nursing service unit

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Slide 2: 

NURSING SERVICE UNIT ADMINISTRATION

Slide 3: 

“………….of all the hospital staff, the best organized and most compliant are invariably the nurses………….”

OBJECTIVES OF THE NURSING SERVICE: : 

OBJECTIVES OF THE NURSING SERVICE: To organize the nurses in a manner so as to render high quality of nursing care. To support and assist the physicians in medical care and carry out the procedures prescribed by them. To establish and implement the philosophy, standards, policies, rules and procedures for the nursing service.

CNTD….. : 

CNTD….. To delineate the duties and responsibilities among the nursing staff at various levels. To estimate the requirement for nursing personnel, appointment of competent nurses and establish policies and programmes for their orientation, placement, on the job training and supervision. To estimate the need for facilities, equipment and supplies.

CNTD…… : 

CNTD…… To develop and maintain a system of recording patient care. To organize and supervise the functioning of wards. To ensure healthy work environment. To periodically appraise the performance of nurses and carry out regular nursing audits. To train student nurses.

PLANNING FOR HOSPITAL NURSING SERVICE. : 

PLANNING FOR HOSPITAL NURSING SERVICE. All elements of administration serve as a framework for the study of nursing service administration. Some tangible evidences of sound organizational planning for hospital nursing services are follows:

CNTD…. : 

CNTD…. A WRITTEN STATEMENT OF THE PURPOSE AND OBJECTIVES OF THE NURSING SERVICE. A PLAN OF ORGANIZATION POLICY AND ADMINISTRATIVE MANUALS NURSING PRACTICE MANUAL A NURSING SERVICE BUDGET A MASTER STAFFING PATTERN

CNTD……. : 

CNTD……. PLANS FOR APPRAISAL OF NURSING NURSING SRVICE ADMINISTRATIVE MEETINGS ADVISORY COMMITTEES ADEQUATE FACILITIES, SUPPLIES AND EQUIPMENT WRITTENJOB DESCRIPTIONS AND JOB SPECIFICATIONS PERSONNEL RECORDS PERSONAL POLICIES HEALTH SERVICES

CNTD…… : 

CNTD…… IN-SERVICE EDUCATION Orientation Skill training Continuing education Leadership and management development MEETING WITH PERSONNEL FROM OTHER DEPARTMENTS

PHILOSOPHY AND OBJECTIVES OF THE NURSING SERVICE IN HOSPITAL : 

PHILOSOPHY AND OBJECTIVES OF THE NURSING SERVICE IN HOSPITAL The philosophy and objectives of the nursing service should aim to meet the personal need for status and reward of nurses in the delivery of competent services in the direct care of patients. It should evolve from the information presented by the staff nurses and it should reflect ideas gathered from literature related to nursing, hospital, medicine and social sciences, as well as nurse’s own values and attitude towards patient care services and to the accomplishment of hospital objectives.

NURSING SERVICE ADMINISTRATION UNIT : 

NURSING SERVICE ADMINISTRATION UNIT Function Establishing objectives for the department of nursing and an organizational structure to achieve these objectives. Formulating nursing service policies and procedures, and for keeping them up-to-date. Putting into effect and interpreting the administrative policies established by the governing board. Maintaining stable staffing pattern. Selecting and assigning nursing personnel.

CNTD…… : 

CNTD…… Planning and directing orientation and in-service training programmes for professional and non-professional nursing staff. Maintaining proper nursing records for clinical and administrative purposes. Assisting in the preparation of and administering the budget for the department. Coordination of activities of various nursing units. Promoting and maintaining effective and harmonious relationship among nursing personnel. Participating in community health and health education programmes.

NURSING SERVICE ADMINISTRATIVE OFFICE : 

NURSING SERVICE ADMINISTRATIVE OFFICE Location Design Organization Staffing pattern For a 15 bed hospital: Nursing superintend – 1 Deputy nursing superintend – 1 Assistant Nursing Superintend - 2 For every additional 50 beds one more assistant nursing superintendent.

TYPES OF STAFFING PATTERN : 

TYPES OF STAFFING PATTERN Conventional staffing pattern (centralized –decentralized) – float nurse Cyclical staffing pattern – 4 -6/ 7 – 12 wk. float nurse The 40 hours, 4 days week work/10 hours/day. The 7 days on 7 days off pattern by Cleveland and Hutching Master plan

NURSING SERVICE AND COMPUTERS (NJI) : 

NURSING SERVICE AND COMPUTERS (NJI) a) Admission, Discharge and Transfer (ADT) b) Nursing Documentation:

OBJECTIVES OF NURSING SERVICE IN HOSPITAL : 

OBJECTIVES OF NURSING SERVICE IN HOSPITAL Objectives of nursing services in hospitals include: Management of nursing care and services Education, training and staff development programme Nursing research Community health programmes.

