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Nursing Admin II
Jester B. Rafols RN Ma.Lenore G. Pasol RN DNM
NURSING ADMINISTRATION IILearning Objectives:
• At the end of the presentation MAN students will be able to:
• Recognized the Organizational Structure of National Children’s Hospital, its relationship and characteristics, Patient Classification System and Job Description
• Recognized the different roles and responsibilities of Nurse I to Nurse VII according to their respective Job Description
Organizational Structure
Organizational Structure refers to the way a group is formed depicting its line of authority, span of control and the channels of communication.
It affects how people perceived the roles and the status given to them by other people in the organization
It is effective when: the design is clearly communicated, there are as few manages as possible to accomplish goals, communication is facilitated, decisions are made at the lowest possible level, Informal groups are encouraged and future leaders are developed.
Organizational Charts depict formal relationships, channels of communication and authority
Structural Charts show the various components of the organization and outlines their basic interrelationships.
Functional Charts reflects the functions and duties of the components of the organization and indicates the interrelationships of these functions. Within the boxes is the function statement which should be clear, inclusive and written in the present tense.
Position Charts specify the names, positions and titles or ranks of the personnel which fit into the organizational structure. It identifies channels of communication, level of accountability and area of responsibilities.
Major Characteristics of an Organizational Structure
An organizational structure has 5 major characteristics
Division of Work each box represents an individual or sub unit responsible for a given task of the organizations’ work load for instance, Medical, Administrative, Nursing and Finance Division
Chain of Command follows a solid line and is called scalar chain. The chain can be flat (decentralized organizations) or tall (centralized organizations). Going outside the chain of command is very risky in
most organization and should be done only in rare circumstances after other avenues have been exhausted.
Type of work to be performed is indicated by labels or description for the boxes, for instance, X ray, Laboratory, Dietary, Social Service etc.
The grouping of work segments or homogenous assignments are shown by clusters of work groups, for instance OPD, Pediatric-PICU, Surgery-SICU, and Medical-MICU.
The level of management indicate the individual and entire management hierarchy regardless of where an individual appears on the chart. Hierarchy refers to a body of persons or things organized or classified in a pyramidal fashion according to rank, capacity of authority assigned to vertical levels with officer ranked in grades, order or classes, one above the other. For instance, Top Management, Middle Management, Operational Level.
Relationships within the Nursing Service
Relationship Individual
Line- Those that exist between the superior and the subordinates immediately and directly responsible to him/her
Chief Nurse to Supervising Nurse to Senior Nurse to all nursing personnel
Lateral- those that exist between position in various divisions and sections of an undertaking where no direct authority is involved
Senior Nurse with Doctor, Social Worker and Dietitian
Functional- those which arise when duties are divided on a functional basis, for instance, when an individual exercises authority on one particular subject by special skill or knowledge
Chief Nurse with Administrative Officer, Senior Nurse with Clinical Instructor
Staff- this individual is not vested with but is acting “for and in behalf” of the person on which authority lies. His/her function is one of transmission and interpretation coupled with the duty of ascertaining that the orders given are carried out
Supervising Nurse acting on behalf of the Nursing Service after office hour
Nursing Service Administration
Position FunctionChief Nurse Under direct supervision of the Medical Center
Chief, spearheads in the development of policies, guidelines, standards and protocols, provides technical supervision and assistance to nursing staff and conducts continuous monitoring and evaluation
Assistant Chief Nurse Under direct supervision of the Chief Nurse, participates in the development of policies, guidelines, standards and protocols, provide technical assistance, provides technical supervision of staff and conducts monitoring and evaluation
Nurse V Under general supervision, assists in the implementation of hospital health programs and hospital programs and hospital nursing work likewise, participates in the formulation of nursing service policies and standards
Nurse IV Under general supervision, assists in the implementation of hospital health programs and hospital nursing work, likewise, participates in the formulation of nursing service policies and standards
Nurse III (Training Office) Under general supervision, supervises training and development of nursing students, staff nurses, and other personnel through planning, implementing and monitoring and training activities related to patient care
Nurse III (HEPO Designate) Under general supervision, manages health education and promotion unit of the hospital, staff nurses, and other personnel through planning, implementing and monitoring and training activities related to health education in the hospital and in the community
Nurse III (Clinical Areas) Under general supervision, supervises the nursing care service unit through monitoring and mentoring work of nursing staff and student in the hospital, performs regular staff functions, and assists in developing applicable policies, rules and regulations for the hospital.
