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Total score Situation Differentiate T & F Short notes MCQ Types of question 5 questions 3 5 15 10 15 Number of questions

80 10 20 15 20 15 Grades Marks Signature

Question (1) Question (3)

No. MCQ No. T or F 1. C 1 ( F ) 2. C 2 ( F ) 3. C 3 ( F ) 4. C 4 ( T ) 5. D 5 ( F ) 6. B 6 ( F ) 7. A 7 ( T ) 8. C 8 ( F ) 9. D 9 ( F ) 10. D 10 ( T ) 11. B 11 ( F ) 12. D 12 ( F ) 13. A 13 ( T ) 14. B 14 ( F ) 15. D 15 ( F )

Faculty of Nursing Zagazig University Nursing administration 4th year exam First term Exam Date: 9- 1-2016 Time allowed: 3 Hours Total Marks: 80 Marks pages number: 6

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Answer all the following questions: I. Multiple choice questions (15 marks): Read the following questions carefully and choose only one answer 1. Factors related to patient that affecting staffing pattern include

the following Except: a) Length of stay b) Age group c) Patient care objectives d) Patient numbers

2. The decision style that is appropriate for followers with high degrees of readiness is: a) Facilitative b) Authoritative c) Delegative d) Consultative

3. The objectives of time scheduling include the following Except: a) Provide adequate staffing b) Ensure patients’ care c) Decrease staff morals d) Achieve balance distribution of days off

4. Characteristics of effective assignment include the following Except: a) Clear b) Simple c) Oral d) Posted in advance

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5. The internal factors that affecting decision making include the following Except: a) Experience b) Knowledge c) Attitude d) Resources

6. When head nurse acts as a focal point for receiving information; this considered: a) Distribution role b) Nerve center role c) Negotiator role d) Liaison role

7. Span of control is affected by: a) Supervisors’ competence b) Organization size c) Organizational culture d) All of the above

8. The power that residence in the position not in the person is: a) Responsibility b) Accountability c) Authority d) None of the above

9. One of disadvantages of the organizational chart is: a) Showing the informal organizational relationship b) Showing duties and responsibilities c) Not helping in the organizational planning d) Becoming outdated quickly

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10. Strategies for successful planning include: a) Gathering data appropriately b) Keeping target date realistic c) Clear objectives d) All of the above

11. Effective planning is characterized by: a) False assumption b) Based on clearly defined objectives c) Inadequate time d) Inadequate delegation of authority

12. Methods of recruitment includes: a) Advertising b) Employees’ referral c) College recruitment d) All of the above

13. Employee indoctrination content includes: a) Staff development program b) Employee motivation c) Employee authority d) Organization chart

14. Characteristics of good vision includes: a) Flow from purpose b) Relevance to the community c) Visible in employees’ believes d) Balance

15. In which category the head nurse act as resources allocate: a) Interpersonal role b) Leadership role c) Informational role d) Decisional role

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II. Give short answers (20 marks) 1. List (6) principles of personnel assignment?

Made by the head nurse or nurse in charge for each individual nurse.

Based on: Nursing needs of each patient and approximate time required to

care for him. The capabilities, skill level, previous experience and the interest of

the staff members. Job description, Planned weekly and revised daily if necessary to assure continuity

of care. All nurses have a duty to provide safe and appropriate nursing care

to clients. Nurses act in a manner that is consistent with their standards of

practice, codes of ethics, scopes of practice and other relevant legislation.

Nurses practice within their own level of competence and seek direction and guidance from other health care professionals when aspects of the care required are beyond their individual competence.

Where two or more categories of nurses work together, safe and appropriate care can best be achieved through collaboration and cooperation among nurses, respecting the contributions of each professional.

Effective communication among nurses and within organizations is essential in order to achieve quality client outcomes.

Supervise those to whom nursing activities have been delegated. Determine the model of care delivery (i.e. primary nursing, team

nursing or functional nursing), the complexity of the client’s nursing care needs; and the context of care and the degree of direction and/or supervision available.

