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Jester B. Rafols RN Ma.Lenore G. Pasol RN DNM NURSING ADMINISTRATION II Learning 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

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Page 1: Nursing Adminstration II-rafols, Jester b

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

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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

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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

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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

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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.

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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

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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

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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:

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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

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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

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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)

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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