Nurse III (Special Areas) Under general supervision, supervises the nursing care service unit through mentoring and monitoring work of nursing staff and students in the hospital, performs regular staff functions and assists in developing applicable policies, rules and
regulations for the hospitalNurse II (Clinical Areas) Under general supervision, manages the nursing
care service through mentoring and monitoring work of nursing staff and students performs regular staff functions when necessary
Nurse II (Special Areas) Under general supervision, manages the nursing care service through mentoring and monitoring work of nursing staff and students performs regular staff functions when necessary
Nurse II (Training Office) Under general supervision, training and development of nursing students, staff nurses and other personnel through planning, implementing, monitoring and training activities related to patient care
Nurse I (Clinical Areas) Under general supervision, performs direct nursing care services and assists physicians in diagnostic and therapeutic procedures in order to provide proper patient care
Nurse I (Special Areas) Under general supervision, performs direct nursing care services and assists physicians in diagnostic and therapeutic procedures in order to provide proper patient care
Nurse I (Training Office) Under general supervision, establishes, organized and implements training programs and activities for nursing students, staff nurses and other personnel related to patient care
Patient Classification System Means of categorizing present patients on the basis of certain care needs that can be clinically
observed by the nurse.
CATEGORY I. Self-care/Minimal Care
Minimal care is given to patients who are convalescing and who no longer require intensive, moderate or maximum care.
Patients who require diagnostic studies, minimal therapy, less frequent observations, and daily care for minor conditions and who are awaiting elective surgery.
CATEGORY II. Moderate Care
Care given to patients who are moderately ill or are recovering from the immediate effects of a serious illness and/or an operation.
Patients require nursing supervision or some assistance related to ambulating and caring for their own hygiene.
CATEGORY III. Maximum Care
Given to patients with who need close attention throughout the shift, that is complete care for patients who require nursing to initiate, supervise and perform most of their activities or who require frequent and complex medications or treatments.
CATEGORY IV. Intensive Care
Given to acutely ill patients who have a high level of nurse dependency, including those requiring intensive therapy and/or intensive nursing care and whose unstable condition requires frequent evaluation with adjustment of therapy.
PERCENTAGE OF PATIENTS IN VARIOUS LEVELS OF CARE
Types of Hospital Minimal Care Moderate Care Intensive Care Highly Specialized Care
Primary Hospital
Secondary Hospital
Tertiary Hospital
Special Tertiary Hospital
70
65
30
10
25
30
45
25
5
5
15
45
-
-
10
20
LEVELS OF CARE NCH needed Ratio of
per patient per day
Professionals to Non-professionals
Level I
Self Care or Minimal Care
Level II
Moderate or Intermediate
Level III
Total or Intensive Care
Level IV
Highly Specialized or Critical Care
1.50
3.0
4.5
6.0
7 or higher
55:45
60:40
65:35
70:30
80:20
CATEGORIES OR LEVELS OF CARE OF PATIENTS, NURSING CARE HOURS NEEDED PER PATIENT PER DAY AND RATIO OF PROFESSIONAL TO NON-PROFESSIONALS
Job Description
Nurse I
Accountable to: Nurse II and Nurse III
Directly supervises: Nursing Attendants
Job Summary:
Under general supervision, performs direct nursing care and assists physician in diagnostic and therapeutic procedures in order to provide proper patient care
Competency Model
A. Core Organizational Commitment Integrity Quality Service Focus Teamwork Stewardship of Resources Attention to Communication Self-Development
B. Functional Competence Profile:
Knowledge Behavior Motivation Nursing Degree and
Clinical Nursing Nursing Law Nursing and Patient
Care Procedures Patient Assessment IV therapy Occupational
Hazards and Safety Standards Practices
Collaboration Building Trust Building Client
Loyalty Communication Planning and
Organizing Decision Making Work Standards Continuous Learning
