leadman ni henz
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PRAYERPRAYER
Grant us peace O God, as we open our books andnotes, open our minds to Thy will and may we
dedicate these hours to Thy son, Jesus Christ.
Offer us insight, O Lord, that we may understandthese things and see them as a part of thy
kingdom. May we offer Thee our best in reading
and learning that it may be a part of our
discipleship.O Jesus, may this be a worthy time that is faithful
to thee and bring us closer to the goals we have
in order to serve thee. We offer this time and
prayer in Thy holy name. AMEN
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It is not intelligence alone thatIt is not intelligence alone that
brings success, but rather the drivebrings success, but rather the drive
to succeed, the commitment toto succeed, the commitment to
work hard and the courage towork hard and the courage to
believe in yourself=)believe in yourself=)
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LEADERSHIPLEADERSHIP
AND
MANAGEMENTMANAGEMENT
By Heneli S. Segura BSN, RN
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Identify whetherIdentify whetherLeadership or ManagementLeadership or Management
May or may not be appointed
Fulfilling organizational mission
Towards Goal setting
Risk Taker
Officially Appointed
Intuitive, empathic
Do things right
Challenge change
Judgment based on performance
Time frame based on present
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LEADERSHIPLEADERSHIP
Leadership- process of influencing
the activities of an organized group
in its efforts toward goal setting andgoal achievement
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Leader- person who will show the
way, mark the way or guide a
course
Nursing Leadership- process
whereby a nurse influences one or
more persons to achieve specificgoals in the provision of nursing
care
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THEORIESTHEORIESGreat man Theory
(Aristotelian Philosophy)
- argues that few people areborn with necessary
characteristics to be great
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Trait Theory
- maintains that traits areinherited but latersuggested that traitscan be obtainedthrough learning
and experiences
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Behavioral Theory
- highlights the understanding ofhuman behavior
Contingency Theory- leadership stylewill be effective or
ineffectivedepending onsituation
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LEADERSHIP STYLESLEADERSHIP STYLES
Path Goal Leadership
-- facilitates task accomplishment byfacilitates task accomplishment by
minimizing obstructions tominimizing obstructions to
accomplish the goals andaccomplish the goals and
reward the followersreward the followersfor completion of thefor completion of the
taskstasks
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Situational Leadership
- leader structures the tasks which
include planning, organizing, directingand controlling; best leadership style;posses FLEXIBILITY
5 Levels of Experience-framework of situational leadership
Novice
Advance BeginnerCompetentProficient
Expert
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Transactional Leadership
- exchange posture that identifiesneeds of followers and providesreward to meet those needs in
exchange for expectedperformance
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Transformational Leadership
- cooperative,process-focusednetworking
Servant Leadership- servant as a leader,
put serving first andtake a holisticapproach
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Result C-based Leadership
- recommends simplifying practicesand procedures; workers tell
manager what is wrong and make
suggestions for improvement
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5.Pinoy Management ( Tomas Andres)
a) Management by Kayod (Realist)
has gut feelings
segurista
mabilis/ action agad
b) Management by Libro (Idealist)
palaisip
perfectionist in a bookish way
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LEADERSHIP STYLESLEADERSHIP STYLES
Autocratic
Democratic
Laissez-faire
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The nurse is concerned because she receivedmany time-off requests from her staff for thecoming holiday season. She has come up withseveral possible solutions to the staffingdilemma and has scheduled staff meeting topresent ideas to the staff. Which managementstyle is this manager demonstrating?
a. Participativeb. Bureaucraticc. Autocraticd. Laissez-faire
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Frederick Taylor
- Father of Scientific
Management
- proposed a set of
techniques to increasethe efficiency and
productivity of each
worker
THEORISTS OFTHEORISTS OF
MANAGEMENTMANAGEMENT
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Henri Fayol
- Father of ManagementProcess School/ Modern
Management Theory
- formulated the 14 principles of
management; believed that
management is universal and
that specialization increasesefficiency
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Max Weber
- Father ofOrganization Theory
- believed thatpersonnel
are selected for their
competence
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Elton Mayo
-- HawthorneE
ffectHawthorneE
ffect-- discovered that when managementdiscovered that when management
paid special attention to workers,paid special attention to workers,
productivity was likely to increase,productivity was likely to increase,regardless of environmentalregardless of environmental
conditioncondition
Abraham Maslow
-- Hierarchy of Needs TheoryHierarchy of Needs Theory
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POWERPOWERthe capacity to ensure the
outcome one wishes, and preventthose one does not wish.
