag the victims in about 30 to 60 seconds Emergent (Red):  Priority 1 (Highest)  clients who have life-threatening injuries and need immediate attention Priority 2  require treatment and whose injuries have complications that are not life threatening,  should treated within 30 minutes to 2 hours No urgent (Green): Priority 3  clients with local injuries who do not have immediate complications  can wait at least 2 hours for medical treatment  require evaluation every 1 to 2 hours thereafter 13 0503327640 ‫احمد السيد‬ 01011395301 Patient Classification Systems  Measurement systems in nursing that reflect actual patient care needs for staffing purposes. Quality management  The quality of patient care must be evaluated in order to search for methods of improvement.  Risk management assesses and evaluates care and identifies areas that need improvement by reviewing such incidents or events as: Medication errors Patient falls Treatment errors Treatment omissions. 14 0503327640 ‫احمد السيد‬ 01011395301 Benchmarking  Method for evaluating patient care  The best practices from the top hospitals are compared with the practices in a comparable unit.  That unit’s practices may then be adapted based on how they compare with the best hospitals’ practices or benchmarks. A religious experience Some patients may refuse treatment on the grounds of freedom of religion. Jehovah’s Witnesses, for instance, oppose blood transfusions If your patient refuses treatment  Never ignore a patient’s request to refuse treatment.  Stop preparations for any treatment at once.  Notify the doctor immediately.  Report your patient’s decision to your supervisor promptly. Don’t administer drugs you think will harm patients the prescribed dosage is too high the drug is contraindicated because of possible dangerous interactions with other drugs or with substances such as alcohol the patient’s physical condition contraindicates using the drug. 15 0503327640 ‫احمد السيد‬ 01011395301 When you refuse to carry out a drug order notify the prescribing doctor if he insist notify your supervisor Document that the drug wasn’t given and explain why (if your employer requires it) If you make an error in giving a drug, or if your patient reacts negatively to a properly administered drug o immediately inform the patient’s doctor o protect yourself by documenting the incident report. Documentation errors Avoid these eight common documentation errors: Omissions Include all significant facts that other nurses need to assess the patient. Personal opinions Don’t enter personal opinions. Record only factual and objective observations and the patient’s statements. Vague entries Instead of “Patient had a good day,” state why: “Patient didn’t complain of pain.’’ Late entries If a late entry is necessary, identify it as such and sign and date it. Note the date and time you’re relating back to. Improper corrections Never erase an error. draw a single line through it, label it “error,” and sign and date it. Unauthorized entries Only you should be keeping your records. vague abbreviations 16 0503327640 ‫احمد السيد‬ 01011395301 Use only standard abbreviations and follow facility policies. Illegibility and lack of clarity—  Write so that others can read your entry. Use a dictionary if you’re unsure of spelling or usage Sign language o Sign all notes with your first initial, full last name, and title. o Place your signature on the right side of the page o If the last entry is unsigned, request that the nurse who made the entry sign it. o Draw lines through empty or remaining spaces to prevent subsequent amendments or additions. Abuse While caring for patients, and note evidence of apparent abuse o You must pass the information along to the appropriate authorities. Always document your findings objectively; try to keep your emotions out of your charting using the SOAP technique, (S) subjective part of the note,  Record information in the patient’s own words. (O) objective part  record your personal observations. (A)assessment  record your evaluations and conclusions. 17 0503327640 ‫احمد السيد‬ 01011395301 (P)plan  list sources of facility and community support available to the patient after discharge. 5 Stages of Group Development  Forming, Storming, Norming, Performing, and Adjourning. Forming The first stage of this Group Process Members concern’s include:  Getting to know each other  Determining group’s real task  Defining group rules  Guidance is needed from the leader. key features of this stage. Anxiety, isolation, hesitation, inadequacy and frustration Storming Stage  group members begin to confront with each other.  begin to compete for roles within the group that will help in strong bonding and feel valued key features of this stage. Aggression due to group conflicts.  conflict can produce benefits for the group in terms of development, strong bonding and Goal achievement. 18 0503327640 ‫احمد السيد‬ 01011395301 Norming  group begin to work more constructively together towards formal style of group  Roles begin to develop and be allocated within the group  sub-groups can likely to form in order to support environment or to group.  Acceptable and unacceptable behaviours created and can reinforce them and then the `norms` play as the role of fabric to this group.  Rules, Regulation & Norms prepare by the group….. Performing stage  mature, organized, well-functioning group  Members deal with complex tasks and handle internal disagreements in creative ways.  Primary challenge is to continue to improve relationships and performance.  Group perform effectively with defined roles  group has transformed into a team.  The discomfort of the storming and norming phases has been overcome  group has a general feeling of unity- strong group feelings.  This is the best stage for a group to complete tasks Adjourning stage  Termination: The final stage in the life of a group  The group terminates because the task has been achieved or when the members have left due to failure or loss of interest. 19 0503327640 ‫احمد السيد‬ 01011395301 A well-integrated group is:  Able to disband when its work is finished.  Willing to work together in the future.  important to positive outcomes.  The ending of a group can be a very unhappy and distressing time for some members 20