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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 Childrens Hospital, its


relationship and characteristics, Patient Classification System and Job
Description

Recognized the different roles and responsibilities of Nurse I to Nurse VII


according to their respective Job Description

Organizational Structure
Organizational Structure refers to the way a group is formed depicting its line
of authority, span of control and the channels of communication.
It affects how people perceived the roles and the status given to them by
other people in the organization
It is effective when:
the design is clearly communicated,
there are as few manages as possible to accomplish goals,
communication is facilitated,
decisions are made at the lowest possible level,
Informal groups are encouraged and future leaders are developed.
Organizational Charts depict formal relationships, channels of communication
and authority
Structural Charts show the various components of the organization and outlines
their basic interrelationships.
Functional Charts reflects the functions and duties of the components of the
organization and indicates the interrelationships of these functions. Within the
boxes is the function statement which should be clear, inclusive and written in the
present tense.
Position Charts specify the names, positions and titles or ranks of the personnel
which fit into the organizational structure. It identifies channels of communication,
level of accountability and area of responsibilities.
Major Characteristics of an Organizational Structure
An organizational structure has 5 major characteristics
Division of Work each box represents an individual or sub unit responsible for a
given task of the organizations work load for instance, Medical, Administrative,
Nursing and Finance Division

Chain of Command follows a solid line and is called scalar chain. The chain can be
flat (decentralized organizations) or tall (centralized organizations). Going outside
the chain of command is very risky in most organization and should be done only in
rare circumstances after other avenues have been exhausted.
Type of work to be performed is indicated by labels or description for the boxes,
for instance, X ray, Laboratory, Dietary, Social Service etc.
The grouping of work segments or homogenous assignments are shown by
clusters of work groups, for instance OPD, Pediatric-PICU, Surgery-SICU, and
Medical-MICU.
The level of management indicate the individual and entire management
hierarchy regardless of where an individual appears on the chart. Hierarchy refers to
a body of persons or things organized or classified in a pyramidal fashion according
to rank, capacity of authority assigned to vertical levels with officer ranked in
grades, order or classes, one above the other. For instance, Top Management,
Middle Management, Operational Level.

Relationships within the Nursing Service


Relationship

Individual

Line- Those that exist between the


superior
and
the
subordinates
immediately and directly responsible to
him/her

Chief Nurse to Supervising Nurse to


Senior Nurse to all nursing personnel

Lateral- those that exist between


position in various divisions and
sections of an undertaking where no
direct authority is involved

Senior Nurse with Doctor, Social Worker


and Dietitian

Functional- those which arise when


duties are divided on a functional basis,
for instance, when an individual
exercises authority on one particular
subject by special skill or knowledge

Chief Nurse with Administrative Officer,


Senior Nurse with Clinical Instructor

Staff- this individual is not vested with


but is acting for and in behalf of the
person on which authority lies. His/her
function is one of transmission and
interpretation coupled with the duty of
ascertaining that the orders given are
carried out

Supervising Nurse acting on behalf of


the Nursing Service after office hour

Nursing Service Administration


Position
Chief Nurse

Assistant Chief Nurse

Nurse V

Nurse IV

Nurse III (Training Office)

Nurse III (HEPO Designate)

Nurse III (Clinical Areas)

Function
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
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
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
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
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
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
Under general supervision, supervises
the nursing care service unit through
monitoring and mentoring work of

Nurse III (Special Areas)

Nurse II (Clinical Areas)

Nurse II (Special Areas)

Nurse II (Training Office)

Nurse I (Clinical Areas)

Nurse I (Special Areas)

Nurse I (Training Office)

nursing staff and student in the


hospital,
performs
regular
staff
functions, and assists in developing
applicable
policies,
rules
and
regulations for the hospital.
Under general supervision, supervises
the nursing care service unit through
mentoring and monitoring work of
nursing staff and students in the
hospital,
performs
regular
staff
functions and assists in developing
applicable
policies,
rules
and
regulations for the hospital
Under general supervision, manages
the nursing care service through
mentoring and monitoring work of
nursing staff and students performs
regular staff functions when necessary
Under general supervision, manages
the nursing care service through
mentoring and monitoring work of
nursing staff and students performs
regular staff functions when necessary
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
Under general supervision, performs
direct nursing care services and assists
physicians in diagnostic and therapeutic
procedures in order to provide proper
patient care
Under general supervision, performs
direct nursing care services and assists
physicians in diagnostic and therapeutic
procedures in order to provide proper
patient care
Under general supervision, establishes,
organized and implements training
programs and activities for nursing
students, staff nurses and other
personnel related to patient care