Job has opportunities for Relationship Building Challenging Work Achievement
Key Result Areas Nursing Service and Patient Care Medication and Treatment Administration Patient Record Maintenance Coordination Health Information
Functions:
1. Performs direct nursing care procedures which include bedside nursing hygiene, pre and post -operative nursing care as well as admission and discharge duties
2. Administers Medication3. Observes records and reports patients’ symptoms, conditions, and progress of treatment
and therapy4. Prepares patients for and assists physicians with diagnostic and therapeutic procedures for
both normal and specialized procedures5. Operates Diagnostic machines6. Maintains records reflecting patient’s condition, medication and treatment7. Coordinates with other sections on the hospital regarding patient care.8. Assist in the education and rehabilitation of patients and their families in relation to physical
and mental health9. Set up treatment trays, prepares instruments and equipment, and ensures adequate
medical or hospital supplies and availability of proper equipment and instruments10. Performs other related duties as may be assigned
Qualifications Standards
Minimum Requirement for the position
Education: Bachelor of Science in Nursing Training: None required Experience: None required
Work Conditions/Contact Tools and Equipment
Work Conditions Contacts Equipment Hospital Based Exposed to health
hazards/accidents
Other DOH units LGU’s/NGO’s Clients
Computer Telephone
Nurse II
Accountable to: Nurse III
Directly supervises: Nurse I and Nursing Attendants
Job Summary:
Under general supervision, manages his/her own unit, performs and monitors direct nursing care and assists physician in diagnostic and therapeutic procedures in order to provide proper patient care
Competency Model
A. Core Organizational Commitment Integrity Quality Service Focus Teamwork Stewardship of Resources Attention to Communication Self-Development
B. Functional Competence Profile:
Knowledge Behavior Motivation Patient Care Basic Medical
Procedures Usage of Medical
Equipment and Instruments
Drugs and Medicine Regulations
Training and Education methods
IV therapy Research Administrative
Process Performance
Management Occupational
Hazards and Safety Standards Practices
Collaboration Building Trust Building Client
Loyalty Communication Planning and
Organizing Decision Making Work Standards Continuous Learning
Job has opportunities for Relationship Building Challenging Work Achievement
Key Result Areas
Nursing and Patient Care Procedures Medication and Treatment Administration Patient Record Maintenance Quality Management Coordination Training Education and Performance Monitoring Equipment Supplies and Facility Maintenance
Functions:1. Performs and monitors patient care and other nursing activities such as conducting rounds,
soliciting patient feedback, administering medications and reporting unusual symptoms.2. Monitors and evaluates the performance of staff nurses and other non-professional staff in
providing patient care and organizes work schedules to maximize development.3. Orients staff, nursing students, patients and their families in related areas such as philosophy,
objectives and policies of hospital/nursing service and other health information. 4. Monitors inventory and maintenance of supplies, equipment and facilities to provide
appropriate service and a healthy physical environment5. Performs administrative duties such as preparing reports and schedules of assignments6. Performs direct nursing care procedures which include bedside nursing hygiene, pre and post-
operative nursing care as well of admission and discharge of patients when necessary7. Liaises between nurses, patients, members of the health team and other units to coordinate
functions and provide a healthy social environment.8. Monitors student nurses and monitors development by preparing programs/assignments with
the clinical instructor and evaluating performance9. Performs other related functions as may be assigned
Qualifications Standards
Minimum Requirement for the position
Education: Bachelor of Science in Nursing Training: 4 hours of relevant training Experience: 1 year of relevant experience Eligibility: RA 1080
Work Conditions/Contact Tools and Equipment
