ELVIS R. QUITALIG M.A.N.

I UNION CHRISTIAN COLLEGE Graduate School SY 2013-2014 Advanced Nursing Administration I

Name of the Hospital:

Lucas-Zenaida Quitalig Memorial Medical Center

Description: The Lucas-Zenaida Memorial Medical Center is a government operated, tertiary medical center, under the Department of Health, committed to serve the public particularly the poor and the vulnerable in pursuit of high quality of health care services, through effective, responsive and integrated referral and networking system with other health and welfare agencies, not only in La Union and its catchment areas but throughout the country. Mission: The Lucas-Zenaida Memorial Medical Center, as a public, tertiary hospital is so maintained as the peoples partner and improved to provide accessible, cost effective, equitable, preventive, promotive, curative, rehabilitative health care services to the general public, especially the poor and the vulnerable. This institution is also committed to medical, nursing and allied health education, training and research. Vision: The Lucas-Zenaida Memorial Medical Center envisions itself to become a Center of Excellence providing holistic approach to health care services. As a Center of Wellness, the services provided shall enable the people to improve their health and increase control over it. Philosophy: The Lucas-Zenaida Memorial Medical Center is guided by the following beliefs:

ELVIS R. QUITALIG M.A.N. I 1. The hospital is committed to assume a vital role in health promotion, disease prevention, curative, rehabilitative, and primary health care in partnership with public health counterparts, the clients, families and communities. 2. The clients are the reason for the hospitals existence. Thus, all services are directed toward their care and rehabilitation. 3. The personnels concern for the quality of their services constitutes the heart of their responsibility to the public. 4. Each individuals personal worth and dignity should be respected and preserved regardless of his race, creed, and color, social or economic status. 5. Maximal collaboration and cooperation within its divisions, the health team, and the community is necessary to attain quality patient care. 6. The Lucas-Zenaida Memorial Medical Center is a learning institution for health personnel and affiliates as well as an area for research in the promotion of health, prevention of disease, restoration of health, and alleviation of suffering. Core Values: They shape our actions and motivate and inspire us to pursue excellence and achieve the goals we have set forth for the future. Our core values include: Humanity: Our physicians, nurses and other clinical and support staff serve with extraordinary care and compassion. We see our patients as people first, with a set of values, beliefs and experiences that shape their needs and our care. Innovation: Our innovative delivery system, research endeavors and use of technology to improve how care is provided are fundamental to our success. Together, advance clinical and translational research to facilitate the transformation of new discoveries into treatments and therapies that benefit our patients.

ELVIS R. QUITALIG M.A.N. I We are never satisfied with the status quo and are always challenging ourselves to elevate to a new level of patient care. Teamwork: At The Lucas-Zenaida Memorial Medical Center, our collaborative approach ensures a culture of participation, learning and respect. We build on the knowledge and specialized expertise of all disciplines, which contribute vital insights and new perspectives in pursuit of a common goal. By bringing together multidisciplinary teams and involving patients and their families throughout the treatment process, we improve the quality of patient care, enhance patient safety and provide the broadest range of expertise possible. Diversity: We embrace our diverse workforce and community, knowing that it is an intrinsic part of who we are. The Lucas-Zenaida Memorial Medical Center is proud of its heritage, serving residents of the La Union, and the areas, as well as patients from across the nation. Different backgrounds bring new contributions to patient care and medical advances. We seek to recruit and retain candidates with a breadth of experiences and backgrounds. Equity: Our actions are the result of a deep belief in fairness to those we serve. We are committed to offering access to vital programs and exceptional care to all patients regardless of social or economic status, ethnicity, creed, gender, and sexual preference. The Lucas-Zenaida Memorial Medical Center also advocates for government policies that ensure equitable access to all care both primary and advanced specialty care. General Objective To provide the best possible health care services to its clients in a high quality setting conducive to attaining its vision as a center of wellness and a standard medical center.

ELVIS R. QUITALIG M.A.N. I Specific Objectives: 1. To establish an organized governing body so functioning that has overall responsibility for the conduct of the hospital in a manner consonant with its philosophy, mission, core values and objectives. 2. To provide the best quality, accessible and cost effective health services to all its clients especially the poor and the vulnerable ensuring the preservation of their basic human rights for independence of expression, decisions, and action, and concern for personal dignity and human relationships. 3. To strengthen and integrate the role of the hospital in the promotion of health and prevention of illness through primary health care services, linkages and referrals with the community leaders, civic and government organizations and agencies. 4. To effectively link services and facilities through networking to avail of curative, diagnostic, and rehabilitative services offered by the Department of Health agencies, hospitals and medical centers. 5. Through cooperative planning and decision-making, develop and establish policies, procedures, and standards for the smooth operation of each division or department or service in meeting its responsibilities and achieving its objectives. 6. To install a rigid control system to maximize the utilization of resources and evaluate the quality of services rendered through quality assurance programs and quality monitoring systems. 7. To expand and upgrade the hospital infrastructure, its frontline, diagnostic and therapeutic services to meet the demands of scientific advancement and technology in providing quality patient care.