Patient Classification System

Means of categorizing present patients on the basis of certain care needs that
can be clinically observed by the nurse.
CATEGORY I. Self-care/Minimal Care
Minimal care is given to patients who are convalescing and who no longer
require intensive, moderate or maximum care.
Patients who require diagnostic studies, minimal therapy, less frequent
observations, and daily care for minor conditions and who are awaiting
elective surgery.
CATEGORY II. Moderate Care
Care given to patients who are moderately ill or are recovering from the
immediate effects of a serious illness and/or an operation.
Patients require nursing supervision or some assistance related to ambulating
and caring for their own hygiene.
CATEGORY III. Maximum Care
Given to patients with who need close attention throughout the shift, that is
complete care for patients who require nursing to initiate, supervise and
perform most of their activities or who require frequent and complex
medications or treatments.
CATEGORY IV. Intensive Care
Given to acutely ill patients who have a high level of nurse dependency,
including those requiring intensive therapy and/or intensive nursing care and
whose unstable condition requires frequent evaluation with adjustment of
therapy.

PERCENTAGE OF PATIENTS IN VARIOUS LEVELS OF CARE


Types
Hospital

of

Primary
Hospital
Secondary
Hospital
Tertiary Hospital
Special Tertiary
Hospital

Minimal Care

Moderate
Care

Intensive Care

Highly
Specialized
Care

70

25

65

30

30

45

15

10

10

25

45

20

LEVELS OF
CARE

NCH
needed per
patient per
day

Ratio of
Professionals
to Nonprofessionals

Level I

1.50

55:45

Self Care or
Minimal Care

3.0

60:40

4.5

65:35

6.0

70:30

7 or higher

80:20

Level II
Moderate or
Intermediate
Level III
Total or Intensive
Care
Level IV
Highly Specialized
or Critical Care

CATEGORIES OR LEVELS OF CARE OF PATIENTS,


NURSING CARE HOURS NEEDED PER PATIENT PER
DAY AND RATIO OF PROFESSIONAL TO NONPROFESSIONALS

Job Description
Nurse I
Accountable to: Nurse II and Nurse III
Directly supervises: Nursing Attendants
Job Summary:
Under general supervision, performs direct nursing care and assists physician in
diagnostic and therapeutic procedures in order to provide proper patient care
Competency Model
A. Core

Organizational Commitment
Integrity
Quality Service Focus
Teamwork
Stewardship of Resources
Attention to Communication
Self-Development

B. Functional Competence Profile:

Knowledge
Nursing Degree
and
Clinical
Nursing
Nursing Law
Nursing
and
Patient
Care
Procedures
Patient
Assessment
IV therapy
Occupational
Hazards
and
Safety Standards
Practices

Behavior
Collaboration
Building Trust
Building
Client
Loyalty
Communication
Planning
and
Organizing
Decision Making
Work Standards
Continuous
Learning

Motivation
Job has opportunities
for
Relationship
Building
Challenging
Work
Achievement

Key Result Areas


Nursing Service and Patient Care
Medication and Treatment Administration
Patient Record Maintenance
Coordination
Health Information

Functions:
1. Performs direct nursing care procedures which include bedside nursing
hygiene, pre and post -operative nursing care as well as admission and
discharge duties
2. Administers Medication
3. Observes records and reports patients symptoms, conditions, and
progress of treatment and therapy
4. Prepares patients for and assists physicians with diagnostic and
therapeutic procedures for both normal and specialized procedures
5. Operates Diagnostic machines
6. Maintains records reflecting patients condition, medication and treatment
7. 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 health
9. Set up treatment trays, prepares instruments and equipment, and ensures
adequate medical or hospital supplies and availability of proper
equipment and instruments
10.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
Hospital Based
Exposed to health
hazards/accidents

Contacts
Other DOH units
LGUs/NGOs
Clients

Equipment
Computer
Telephone

Nurse II
Accountable to: Nurse III
Directly supervises: Nurse I and Nursing Attendants
Job Summary:
Under general supervision, manages his/her own unit, performs and monitors direct
nursing care and assists physician in diagnostic and therapeutic procedures in order
to provide proper patient care
Competency Model
A. Core

Organizational Commitment
Integrity
Quality Service Focus
Teamwork
Stewardship of Resources
Attention to Communication
Self-Development

B. Functional Competence Profile:

Knowledge
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

Behavior
Collaboration
Building Trust
Building
Client
Loyalty
Communication
Planning
and
Organizing
Decision Making
Work Standards
Continuous
Learning

Motivation
Job has opportunities
for
Relationship
Building
Challenging
Work
Achievement

Key Result Areas


Nursing and Patient Care Procedures
Medication and Treatment Administration
Patient Record Maintenance
Quality Management
Coordination
Training Education and Performance Monitoring
Equipment Supplies and Facility Maintenance

Functions:
1. Performs and monitors patient care and other nursing activities such as
conducting rounds, soliciting patient feedback, administering medications
and reporting unusual symptoms.