Work Conditions Contacts Equipment Hospital Based Exposed to health
hazards/accidents
Other DOH units LGU’s/NGO’s Clients Academe Professional
Organization International Groups
Computer Telephone Fax Machine A/V equipment Photocopier Calculator
Nurse II (Blood Bank)
Accountable to: Senior Medical Technologist
Directly supervises: Medical Laboratory Technicians
Job Summary:
Under general supervision, participates in blood donor selection and screening activities
Competency Model
A. Core Organizational Commitment Integrity Quality Service Focus Teamwork Stewardship of Resources Attention to Communication Self-Development
B. Functional Competence Profile:
Knowledge Behavior Motivation Donor Selection and
Screening Counseling Phlebotomy Patient Care Basic Medical
Procedures Occupational
Hazards and Safety Standards Practices
Collaboration Building Trust Building Client
Loyalty Communication Planning and
Organizing Decision Making Work Standards Continuous Learning
Job has opportunities for Relationship Building Challenging Work Achievement
Key Result Areas Donor Screening and Phlebotomy Equipment Maintenance Counseling
Functions:
1. Interviews, screens and physically assesses prospective blood donors.2. Conducts phlebotomy of qualified blood donors 3. Conducts pre and post-donation counseling to prospective donors4. Takes note of and manages adverse blood donation reaction and implements nursing care as
needed5. Prepares supplies and equipment needed during blood drives6. Orients new staff on new equipment and procedures as necessary7. Ensures proper use and maintenance of equipment8. Performs other related functions as may be assigned
Qualifications Standards
Minimum Requirement for the position
Education: Bachelor of Science in Nursing Training: 4 hours of relevant training Experience: 1 year of relevant experience Eligibility: RA 1080
Work Conditions/Contact Tools and Equipment
Work Conditions Contacts Equipment Hospital Based Exposed to health
hazards/accidents
Other DOH units LGU’s/NGO’s Clients Academe Professional
Organization International Groups
Computer Telephone Fax Machine A/V equipment Photocopier Calculator
Qualifications Standards
Minimum Requirement for the position
Education: Bachelor of Science in Nursing Training: 4 hours of relevant training Experience: 1 year of relevant experience Eligibility: RA 1080
Work Conditions/Contact Tools and Equipment
Work Conditions Contacts Equipment Hospital Based Exposed to health
hazards/accidents
Other DOH units LGU’s/NGO’s Clients Academe Professional
Organization International Groups
Computer Telephone Fax Machine A/V equipment Photocopier Calculator
Nurse III
Accountable to: Nurse IV
Directly supervises: Nurse II
Job Summary:
Under direction, supervises the nursing care service through monitoring and mentoring work of nursing staff and students in the hospital: and performing regular staff functions when necessary
Competency Model
A. Core Organizational Commitment Integrity Quality Service Focus Teamwork Stewardship of Resources Attention to Communication Self-Development
B. Functional Competence Profile:
Knowledge Behavior Motivation Patient Care Basic Medical
Procedures Usage of Medical
Equipment and Instruments
Drugs and Medicine Regulations
Training and Education methods
IV therapy Research Administrative
Process Performance
Management Occupational
Hazards and Safety Standards Practices
Collaboration Building Trust Building Client
Loyalty Communication Planning and
Organizing Decision Making Work Standards Continuous Learning
Job has opportunities for Relationship Building Challenging Work Achievement
Key Result Areas Policies, Procedures, Standards and Guidelines Development Quality Assurance Nursing Personnel Supervision Report Preparation
Functions:1. Collaborates with the Assistant Chief Nurse in developing applicable policies, procedures
and standards for the improvement of patient care.2. Supervises and monitors the quality of nursing services against prescribed standards in the
administration of policies by conducting periodic nursing service audits and soliciting patient feedback
3. Monitors performance of staff by determining performance efficiency ratings and reviewing with them procedures and techniques in service delivery.
