Republic of the Philippines

CAVITE STATE UNIVERSITY

(CvSU)
Don SeverinoDelas Alas Campus
Indang, Cavite
(046) 4150-010 / 4150-011 (046) 4150-012

GENERAL EMILIO AGUINALDO

MEMORIAL HOSPITAL
OB WARD
In Partial Fulfillment of the Requirement in NURS90B- Nursing Leadership and Management
for the Degree for the Bachelor of Science in Nursing
Submitted by:
De Ocampo, Leah Claudia G.
Jauod, Kiethlyn Jade S.
Lopez, Dexter Paolo V.
Luego, Cherry Rose F.
Musni, Michelle Marie V.
Pulido, Raymund Jr. P
Purificacion, Roliver John A.
Ramos, Diana H.
Salud, Allysa Toni Marie G.
Sudario, Carmella Dawn B.
Supnet, Javern M.
Tumampos, Ma. Margarita P.
BSN IV-1 Batch 2015/ Group 1

Submitted to:

Level IV Clinical Instructor

MARCH, 2015

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 ACKNOWLEDGMENT

It is a pleasure to convey the group’s deepest gratitude to the following people in our

humble acknowledgment.

We would like to thank our clinical instructor Mrs. Ederlyn Papa-Destura for giving us

supervision, guidance, and support during our exposure in the hospital. We deeply appreciate

your effort in helping us in every activity we have conducted during the working phase of our

duty until the end.

In addition we extend our deepest gratitude to General Emilio Aguinaldo Memorial

Hospital OB Ward for allowing us to practice our Intensive nursing practicum course.

We also thank the Chief Nurses, Assistant Chief Nurses, Nurse Supervisors, Staff Nurses

and Personnel for guiding us and helping us all throughout our stay. We appreciate the time and

assistance you gave us throughout our exposure in the hospital.

We especially thank Dean Lenila A. De Vera, RN, MPH, MAN, the Dean of the College

of Nursing, for teaching us the principles and theories of Nursing Leadership and Management.

This served as our foundation in executing our Intensive Nursing Practicum in the hospital

setting.

We would never forget the big help of our Almighty God, who provided the group with

determination and strength during the exposure at the hospital. He miraculously made everything

possible by giving us knowledge, abilities, and resources we needed. He helped us in many ways

and we undoubtedly appreciate it and we give Him all our praises.

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 TABLE OF CONTENTS

PAGE

Cover Page 1

Acknowledgment 2

I. INTRODUCTION OF THE COURSE 4

II. PRESENTATION OF THE HOSPITAL

5
A. HISTORICAL BACKGROUND
B. MISSION, VISION, CORE VALUES, GOAL, QUALITY POLICY 7
C. FLOOR PLAN 9
D. ORGANIZATIONAL CHART 11
E. HOSPITAL LEADERSHIP AND PERSONNEL 12
F. HOSPITAL MANAGEMENT 30

F1. HENRI FAYOL’S 14 PRINCIPLES OF MANAGEMENT 30

F.2 MANAGEMENT PLANNING 36

F.3 NURSING SERVICE MANAGEMENT PLANNING 36
F.4 PERFORMANCE EVALUATION 37
F.5 EFFICIENCY OF EQUIPMENT, BUDGETS, PLANS, 37
SUPPLIES AND MATERIALS
F.6 DISCIPLINARY ACTIONS 37
F.7 QUALITY ASSURANCE AND CONTROL 38
III. ANALYSIS AND INTERPRETATION OF FINDINGS
38
A. SWOT ANALYSIS 38
B. PROBLEMS IDENTIFIED 41
IV. NURSING CARE PROCESS
42
V. RESULTS 46
VI. APPENDICES 48

I. INTRODUCTION OF THE COURSE

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Intensive Nursing Practicum/ Nursing Leadership and Management

As part of the Commission on Higher Education Memorandum No. 14 for the degree

Bachelor of Science in Nursing is the course Intensive Nursing Practicum – Nursing Leadership

and Management. This course is about the actual application of the theories, principles, and

concepts of clinical nursing practice to groups of clients in various settings to refine nursing

skills in the different basic nursing services including community, industrial, school, and

hospital.

General Emilio Aguinaldo Memorial Hospital, as one of the hospital affiliates of Cavite

State University, was assigned to our group as the clinical area to practice the intensive nursing

practicum in leadership and management course. It was a two-week exposure at the hospital

wherein the student nurses reported for eight hours a day.

During the first week of exposure, we assessed the hospital- OB Ward and gathered data

about the hospital through the hospital’s manual of operations and interviews with the staffs of

the hospital. On the final week, our group presented the SWOT (Strengths, Weaknesses,

Opportunities, and Threats) Analysis. Based on the weaknesses cited on the analysis, the group

formulated plans regarding the problems of the hospital and implemented the programs the

following day. On the same week of duties, the student nurses evaluated the effectiveness and

efficiency of the programs implemented.

Nursing Leadership and Management was utilized in this exposure as we created the

staffing wherein each member of the group was given a chance to become the head nurse of the

day in the ward. The student head nurse was responsible for assigning the rest of the group

member as researcher and staff nurses incorporating the theoretical knowledge in leadership and

management.

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II. PRESENTATION OF THE HOSPITAL

General Emilio Aguinaldo Memorial Hospital OB Ward

A. HISTORICAL BACKGROUND

Andres Bonifacio Memorial Hospital (ABH) started its operation on May 19, 1956 with a

bed capacity of 25 beds, with 1 resident physician, 3 nurses, 1 dietician, 3 nursing attendant,

property officer – cashier, 3 utility workers, at the start it has only one wing. We had the OPD

wards, OR and office. This hospital was realized by the combined effort of Congressman

Justiniano Montano and Governor Delfin Montano with the aid extended by Ramon Magsaysay

on that time.