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Identification: Determine whatIdentification: Determine what type of powertype of power
Based on the position and organizationalpolicies
Based on ones ability to inflict threat or
punishment
Based on possession of valuable
information
Based on personality
Based on knowledge of complex situation
Based on ability to distribute anything
Based on connection with authority
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TYPES OF POWER
REWARD
COERCIVE
LEGITIMATE EXPERT
REFERENT
PERSONAL INFORMATIONAL
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COMMUNICATIONCOMMUNICATIONTransfer of
information andunderstanding
from one personto another
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COMMUNICATION PROCESS
IdeationIdeation
EncodingEncoding
TransmissionTransmission
ReceivingReceiving
DecodingDecoding
Response/feedbackResponse/feedback
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Downward Communication
- flows from the people at the top
management levels in theorganizational hierarchy
LINES OFLINES OF
COMMUNICATIONCOMMUNICATION
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Upward Communication
- travels from staff and lower and
middle management personnel and
continues up the organizational
hierarchy
Horizontal Communication
- flows between departments and
personnel in the same level of
hierarchy
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Outward Communication
- deals with information that flows fromthe caregiver to the patient, their
family, relatives, visitors and the
community
Diagonal Communication
- occurs between individual or depart-
ments that are not on the same level
of hierarchy
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Grapevine Communication
- informal method of communication
involving three or more person at atime instead of one person to
another; rapid spread of information
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Knowing theKnowing the lines ofcommunicationlines ofcommunication
Letters
Bulletin Boards
Coordination Meeting
Health teaching
Feedbackaff
Chismis
LaboratoryR
equest IRReport accomplished by the staff
Operations Manual
Job description shift
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Communications ties people to their:
a. Social surroundings
b. Physical surroundingsc. Materialistic surroundingsd. Environmental surroundings
No. 59
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The effectiveness of nurse-client communicationis best validated by:
a.Client feedbackb. Medical Assessment
c. Health team conferencesd.Clients physiologic adaptations
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Since people need some gratifyingcommunication to learn, to grow, and tofunction in a group, all events that
significantly curtail communication willproduce:
a. Withdrawalb. Severe disturbancesc. Some degree of mental deficiencyd. Further attempts to increase
communication
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LEADER MANAGER
APPOINTMENT
May or may
not haveofficial
appointmen
t
Officially
appointed
POWER
As long as
the the
followers
are willing
to follow.
have power
and
authority to
enforce
decision.
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PLANNINGPLANNING
pre-determining the course
of action in order to arrive
at a desirable result
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Forecasting
- looking into the future
Setting the Vision, Mission,Philosophy, Goals and Objectives
ELEMENTS OF
PLANNING
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Vision Statement
- outlines the organizations futurerole and function
Mission Statement
- outlines the agency reason for
existing, who the target clientsare, and what services will be
provided
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Philosophy
- statement of beliefs and values thatdirect ones life or ones practice
Goals
- broad sentences of action
commitments through which anorganizations mission and purpose
will be achieved
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Objectives
- specific sentences of action
commitments through which anorganizations mission and purpose
will be achieved
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A nurse manager notices that one of the
staff nurses is always 15 to 20 minutes late.
When the nurse manager discusses theproblem with her, the nurse says that shehas been late because her sons nurseryschool does not open until 7 am. The nurse
manager should respond by telling her to:
a. Ask one of the night nurses to cover for herb. See if the neighbor can take the child to
schoolc. Find out if other schools open earlierd. Find some way to solve the problem and be
on time
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Developing and Scheduling Programs
Time Management- technique forallocating ones time through the
setting of goals, assigning
priorities, identifying andeliminating wasted time, and using
managerial techniques to reach
goals efficiently
Preparing the budget
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Which of the following activities demonstrates
application of budgeting by Erlys
headnurse?