Should be in written form

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Use simple clear words in writing assignment Fix responsibility for all duties clearly with no over lapping Provide for emergency situations and provide for special nursing

activities Give each person time and opportunity to plan her work Assignment must rely on the preliminary planning Arrange the various parts of the assignment in logical order Ensure continuity of patient care Assignment should be made in accordance with the administrative

policy Based on accurate assessment Two workers should never be assigned to do the same work It should be related to previous assignment

2. Enumerate (4) responsibilities of the unit manager regarding material resources? Supplies & equipment should be checked for specification

&quantity when received from the purchasing department. Supplies & equipment should be inspected to determine

completeness, availability for use, cleanliness, safety & convenience in place.

There must casual supervision of staff members to assure that supplies & equipment are being used for specific & intended purposes.

Supplies & equipment should be conveniently located & easily accessible to all staff members.

Staff members who will use the equipment must understand its operation, purpose &after care.

Make provision for ordering on an emergency basis. Quantities of supplies on hand should be checked before recording.

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3. State (4) advantages of cyclic and block time scheduling? Once developed; it is relatively permanent schedules and requiring

only temporary adjustments. Same schedule is repeatedly, so it decrease time spent on

scheduling Nurse know schedule in advance Staff treated fairly Nurse can schedule social events Self scheduling

4. List (3) skills needed to conduct and maintain equipment? Convincing staff of the important of maintenance. Inspection check list what are present & comparing it with the

inventory list of equipment in the unit. Detecting & interpreting discrepancies (is the difference between

equipment entered on the inventory list & the equipment actually present.

5. State (5) personal qualifications of the head nurse? (Including all the qualities of the good leader) Good physical and mental health. Cheerful and accept criticism. Loyalty and sense of belonging. Can work effectively with a team. Teaching ability. She must be honest and patient. She must have good judgment. She must have the ability to communicate with people. She should have sense of responsibility. She should have good grooming and hygiene. She must have an ethical approach to problem.

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6. Enumerate (4) principles of good plan? All plans must flow from other plans. Short-range plans must be

congruent with long-range plans. Planning in all areas of the organization must follow the mission,

philosophy, and goals of the overall organization. Planning involves the same process regardless of the period

involved The length of the plan is determined by what actions are necessary

to make the plan successful. All plans must include a regular review process (an evaluation

step). 7. List (4) factors to be considered in distributing duties?

The number, qualifications, experience and abilities of nurses The number, condition and location of patients Nursing needs of each patient and appropriate time required for

care Consider each nurse as individual It should provide for new learning experiences Type of service rendered should be considered The availability of supplies and equipment Architectural features of the unit Availability of nursing service manual for policies and procedures

8. Identify (3) methods for use of supplementary staff? Borrowing method Float staff On call staff

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9. Determine (4) limitations of interview? Inter- rater reliability is satisfactory if the interview is structured

and the same format is used by both interviewers & a low in unstructured

Structured interviewers have greater validity than unstructured. High interview assessments are not related to subsequent high-level

job performance. Validity increases when there is a team approach to the interview.

10. Identify (3) importance of organizing? Creating relationships that will minimize friction. Focus on objectives, and facilitate attaining them. Cleary define responsibilities and line of authority of all members

of staff. Arrangement of positions, and jobs within the hierarchy. Spelling out responsibility and line of authority in terms of

decision making.