ELVIS R. QUITALIG M.A.N. I 8. To provide a dynamic and innovative setting for clinical experiences of post graduate trainees, medical, nursing and allied health affiliated students, and for continuing staff development, training and research. -OThe Organizational Chart of Lucas-Zenaida Memorial Medical Center MEDICAL CENTER CHIEF

MEDICAL DIVISION

NURSING DIVISION

ADMINISTRATIVE DIVISION

ANCILLARY

TRAINING & RESEARCH

MEDICAL RECORDS

CLINICAL

CLINICAL

TRAINING & RESEARCH

SPECIAL AREAS

BUDGET AND FINANCE

DISBURSING COLLECTING

PHARMACY

LABORATORY

SURGERY
STAFF DEVELOPMENT ANESTHESIA STUDENTS AFFILIATION

OR

MED. SOCIAL SERVICE

RADIOLOGY

DOH TRAINING PGMI TRAINING RESIDENCY TRAINING

DENTAL

EENT

ICUCCU

PERSONNEL

DIETARY

RESEARCH
ORTHOPEDIC

CSR

SUPPLY

HOUSE KEEPING

MED. SP. TRAINNING

DOH TRAINING

PARAMEDICAL STUDENT AFFILIATION

MEDICINE

NICU

INTERNAL AUDIT
MAINTENANCE

LINEN LAUNDRY
HOUSE KEEPING

OB-GYNE

DR

TRANSPORTATION

PEDIATRICS

OPD-ER

ELVIS R. QUITALIG M.A.N. I The Lucas-Zenaida Memorial Medical Center NURSING DIVISION Philosophy The Nursing division strongly believes that: 1. Its philosophy and objectives are congruent to the vision, mission, philosophy, objectives and core values of the Lucas-Zenaida Memorial Medical Center. 2. It has the primary responsibility of providing comprehensive, individualized nursing care to patients based on their assessed nursing needs. Nursing care is coordinated and collaborated with the health team. 3. The most important asset of an institution is its staff. To provide the best quality of nursing care, nursing personnel should be adequately prepared by education, experience, and training to assume the duties and responsibilities of their position. They are to be treated with dignity and respect. 4. Nurses are advocates of patients. As such, they should take appropriate steps to safeguard their patients rights and privileges. 5. As a center of wellness, self-care concepts through health education are promoted in partnership with clients, families, and significant others. 6. Continuous evaluation of services and nursing care provided is vital to the quality of nursing care services rendered. Quality can always be made better. 7. Continuing education enhances professional competence. While it is a personal responsibility, the nursing division provides the motivation and opportunities for professional growth and development. 8. A dynamic and innovative environment enhances the learning experiences of students affiliates and trainees. 9. Research is an important aspect of the functions of nurses.

ELVIS R. QUITALIG M.A.N. I Specific objectives of the Lucas-Zenaida Memorial Medical Center NURSING SERVICE The specific objectives of the Nursing Service of the Lucas-Zenaida Memorial Medical Center are: 1. To establish, maintain, and utilize standards of safe and ethical nursing practice; 2. To support the programs of the hospital in becoming a Center of Wellness by promoting selfcare concepts in partnership with clients, their families, community leaders, civic and government organizations and agencies; 3. To develop and utilize various evaluation parameters as a means of providing information on how well the goals of care are met, at the same time identifying opportunities for improvement; 4. To establish a systematic staffing pattern that ensures availability of nursing personnel who can provide quality and safe nursing care to patients in accordance with their skill level; 5. To coordinate with Budget/Supply and Property sections in requisitioning proper resources to facilitate patient care and for funding staff development programs and research; and 6. To promote professional competency by encouraging and providing opportunities for in-service staff education programs, formal studies, scholarship grants, and attendance in professional activities outside the agency. Objectives of the Lucas-Zenaida Memorial Medical Center NURSING UNIT The objectives of this unit shall be: 1. To provide individualized, total patient care based on the physical, emotional and spiritual needs of the patient, family, and significant others; 2. To utilize the nursing process as the basis of all care given by the nurses; 3. To provide quality care in cost-effective manner to the patient and the hospital; 4. To coordinate services with other hospital divisions, members of the health team and the community for optimum patient care while hospitalized and after discharge;