To maintain hospital operation, Governor Montano solicited the help of civic

organization and philanthropic individual and to mention some PCSO and Sangley Point US

Naval Station were the one who gave periodic contribution for the maintenance of the hospital.

With the increasing number of patients coming from the different municipalities and cities, bed

capacity was expanded into 100 beds in 1960 and divided it to four clinical areas; Medical, OB –

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Gyne, Pedia, Surgery. Likewise, number of staff and personnel was increase to cope with the

expanded and extended services. In 1972, the institution was designated training and teaching

hospital herein we started conducting medical interns. Bed capacity was increase into 150 beds

and consequently the implementation of the Medicare System.

In November 1976, Saint Joseph College Institute of Nursing started their affiliation

followed by De La Salle University in January 1978 and in 1979 De La Salle University School

of Midwifery also utilized the hospital for their clinical service practice, in 198 De La Salle

University College of Medicine started their affiliation. Because of the integration of the health

services in 1984 it became the Provincial Health Office and have its catchments areas of the filed

health unit of the following municipalities: Tanza, Naic, Maragondon, Ternate, Indang, Mendez,

Amadeo, Alfonso, GMA, Carmona, Gen Aguinado, Magallanes, Dasma Proper, Dasma Bagong

Bayan, Tagaytay City and Trece Martires City.

In this year also the former region IV Mental Hospital has been absorbed and became as

one of the department of the Provincial Hospital. The Philippine Union College now Adventist

University of the Philippines, started their affiliation in 1987. In January 1988 reorganization of

the PO started including of the two districts Medicare and Municipal Hospital and on April 1,

2000 the psychiatric department was function separately as an independent institution, in

preparation of the proposal. CCMH but still under the direct supervision of the PHO.

On March 2, 2002, ABMH was renamed General Emilio Aguinaldo Memorial Hospital in

honor of the late General Emilio Aguinaldo. The Korean Government grant a special project thru

the Philippine Government in the year 2000 now the Annex Building, Korea – Philippine

Friendship Project started its operation July 2002, likewise ER department of General Emilio

Aguinaldo Memorial Hospital was established and become functional with the same date.

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 B. MISSION, VISION AND OBJECTIVES

MISSION

 To offer dependable quality and safe OB GYNE services

 To provide excellent and comprehensive OB GYNE training of health care providers

 To conduct relevant research that will provide quality OB GYNE health care

VISION

We envision the GEAMH Department of OB GYNE to be at par with the best tertiary hospital in

the Philippines offering quality and dependable services and to be a center from training and research

responsive to the reproductive health care needs of the women in Cavite in the next ten years.

We commit to:

1. Provide quality, safe, affordable and comprehensive health care services to the residents of Cavite

2. Be a center of excellence in training, education and research in health care

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C. FLOOR PLAN

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 D. ORGANIZATIONAL CHART

E. HOSPITAL LEADERSHIP AND PERSONNEL

The OB-Gyne ward consists of the following:

A. OB unit where expectant mothers are admitted.

1. Caesarian Section
2. Normal Delivery
3. Eclamptic / Pre-eclamptic Cases
4. Cases of abortion
B. GYNE ward unit where female patients with cases of PID, Sepsis and patients who will

undergo BTI, Hysterectomy are confines

GENERAL OBJECTIVE

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 The purpose of the Nursing Services is to provide quality patient care to OB Gyne

Department and provide comprehensive nursing care to patients through surgical and

obstetrical basis.

ORGANIZATION

The OB Gyne Ward Nursing Unit is composed of One Senior Nurse, Ten Staff and 5 Well

Baby Nurse.

CONTROL AUTHORITIES

The unit is under the supervision or the direction of a SENIOR NURSE to whom is

delegated the responsibilities of its administration and the supervision of the activities of the

nursing personnel. The Senior Nurse is directly responsible to the senior nurse.

While this direct line of authority should not be crossed under casual condition any

member of the nursing personnel may confer with the chief nurse or assistant chief nurse on

personal or professional matter.

STANDARD OPERATIVE PROCEDURES OF OBSTETRIC GYNECOLOGY WARD

1. Admitting patients
a. Direct to the ward
1. Patients data collection (Data should be made accessible)
a. Personal profile
- Name
- Age
- Sex
- Religion
- Citizenship
- Birthday
- Birthplace
b. Health profile
1. Physiological appraisal system
Vital signs such as:
- Temperature
- Pulse

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 - Respiration
- Cardiac rate
- Fatal heart tone
- Blood pressure
c. Past and present history including allergy and family history of present illness

(Diabetes and mental disturbances)

2. Psychological profile / Educational attainment/ work experience
3. Occupational status of the patient

b. Consent
- Consent for admission
- Consent for any surgical intervention
- Consent for breastfeeding
- Consent for blood transfusion
- Consent for D & C
c. Place patient in bed
- Make patient comfortable
d. Implementation of delegated functions
- Established priorities (carry out stat orders)

MGA ALITUNTUNIN SA OB GYNE WARD

1. Oras ng dalaw ng Doktor

7:00 ng umaga – 9:00 ng umaga
2. Oras ng pagpapauwi (Clearance)
1:00 ng hapon – 5:00 ng hapon
3. Oras ng pagpasok ng bantay
6:00 ng umaga – 7:00 ng umaga
11:00 ng uamaga – 1:00 ng hapon
6:00 ng gabi – 8:00 ng gabi
a) Bawal ang bata 13 pababa
b) 2-3 dalaw lang po ang pinahihintulutan sa oras ng dalaw
4. Wala pong batay na pinahihitulutan sa loob ng ward maliban sa mga pasyente na

kailangang may bantay.

