Assignmant,rotation and deligation

Assignmant,rotation and deligation

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  MANAGEMENT OF NURSING SERVICESIN HOSPITAL AND COMMUNITY- ASSIGNMENT, ROTATION AND DELEGATION KULDEEP VYAS ASST.PROF HOD – COMMUNITY HEALTH NURSING DSSNI
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  Patient ASSIGNMENT doesnot only mean that dividing the patient among available staff nurses but it is assigning an individual patient or group of patients to nurses according to the required nursing care needs and nurses capability to provide the quality care Objectives of patient assignment:- 1. To promote good health in the patient with the best possible nursing care 2. To plan assignments that are interesting and stimulating to professional growth 3. To provide a broad education and experience for each student nurse 4. To achieve good ward management
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  PRINCIPLES OF PATIENTASSIGNMENT 1. There should be an equal case load on each staff nurse depending on staff ability and hours. 2. Patient assignments should be made according to the needs of each patient and the nurse's ability to give him/her the care. 3. In hospitals where student nurses are being educated, assignments must necessarily revolve round the requirements for the students' education. 4. For nurses to grow in professional competence, assignments must be varied and challenging. 5. Activities are better performed when each one is made responsible for a single person. 6. If there are not enough nurses on duty to carry the nursing load, it is preferable to overload the graduate staff nurses rather than the students or non- professional workers.
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  7.Assignments of patientsand duties should not be changed more frequently than is absolutely essential. 8.The care required by all patients in a group assignment to one nurse must be considered 9.Assignment planning is closely related to time planning. If patients are to receive good care in the late afternoon and early evening, usually as many nurses are required during these periods as during the morning hours. 10.The best use will be made of a nurse's time if the patients assigned to one nurse are located close to one another.
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  Types of PatientAssignment 1.The patient method 2. The functional method 3.The team method 1.Patient M ethod 1.A nurse is expected to give complete nursing care to one or more patients. 2.The care includes general nursing measures, treatment, medications, taking temperature. pulse and respiration, serving nourishments and giving health instructions. 3.If the primary nurse goes off duty, her group of patients will be taken over by another nurse in her absence. Advantages of Patient Assignment 1.More individualized nursing care is possible. 2.The opportunity for nursing education is superior. Better nursing education results when nursing care is patient centered and the student knows the patient as an individual. 3.The satisfaction to the nurse is tar greater when she has personal contact with the patient and the opportunity to see her plans for his care materialize.
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  Disadvantages 1.There is noguarantee for a fair case load. 2.Accountability for patient care is unclear because both the primary nurse and associated nurse care for the patients. 3.There are more chances tor employee burnout because of increased workload. 2.Functional Method 4.It is a task oriented method in which distinct duties are assigned to specific personnel. 5.One nurse does all the vital signs, another makes all the beds, a third nurse does the dressings. Advantages of Functional Method 1.Care providers get expertise in a-particular type of care. 2. More care can be given in a short time. 3. There is a fair case load. 4.Since each nurse is accountable for one specific function, the quality of care will be good. 5. The staff is motivated to show competence. 6. This method is an apt learning method for beginners.
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  Disadvantages 1.Although efficient, functionalnursing fragments care and can be confusing for the client. 2. The client does not get holistic care. 3.Student nurses do not get a variety of experiences. 3.Team Method 1.In this method, two or more members of the nursing staff are assigned along with a leader to work together. 2.The team leader is always a professional nurse. 3.The members may be graduate students, professional or practical nurses, aids or orderlies. 4.The care assigned to each member of the team will be based on varying levels of education skills and experience. 5.Job responsibilities will be clearly explained to all the team members. 6.The team leader is responsible for planning the team work and execution of the plan.
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  Advantages of T eamMethod 1.Since increased responsibility is given to staff nurses, they will be happier and more satisfied with their jobs. 2.Non-professional team members get a greater sense of importance and belonging because their contribution is recognized as valuable. 3. Nursing care will be organized. 4.Higher nursing care will be given only by experienced professional nurses. 5.The staff is motivated to show competence. 6. There is increased role clarity. 7.Beginners in nursing get adequate supervision from other team members. 8.There is a greater sense of team spirit. Disadvantages 9. The care load is not fair. 10. Proper planning is needed. 11. More time is spent on planning.
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  DELEGATION Delegation is theprocess through which the manager assigns specific tasks or duties to workers with appropriate authority to perform the job. Delegation is one of the most important methods of organizing as well as a skill required of a manager.“ PURPOSES OF DELEGATION Purposes of delegating are listed below: 1.Assigning routine tasks 2. Problem solving 3.Changes in the emphasis of a nurse manager's own job requirements 4. Capability building S. Assigning tasks for which the nurse manager does not have time PRINCIPLES OF DELEGATION 1.Select the right person to whom the job is to be delegated. 2.Delegate both interesting and uninteresting tasks. 3. Provide subordinates with enough time to learn. 4. Delegate gradually. 5. Delegate in advance. 6. Consult before delegating. 7. Avoid gaps and overlaps.
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  TYPES OF DELEGATION Thereare three types of delegation: formal, Fimak and informal: 1.Formal delegation: This is found in the exercise of authority defined by an organization's role. 2.Fimak delegation: This is 'downward delegation'. It is effective to the extent of the acceptance and respect for formal authority. 3.Informal delegation: It occurs because people want to do something apart from what they are told to do. It is something that is not formally required to be done. When there is al problem in the exercise of formal authority, informal delegation is accepted. PREREQUISITES FOR EFFECTIVE DELEGATION The following are some of the essential preconditions for effective delegation: 1.Good organizational climate 2. Clarity in objectives and goals 3. Responsibility and authority 4. Motivation 5. Training 6. Effective controlling 7. Centralization vs. decentralization
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  JOB ROTATION INNURSING Nurses work with a variety of settings to provide quality patient care. The nursing care need not be only in the hospital set-up. Nurses also work in the community centers, polyclinics, schools offices, industries and military services. The nursing staff needs to be efficient in providing care at any set-up given. The job rotations given in the hospital are discussed below. Patient care setting in the hospital: 1.In-patient department 2. Out-patient department 3. Emergency care unit (ER/casualty) 4. Intensive care unit 5. Operation theatre 6. Dialysis unit 7. Burns unit 8. Rehabilitation unit 9. Mental health centres 10.Maternal child health centres 11.Pediatric health centres
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  In a hospitalsetting, a nurse works with different wards, as listed below: 1.Neuromedical and surgical wards 2. Cardiac medical and surgical wards 3. Cardiothoracic units 4. General medical wards (male and female) 5. General surgical wards (male and female) 6. Renal wards 7. Orthopedic wards 8. Obstetrics and gynecological wards 9. Plastic surgery wards 10.Ophthalmic wards 11.ENT wards 12. Isolation wards There are different intensive care units, where the nurses are given job rotation: 1.Medical intensive care unit 2. Surgical intensive care unit 3. Coronary care unit 4. Cardio-thoracic intensive care unit 5. Neurosurgical intensive care unit 6. Neonatal intensive care unit 7. Step-down ICU
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  Benefits of jobrotation: 1.Enhances work performance. 2. Promotes responsibility. 3. Gives more knowledge and skill. 4.Improves confidence to carry out the duties and assignments. 5.Helps to become familiar with the settings