4. Collaborates with other departments of the hospital to align nursing activities with other service.
5. Conducts researches and studies to identify opportunities to improve the nursing service6. Monitors adequacy and maintenance of medical supplies and equipment7. Check important documents such as daily time records of personnel and patient hospital
records for completeness and accuracy: and consolidates weekly, monthly and quarterly reports of hospital output
8. Participates in different nursing committees when necessary9. Perform other tasks or functions as maybe assigned.
Qualifications Standards
Minimum Requirement for the position
Education: Bachelor of Science in Nursing Training: 4 hours of relevant training Experience: 1 year of relevant experience Eligibility: RA 1080
Work Conditions/Contact Tools and Equipment
Work Conditions Contacts Equipment Hospital Based Exposed to health
hazards/accidents
Other DOH units LGU’s/NGO’s Clients Academe Professional
Organization International Groups
Computer Telephone Fax Machine A/V equipment Photocopier Calculator
Nurse IV (Nurse Trainer)
Accountable to: Nurse VI
Directly supervises: Clinical Instructors and other Nursing Staff
Job Summary:
Under general supervision, manages training and development of nursing students, staff nurses and other personnel through planning, implementing and monitoring and training activities related to patient care.
Competency Model
A. Core Organizational Commitment Integrity Quality Service Focus Teamwork Stewardship of Resources Attention to Communication Self-Development
B. Functional Competence Profile:
Knowledge Behavior Motivation Training and
Education Methods Basic Life Support
and OR Techniques Methods on Nursing
Operation and Administration Usage of Medical Equipment and Instruments
Occupational Hazards and Safety Standards Practices
Computer Software Application
Quality Management Technical Writing Research
Managing Performance
Building a Successful Team
Building Strategic Working Relationships
Building Trust Planning and
Organizing Decision Making Work Standards
Job has opportunities for High Responsibility Accountability Challenging Work Achievement
Key Result Areas Training and Development Programs Monitoring and Evaluation Performance Management Training Report
Functions:1. Develops plans and determines resources needed for orientation, training and affiliation
programs of nursing personnel, student affiliates.2. Organizes and implements affiliation and training programs through screening, teaching,
mentoring and other training methods.3. Collaborates with staff nurses, instructors, clinical instructors, training program coordinators
and other health personnel in the implementation of training.4. Monitors the performance of student nurses and initiates regular communication with them
and the academe5. Performs research studies to improve the training programs. 6. Monitors pre and post training activities such as preparation of manuals, evaluation reports,
and contracts and billing documentation.7. Orients clinical instructors, student affiliates and new employees on related information in
the nursing service.8. Performs other related functions as may be assigned.
Qualifications Standards
Minimum Requirement for the position
Education: Bachelor of Science in Nursing Training: 8 hours of relevant training Experience: 2 year of relevant experience Eligibility: RA 1080
Work Conditions/Contact Tools and Equipment
Work Conditions Contacts Equipment Hospital Based Exposed to health
hazards/accidents
Other DOH units LGU’s/NGO’s Clients Academe Professional
Organization International Groups
Computer Telephone Fax Machine A/V equipment Photocopier Calculator Basic Medical
Equipment
Nurse IV (OR supervisor)
Accountable to: Nurse VII
Directly supervises: Nurse III, Nurse II (OR)
Job Summary:
Under general supervision, supervises nursing activities in the Operating Room in order to ensure proper pre and post-operative patient care
Competency Model
A. Core Organizational Commitment Integrity Quality Service Focus Teamwork Stewardship of Resources Attention to Communication Self-Development
B. Functional Competence Profile:
Knowledge Behavior Motivation Clinical Nursing Nursing Law Nursing
Administration and Operation
Patient Assessment Technical Writing Medical Equipment
Functions OR Techniques and
Management Knowledge of
business and financial management
Occupational Hazards and Safety Standards Practices
Managing Performance
Building a Successful Team
Building Strategic Working Relationships
Building Trust Planning and
Organizing Decision Making Work Standards
Job has opportunities for High Responsibility Accountability Challenging Work Achievement
Key Result Areas Training and Development Programs Monitoring and Evaluation Performance Management Training Report
Functions:
1. Plans and supervises nursing related activities in the Operating Room2. Maintains all OR supplies and equipment3. Coordinates administrative duties to ensure proper functioning of staff.4. Coordinates with other departments regarding patient needs5. Coordinates with Administration and Supply Department in requisition of supplies and
equipment for OR use.6. Monitors and evaluates staff performance and the implementation of the nursing standards
in the delivery of quality nursing care7. Prepares and ensure safekeeping of OR records and reports.8. Determines needs of staff related to professional growth and development, and participates
in the orientation and training of new staff, trainees and student affiliates9. Performs other related functions as may be assigned.