5. Mga bawal dalahin sa loob ng ward
- Bote at milk formula, pacifier, at teethers
- Lahat ng bagay na ginagamitan ng kuryente tulad ng electricfan
- Malalaking bag
6. Lahat ng pasyente na maaadmit ay kailangan nakasuot hospital gown.

The different room as follows:

ROOMS PURPOSE & CASES EQUIPMENT/ ARTICLES

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1. Gyne room / Septic room All gyne cases are confirmed 3 beds, 3 mattresses, & 3
in this room bedside tables

All infected OB cases & all 4 beds & mattresses

patients with cases of
abortion.
2. NSD room
For Normal Deliveries 11 beds, 11 mattresses & 11
bedside tables

3. Pre-eclamptic/ High risk All eclamptic & pre-eclamptic 11 beds, 11 mattresses & 11
room cases are found bedside tables

4. Medicare room/ Philhealth All OB patient with medicare 3 beds, 3 mattresses, & 3
are confined in this room bedside tables

5. CS room For all ceasarian section 10 beds, 10 mattresses & 10

patients bedside tables

HOUSEKEEPING DUTIES

1. Cleans patient’s unit upon discharge.

2. Keeps patient’s room tidy.
3. Cleans and sterilizes syringes, needles, instruments and equipment.
4. Keeps bedpans and urinals clean and keeps them in proper places.
5. Washes glasses, spoon and forks, plates of helpless patients.
6. Saves water from the night shift.

RECORDS AND REPORTS

1. Chart TPR, urine and stool.

2. Records intake and output.
3. Reports to the nurse highly febrile patients and with unusual findings.
4. Sees to it that there are available sets of form for the next shift.

OTHER DUTIES

1. Does messengerial services to the other area of the hospital if told to do so.
2. Sees to it that there are no visitors after visiting hours.
3. Assists in orienting new patients on hospital rules and regulations.

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 4. Gives health teaching about personal hygiene.

WEEKLY DUTIES

1. Genera cleaning of bedpans, urinals, speculum, cups and basins.

2. Inventory of linens and articles.
3. Checks respective room assignments.
4. Disinfects and scrubs all beds and bedside tables as necessary.

NURSING AIDE 12-8 SHIFT

A. ENDORSEMENT
1. Receives endorsement from the outgoing shift as to:
a. Census
b. Condition of the patient
c. Articles and equipment
d. Procedures done and to be done\

B. PATIENT CARE
1. Takes vital signs of awake patients, refer to nurse to nurse on duty for any hormonal

findings.
2. Perform some minor nursing procedure and treatment like hot sitz bath, perineal care and

heating and steam inhalation.

3. Instructs or encourages ambulatory patients to do self morning care.
4. Assists in the preparation of patients for operation like bathing, enemas and taking vital

signs.
5. Assists in feeding helpless patients.
6. Weigh patients with orders so delegated.
7. Provides hot water for the thermos and bottles.
8. Sponge febrile patients and mildly ill patients.
9. Measures intake and output.
10. Collects all specimens and bring them to the laboratory at 7:00 AM.

JOB DESCRIPTION

POSITION TITLE: CHIEF NURSE I – II – III – IV

A. Definition: Chief Nurse is the executive head of the Nursing Service

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B. Job Summary: Under Direction

Carries full administrative responsibility and authority for the entire nursing

service of the hospital. Participate in formulating hospital policies, in developing and

evaluating program and services; Assumes full authority and responsibility for

development of nursing service policies; Organizes, directs, coordinates, evaluates

activities of the Nursing Service Staff which allow for satisfaction and professional

growth. Provides means and methods by which nursing personnel can interpret the goals

and policies of hospital and nursing service to the patient and to the public; Initiates and

direct studies, evaluates procedures for the improvement of nursing in relation to the total

care of patients; Directs planning and implementation of staff development programs for

different categories of nursing personnel; Directs nursing personnel in function related to

the clinical training program of nursing students and other affiliates; Prepares with her

supervisory staff budget proposal for the nursing personnel; Defines job description for

each category of nursing personnel; Recruits and recommends personnel for appointment,

promotion or dismissal defending on staffing needs of the services.

C. Qualification Requirements
1. Education: Master Degree in Nursing
2. Training and Experience:
1.1 Chief Nurse I – II: A minimum of three (3) years of nursing experience, one

(1) year of which has been spent in a supervisory position, as a Senior Nurse,

Supervisor, and/or Assistant Chief Nurse. Demonstrated professional

competence in clinical practice and administration. Completed Chief Nurse

Training Course or its equivalent at least fifteen (15) units in public

administration or course in nursing administration andsupercision of atleast

fifteen (15) units leading to Maser’s Degree in Nursing.

1.2 Chief Nurse III – IV: A minimum of five (5) years of nursing experience,

three (3) years of which have been in a supervisory and/ or Assistant Chief

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 Nurse. Demonstrated professional competence in clinical practice and

administration. Completed Chief Nurse Training Course Master’s Degree in

Nursing required.
D. Job Knowledge
 Broad knowledge and understanding of principles of nursing practice

based on physical, biological and social sciences and their application to

nursing care for the solution of nursing problem.

 Adequate knowledge and understanding of the principles of supervision,

administration and research. Through knowledge of the organizational

structure of nursing service, as well as organization, function, policies,

regulations and procedure of hospitals. Knowledge and experience in

reconciling needs and goals of nursing practitioners with the objective of

raising service and hospitals as whole.