1. Working overtime
2. Requesting the assistance of others
3. Proper use of supplies and materials
4. Avoidance of waste
a. 1,4b. 1,2
c. 3,4
d. 2,4
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BUDGETINGBUDGETING
allocation of a scarce
resources to meet
the basic needs
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TYPES OF BUDGETTYPES OF BUDGET
Revenue Budget- summarizes the income which
management expects to generate
during the planning period
Expense Budget
- describes the expected activity in
operational and financial terms for a
given period of time
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Capital Budget
- outlines the programmed acquisitions,disposals and improvements in an
institutions physical capacity
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The nurse manager of a busy pediatric unitwants to purchase additional computers forpatient data collection and for online
continuing education programs. The total costis P10,000.00. She should include thisexpense in what portion of her budget?
a. Personnelb. Operatingc. Capitald. Managerial
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Establishing Nursing Standards,
Policies and Nursing Procedures
Nursing Standards- provide professionally
desirable norms against which the
departments performance can be measured.
Policies- broad guidelines for managerial
decisions that govern the action of workers
and supervisors at all levels
Nursing Procedures- specific directions of
implementing written policies
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ORGANIZINGORGANIZINGprocess of grouping the
necessary
responsibilities and
activities for the
purpose of achieving
objectives
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ORGANIZATIONALCHARTORGANIZATIONALCHART
graphicrepresentations of theorganizing process
distribute thenursing
responsibilities andlines connect thepositions
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1. Chain of Command
organizations are established with
hierarchal relationships
2.Unity of Command
indicates one person has one boss
3.Span of Control a person should be a supervisor of a
group that he can effectively manage
ORGANIZING PRINCIPLEORGANIZING PRINCIPLE
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TYPES OF ORGANIZATIONTYPES OF ORGANIZATION
Line Organization- simplest and most
direct type of organization in which
each position has general authorityover the lower positions in the
hierarchy
Informal Organization- horizontal
relationships rather than vertical.
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A registered nurse of the ICU is interviewing a RN for ateam leader position. The nurse appeared to bequalified and has excellent references. She states that
shes certified in critical care nursing but she misplacedher verification card. Based on her knowledge of hersupervisory responsibility, the nurse manager should:
a. Contact the credentialing center and confirm the
nurses certificationb. Hire the nurse, but tell her that she must provideproof of certification completing orientation
c. Avoid hiring the nursed. Trust that the nurse is telling the truth
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1. Setting up the Organization Structure
2.Staffing- process of determining and
providing the acceptable number and
mix of nursing personnel to produce a
desired level of care to meet the
patients demand
ELEMENTS OFELEMENTS OF
ORGANIZINGORGANIZING
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Staffing the Units
Basic Staff minimum number ofpersonnel needed to staff a unit and
includes fully oriented full and part-time
employeesComplementary Personnel - scheduled
in addition to the basic group; provide
the flexibility needed to meet short-term
and unexpected changes
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Level ofNursing
Care
Nsg. Care
Hours/ day
Ratio of Prof.
to Non Prof
Level I 1.5 5:45
Level II 3.0 60:40
Level III 4.5 65:35
Level IV 6.0 70:30
STAFFINGSTAFFING
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Vacation Leave 15 15
Sick Leave 15 15
Legal Holidays 10 10
Special Holidays 2 2
Special Privileges 3 3
Off Duties 104 52
Continuing Ed 3 3
Total Non Working Days/yr 152 100
Total Working Days/yr 213 265Total Working Hours 1704 2120
STAFFINGSTAFFING
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Categorized according to level of careneeded
Find Nursing Care Hours needed per
patient
Multiply everything with total working
Hours
Find Total Nursing Care Hours Needed
per year
Actual Working Hours /Person/year
STAFFINGSTAFFING
COMPUTATIONSCOMPUTATIONS
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SCHEDULESCHEDULE
timetable showing planned work daysand shift for nursing personnel
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Centralized Schedule
Decentralized Schedule
Cyclical Schedule
TYPES OF SCHEDULINGTYPES OF SCHEDULING
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1.Self-Scheduling
personnel are scheduled to work their
preferred shift
2. Flextime /Flexible Scheduling
allows employees to select the time
schedule that best meet their personalneeds
TYPES OF SCHEDULINGTYPES OF SCHEDULING
Developing Job Description
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Developing Job Description
Job description- statement thatsets the duties and responsibilities ofa specific job
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DIRECTINGDIRECTING
issuance of orders,
assignments and
instructions that enable
nursing personnel to
understand what are
expected from them
The Division Chief Nurse is often busy She
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The Division Chief Nurse is often busy. Sheis required to participate in several
committees and meetings. She brings herassistant to some of these, assigns andorients her to the committees task
Which of the following directing activities isthe chief nurse primarily performing?