ELVIS R. QUITALIG M.A.N. I 5. To involve the patients family and/ or significant others not only in caring for the patient but in promoting their own health and preventing illness through health education programs; 6. To identify problem areas in nursing care through monthly audits in order to ensure the quality of nursing care the patients receive; 7. To provide a variety of in-service trainings for all departments involved in the care of patients to increase their knowledge and improve nursing care; and 8. To coordinate with Clinical Instructors of the affiliated schools in providing the appropriate experiences for the students in an environment conducive to learning. The Organizational Structure of Nursing Division of The Lucas-Zenaida Memorial Medical Center 9. CHIEF MEDICAL CENTER 10. CHIEF NURSE 11. C ASST. CHIEF NURSE

SUPERVISING NURSE OPD ER SENIOR NURSE OPD ER

SUPERVISING NURSE CLINICAL AREA SENIOR NURSES

SUPERVISING NURSE 12. OC-DR-CSR SENIOR NURSES

SUPERVISING NURSE INSTRUCTOR IN-SEVICE R/S

NURSE INSTRUCTORS

STAFF NURSES MIDWIVES

STAFF NURSES

STAFF NURSES

TRAINEES

MIDWIVES

NURSING ATTENDANTS

NURSING ATTENDANTS

NURSING ATTENDANTS

INSTITUTIONAL WORKERS

INSTITUTIONAL WORKERS

INSTITUTIONAL WORKERS

ELVIS R. QUITALIG M.A.N. I Human Resource Requirements in Nursing Division CHIEF NURSE EXECUTIVE QUALIFICATIONS: Masters degree in healthcare or a business related field, or enrolled in a Masters degree program and positioned to complete the degree as required; Baccalaureate or Masters degree must be in N ursing (MAN/MSN). Doctoral preparation preferred. Current registered nurse license in the Philippines. Certification from the Philippine Nurses Credentialing Center in Nursing Administration preferred. Experience working in a shared decision making or nurse empowerment model required. 5 years of nursing management experience with 3 years executive management experience in an organization with similar complexity. SUMMARY OF JOB RESPONSIBLITIES: The functions of the Chief Nurse Executive (CNE) are to develop, maintain, and evaluate an environment of excellence that supports the professional nurse and other nursing care providers. The CNE ensures that the nursing services are in alignment with organizational priorities, goals and objectives and core values, standards of excellence and the DOH National Quality Program. The CNE is responsible and accountable for the overall management of nursing practice, nursing education and professional development, nursing research and the implementation of evidence-based practice, and nursing administration of nursing services. The CNE is ultimately responsible for sustaining the standards of nursing practice in all areas that nurses practice at the Lucas-Zenaida Memorial Medical Center. ESSENTIAL JOB FUNCTIONS TO INCLUDE BUT NOT LIMITED TO: Organizational Leadership Acquires and maintains current knowledge in administrative practice. Makes decisions and actions based on ethical principles. Accepts organizational accountability for services provided to recipients. Fosters continuous, positive peer review and ongoing leadership development throughout organization. Participates in planning and monitoring the budget for defined areas. Participates in the annual resource allocations for the entire Lucas-Zenaida Memorial Medical Center. Participates as a key member of the Lucas-Zenaida Memorial Medical Center Joint Conference Committee, a committee of the Joint Operating Board. Collaborates with nursing councils, nursing leaders, interdisciplinary teams, executive officers, and other stakeholders including the SCF Nurse Directors. He/ she speaks on behalf of nursing issues. Responsible for teaching, coaching, mentoring and challenging all staff to use quality improvement and management principles, and the principles in the DOH National Quality Award by: creating and reinforcing a customer focus and quality values setting expectations and planning reviewing quality and operational performance recognizing employee contributions Communicating our quality values outside the Lucas-Zenaida Memorial Medical Center. Provides critically important leadership by: creating, coordinating, and reinforcing mission, vision, values and expectations creating and sustaining a focus on the highest quality of patient-centered care

ELVIS R. QUITALIG M.A.N. I setting directions in health care and performance excellence goals through organizationwide strategy mapping reviewing overall performance including all stakeholders; interests and operational performance Leading the areas of supervision in growth and improvement as a learning organization.