E. Job Relationships
1. Source of workers – Professional Nurses
F. Specific and Actual Functions and Activities
1. Plans, organizes, and supervises the nursing service in order to provide adequate

nursing care to patients;

2. Coordinates all activities of the nursing service department with other services;
3. Prepares nursing service budget to provide adequate personnel, equipment and

physical facilities needed and submits to Administration Office;

4. Interviews and screens all applicants for the nursing service and evaluates their

qualifications and experiences;

5. Observes and evaluate the performance of the personnel, as well as analyzes and

evaluates the nursing activities to determine whether they are meeting desired

standards;
6. Formulates and recommends policies for improvement of patient care, participate

in planning of personnel policies and interprets to the Chief of Hospital the needs

and interest of the nursing personnel;

7. Promotes individual growth and development by maintaining a program of staff

education, conducts monthly meeting of nurses and nursing aides;

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 8. Promotes and maintains cordial relationship with patients, their families and the

community and provide opportunities for nursing staff to work with other groups

so that the aims of the hospital can be interpreted to mean good interpersonal and

interdepartmental relationships;
9. Participates in the hospital outreach program;
10. Participates in professional meetings as the representation of the nursing service

personnel and provides for healthful living condition of nursing personnel;

11. Subject “to call” as the need arises;
12. Daily ward rounds. To gain an insight to the problems and needs as presented by

the patient and the family, the nurses and the other health disciplines;
13. Approves Schedule of Duties and Off duties prepared by the Assistant Chief

Nurse;
14. Signs Daily Time Records;
15. Performs other duties as required by the Chief of Hospital;
16. Attends seminars, workshops locally and nationally as the need arises

POSITION TITLE: SUPERVISING NURSE

Under supervision, assumes responsibility in the nursing care and services in OR wards, or

1. Supervision of Patient Care

1.1 Checks the Senior Nurse’s plans for patient care and sees to it that they are properly

executed.
1.1.1 Keeps herself informed of patient’s needs and problems.
1.1.2 Reinforces health instructions given to patients and their families as the need

arises.
1.1.3 Verifies implementation of requests of referrals to evaluate continuity of care.
1.1.4 Serves as consultant and adviser to the Senior Nurse in developing, devising,

and adopting work techniques and methods for the solution of problems

related to patient care.

2. Personnel Management
2.1 Interprets operating and new procedures and policies, reviews work performances of

personnel to determine if it conforms to recognized standards.

2.2 Plans the programs and work of all the nursing personnel of the unit.

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 2.3 Directs arrangements of schedule of work hours, off duties, vacation leaves, etc., of

all nursing personnel not assigned in the unit.

2.4 Evaluates work accomplished each nursing employee in the ward.
2.5 Prepares the plans for counseling of co – workers, this done individually especially to

personnel with problems. Example is Habitual absenteeism and alcoholism.

2.6 Renders harmonious relationships, self – discipline among nursing personnel under

her supervision.
3. Helps in providing an adequate and safe environment by guiding and helping Head Nurse

in providing and maintaining a safe, orderly, and clean environment for patient and

personnel.
4. Helps in providing adequate supply and equipment by:
4.1 Determining the needs for supplies and equipment based upon experience and future

plans for programs of patient care.

4.2 Making proper representation to the administration of the needs of the department.
4.3 Coordinating with the specialty department (maintenance and property) to meet the

needs for supplies and equipment for the department.

Education/ Training/ Experience Requirements

BSN with fifteen (15) masteral units in Nursing at least two (2)years’ experience

in supervision

POSITION TITLE: SENIOR NURSE

Under direction, responsible for the administration and supervision of a particular nursing

unit, or:

1. Makes patient rounds and sees to it that all patients in her ward get the necessary care;
2. Sees to it that all equipment are in order and properly kept and supplies are available;
3. Makes weekly schedules and daily assignment of her staff;
4. Checks and countersigns recording done by the staff nurse;
5. Assist the Clinical Instructor, prepares the student’s assignments for their clinical

experiences and assists in the evaluation of their performance.

6. Sees to it that doctor’s order are carried out properly and intelligently by the staff;

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 7. Plans and supervises all nursing activities in her ward;
8. Evaluates performance of her staff every six (6) months;
9. Coordinates ward activities in the administration of nursing service with all other hospital

services;
10. Directs and supervises activities of nonprofessional workers in the ward;
11. Participates in the orientation of new staff and nursing students;
12. Interprets hospital philosophy, objectives and policies to staff, patients, and their families

and students;
13. Represents her ward in the nursing service and other hospital meeting when necessary;
14. Act as supervising nurse when so delegated;
15. Renders direct nursing care if the unit is understaffed;
16. Supervises cleanliness and orderliness of the ward;
17. Provides/ maintain adequate facilities, equipment, and supplies necessary for good patient

care for her unit.

18. Provides an environment that is conducive to the physical spiritual, and emotional well

– being of patients and personnel;

19. Participates and formulating/ interpreting/ implementing philosophy, objectives and

policies of the nursing services;

20. Establishes, promotes, and maintain good interpersonal relationship;
21. Evaluates nursing staff in her unit, and gives them assignment according to their capacity;
22. Identifies nursing problem in the ward;
23. Acts as liason between patient and members of the health team.

Education/ Training/ Experience Requirements:

B.S.N. with training in supervision and with at least one (1) year experience in Staff Nurse

Position.

