PLANNING

Discuss the guidelines in planning

When planning, the first step to consider is to establish a purpose then analyzes the
situation which includes problem verification, identifying situational variables and the
anticipated response to change. After analyzing all of these, objectives should be
formulated then generating or making alternative solutions to the problem. When
alternative solutions have been formulated, it would be analyzed again and lastly
selection of action will be done.

Analyze the different phases of planning

When problem arises, plan should be developed these includes decision making,
brainstorming and coordinating with other members about the plan. After gathering all
the possible plans, it should be presented to the management or administration for the
implementation/approval. The planner when proposing the plan needs to be persuasive
in convincing others to accept the plan and obtain approval. The plan should be
presented in an organized manner. The problem plans and solutions must be presented
clearly. The plan must be presented in a professional manner. The last phase of
planning is implementing and monitoring the plan. After the approval of the plan,
monitoring and evaluation should be done to know the effectiveness of the plan and if
the objectives have been met.

Differentiate strategic planning from operational planning. Give example of each

Strategic planning means planning for achieving the vision of the organization while
operational planning is a process of deciding in advance of what is to be done to
achieve the tactical objectives. Strategic is a long term planning while Operational is a
short term planning. The plan for strategic plan lasts longer while operational planning,
the plan changes every year. Strategic plan performed by top level management while
operational planning it performs by middle level management. The scope in strategic is
wide while the other is narrow. Strategic planning emphasis on planning of vision,
mission and objectives while operational it emphasis on planning the routine activities of
the company.

Example of strategic planning is the mission and vision and objectives of Gentri Doctors
Medical Center NSO department.

On the other hand, example of Operational planning are as follows:

Delivering high quality care, employing more care staff, expanding critical care and
neonatal intensive care areas, training OR nurses to be more competent on different
surgical procedures
If given a chance and plan for a nursing service, what are the forecasting aspect
tests you have to discuss?
1. Review of some nursing procedures
2. Preop nursing responsibilities
3. Case study
4. Public attitude
5. Delegation
6. Quality care/ holistic care

DIRECTING

Observe communication pattern in your workplace and answer the following

questions

What media of communications are used to keep staff informed?

The most commonly used type of media use in the hospital is the use of

facebook messenger and group chats.

Describe the communication climate. Would you say it is supportive or

defensive? Justify your answer.

As far as I can see the communication climate is very supportive in terms of

informing and dissemination of information to co-staff

Describe any area of concern that related to communication gap. Suggest

ways to improve.

Misunderstanding is very common to non-verbal communication sometimes two

people understands a message differently compared to other. One way to avoid

this is to encourage verbal communication. If communication gap is already

 present with in a group I would suggest a team building to remove the gap

between each other

Identify at least 3 barriers of communication.

Poorly expressed messages

Unclarified Assumption

Poor transmission channel

Compare nursing process to problem solving process

Nursing process makes use of five phases assessing, diagnosing, planning,

implementing and evaluation while problem solving process uses, defining the problem,

generate alternative solutions, evaluate and select alternative and implement and follow

up on the solution.

Describe the steps of problem solving process

1. Define the problem

o Differentiate facts from opinion.

o Specify underlying causes.

o Tap everyone involved for information

o State the problem explicitly.

 o Identify what standard is violated

o Determine whos problem it is.

o Avoid stating the problem as a disguised solution.

2. Generate alternative solutions

o Postpone evaluating alternatives

o Be sure all involved individuals generates alternatives
o Specify alternatives that are consistent with goals.
o Specify both short-term and long term alternatives.
o Build on others ideas
o Specify alternatives that solve the problem.

3. Evaluate and select alternative

o Evaluate relative to an optimal standard.

o Evaluate systematically.

o Evaluate relative to goals

o Evaluate main effects and side effects

o State the selected alternative explicitly.