MODES OF ORGANIZING PATIENT CARE/ NURSING CARE DELIVERY SYSTEM : 

MODES OF ORGANIZING PATIENT CARE/ NURSING CARE DELIVERY SYSTEM There are five primary means of organizing nursing care for patients: Case method of patient care or total patient care Functional nursing Team nursing Primary nursing Case management or managed care

Slide 19: 

NURSING SUPERVISION EVALUATION OF NURSING SERVICES

Types of evaluation : 

Types of evaluation Formative evaluation includes several evaluation types: Needs assessment Evaluability assessment Structured conceptualization Implementation evaluation Process evaluation

Slide 21: 

Summative evaluation can also be subdivided: Outcome evaluations Impact evaluation Cost-effectiveness and cost-benefit analysis Secondary analysis Meta-analysis

Slide 22: 

Nursing audit Performance evaluation 1. Critical incident method 2. Weighted checklist method 3. Paired comparison analysis 4. Graphic rating scales 5. Essay Evaluation method 6. Behaviourally anchored rating scales 7. Performance ranking method 8. Management By Objectives (MBO) method 9. 360 degree performance appraisal 10.Forced ranking (forced distribution) 11. Behavioural Observation Scales

PHYSICAL FACILITIES FOR NURSING SERVICE UNIT : 

PHYSICAL FACILITIES FOR NURSING SERVICE UNIT THE NIGHTINGALE WARD.

CLASSIFICATION OF WARD ACCOMMODATION : 

CLASSIFICATION OF WARD ACCOMMODATION

WARD SIZE AND CONFIGURATION : 

WARD SIZE AND CONFIGURATION The optimum size of a nursing unit should primarily depend on the number of patients. Smaller units are expensive to construct and maintain. It may be economical to plan for – treatment rooms, pantry, and toilet facilities – to be shared between two or more units. Smaller rooms give a feeling of privacy and comfort, they also offer flexibility in the use of beds. On the other hand, they call for large staff and are difficult to supervise. The concept of personal privacy is variable.

Slide 26: 

A ward floor of 60 – 100 patients subdivided into 2/3 ward units – each cared for by a nursing team is functionally quite efficient. Within a ward plan now generally accepted provides for grouping of patients into 6 beds and 4 beds rooms, together with a small number of 2 bed and 1 bed rooms for more serious patients and for patients requiring segregation from other for various reasons. Up to 20% of the beds in a ward should be located in a single room. This type of ward divided into small rooms of 6, 4 and 1 bed each, the beds being arranged parallel to the longitudinal wall of the ward is called the Rig’s pattern ward.

COMBINING TWO WARDS WITH COMMON SERVICE FACILITIES. : 

COMBINING TWO WARDS WITH COMMON SERVICE FACILITIES. Two nursing units served by a common core of work areas can be economical and efficient in functioning. Certain facilities like pantry, toilets, dirty utility, day areas etc. can be shared between two nursing units. The nurses’ station should be placed at the centre. A single operation station for both the wards or two separate stations each for each ward can be made. To achieve separation of circulation of patients and visitors, entrance can be provided at both ends of the unit.

Slide 28: 

NURSING STATION Doctor’s room SANITORY FACILITIES WCs and Bathrooms Wash Basins Dirty Utility Room and Safaiworker’s closet TREATMENT AND DRESSING ROOM ISOLATION ROOM WARD PANTRY CLEAN UTITLITY ROOM DAY ROOMS AUXILIARY ACCOMMODATION MISCELLEANEOUS FACILITIES PATIENT MONITORING SPECIAL NURSING UNITS

INTENSIVE CARE UNIT : 

INTENSIVE CARE UNIT Neonatal intensive-care unit (NICU) Special Care Nursery (SCN) Paediatric intensive-care unit (PICU) Psychiatric intensive-care unit (PICU) Coronary care unit (CCU) for heart disease Cardiac Surgery intensive-care unit (CSICU) Cardiovascular intensive-care unit(CVICU) Medical intensive-care unit (MICU) Medical Surgical intensive-care unit (MSICU) Surgical intensive-care unit (SICU) Overnight intensive recovery (OIR) Neuroscience/Neurotrauma intensive-care unit (NICU) Neurointensive-care unit (NICU) Burn intensive-care unit (BWICU) Trauma Intensive care Unit (TICU) Shock Trauma intensive-care unit (STICU) Trauma-Neuro Critical Care intensive-care unit (TNCC) Respiratory intensive-care unit (RICU) Geriatric intensive-care unit (GICU)