POSITION TITLE: STAFF NURSE

Under supervision, responsible for delivering nursing care to patient within an assigned area as:

1. Gives direct nursing care;

2. Identifies nursing needs of the patient;
3. Plans, give, and evaluates nursing care;
4. Admits patients;
5. Performs such nursing activities such as bathing and oral hygiene;
6. Assists patients in moving, maintaining proper alignment of patients body and utilizing

good body mechanics;

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 7. Takes and records vital signs;
8. Observes medical sepsis;
9. Observes signs and symptoms, institutes remedial actions when appropriate and records

these in her chart;

10. Reports observations to the physician;
11. Observes and responds to patient’ emotional spiritual needs;
12. Acts as a liason between patients and hospital personnel;
13. Interprets to the patient and his family their roles in promoting successful therapy and

rehabilitation;
14. Prepares patients for, and assists physicians with diagnostic and therapeutic procedures;
15. Carries out doctor’s legal orders;
16. Assists physicians when examining patients;
17. Performs irrigation, catheterization, and give enemas
18. Administers and charts medications and patients’ reactions to medications;
19. Instructs patients and families;
20. Sees to it that equipment receive proper care and maintenance;
21. Discharge patients;
22. Performs post – mortem care;
23. Teaches and directs nonprofessional nursing personnel;
24. Acts as senior nurse when so delegated;
25. Receives and endorses ward equipment and supplies;
26. Interprets hospital policies and procedures;
27. Gives health teachings;
28. Maintains good relationships with other hospital personnel;
29. Charts accurately medications and treatments given, and
30. Attends meetings and conferences.

Education/ Training/ Experience Requirements:

B.S.N. graduate from a recognized school/ college

POSITION TITLE: NURSING ATTENDANT

Under supervision, performs the following:

1. Checks and receives articles from outgoing aide;

2. Accounts for all linens during her shift and endorses them to the nursing aide of the next

shift;
3. Attend morning rounds with ward nurse;
4. Assists in giving baths to ambulatory patients;
5. Serves drinking water and nourishment;
6. Feeds patients who cannot eat by themselves;

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 7. Give/ performs simple treatments like perineal care, SS enema, refilling of hot water bags

and ice caps;

8. Measures fluid intake and output;
9. Takes and chart vital signs when delegated;
10. Provides specimen vials, collect urine and stool specimen and send them to the

laboratory;
11. Answer patients call and delivers messages;
12. Provides clean linen and makes bed; serve empty bedpans;
13. Scrub bedpans and urinals;
14. Shaves patients for surgery;
15. Maintain cleanliness and orderliness of the patients unit at all times;
16. Sees to it that all beds are complete with linen and pillows
17. Tidy beds and bedside tables, counters, cabinets and bedside chairs;
18. Fills drinking bottles the bedside tables;
19. Washes glasses and spoon of bed patients;
20. Removes all used or discontinue equipment from patient areas and clean and returns them

fully to the utility.

POSITION TITLE: UTILITY WORKER

1. Received endorsed linen, oxygen equipment to the next shift;

2. Transport patients to different wards morgues;
3. Assist for x-rays, ECG and ultrasound
4. Prepares and administer oxygen inhalation to different wards
5. Run errands to nurses and doctors
6. Assist patient when discharged
7. Report to the senior nurse on loses and breakage
8. Lifts, carries or wheel patients
9. Distributes clean clothes and linen and collect soiled one
10. Prepares bed and sterilize instruments

AFFILIATION POLICY

OBJECTIVE: Establish a smooth working partnership with the affiliating schools in providing

related learning experiences to student nurses and midwives.

1. All contracts of affiliation shall be reviewed by the concern training departments.

2. All contracts of affiliation shall be duly accomplished and signed by both parties (the

Chief of Hospital / Provincial Health Office, and the Dean/ President of the Affiliating

College/ University).

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3. A letter of application regarding the college’s/ university’s intent to affiliate shall be filed

six (6) months before the start of actual affiliation.

4. A letter of intent to review the affiliation contract shall likewise be filed six (6) months

before the commencement of re – affiliation.

5. An approved MOA between the school and hospital is a requirement before the actual

affiliation.
6. It’s a must that all Clinical Instructors (C.I.) and student to undergo orientation before the

affiliation.
a. Must be done before the start of the semester, first week of June and October.
b. Must be properly coordinated and scheduled.
7. Students and Clinical Instructors (C.I.) are required to to be always on proper decorum

during the tour of duty.

8. Student must provide the hospital a log book for students and Clinical Instructors (C.I.)
9. All preceptors must at least have masteral units.
10. All preceptors must submit a copy of the resume.
11. No students will be allowed to go on duty without their Clinical Instructor (C.I.)
a. Maximum of twelve (12) students to one (1) Clinical Instructor (C.I.)
b. Two (2) groups of students in the ward is allowed but not in special areas like in OP

Complex.
12. Each student must have a log book for their cases for their PRC requirements properly

countersigned by GEAMH nursing personnel on duty that will coincide with the hospital

logbook as per plotted schedule and list of students.

13. Plotting of schedule is done a month before the end of the semester through a consensus

meeting with all of the affiliating schools on a Friday at 9:00 a.m.

14. Communication and coordination should be properly documented.
a. Schedule/ List of students
b. Schedule of orientation
c. Charges, adjustment of schedules
d. Affiliation fees statement
e. Conflict problems/ issues and concerns
15. Any changes and adjustment of schedule must only coordinated with Assistant Chief

Nurse for Training and the Chief Nurse.

16. Copy of plotting of schedule is provided to all affiliating schools and clinical areas of

concern for proper reference.

17. As per CHED Memo No. 30 series of 2001, Article VII Section 3a. The minimum

capacity of 100 beds and the minimum bed occupancy of eighty percent (80%) are

required of every base hospital.

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 18. Payment of fees should be settled at the end of the semester.
19. Courtesy and professional ethics should be observed at all times.
20. The hospital will not be held responsible for any losses, so therefore, valuables of

affiliates and Clinical Instructor (C.I.) should be personally taken cared of.

F. HOSPITAL MANAGEMENT

F1. HENRI FAYOL’S 14 PRINCIPLES OF MANAGEMENT

The Principles of Management by Henri Fayol rendered a significant influence on

modern management theory. His practical list of principles helped early 20 th century managers

learn how to organized and interact with their employees in a productive way. All managers,

regardless of the type of organization or their level in the organization essentially have the

following tasks; planning, organizing, directing, and controlling. The manager is a firm believer

who advocates “a place for everything and everything in its place.”