4. Implement and follow up on the solution

o Implement at the proper time and in the right sequence.

o Provide opportunities for feedback
o Engender acceptance at those who are affected.
o Establish an ongoing monitoring system.
o Evaluate based on problem solution.

Describe the relationship between problem solving and decision making

Problem solving is the systematic process of finding solutions or alternatives to the

problem while decision making is a sequential process of choosing among alternatives

and putting the best choice into action.

You have been promoted to be the director of 200 bed capacity private urban hospital.

In your first meeting with the owner of the hospital you were informed that the hospital is

in financial difficulty. Nursing service as it share in the cost cutting measures

implemented by the hospital needs to cut each budget. The amount being asked is

equivalent to the salaries of four staffs or two supervisors.

What other information do you need to make the decision

The opinions of the staffs in order to gather and develop new ideas

Describe the decision making steps that you will use.

Define and analyze problem

Identify all available alternative

Evaluate the pros and cons of each alternative.

Rank the alternatives.

 Select the alternative that maximizes situation

Select the alternative that maximizes situation

Implement the decision

Follow-up outcome.

CONTROLLING

DESCRIBE AT LEAST TWO PURPOSES OF CONTROLLING

One process of controlling is to make improvement deemed necessary from the

feedback wherein connect deviation remedial actions must be undertaken. In this
process, it opens opportunities for improvement and comparing performance against set
standard.

Second is establishing standards for all elements of management in terms of

expected and measurable outcomes, this is to ensure that quality of nursing care
provided including the delivery processes and procedures, and the desired outcome of
these processes.

DESCRIBE THREE PRINCIPLES OF CONTROLLING

1. Principles of uniformity ensure that controls are related to the organizational

structure.
2. Principles of comparison ensure that controls are stated in terms of the
standards of performance required.
3. Principles of exceptions provide measures that identify exceptions to the
standards.

NAME THE CHARACTERISTICS OF A GOOD CONTROL/EVALUATION SYSTEM

1. Reflect the nature of the activity
2. Report errors prompt/timely
3. Forward-looking and comprehensive
4. Point out expectations at critical points
 5. Objective, specific and appropriate
6. Flexible
7. Reflect organizational pattern; reflect authority and responsibility pattern.
8. Economical
9. Use understanding devices
10. Indicate corrective actions

DISCUSS THE IMPORTANCE OF STANDARDS IN IMPROVING QUALITY OF CARE GIVEN

BY NURSES

Health care is the diagnosis, treatment and prevention of disease, illness, injury
and other physical and mental impairments in human beings. Health care is delivered by
practitioners in allied health, dentistry, midwifery, obstetrics, medicine, nursing,
optometry, pharmacy, psychology and other care providers.
It refers to the work done in providing primary care, secondary care and tertiary care as
well as in public health. Quality is the standard of something as measured against other
things of a similar kind. The Institute of Medicine (IOM) has defined the quality of health
care as the degree to which health services for individuals and populations increase the
likelihood of desired health outcomes and are consistent with current professional
knowledge

To reduce the risk of unnecessary harm associated with healthcare to an

acceptable minimum. An accepted minimum refers to the collective notions of given
current knowledge, resources knowledge, resources available and the context in which
care was delivered weighed against the risk of non-treatment or other treatment (WHO).

DIFFERENTIATE AMONG STRUCTURES, PROCESS AND OUTCOME

There are 3 types of measures used in quality work:

Structure: Physical equipment and facilities

Process: How the system works
Outcome: The final product, results
 Structure refers to the setting in which care is delivered including adequate facilities and
equipment, qualification of care providers, administration structure and operations of
programs. Using this approach, good care settings and supporting structures contribute
to good care. Structure variables are often concrete and accessible, making them
relatively easy to assess.

Process examines how care has been provided in terms of appropriateness,

acceptability, completeness or competency. These measurements are typically have
more grey area and are less definite than those obtained through assessing
outcomes. Instruments that assess process variables are categorized under the
following headings: communication, patient knowledge, performance appraisal and
quality of care.