Nursing Leadership Fosters accountability in a professional shared governance environment: Promotes, implements and evaluates theory based nursing practice, nursing research and evidence-based practice as an integral part of professional nursing care and administration Participates in and facilitates staff involvement in nursing and organizational policy formulation and decision making. Coordinates nursing services with the services of other health care disciplines. Develops organization-wide patient care programs, policies, and procedures that define the nursing needs of the patient population and how treatment and services are assessed, evaluated and met. Strategic planning of health care delivery and nursing. Evaluates the use of resources of organized nursing services. Assures appropriate orientation, education, performance evaluation, credentialing, and continuing professional development for personnel. Fosters a climate conducive to educational experiences for nursing and other students. Provides guidance for and supervision of personnel accountable to the nurse executive: o Participates in the recruitment, selection, and retention of personnel. Responsible for regulatory oversight as it relates to nursing (i.e. JCAHO, HCFA, Magnet, etc): o Systematically evaluates the quality and effectiveness of nursing practice and nursing services administration o Evaluates performance based on professional practice standards, relevant studies and regulations, and organizational criteria o Evaluates the quality and appropriateness of care. KNOWLEDGE, SKILLS AND ABILITIES: Leadership Ability to participate, lead and evaluate interdisciplinary teams. Ability to share knowledge and skills with colleagues and others and act as a role model/mentor. Knowledge of and demonstrates commitment to the PNA Code for Nurses. Skill in participating in practice and administrative groups within and outside nursing. Skill in ensuring alignment between key groups such as the Nursing Management Council, Nursing Coordinating Council, Executive Management Team and the Joint Operating Board. Ability to communicate executive leadership initiatives in a complex organization. Skill in developing peer review programs and the self-performance appraisal process. Skill in creating a climate of effective communication that contributes to an environment of mutual respect and understanding. Knowledge of organizational staffing plans. Ability to serve as a professional role model and mentor to motivate, develop, recruit, and retain future nurse administrators. Ability to provide leadership in developing strategies to promote critical thinking, conflict management, and problem-solving skills to promote a developing corps of future nursing leaders.

ELVIS R. QUITALIG M.A.N. I Ability to foster a non-discriminatory climate in which care is delivered in a manner sensitive to socio-cultural diversity. Supports the system to address ethical issues within nursing and the organization.

Strategic Planning Ability to cooperate and coordinate with nursing schools and programs. Skill in networking with educational institutions and evaluating student experiences. Skill in strategic planning. Ability to ensure that a plan for nursing quality monitoring is established, implemented, and evaluated throughout Lucas-Zenaida Memorial Medical Center. Ability to provide leadership in determination of clinical and administrative nursing goals and directions. Knowledge of nursing research, the protection and rights of human subjects, evidence based practice, and implementation of protocols. Ability to advocate for resources to support research and promote evidence-based nursing practice. Knowledge to contribute to efforts to improve and standardize core processes, including benchmarking efforts and assure incorporation of initiatives in organization-wide decision making group(s). Focus on Patients, Other Customers, and Markets Ability to advocate on behalf of recipients of services and personnel, maintaining privacy, confidentiality, and security of patient, client, staff, and organization data. Knowledge of health care needs of the Alaska Native/American Indian population. Ability to ensure patient needs is central focus during decision making. Measurement, Analysis, and Knowledge Management Skill in developing, implementing and evaluating systems and data, and processes that complemen t the overall system for performance improvement. Skill in evaluating factors related to safety, outcomes, effectiveness, cost, and social impact when supporting the development and implementation of practice innovations. Ensures that effective systems exist and are maintained where data collec tion & information systems are utilized to improve patient care. Staff Focus Ability to advocate for nursing representation in all appropriate multidisciplinary committees. Demonstrates self-directed learning capabilities and skill in networking outside the agency. Knowledge of licensure, education and experience requirements of staff. Ability to develop and implement recruitment and retention programs for staff. Knowledge to evaluate orientation, education, credentialing, and continuing professional development programs. Ability to serve as a change agent that facilitates staff understanding of the importance, necessity, impact, and process of change. Ability to facilitate point-of-service staff and management participation in nursing initiatives, both within and outside the organization. Process Management Skill in negotiating for appropriate role expansion and delineation of nursing staff