The essence of this theory of management among student nurses for intensive nursing

practicum in hospital nursing is to apply our own strategies of being a leader and how we could

manage one organization using our skills and knowledge on how to handle a group of people in

one organization. Fayol’s concept of management provides assistance on how to enhance the

capability of one potential leader to grow and to build a strong organization where they are

involved.

1.) Division of Work

According to Fayol, work should be divided among individuals and groups to ensure that

effort and attention are focused on special portions of the task. Fayol presented work

specialization as the best way to use the human resources of the organization.

Every staff in OB Ward of General Emilio Aguinaldo Memorial Hospital has their own

roles and responsibilities specific to their job description. The head nurse, Mrs. Pamfila A. Fijer,

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makes sure that work is equally distributed to every personnel in the OB Ward - particularly

pertaining to their fields. In turn, the Head Nurse assures that their staff are skilled, proficient,

and competent in every case they handle.

2.) Authority
Authority was defined by Fayol as the right to give orders and the power to exact

obedience. Whoever assumes authority also assumes responsibility.

In connection to the department, the one who has great authority as well as responsibility

is the Head Nurse, Mrs. Pamfila A. Fijer. As we have observed, she exhibits both democratic and

authoritative type of management.

3.) Discipline
According to Fayol, discipline means sincerity, obedience, respect of authority and

observance of rules and regulations of the enterprise. In GEAMH-OB Ward they have a guiding

manual of operation in implementing rules and regulations as well as sanctions and warnings of

the violators.

According to the Nurse Supervisor, their staff nurses and other employees have good

morals and right conduct, since it is the secret to having a good foundation in an organization.

There are moments when discipline is executed when one of the staffs commit a misdemeanor or

misunderstanding between other staffs. In any case, the Head Nurse talks to them first and finds

solutions to address the problem. The Human Resources as well as the Quality Control

Department take part with the disciplinary actions and counseling for staff for any transgressions.

4.) Unity of Command

According to Fayol, every employee should receive orders from only one superior.

Workers should receive orders from only one manager.

In General Emilio Aguinaldo Memorial Hospital, Dr. George R. Repique Jr. directs orders

to his subordinates. The next person to receive the directive for the nurse is the Chief Nurse. The

Chief Nurse then passes the directive to the Nurse Supervisor. He/she will distribute the

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directive to the different staff of all the hospital’s departments. After which, the head nurses

disseminate the information to his/her subordinates. This leads to a more organized and clear

structure of chain of command within the hospital’s organization.

5.) Unity of Direction.

Fayol describes this principle where the entire organization moves towards a common

objective in a common direction. Simply put, it is where people are within the same group,

engaged in the same kind of activities that are bounded by the same set of objectives.

The hospital has vision, mission, set of goals and objectives, and policies directed

towards excellent client service as well as professional and personal growth for their employees.

These are still on the progress of being attained by the members of the organization through

different activities such as programs and team-building activities.

6.) Subordination of Individual Interests to the General Interest

The interests of one person should not take priority over the interests of the organization

as a whole. One of Fayol’s lines was that, “one employee’s interests or those of one group should

not prevail over the organization as a whole.” Every member would have an understanding that

their individual desires sometimes must be set aside for a general interest that will benefit

everyone.

The hospital staff set aside their personal intents during work for them to serve their

patients well. The staffs are capable of making plans about their decision; they also have the right

to share their ideas, comments, and suggestions within the administration staff and the heads.

Every staff has the right to verbalize their own opinion about such matters and the head nurse

will think if their suggestions are appropriate or can help. But the most important thing is that

everyone in the area agrees to the most applicable and best decision among the varieties of ideas

proposed within the group.

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 7.) Remuneration

According to Henri Fayol, remuneration means compensation for work done should be

fair to both employees and employers.

The General Emilio Aguinaldo Memorial Hospital is a public hospital so the source of

salaries of the employees comes from the budget allotted by the Government. Salary is based on

the regulation of the hospital, every staff in the hospital given the salary per time with

appropriate unit in every hour they work. According to the head nurse, regularity of the

employees in their units depends upon the length of service and level of performance. For

instance, an employee has just started working having only minimum requirement; the salary of

the certain employee will fall on the minimum salary level because it was the level of salary that

is fair to the employee. Despite of the minimum level of salary, the employees on the hospitals

enjoy benefits such as SSS, and PhilHealth.

8.) Centralization

Fayol differentiated centralization from decentralization by giving it two different

meanings. Centralization is the act of lowering the importance of the subordinate’s role while

decentralization is vice versa.

As observed, centralization is used within the organization. Although they value their

subordinates, they cannot just do something without any supervision from the Chief of Hospital

or at least the chief nurse that holds the entire nursing service. In here, there is quite longer time

for the decision making since it will come from the top of the organization.

Certain procedures given by the top hierarchy are followed by the subordinates. In turn,

the subordinates execute these policies to give a unified and better service to their patients.

9.) Scalar Chain.

The existence of a scalar chain and adherence to it are necessary if the organization is to

be successful. Scalar chain is a way of distributing information from the highest authority to its

staffs and members.

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 The chief nurse disseminates the information to their respective head nurses and then the

head nurses of each department are the one responsible disseminating announcements and

information to their subordinates as is well observed in the organization. This enables the

organization to have a specific flow of direction therefore goals are reached.

10.) Order

According to Henri Fayol, materials and people should be in the right place at the right

time. Order is a vital principle of management. It signifies proper arrangement of things,

distribution of people, organized papers, and the likes.