a. Communicatingb. Delegatingc. Trainingd. Motivating
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ELEMENTS OF DIRECTINGELEMENTS OF DIRECTING
1.Delegation- process by which amanager assigns specific tasks/
duties to workers with
commensurate authority to performthe job
What cannot be delegated?
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What cannot be delegated?
Overall responsibility, authority and accountability
for satisfactory completion of all activities in theunit.
Authority to sign ones name
Responsibility for maintaining morale or the
opportunity to say few words of encouragement tothe staff especially the new ones.
Evaluating the staff and or taking necessary
corrective or disciplinary action
Jobs that are too technical and those that involve
trust and confidence
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Underdelegating- false assumptions that
maybe interpreted as lack of ability
Overdelegating- feel insecure in theirability to perform a task
Improper delegation- task andresponsibility that are beyond thecapability of the person
COMMON DELEGATIONCOMMON DELEGATION
ERRORERROR
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The nurse manager of an inpatient pediatricunit is at home one evening when shereceives a call from a staff nurse informing
her of a serious medication error that justoccurred on the unit. The nurse manager wasnotified because she assumes accountabilityfor what happens on the unit:
a. 5 days a weekb. 24 hours a day, 7 days a weekc. 8 hours a day, 7 days a weekd. 24 hours a day, 5 days a week
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A nursing team consists of an RN, an LPN/LVN, anda nursing assistant. The nurse should assign whichof the following patients to the LPN/LVN?
a. A 72 year old patient with diabetes whorequires a dressing change for a stasis ulcer
b. A 42 year old patient with cancer of the bonecomplaining of pain
c. A 55 year old patient with terminal cancerbeing transferred to hospice home care
d. A 23 year old patient with a fracture of theright leg who asks to use the urinal
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A nurse plans for care of a patient with anemiawho is complaining of weakness. Which of thefollowing tasks should the nurse assign to the
nursing assistant?
a. Listen to the patients breath sounds.b. Set up the patients lunch tray.c. Obtain a diet history
d. Instruct the client on how to balance restand activity
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The nursing team consists of an RN, 2LPNs/LVNs, and three nursing assistant. TheRN should care for which of the following
patients?a. A patient with a chest tube who is
ambulating in the hall.b. A patient with a colostomy who requires
assistance in colostomy irrigationc. A patient a right-sided CVA who requires
assistance with bathingd. A patient who is refusing medication to
treat cancer of the colon
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After receiving report, which of the followingpatient should the nurse see FIRST?
a. A 14 year old patient in sickled-cell crisiswith an infiltrated IV
b. A 59 year old patient with leukemia whohas received half of a packed red celltransfusion
c. A 68 year old patient scheduled for abronchoscopy
d. A 74 year old patient complaining of aleaky colostomy bag.
MODALITIES OF CAREMODALITIES OF CARE
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MODALITIES OF CAREMODALITIES OF CARE
Functional Nursing- task-oriented in which a
particular nursing action is assigned to eachworker
Total Care/ Case Nursing- assignment of one
nurse to one patient for the delivery of totalnursing care
Team Nursing- decentralized system of care in
which a qualified professional nurse leads agroup of nursing personnel in providing for the
nursing needs of a group of patient/ client
through participative effort
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Primary nursing- nurse will be responsible
for patient care from admission to discharge
Modular Method- modification of team andprimary nursing
Case Management- system of patient caredelivery that focuses on the achievement of
outcomes within effective and appropriatetime frames and resources
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A nurse-manager of 30 bed surgical unit arrives atwork during a snowstorm. She finds that only theLPN and 2 nursing assistants have been able to
make the journey to work. Each reporting staffmember has skills that can be used to provide carefor the patients in the unit. Which nursing caredelivery system would be most effective under
these circumstances?a. Primary Nursingb. Team Nursingc. Functional Nursing
d.Case Management
2. Supervision- means to inspect, to guide,
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p p gevaluate and improve work performanceof employees through a criteria against
which the quality and quantity of workproduction are made
3. Coordination- synchronization of activities
among the various services anddepartments.