ELVIS R. QUITALIG M.A.N. I Knowledge of methods to secure appropriate fiscal and human resources to accomplish the work/goals of nursing service. Skill in collaborating with administrative colleagues in determining the acquisition, allocation, and utilization of organizational fiscal and human resources. Skill in budget development and tracking processes to manage budget variances. Organizational Performance Results Knowledge of nursing productivity assessment tools and their successful utilization. Knowledge of organization, management, and nursing theories and research. Knowledge of nursing standards. The ability to assure a system for implementation of standards is in place including a method for documenting employees exceeding or failing to meet standards. AGE SPECIFICITY: None ASSISTANT CHIEF NURSE EXECUTIVE QUALIFICATIONS: A current PRC license to practice as a registered professional nurse and Bachelors degree in nursing from an accredited college or university and Four years of experience as registered professional nurse, including two years in an administrative or supervisory capacity. Masters degree in nursing, nursing administration, public health or directly related area and one year in an administrative or supervisory capacity. Eight years of experience as a registered nurse, including two years in an environment related to the area of assignment and three years of supervisory experience. Experience in conducting training program or teaching nursing practice. Experience in health evaluation, outcomes measurement and/or quality assurance/quality improvement. Experience with directing and/or managing health programs. Experience in collaborating with multiple disciplines or providers in large, complex and/statewide health systems. JOB RELATIONS: Source of Workers: Nurse IV Promotion to: Chief Nurse Responsible to: Nurse III/ Supervising Nurse SUMMARY OF JOB RESPONSIBLITIES: The functions of the ACNE is to provide leadership, guidance, and technical assistance to state office nurses, state office staff and district nursing leaders. Also, he/ she is responsible for the development of quality assurance/quality improvement standards at hospital. Directs and manages statewide programs that support and advance nursing practice and enhance professional and personal development of nurses. Under limited supervision, serves as an Assistant to the Chief Nurse and as a team member of the Office of Nursing and Department of Health. Directs and/or supervises staff. He or she manages the statewide Quality Assurance/Quality Improvement (QA/QI) Program for Nursing.

ELVIS R. QUITALIG M.A.N. I ESSENTIAL JOB FUNCTIONS TO INCLUDE BUT NOT LIMITED TO: Coordinates statewide Quality Assurance/Quality Improvement training activities for nurses. Serves as a member of the Quality Improvement /Performance Management Network. Manages the Health Assessment and Clinical Competency Development Program. Reviews state and other regulatory standards information in order to direct quality improvement activities and achieve compliance. Oversees the Health Assessment budget. Coordinates the Continuing Nurse Education Program. Coordinates Population Health Training for Public Health Nurses. Serves on the Departments Emergency Preparedness team for planning and responding to emergencies/disasters. Coordinates and provides administrative support to the Practice and Education Work group. Collaborates with academic partners and colleagues to coordinate research initiatives related to nursing research priorities. Interprets policies and communicates changes in regulations and procedures. Organizes and plans a systematic and continuous quality/performance improvement program for the practice of nursing. Develops nursing guidelines, standards and protocols for implementation at the district/county levels. Coordinates response to disaster and emergencies. Directs special projects and participates on team projects. AGE SPECIFICITY: None NURSE SUPERVISOR QUALIFICATIONS: Bachelors Degree in Nursing required. Masters Degree in Nursing or closely related field preferred. Current nursing license (in good standing). Worked in public/community health, including home visitation. Provided maternal/child health services, particularly in community and hospital setting. Program management and one-on-one supervision. Worked with diverse populations, communities, and organizations. JOB RELATIONS: Source of Workers: Nurse III Promotion to: Assistant Chief Nurse Responsible to: Nurse II/ Head Nurse SUMMARY OF JOB RESPONSIBLITIES: Nurse Supervisor role is to work within the local community and lead agency structure to assure that the Hospital Program is implemented in accordance with established guidelines and contract requirements. He/ she is responsible to look into the functioning of Head Nurses in the clinical areas. Also, Another primary purpose of the Nurse Supervisor is using principles of supervision, reflective practice, and staff development, to provide primary support and appropriate oversight to the nurse home and hospital

ELVIS R. QUITALIG M.A.N. I visitors, and to build and model a strengths-based, client-centered culture. ESSENTIAL JOB FUNCTIONS TO INCLUDE BUT NOT LIMITED TO: Administrative Responsibilities Staffing and Education Oversees the recruitment and hiring of all nurse home and hospital visitors and administrative data support staff ensuring that they can implement the hospital philosophy and model. Ensures that all staff, including supervisor, attend all required education sessions as outlined in the orientation materials and the contract with the hospital. Assesses and develops strategies to address knowledge and skill gaps of nurse home and hospital visitors and support staff. Provides adequate orientation, professional development opportunities and study time to remediate gaps in necessary knowledge and skill. Assigns client caseloads and monitor nurse home and hospital visitors ability to build and manage caseload. Provides useful developmental feedback, and confronts and develops a plan with staff to address performance and resolve issues. Builds confidence and skill of nurse home visitors. Provides supervision and evaluation of nurse home visitors and administrative data support staff (including annual leave, annual review, disciplinary action, etc.). Budget and Contracts (could be responsibility of manager level above Nurse Supervisor) Becomes familiar with and actively participates in the preparation and monitoring of the nurses budget to ensure appropriate use of funds. Plans and expends budget to ensure compliance with fidelity to hospital model and contract agreements. Understands and actively participates in monitoring hospital contract with the agency. Is proactive with local, state, and national issues that may affect sustainability of program. Quality Improvement and Evaluation Oversees and ensure timely and accurate data input and utilization of the web-based reports and other reports available through hospital. Reads and interprets reports; shares appropriately with team and partners. Ensures implementation of quality improvement strategies. Develops methods for ongoing assessment of staff development needs; compare available data to structure appropriate continuing education and guidance of staff. Provides routine surveillance of potential client care incidents. Evaluates implementing agency outcomes and interventions. Create and Maintain NFP Culture Ability to maintain relationships based on trust, support and growth with team colleagues and community members. Ensures that supervision of nurse home and hospital visitors utilizes principles and concepts of motivational interviewing, coaching and reflective practice (modeling