For the sake of efficiency and coordination, order is being made by the superior for the

sake of effectiveness and organization of the hospital. That is why there are head nurses for each

of the departments to have a clear order of the people and their specified work.

11.) Equity

All employees should be treated as equally as possible. Equity means combination of

fairness, kindness, and justice. This is applicable to all the employees of the whole organization.

It is fair and right to treat each individual equally from maintenance to health care professionals

to build a harmonious relationship at work.

As we observed, the head nurse is very approachable. Although there are limits on how

her subordinates treat her, closeness and respect between the head nurse and staff nurse were

seen. The Head nurse showed fairness upon dealing with her staff. The head nurse treats her

staffs accordingly and as equals, showing no favoritism.

12.) Stability of Tenure of Personnel.

Fayol emphasized that employees should not be moved frequently from one job position

to another before the period of service in a job should be fixed. Therefore employees should be

appointed after keeping in view principles of recruitment and selection but once they are

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appointed their services should be served. Stability of job creates team spirit and a sense of

belongingness among workers which ultimately increase the quality as well as quantity of work.
A sense of belongingness and tenure is observed among staffs for a lot of them have

already been working at General Emilio Aguinaldo Hospital, however, there is a presence of

turnover in the hospital setting every 6 months.

13.) Initiative

According to Fayol, subordinates should be given the freedom to conceive and carry out

their plans, even though some mistakes may result.

According to the Head nurse their staffs are all hard-working. They carry out doctor’s orders as

well as help each other. Although they receive certain instructions, they remain autonomous in

performing independent nursing interventions for the care of their patients.

14.) Esprit de Corps

Management should encourage harmony and general good feelings among employees. In

order to achieve the best possible results, individual and group efforts are to be effectively

integrated and coordinated.

There is good rapport in the area among employees upon observation. According to the

head nurse, they occasionally go out for lunch together with their staffs. And sometimes engage

in leisure activities when they have day offs. There are also exercises and other team-building

activities once in a while to establish good teamwork and camaraderie among everyone. The

head nurse said that such bonding is essential so that every staff could enjoy and enhance their

relationship among each others.

F.2 MANAGEMENT PLANNING

The hospital has their plans to improve their management. They set their objectives, goals,

and project proposals for every activity that they plan for improvement of their management.

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They have ongoing projects and different programs for the consumers as well as for the staffs

such as wellness program and team building activities. This is to promote good physical health

and pleasant working environment.

F.3 NURSING SERVICE MANAGEMENT PLANNING

The nursing service management gives quality care to their patients. They have

evaluation tools in monitoring the service and care rendered by the nurses care of the Quality

Assurance department. There are also in-house seminars to promote personal and professional

growth of staffs and personnel. Proper attitude within the workplace as well as good decorum

shown to clients are instilled in the minds and hearts of the staffs in order to provide quality

service to the clients.

F.4 PERFORMANCE EVALUATION

The performance of each staff is being evaluated by the chief nurse of the hospital. The

performance evaluation is unannounced to staffs and sometimes and it is done randomly.

F.5 EFFICIENCY OF EQUIPMENT, BUDGETS, PLANS, SUPPLIES AND MATERIALS

Central unit supplies is the one responsible for checking the number of instruments, the

functions and maintenance of the equipment, the budgetary plan and other materials needed by

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the hospital. Preventive maintenance system is quarterly done in collaboration of central supply

office and quality.

While the quality assurance officer of the hospital are the one who is for the overall

assessment of the actual operations done by the staff in the hospital. An evaluation tool is being

used and utilize in conducting monthly evaluation.

F.6 DISCIPLINARY ACTIONS

The hospital has rules, regulations and policies which, must be followed.

Disciplinary action is given to personnel who violated certain rules, regulations and

policies. The Supervisors and Management staff, assisted by the Human Resource and the

Chief Nurse are responsible for maintaining good behaviour and for implementing

appropriate disciplinary action to different staffs in the hospital. The process of giving

sanctions includes: Written warning, Final written writing, Warning suspension and even

termination depending on the degree of actions of the employees and nature of offense.

F.7 QUALITY ASSURANCE AND CONTROL

The hospital has a quality assurance system being implemented in the hospital. The

management sent an evaluation form to the station. For the Nursing station, there is a form given

to patients who are about to be discharged. This form is their Patient’s Evaluation Form; given

prior to discharge. These forms are very important to the hospital because it is the way to know

the status of the hospital’s nursing care through patient’s response. The form being answered by

the patient are then sent to the nursing station and collected by the managements.

Quality assurance and control is important in the nursing service for it helps identify the

quality and satisfaction of patients regarding nursing care rendered. This helps make sure that the

quality of nursing care and service was not compromised despite the attempt to meet

expectations.

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III. ANALYSIS AND INTERPRETATION OF FINDINGS

C. SWOT ANALYSIS

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 STAFF/NURSE

 Nurses are licensed and well-trained.

 Nurses are very accommodating to the patients/
relatives, and students.
 The Nurse updates their knowledge through
attending different seminars
 Tangible teamwork and efficient staff.
 With sufficient knowledge on management of
resources and environment.
 Ability to provide safe and quality nursing care.
 The Nurses are well-groomed.
 With sufficient knowledge on OB-Gyne related
drugs.
 Practices legal responsibility.
 Knowledgeable and skilled in managements of
record.
 Ability to relay information to colleagues efficiently.
 The well baby nurse provides health teaching upon
admission.