4. Decision Making
Decision- course of action that isconsciously chosen from availablealternatives for the purpose of achieving adesired result
PROCESS OF DECISION MAKINGPROCESS OF DECISION MAKING
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Definition of the Problem
Analysis of the Problem
Development of an alternative solution
Selection of a solution
Implementation and Follow-up
PROCESS OF DECISION MAKINGPROCESS OF DECISION MAKING
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CONF
LIC
TC
ONFLIC
Tinevitable clash between two opposing
and oftentimes hostile parties
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A nurse manager dealing with conflict should:
a. Establish the source of the problem
b. Redefine the problem to find new solution
c. Provide the solution to all problemd. Ignore the problem and allow the staff to
find the solution
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CONFLICT MANAGEMENT
A. Avoiding- parties involved are awareeither consciously or unconsciously
B. Accommodating- person ignores hisown feelings about an issue in orderto agree with the other side
C. Competing- one side wins and theother side losses
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D. Compromising- each side gives up
something as well as gets something
E. Collaborating- both sides in conflictwork to develop the outcomes that is
best for both sides
F. Confronting- block the conflict from
the start; brings the parties together
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Performance Appraisal- control process in
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pp pwhich employees performance is evaluatedagainst standards
Methods of Measuring PerformanceInformal Appraisal- consists of incidentalobservation of performance while the workeris engaged in performing nursing care
Formal Appraisal- regular and methodicalcollection of objective facts that candemonstrate the difference between what isexpected and what is done.
METHODS OF
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METHODS OF
PERFORMANCEAPPRAISAL1. Anecdotal Records- objective
description of behavior; brief account
of incident2. Rating Scale- methods of rating an
individual against a set standard
3. Checklist- assess presence orabsence of behavior or desiredcharacteristics
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4. Essays- narrative description of
employee strengths and areas forimprovement
5. PeerReview- monitoring andassessing work performance by peers
6. Coaching-
manager's role in informalday-to-day appraisals
Assistants Evaluation Memo
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Judy Smith, my assistant, can always be foundhard at work in her station. Judy works independently, withoutwasting hospital time talking to colleagues. Judy never
thinks twice about assisting fellow employees, and she alwaysfinishes given assignments on time. Often, Judy takes extendedmeasures to complete her work, sometimes skipping coffeebreaks. Judy is an individual who has absolutely novanity in spite of her high accomplishments and profoundknowledge in her field. I firmly believe that Judy can be
classed as a high-caliber employee, the type which cannot bedispensed with. Consequently, I duly recommend that Judy bepromoted to executive management, and a proposal will beexecuted as soon as possible.
Regards - Charge Nurse
Shortly thereafter, the HR department received the following memo fromthe Charge Nurse:
Sorry, but that idiot (Judy) was reading over my shoulder while Iwrote the report sent to you earlier today. Kindly read only the odd
numbered lines for my true assessment ofher...
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Quality Assurance- is the estimation of the
degree of excellence in patient healthoutcomes and in activity and other resource
outcome
Developing quality assurance criteria
Nursing audit Committee
Patient Care Audits
PeerReview
Quality Circles
Utilization ofResults
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Discipline- constructive and effective
means by which employees take personalresponsibility for their own performance and
behavior
Disciplinary Actions: Counseling and Oral Warning
Written Warning or Memo
Final Warning/ Suspension Dismissal
CBQ:
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Q
The headnurse is assign to do the following
in order of priority?1. Ask Precy to write a report2. Obtain explanation for non-
documentation of medicine3. Ascertain from himself4. Call Precys attention
a. 4132b. 4123c. 1423d. 1234
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GOD BLESS and ALWAYS keep your
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GOD BLESS and ALWAYS keep yourFEET on the Ground!!!
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