2. Monitors and evaluates the performance of staff nurses and other nonprofessional 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 environment
5. Performs administrative duties such as preparing reports and schedules of
assignments
6. 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 necessary
7. 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
performance
9. 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
Hospital Based
Exposed to health
hazards/accidents

Contacts
Other DOH units
LGUs/NGOs
Clients
Academe
Professional
Organization
International
Groups

Nurse II (Blood Bank)


Accountable to: Senior Medical Technologist
Directly supervises:
Job Summary:

Medical Laboratory Technicians

Equipment
Computer
Telephone
Fax Machine
A/V equipment
Photocopier
Calculator

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
Donor Selection
and Screening
Counseling
Phlebotomy
Patient Care
Basic
Medical
Procedures
Occupational
Hazards
and
Safety
Standards
Practices

Behavior
Collaboration
Building Trust
Building
Client
Loyalty
Communication
Planning
and
Organizing
Decision Making
Work Standards
Continuous
Learning

Key Result Areas


Donor Screening and Phlebotomy
Equipment Maintenance
Counseling

Functions:

Motivation
Job has opportunities
for
Relationship
Building
Challenging
Work
Achievement

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 donors
4. Takes note of and manages adverse blood donation reaction and
implements nursing care as needed
5. Prepares supplies and equipment needed during blood drives
6. Orients new staff on new equipment and procedures as necessary
7. Ensures proper use and maintenance of equipment
8. 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
Hospital Based
Exposed to health
hazards/accidents

Contacts
Other DOH units
LGUs/NGOs
Clients
Academe
Professional
Organization
International
Groups

Equipment
Computer
Telephone
Fax Machine
A/V equipment
Photocopier
Calculator

Qualifications Standards
Minimum Requirement for the position

Education: Bachelor of Science in Nursing


Training: 4 hours of relevant training
Experience: 1 year of relevant experience
Eligibility: RA 1080

Work Conditions/Contact Tools and Equipment


Work Conditions
Hospital Based
Exposed to health
hazards/accidents

Contacts
Other DOH units
LGUs/NGOs
Clients
Academe
Professional
Organization
International
Groups

Equipment
Computer
Telephone
Fax Machine
A/V equipment
Photocopier
Calculator

Nurse III
Accountable to: Nurse IV
Directly supervises: Nurse II
Job Summary:
Under direction, supervises the nursing care service through monitoring and
mentoring work of nursing staff and students in the hospital: and performing regular
staff functions when necessary
Competency Model
A. Core

Organizational Commitment
Integrity
Quality Service Focus
Teamwork
Stewardship of Resources
Attention to Communication
Self-Development

B. Functional Competence Profile:

Knowledge
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

Behavior
Collaboration
Building Trust
Building
Client
Loyalty
Communication
Planning
and
Organizing
Decision Making
Work Standards
Continuous
Learning

Motivation
Job has opportunities
for
Relationship
Building
Challenging
Work
Achievement

Practices

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 service
6. Monitors adequacy and maintenance of medical supplies and equipment
7. 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 necessary
9. 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
Hospital Based
Exposed to health
hazards/accidents

Contacts
Other DOH units
LGUs/NGOs
Clients
Academe
Professional
Organization
International
Groups

Equipment
Computer
Telephone
Fax Machine
A/V equipment
Photocopier
Calculator

Nurse IV (Nurse Trainer)


Accountable to: Nurse VI
Directly supervises: Clinical Instructors and other Nursing Staff
Job Summary:
Under general supervision, manages training and development of nursing students,
staff nurses and other personnel through planning, implementing and monitoring
and training activities related to patient care.
Competency Model
A. Core

Organizational Commitment
Integrity
Quality Service Focus
Teamwork
Stewardship of Resources
Attention to Communication
Self-Development