ICU CNTD…… : 

ICU CNTD…… Equipment and systems Quality of care Staff

Slide 31: 

WARD VENTILATION WARD LIGHTING General lighting Reading lighting Examination lighting Night lighting CALL BELL

Slide 32: 

PROGRESSIVE NURSING CARE INTENSIVE CARE INTERMEDIATE CARE LONG TERM CARE

JOURNAL REVIWS : 

JOURNAL REVIWS A study was conducted on Leadership and management in the aged care sector: a narrative synthesis by Jeon YH, Merlyn T, Chenoweth L. The aim of this study is to examine the issues and the progress being made in leadership and management with relevance for the residential aged care workforce. Strong, effective leadership and management promotes staff job satisfaction and retention, high care quality and the well-being of care recipients, and reduces associated costs. Good leadership and effective management also play a key role in bringing about a successful change to a positive workplace culture through innovative programs and research projects. Organisational investment in improving leadership and management skills and capabilities can only improve outcomes for staff stability and productivity, care quality and budgets, and better prepare the aged care sector

Slide 34: 

A study on Impact of shift work on the health and safety of nurses and patients by Berger AM, Hobbs BB. College of Nursing, University of Nebraska Medical Center, Omaha, USA. Found that Shift work generally is defined as work hours that are scheduled outside of daylight. Shift work disrupts the synchronous relationship between the body's internal clock and the environment. The disruption often results in problems such as sleep disturbances, increased accidents and injuries, and social isolation. Physiologic effects include changes in rhythms of core temperature, various hormonal levels, immune functioning, and activity-rest cycles. Adaptation to shift work is promoted by reentrainment of the internally regulated functions and adjustment of activity-rest and social patterns. Nurses working various shifts can improve shift-work tolerance when they understand and adopt counter measures to reduce the feelings of jet lag. By learning how to adjust internal rhythms to the same phase as working time, nurses can improve daytime sleep and family functioning and reduce sleepiness and work-related errors. Modifying external factors such as the direction of the rotation pattern, the number of consecutive night shifts worked, and food and beverage intake patterns can help to reduce the negative health effects of shift work. Nurses can adopt counter measures such as power napping, eliminating overtime on 12-hour shifts, and completing challenging tasks before 4 am to reduce patient care errors.

Slide 35: 

CONCLUSION…… STUDENT ASSIGNMENT Prepare a master rotation plan for the nursing faculty in a 140 bedded hospital assuming that you are the nursing superintendent of the hospital.

REFERENCES : 

REFERENCES Sakharkar B.M. principles of hospital administration and planning. Jaypee. New Delhi. 2006 Bureau of Indian Standards. Hospital standards. New Delhi Basavanthappa BT. Nursing administration. 2nd edition. Jaypee brothers. New delhi. TNAI. Nursing administration. Clin J Oncol Nurs. 2006 Aug;10(4):465-71. Berger AM, Hobbs BB. College of Nursing, University of Nebraska Medical Center, Omaha, USA. aberger@unmc.edu Wikipedia. Intensive care unit. Retrieved on 30 June, 2010 from http://en.wikipedia.org/wiki/Intensive-care_unit Intensive-care unit Wikipedia. Nursing unit. Retrieved on 30 June 2010 from http://en.wikipedia.org/wiki/Nursing_unit PubMed. Nursing working conditions and nursing unit costs. Retrieved on 30 June, 2010 from http://www.ncbi.nlm.nih.gov/pubmed/19628511

Slide 37: 

University of north California. nursing care delivery systems. Retrieved on 3 July, 2010 from http://www.unc.edu/courses/2005fall/nurs/079/960/delivery_systems/activity2.html Human resource management. Performance appraisal methods. Retrieved on 4 July, 2010 from http://www.humanresources.hrvinet.com/performance-appraisal-methods/ PubMed. Nursing evaluation: purpose, objective and opportunities. Retrieved on 3 July, 2010 from http://www.ncbi.nlm.nih.gov/pubmed/1517024 Real nurse. Team nursing. Retrieved on 4 July, 2010 from http://www.realnurse.net/articles/team.shtml Scribd. Functional nursing. Retrieved on 3 July, 2010 from http://www.scribd.com/doc/27551528/Functional-Nursing Faculty of Nursing and Midwifery, The University of Sydney, Sydney, ACT, Australia. yun-hee.jeon@sydney.edu.auA. Australas J Ageing. 2010 Jun;29(2):54-60. Thomas, Kochuthresiamma.Computers in nursing. Nursing Journal of India, Aug 2002

Slide 38: 

PRESENTED BY:- MR. SUJITH K 2ND YEAR M.Sc. (N) NUINS.CON