MANAGEMENT

 Certified by the ISO 9001:2008

 Accredited by PhilHealth
 The Administrative Personnel and the Staff were
knowledgeable, skilled, equipped, and
accommodating
 The guard provides the patient’s relative with
customized stamp during visitation time
Strength  Availability of cervical cancer prevention unit.
 Availability of breastfeeding and well-baby unit.
 Availability of women & children unit/post abortion
unit.
 Availability of Resident OB-doctors.
 With strict compliance for the visiting hours.
 Has sufficient ability in effective delegation of work.
 Foster espirit de corps on their employees as
evidenced by maintenance of harmonious
relationship among staff and management.
 Health care benefits for No Balance Billing (NBB)
patients

HOSPITAL/ENVIRONMENT

 The hospital has large working area.

 Presence of fire extinguishers and emergency light
around the working area.
 Presence of fire exits is observable.
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 STAFF/NURSE

 The nurse to patient ratio is 1:30.

 Inadequate time to augment health teaching to the
patient due to insufficiency of manpower.
 The nurses’ may not be able to provide the care they
want to perform due to the fact that the nurse patient
ratio is not proportional.
 Lack of ampule file in the medication room.

MANAGEMENT

 Nurse reliever is not available.

 Evidence of deficiency of staff due to frequent
Weakness turnovers.

HOSPITAL/ENVIRONMENT

 There are not enough exhaust fan in the working area

for ventilation
 There are evident stray cats roaming around the
ward.
 The oxygen tanks are stored in inappropriate place.
 Lack of precaution signs and labels such as bed
number, ward identification, and safety reminders.
 Bed to patient ratio, 1:3.
 Some medications are not available.
 Internal structure from an area to area is confusing
 The organizational chart is not updated
 Inadequate stockroom for supplies and equipment

 School affiliated in the hospital. Training hospital for

different medical courses.
Opportunities  Collaborative management with other health care
facility.
 Within the area where business is abundant such as
restaurants, stores and other managements.

 Presence of private birthing homes and diagnostic

Threats laboratories nearby the hospital
 Poor roadway planning surrounding the facility
 Fast turnovers and job offerings with higher salary.

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D. PROBLEMS IDENTIFIED

1. Lack of Manpower
2. Salary is not within the standard rate
3. Bed ratio is not within the standard
4. Lack of precaution signs and labels such as bed number, ward identification, and safety

reminders.
5. Inadequate ventilation
6. The line of command is not strictly observed in the organizational chart.
7. There are evident stray cats roaming around the ward.

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IV. NURSING CARE PROCESS

PROBLEM NO. 1: Lack of Manpower

Cues Problems Identified Objective Implementation Evaluation

Objective: Lack of Manpower The objective of the The student nurse will:
• The nurse to student nurse is to:  Have a dialogue The student was able to
patient ratio is with the hospital have adequate time to
1:30.  Reinforce of personnel
render health teaching to
• Nurse reliever is policies within specifically the
not available. standard head nurse as the patient. As evidenced
• Evidence of  well as the chief by we had our health
deficiency of nurse.
teaching to the patient on
staff due to  Secure a
frequent proposal and March 17, 2015 at 1:00
turnovers. approval. to 2:30pm on the septic
• inadequate time  Encouraged the
and NSD room and on
to augment personnel for
health teaching provision of time March 18, 2015 at 9:30
to the patient in rendering to 11:00am on the CS
health teaching.
and High Risk room.
 Provide teaching
materials e.g
pamphlets

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PROBLEM NO. 4: Lack of Precaution Signs and Labels such as Bed number, Ward identification, and safety reminders.

Cues Problems Identified Objective Implementation Evaluation

Objective: Lack of Precaution The objective of the The student nurse will: The student was able to
• Absence of bed Signs and Labels such as student nurse is to:  Determine the provide precaution signs
numbers and Bed number, Ward precaution signs and labels such as bed
safety reminders. identification, and safety  Provide to be provided/ number, ward
reminders. precaution signs posted. identification, and safety
 Have consent to reminders. As evidenced
and labels such
the head nurse in by on March 17, 2015
as bed number,
providing/postin we’ve done posting of
ward
g of precaution the bed numbers and
identification,
signs. safety reminders on
and safety
 Provide
reminders. septic, NSD, CS and
precaution signs
High Risk room. And on
and labels such
March 18, 2015 we
as bed number,
accomplish to post ward
ward
identification and safety
identification,
reminders.
and safety
reminders.

PROBLEM NO.6: The line of command is not strictly observed in the organizational chart

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 Cues Problems Identified Objective Implementation Evaluation
Objective: The line of command is The objective of the The student nurse will: Goal Met
- The line of not strictly observed in student nurse is to:  Get the updated
command is the organizational chart lists of the staff The student was able to
confusing  Provide updated in the department provide updated
- Evident not organizational including head organizational chart of
updated chart of the nurses, staff the department. As
organizational department. nurses, midwives evidenced by on March
chart. and nursing 18, 2015 we posted a
assistant. new organizational
 Place new together with the
organizational updated list of staff of
together with the the department.
updated list of
staff of the
department.

PROBLEM NO. 7: There are evident stray cats roaming around the ward.

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 Cues Problems Identified Objective Implementation Evaluation
Objective: There are evident stray The objective of the The student nurse will: Goal Partially Met
 Presence of stray cats roaming around the student nurse is to:  Have a dialogue
cats roaming ward. with the The student was able to
around the ward  Reduce the stray personnel about provide awareness and
cats around the the problem. encouragement to the
 Provide guard and utility. As
ward.
awareness to the evidenced by on March
guard and utility 18, 2015 2 health
about the stray teaching rendered to the
cats roaming guard and utility about
around the ward the disadvantages and
risks in health of the
presence of stray cats.

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V. RESULTS

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Page | 39
VI. APPENDICES

COMMUNICATION LETTERS

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EVALUATION TOOL

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Page | 42
Post-test

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ACTIVITY PROPOSALS

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PAMPHLETS

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