ELVIS R. QUITALIG M.A.N. I therapeutic relationships, change theory, self-efficacy, client centered, strength based, and solution focused approaches). Becomes familiar and comfortable with principles and concepts of motivational interviewing, coaching and reflective practice. Develops and implement regular reflective practice supervision within the program and conduct field visits, both with frequency recommended by institution. Ensures that own reflective practice and ongoing professional and personal development needs are addressed. Provides regular case conferences and team meetings as recommended by hospital. Ensures rewards and incentives are aligned with goals of program. Effectively assists nurse home and hospital visitors in analyzing complex problems and case situations.

AGE SPECIFICITY: None HEAD NURSE QUALIFICATIONS: Bachelors Degree in Nursing required. 9 Units of Masters Degree in Nursing or closely related field preferred as required by RA 9173. Current nursing license (in good standing). At least one year of clinical nursing practice and experience With supervisory Development Training or training in the nursing specialty of the clinical nursing unit to which he/she is prepared for promotion. Membership in the agencys nursing association and other professional associations JOB RELATIONS: Source of Workers: Nurse I/ Staff Nurse Promotion to: Nurse III/ Supervising Nurse Responsible to: Nurse III/ Supervising Nurse Responsible for: Nurse I/ Staff Nurse; Nursing Attendant SUMMARY OF JOB RESPONSIBLITIES: A Head Nurse/ Senior Nurse/ Nurse II is a professional nurse who assumes responsibility for managing the human and material resources of a nursing unit to provide quality patient care and an environment conducive to staff growth and satisfaction. ESSENTIAL JOB FUNCTIONS TO INCLUDE BUT NOT LIMITED TO: Patient Care Management: assumes responsibility for the delivery of quality Patient care for the unit. Participates in the development of nursing standards, policies, procedures regarding patient care and updates these as necessary. Promotes/ utilizes quality assurance standards and programs in the unit. Supervises and evaluates the quality of patient care through frequent rounds. Acts as liaison with the Medical Staff to coordinate medical and nursing management of patient care.

ELVIS R. QUITALIG M.A.N. I Serves as resource person to nursing personnel under him/her in assessing, planning, implementing and evaluating nursing care provided. Assumes the role of patient advocate. Coordinates patient care with other members of the health team, other hospital units, services, and/ or divisions. Serves as committee member within the department, hospital or professional organization. Keep superiors informed regarding problems/ issues in patient care within the nursing unit.

Management of Nursing Personnel: provides leadership and direction to nursing personnel in accordance with organizational and departmental goals and objectives. Participates in the selection of nursing staff for the unit. Schedules staff assignments considering experience, interest and training. Adjusts staffing levels/ ratio according to the severity of the patients illness, the number of patients and number of nurses. Advises and/ or informs staff regarding new or revised policies and procedures. Keeps the Supervising Nurse informed of personnel activities and problems. Presents changes or innovations to staff in a positive manner. Provides a conducive climate in which the staff will feel free to consult her/him for problems or assistance. Management of Patient Care Units: Maintains an environment that encourages quality patient care and staff satisfaction. Provides safe, clean, secure environment for patients, visitors and personnel. Requisitions adequate supplies and equipment needed for patient care. Monitors utilization of supplies and equipment through monthly audits and inventories. Cooperates/ coordinates with other hospital services departments for appropriate support services. Prepares monthly, semi-annual, annual reports of achievements/ problems. Maintains effective communication within unit/ departments and other services through conferences/ meetings. Educational Responsibilities: Assists in staff development activities in the unit: o Coordinates with Training staff in planning, implementing and evaluating orientation of new nursing personnel. o Informs training Staff of the training needs of nursing personnel under him/ her. Assist Clinical Instructors of affiliating colleges of nursing in planning, implementing and evaluating the learning experience of the students. Assumes responsibility for own learning and development needs. Acts as Supervising Nurse in the absence of one when so delegated. AGE SPECIFICITY: None