Qualifications Standards
Minimum Requirement for the position
Education: Bachelor of Science in Nursing/18 units in Master of Arts in Nursing Training: 8 hours of relevant training Experience: 2 year of relevant experience Eligibility: RA 1080
Work Conditions/Contact Tools and Equipment
Work Conditions Contacts Equipment
Hospital Based Exposed to health
hazards/accidents
Other DOH units LGU’s/NGO’s Clients Academe Professional
Organization International Groups
Computer Telephone Fax Machine A/V equipment Photocopier Calculator Basic Medical
Equipment
Nurse VII (Chief Nurse)
Accountable to: Chief of Hospital, Medical Center Chief
Directly supervises: Nursing Staff
Job Summary: Under general supervision, participates in development of policies, guidelines, standards and protocols in the hospital, provides technical assistance, provides technical supervision of staff and conducts monitoring and evaluation.
Competency Model
C. Core Organizational Commitment Integrity Quality Service Focus Teamwork Stewardship of Resources Attention to Communication Self-Development
D. Functional Competence Profile:
Knowledge Behavior Motivation Nursing Care Nursing Supervision Public Health Health Policies Research
Development Monitoring and
Evaluation Occupational Hazards
and Safety Standards Practices
Computer Software Applications
Leading Through Vision and Values
Managing Change Managing
Performance Building a Successful
Team Building Partnerships Building Trust Planning and
Organizing Strategic Decision
Making Work Standards
Job has opportunities for
High Involvement member
Challenging work Achievement
Key Result Areas Policies, Guidelines, Standards and Protocols Development Technical Assistance Staffing Plan Networking Monitoring and Evaluation Performance Management
Data and Report Collection Supervision
Functions:
1. Plans, Organizes and supervises the Nursing Service in order to provide good nursing care to patients.
2. Coordinates all activities of Nursing Service Department with other services3. Monitors and evaluates nursing personnel and activities and recommends improvements to
ensure that standards are met.4. Formulates and recommends policies for the improvement of patient care.5. Conducts meeting and in-service programs as a venue to discuss issues, updates in new
technologies and other matters for the Nursing Service personnel: participates in meetings as representative of the Nursing Service personnel
6. Participates in the preparation of the Budget Proposal specifically in the area of Nursing Service7. Screens applicants for the nursing service8. Prepares and submits nursing service report as required9. Approves procurement plan to ensure complete hospital supplies and equipment10. Collaborates with the Medical Center Chief in developing programs, policies, budget and other
plans for the needs of the nursing service and the improvement of patient care11. Performs other related functions as may be assigned.
Qualifications Standards
Minimum Requirement for the position
Education: Bachelor of Science in Nursing/Masteral Degree in Nursing Service Adminstration or its equivalent
Training: 24 hours of relevant training in management and supervision Experience: 5 year of relevant experience in supervisory or managerial position in nursing Eligibility: RA 1080
Work Conditions/Contact Tools and Equipment
Work Conditions Contacts Equipment
Hospital Based Exposed to health
hazards/accidents
Other DOH units Other Hospital Clients
Computer Telephone Fax Machine Photocopier Calculator