Outcomes refer to the end points of care, such as improvement in function, recovery or
survival. Outcomes are usually concrete and precisely measured. Some drawbacks to
using outcomes to evaluate care include: choosing a relevant outcome to measure and
time lapse required for measurement. As well, there are outcomes like attitudes and
satisfaction that are not precisely measured.

DISCUSS THE PURPOSE AND THE PROCESS OF QUALITY OF IMPROVEMENT

Quality Improvement or QI is meant to enhance the safety, efficiency and

effectiveness of all businesses from health care processes and the performance of
delivering products to human resources. The improvement is achieved using various
methods, both qualitative and quantitative. Healthcare delivery is becoming more
complex with the passing of time, and there is a requirement for new and enhanced
methods that will reduce costs and provide access to new technologies.

The main idea of improvement is that, when a system remains unchanged over
time and no enhancements are made, it cannot generate better results than the ones
already created. Bringing a change into the system can facilitate the achievement of a
new performance level. The inefficient parts of the structure are replaced with new
inventions that can prove to be worthy.
WHAT ARE THE GOALS OF COST CONTAINMENT?
Cost containment affect heath care systems in several ways. First is to ensure
the quality of care received by patients. Second, is to maintain ethical basis of health
care system. Finally, maintaining access to health care.

What cost containment measures are being used in your organization? Do you think they
are reasonable and fair?

Our organization mainly focuses cost containment on measuring and limiting the
cost of each department in terms of supplies requisitions, water and electric
consumption, and by cutting the staffing in the departments.
In a business side, I think it would be fair to just limit the resources being
consumed or limit manpower so that the costs will be lower than the gain. In that sense,
there will be a higher revenue. But thinking as a nurse, the more resources we have the
better we can perform. The more manpower we have, the better health care we can
give, since being a nurse is a service-oriented job.

Describe the performance appraisal used in your organization. How does it compare with
the performance appraisal describe in this module?
In our institution, we are conducting staff evaluation every six months to
document employees performance which includes both satisfactory and need for
improvement. However, in our department our performance is very rarely appraised. Our
leaders in our area are the only ones who see the improvement in the skills and in the
performance of our jobs. Also, the potential of our co-staff nurses were just evaluated
within our level.
Compared to the module, it is a little too far from what is really recommended.
Improvements on our institution is recommended in this aspect of controlling.

Describe the advantage and disadvantage of peer review. What are your feelings about
being evaluated by a peer?
Peer reviews allow an employee's colleagues to assess the individual's
performance. They can provide important insight into how employees interact with each
other, including employees who have quietly emerged as leaders within the ranks
without the accompanying formal title. However, these review system can also be
 subjective which makes it a disadvantage because of employees personality issues and
competition. I am very open to being evaluated by any of my peers. My peers are the
ones who see every aspect of me being in my work place. They know my strengths and
my weaknesses. In fact, I would like to believe that a peer evaluation is one of the best
ways of evaluating ones performance.

Describe the disciplinary measures used in your organization. Do you agree with the
methods used and the penalties imposed?
The purpose of disciplinary measures short of termination is corrective, to
encourage employees to improve their conduct or performance. The Management
expects all employees to behave in a mature and responsible manner and to perform
their jobs conscientiously, without the need of disciplinary action.
In our institution, we are practising Oral Warnings by immediate superior and
Written Warnings done by HR personnel to discuss the disciplinary action and the
employee will be asked to sign the warning.
In our institution it is more of coercive, I cannot say that I total agree in this kind of
disciplinary actions. I would recommend that there should be a concrete set of rules,
policies and guidelines with according disciplinary actions that are applicable for
everyone. There would be no exceptions, and also some departments have set their own
rules and regulations independently and putting some of their staff confused on the
those set of regulations as being compared to the companys own set of rules. I believe
that disciplinary actions should be done only of needed, and if done, make sure it is
appropriate and consistent for everybody.