ELVIS R. QUITALIG M.A.N. I STAFF NURSE QUALIFICATIONS: Bachelor of Science in Nursing Registered Nurse With 6 months clinical practice and experience Undergoes training in BLS-CPR and IVT Professional affiliation with professional nursing associations With strong interpersonal communication and leadership skills. Can work under pressure Wiling to learn and supervise With Good Moral Standing Preferably 23 years old and above JOB RELATIONS: Source of Workers: Registered Promoted to: Senior Nurse/Nurse II Responsible to: Senior Nurse/ Nurse II SUMMARY OF JOB RESPONSIBLITIES: The Staff Nurse I is a professional nurse that is responsible for rendering holistic nursing care to patients in assigned areas, the specific functions and responsibilities of which depend upon the organizational structure of the Nursing Service/ Department/ Division. ESSENTIAL JOB FUNCTIONS TO INCLUDE BUT NOT LIMITED TO: Patient Care Management: The Staff Nurse shall initiate and perform nursing care services to meet the needs of patients in assigned areas/ units utilizing the nursing process. Assess the individuals needs for nursing care based on the patients history, results of physical, diagnostic, and laboratory examinations. Infers correct nursing diagnosis. Plans/prioritizes nursing care activities considering overall health needs of the patient, the extent of his/ her coping abilities including that of his family and significant others and his/ her readiness, acceptance, and abilities for self-care. Institutes nursing interventions consistent with the overall plan of care with special considerations for the patients safety and comfort. Executes written, legal prescriptions for treatment, therapies, medication including hypodermic, intramuscular and intravenous injections; provided that in intravenous injections, special training shall be required and according to protocol established. Provides health teaching to patients, his/ her family and significant others so that they may understand this illness and participate actively in his/ her care. Coordinates patients care services with members of the health team. Evaluates/ modifies nursing care provided in terms of: o Effectiveness and efficiency of nursing measures and rendered and; o Feedback from patient/ family/ significant others. Conducts discharge planning with patient, family and health team. Refers to community health agencies as needed.

ELVIS R. QUITALIG M.A.N. I Documents accurately the observations and services rendered to the patients.

Hospital and Nursing Service Policies and Regulations Observes hospital and nursing service rules, regulations and policies. Interprets to patients, family, and visitors the rules, regulations, policies that affect them. Learning experiences of Nursing Students Coordinates with Clinical Instructors the activities of the affiliating students such as helping select patient assignments to enhance learning experiences particularly on patient care. Demonstrates good nursing in the way he or she cares for patients. He or she also acts as a role model to the students. Orientation of Non-Professional Workers in the Unit Participates in the orientation of new, non-professional nursing personnel. Research and studies Participates in/ initiates nursing research and studies. Utilizes results for improvement of nursing practice. Professional Responsibilities: Take initiative and responsibility for membership in professional organizations and participates actively in their programs and activities. Keeps self professionally updated though continuing education. Updates professional license.

MIDWIFE QUALIFICATIONS: Diploma/ Bachelor of Science in Midwifery Registered Midwife With 6 months clinical practice and experience Undergoes training in BLS-CPR Professional affiliation with professional nursing associations With strong interpersonal communication and leadership skills. Can work under pressure Wiling to learn and supervise With Good Moral Standing Preferably 23 years old and above SUMMARY OF JOB RESPONSIBLITIES: A practicing midwife is responsible for providing midwifery care in accordance with such standards as the Council may specify from time to time to a woman and baby during the antenatal, intranatal and postnatal periods. ESSENTIAL JOB FUNCTIONS TO INCLUDE BUT NOT LIMITED TO: Provide sound family planning information and advice