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III. True and false (15 marks) Write (T) in front of true statement and (F) in front of false statement

No. Statement T or F 16. Staffing pattern is the determination of the number of

personnel that must be hired ( F ) 17. Innovative decisions are made when the problems are unusual

and only partially understood. ( F ) 18. Brainstorming create members to free flow of ideas with fear

of criticism ( F ) 19. Planning provides directions and reduces the impact of

change ( T ) 20. The traditional systems of determining the staffing pattern

meet the needs of patients. ( F ) 21. Orientations activities not specific for the personnel positions ( F ) 22. In centralized scheduling one nurse in the nursing

administration office plan coverage for all nursing units ( T ) 23. Decision making is a process of determining the appropriate

actions to alleviate a problem ( F ) 24. One of the disadvantages of the functional method of

assignment is that it requires highly skilled personnel ( F ) 25. Demand forecasting is the first process of managing material ( T ) 26. The formal organization structure could distribute

information more broadly and rapidly than the informal one ( F ) 27. Providing feedback on the results of decisions is unnecessary

to improve the decision making ( F ) 28. Staff relation is depicted by dots in the organizational chart ( T ) 29. Summative evaluation done to provide data allowing changes

in the course while it is being taught ( F ) 30. A large number of personnel can participate in taking

decision through use of decision tree ( F )

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IV. Differentiate between the following (20 marks): Nominal group and Delphi techniques (4 degree)

1. Nominal group technique 2. Delphi – technique Nominal group technique (NGT) is a structure & precise method of eliciting written questions, ideas and reactions from group members This method allows every group member the opportunity for input into decision making process. NGT consists of :

a) Silently generating ideas in writing

b) Round-robin presentation by group members of their individual ideas in a terse phrase on a flip chart

c) Discussion of each recorded idea for clarification & evaluation and

d) Voting individually on priority ideas, with the group solution being derived mathematically through rank ordering or rating using the group's decision rule.

Advantages: Allow equal participation

among members Minimize influence of

dominated personality. Disadvantages:

Time consuming Need for advance preparation

It allows members who are dispersed over a geographical area to participate in decision making without meeting face to face. A problem is identified, & members are asked to suggest potential solutions through the use of questionnaire. Members anonymously return the first questionnaire& the results are compiled. Each member is sent a copy of the results, after reviewing them, members are asked for their suggestion again .Review of the results of the first questionnaire typically triggers new solutions in original positions.. This process continues until consensus is reached. Little change usually occurs after the second round. Advantages:

Ability to involve a large number or participants

Save time Avoid negative verbal or non

verbal. Disadvantages:

Lower sense of accomplishment or involvement

Do not communicate with each other

Time consumed May not develop as many

alternatives as the other technique.

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Rules and procedures (4 degree) Procedures Rules

Procedures Are plans that have been reduced to a sequence of steps that required actions. Procedures identify the process or steps needed to implement a policy. o It is the process or needed to

implement a policy and are generally found in manuals at the unit level of the organization. o Procedures establish acceptable ways of accomplishing a specific task by outlining a set of steps to follow and giving rational for each set of activities. o The manger also has the responsibility to review and revise policies and procedures statements.

Steps of Procedure Development: - State the task or title. - Identify the need or purpose. - Make draft of all the possible

steps and sub- steps. - Type the procedure and distribute to reviewers.

Have procedure printed and distribute.

Rules are plans that define specific action or non action. Rules like policies Provide guidance, but a rule is stronger than a policy in that the guidance given by a rule is final and definite. Rules are inflexible and must be obeyed, under threat of punishment, e.g. (smoking is forbidden).

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Team and modular methods of assignments (4 degree) Team Nursing Modular Nursing RN as team leader coordinates care for a group of patients' plans, supervise, evaluate and participate in the delivery of nursing care. Evolved in the 1950s to improve patient satisfaction. Goal was to reduce fragmented care. Team nursing usually refer to large group of patients. Common use areas—most inpatient and outpatient areas Advantages 1. High-quality, comprehensive care

with a high proportion of ancillary staff.

2. Development of leadership skills 3. Team members participate in decision

making and contribute their own expertise

4. Nursing conferences help problem solving and staff development.

5. It enhances team building, team members’ support for each other.

6. More efficient patient care. 7. It allows members to

contribute their own special expertise or skills.