B. Functional Competence Profile:


Knowledge
Training
Education
Methods
Basic
Support and
Techniques
Methods

and

Life
OR
on

Behavior
Managing
Performance
Building
a
Successful Team
Building Strategic
Working
Relationships

Motivation
has opportunities

Job
for

High
Responsibility
Accountability
Challenging Work
Achievement

Nursing
Operation
and
Administration
Usage of Medical
Equipment and
Instruments
Occupational
Hazards
and
Safety Standards
Practices
Computer
Software
Application
Quality
Management
Technical Writing
Research

Building Trust
Planning
and
Organizing
Decision Making
Work Standards

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 academe
5. 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
Hospital Based
Exposed to health
hazards/accidents

Contacts
Other DOH units
LGUs/NGOs
Clients
Academe
Professional
Organization
International
Groups

Equipment
Computer
Telephone
Fax Machine
A/V equipment
Photocopier
Calculator
Basic
Medical
Equipment

Nurse IV (OR supervisor)


Accountable to: Nurse VII
Directly supervises: Nurse III, Nurse II (OR)
Job Summary:
Under general supervision, supervises nursing activities in the Operating Room in
order to ensure proper pre and post-operative patient care
Competency Model
A. Core
Organizational Commitment
Integrity
Quality Service Focus
Teamwork
Stewardship of Resources
Attention to Communication
Self-Development
B. Functional Competence Profile:
Knowledge

Behavior

Motivation

Clinical Nursing
Nursing Law
Nursing
Administration
and Operation
Patient
Assessment
Technical Writing
Medical
Equipment
Functions
OR
Techniques
and Management
Knowledge
of
business
and
financial
management
Occupational
Hazards
and
Safety Standards
Practices

Managing
Performance
Building
a
Successful Team
Building Strategic
Working
Relationships
Building Trust
Planning
and
Organizing
Decision Making
Work Standards

Job
for

has

opportunities

High
Responsibility
Accountability
Challenging Work
Achievement

Key Result Areas


Training and Development Programs
Monitoring and Evaluation
Performance Management
Training Report

Functions:
1.
2.
3.
4.
5.
6.
7.
8.
9.

Plans and supervises nursing related activities in the Operating Room


Maintains all OR supplies and equipment
Coordinates administrative duties to ensure proper functioning of staff.
Coordinates with other departments regarding patient needs
Coordinates with Administration and Supply Department in requisition of
supplies and equipment for OR use.
Monitors and evaluates staff performance and the implementation of the
nursing standards in the delivery of quality nursing care
Prepares and ensure safekeeping of OR records and reports.
Determines needs of staff related to professional growth and
development, and participates in the orientation and training of new staff,
trainees and student affiliates
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

Hospital Based
Exposed to health
hazards/accidents

Contacts

Equipment

Other DOH units


LGUs/NGOs
Clients
Academe
Professional
Organization
International
Groups

Computer
Telephone
Fax Machine
A/V equipment
Photocopier
Calculator
Basic
Medical
Equipment

Nurse VII (Chief Nurse)


Accountable to: Chief of Hospital, Medical Center Chief
Directly supervises: Nursing Staff
Job Summary: Under general supervision, participates in development of policies,
guidelines, standards and protocols in the hospital, provides technical assistance,
provides technical supervision of staff and conducts monitoring and evaluation.
Competency Model
C. Core

Organizational Commitment
Integrity
Quality Service Focus
Teamwork
Stewardship of Resources
Attention to Communication
Self-Development

D. Functional Competence Profile:

Knowledge
Nursing Care
Nursing
Supervision
Public Health
Health Policies
Research
Development
Monitoring
and
Evaluation
Occupational
Hazards
and
Safety Standards
Practices
Computer
Software
Applications

Behavior
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

Motivation
has opportunities

Job
for

High
Involvement
member
Challenging work
Achievement

Key Result Areas


Policies, Guidelines, Standards and Protocols Development
Technical Assistance
Staffing Plan
Networking
Monitoring and Evaluation
Performance Management
Data and Report Collection
Supervision
Functions:
1. Plans, Organizes and supervises the Nursing Service in order to provide good
nursing care to patients.
2. Coordinates all activities of Nursing Service Department with other services
3. 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 Service
7. Screens applicants for the nursing service
8. Prepares and submits nursing service report as required

9. Approves procurement plan to ensure complete hospital supplies and


equipment
10.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 care
11.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

Hospital Based
Exposed to health
hazards/accidents

Contacts

Other DOH units


Other Hospital
Clients

Equipment

Computer
Telephone
Fax Machine
Photocopier
Calculator

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