ELVIS R. QUITALIG M.A.N. I To prescribe or advise on the examination s necessary for the earliest possible diagnosis of pregnancies at risk To provide a program of parenthood preparation and a complete preparation for childbirth including advice on hygiene and nutrition To care and assist the mother during labor and to monitor the fetus in utero by the appropriate clinical and technical means To conduct spontaneous deliveries including when required an episiotomy and in urgent case, a breech delivery To recognize the warning signs of abnormality in the mother or infant which necessitate referral to a doctor and to assist the latter where appropriate, in particular the manual removal of the placenta, possibly following a manual examination of the uterus To examine and care for the newborn infant: to take all initiatives which are necessary in case of need and to carry out where necessary immediate resuscitation To care for and monitor the progress of the mother in the postnatal period and to give all necessary advice to the mother on infant care to enable her to ensure the optimum progress of the newborn infant To carry out treatment prescribed by a doctor To maintain all necessary records NURSING ATTENDANT QUALIFICATIONS: To be considered for position, candidates must meet the following criteria: Valid Drivers License or eligibility and good driving record. Evidence of automobile collision and liability insurance. Functional automobile able to transport consumers safely to vocational, recreational, medical, religious and other community experiences. Ability to assist consumer to physically transfer from chair to bed, toilet, vehicle, tub, etc. as needed. Vocational Graduate and must be passed his/ her NCII Program under TESDA Completed the Medicare Competency Evaluation Program, or completed one year of institutional or community-based direct service delivery in health care. Minimum of 1,200 hours CNA experience Medical Examination Record of Hepatitis B immunization or signed refusal form Receipt of two professional employment references CPR Certification preferred SUMMARY OF JOB RESPONSIBLITIES: The Nurse Attendant is responsible to help the consumer meet their daily needs and without this service alone or in combination with other waiver services the individual would require institutionalization. ESSENTIAL JOB FUNCTIONS TO INCLUDE BUT NOT LIMITED TO: Assesses, monitors and supervises individuals to ensure their health, safety and welfare Assists individuals with activities of daily living skills: o Basic personal hygiene, care and grooming, including bathing, hair care, dressing o Bladder and/or bowel requirements or problems, including helping individuals to o and from the bathroom or with bedpan routings o Self-administered medications

ELVIS R. QUITALIG M.A.N. I Performs household services and both heavy and light home cleaning tasks Assists with preparing a shopping list, performing grocery shopping and preparing meals Transports individual to vocational, recreational, medical, religious and community activities and experiences; runs miscellaneous errands Independently performs basic medical procedures, including taking blood pressures, pulse, temperatures, and specimens and giving whirlpools. Participates in the consumers Individual Service Plan meetings if and when requested by the consumer and/or the consumers interdisciplinary team. Performs tasks and duties according to the institution, prioritizes and organizes tasks to achieve goals outlined on the hospital. Documents all services provided to the consumer. -o-

ELVIS R. QUITALIG M.A.N. I

The Lucas-Zenaida Quitalig Memorial Medical Center Floor Plan

The Lucas-Zenaida Memeorial Medical Center, as a tertiary hospital can accommodate 300 patients with different levels of care the patient needs. For the nursing personnel, 148 Professional Nurses and 80 Nursing Attendants will be utilized in in-patient based on the standard of computation for nursing personnel. However, additional manpower will be needed for supervisory and administrative works. There will be 10 supervising and Head Nurses respectively in the different areas concerned.

ELVIS R. QUITALIG M.A.N. I

NURSING PERSONNEL NEEDED for Zenaida-Lucas Memorial Medical Center (300 patients) 1. Nursing Personnel needed for 300 patients 300 patients x .30= 90 patients needing minimal care 300 patients x .45= 135 patients needing moderate care 300 patients x.15= 45 patients needing intensive care 300patients x.10= 30 patients needing highly specialized nursing care 300 patients 2. Nursing Care Hours (NCH) needed by patients at level of care per day 90 patients x 1.5 (NCH needed at Level I) = 135 NCH/day 135 patients x 3 (NCH needed at Level II) =405 NCH/day 45 patients x 4.5 (NCH needed at Level III) = 202.5 NCH/day 30 patients x 6 (NCH needed at Level IV) = 180 NCH/day 922.5 NCH/day 3. NCH needed by 300 patients per year 922.5 x 365 (days/ year) = 336,712.5 NCH/ year 4. Actual working hours rendered by each nursing personnel per year 8 (hours/day) x 213 (working days/ year)= 1,704 (working hours/ year) 5. Total number of Nursing personnel Needed Total NCH per year 336,712.5 = = 197.60 round off =198 Working hours per year 1,704 Relief x total nursing personnel 198x 0.15= 29.7 round off= 30 Total number of Nursing personnel Needed 198+30= 228 6. Categorize Professional and Non-Professional of tertiary Hospital 228 x 0.65 = 148 professional Nurses 228 x 0.35 = 80 Nursing Attendants 7. Distribute by shifts For Nurses o 148 Nurses x. 0.45 = 66.6 for AM Shift o 148 Nurses x 0.37= 54.76 for PM shift o 148 Nurses x 0.18 = 26.64 for NIGHT Shift For Nursing Attendants o 80 Nursing attendants x 0.45 = 36 for AM Shift o 80 Nursing Attendants x 0.37 = 29. 6 for PM Shift o 80 Nursing Attendants x 0.18 = 14.4 for NIGHT shift