8. All nurses have contact of patient.

9. They share in the planning and provision of his care

10. It provides high job satisfaction.

11. patient satisfaction is high 12. It enhances good

communication. Disadvantages 1. Continuity suffers if daily team

assignments vary 2. Team leader may not have good

leadership skills

Modification of team nursing Patient unit is divided into modules or units or district, with an RN as team leader. Evolved to increase RN involvement in care. Recent attempts to refine and improve team nursing have resulted in the concept of “modular nursing,” which is a mini –team (two or three members) approach. Keeping the team small and attempting to assign personnel to the same team as often as possible should allow the professional nurse more time for planning and coordinating team members. Additionally, a small team requires less communication, allowing members better use of their time for direct patient care activities. Each small team is responsible for giving the whole nursing care to a group of patients. Those patients receive their care from the same mini-team (module) from their admission till discharge and must arrange for the care of their patients during different shifts and off-duty. Advantages 1. Useful when there are few

RNs 2. Continuity of care is improved 3. RN more involved in planning

and coordinating care 4. Geographic closeness and

efficient communication

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3. Insufficient time for planning and communication

4. Day to day change in team member may reduce the care.

5. It depends basically on good communication among members, so if for any reason communication is disturbed patient care, will be severally affected.

6. This can lead to blurred lines of responsibility, errors, and fragmented patient care.

7. Very high cost 8. Need more equipments and supplies

Disadvantages 1. Increased costs to stock each module

2. Long corridors not conducive to modular Nursing. Paraprofessional does technical aspects of care

Fixed and movable equipment (4 degree) Fixed equipment Movable equipment

Fixed equipment refers to objects built into the walls & floors of the hospital E.g. locker, locker sterilizers.

Movable equipment includes A. Equipment that should last

for more than 5 years E.g. furniture, stretchers, wheel chairs……………ect.

B. Equipment having less than 5 years & are capable of being replaced E. g. syringes , linen ,bed pans ……….ect.

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Intrinsic and extrinsic sources of recruitment (4 degree) Internal resources External sources

Present employees from within the organization e.g. Policy promotion. Advantages:

1. Past experience helps new employees to perform new duties and can safely delegated new responsibilities.

2. It requires less training expenses. 3. It raises the moral of existing

employees and job satisfaction. 4. It stimulates preparation to possible

transfer or promotion. 5. It attracts young people to join the

organization. 6. It provides great incentive to hard

work. Disadvantages:

1. It narrows down the area of selection because recommitment is confined it those who are already in the service.

2. A danger of getting the system to be stagnant, repetitious and overly continued without intrusion of new blood.

Consists of public and private agencies advertising, educational institutions like colleges, universities and business scholars, employees' referrals. It allows the organization to seek people with new ideas.

Most management exports feel that a combination of internal and external sources would give best results.

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V. Situation (10 marks) In the light of this statement answer the following questions:

a) What the type of organizational structure that used in your organization?

Matrix structure (2 degree) b) Enumerate the advantages and disadvantages of this structure? Advantages of matrix: (4 degree)

1. Improve communication through vertical and horizontal control 2. Increased organizational adaptability and flexibility to respond to

environmental changes 3. Increased efficiency of resources use 4. Increased job satisfaction with achievement and fulfillment 5. Improved interpersonal skills

Disadvantages: 1. Potential conflict because of multiple lines of authority,

responsibility and relationships 2. Role ambiguity 3. Loss of control over functional disciplines as a result of a

multiply disciplinary team approach

c) As a head nurse how could you apply planning in your department? (4 degree) - Assign each staff nurse according to level of her competency. - Check the nursing care plan for the professional nurses. - Design the nursing care plan for the non professional nurses. - Determine the time for the routine activities. - Determine the time for nursing rounds - Determine the time for the participation in medical rounds. - Determine the time for nursing conferences. - Determine the equipment which will be needed for the whole unite

or in the time of emergency.