Unit I: Introduction to Health Administration

Contents Unit I: Introduction to Health Administration Chapter 1: Overview of Indian Health Care System 3 Introduction 3 The Constitution of India 3 Indian Administrative System: Health Care Delivery System National, State and Local Level 4 National Level 5 Health Administration at State Level 6 State Directorate for Health 6 Administration and Organization at Regional Level 7 Administration and Organization at District Level 7 Administration and Organization at Subdivision Level 7 Administration and Organization at Block Level 7 Village Level Administration 8 District Administration Urban Areas 8 Other Agencies for Health Care 8 Planning Process: Five Year Plans 8 Chapter 2: India s Health Care Policies 16 Various Committee Reports on Health and their Impact on Nursing 16 Health Survey and Development Committee, 1943 1946 16 (Bhore Committee) Health Survey and Planning Committee, 1959 1961 17 (Mudaliar Committee) Chadha Committee Reports, 1963 18 Dr Mukherjee Committee Reports, 1965 19 Dr Mukherjee Committee Reports, 1966 19 The Recommendations Made by Mukherjiee Committee, 1966 19 Jungalwalla Committee on Integration of Health Services, 1967 20 Kartar Singh Committee on Multipurpose Workers Under Health and Family Planning 1972 20 Shrivastava Committee, a Group of Medical Education and Support Manpower, 1975 21 Rural Health Scheme, 1977 1978 21 Report of the Working Group on Health for All by 2000 22

xiv Newer Trends in Management of Nursing Services and Education Other Important Committees 22 Sokhey Committee 1947 22 Chopra Committee 1948 22 Balwant Rai Mehta Committee 1952 22 Renuka Roy Committee 1960 22 Jain Committee 1966 22 Krishnan Committee 1982 22 Dr Shanthi Lal J Mehta Committee 1983 22 H Bajaj Committee 1987 22 Report of the National Commission on Macroeconomics and Health 2005 23 Committee Constituted by Government of India with Regard to Nursing and Nursing Profession 23 Shetty Committee, 1954 23 Bajaj Committee Report, 1986 87 23 National Health Policies 25 National Population Policy 28 National Health Policy on Ayush and Plans 29 Unit II: Introduction to Nursing Service Administration Chapter 3: Nursing Administration and Management 35 Introduction to Nursing Service Administration 35 The Difference Between Management and Administration 35 Management Theories 36 Human Resource Approach to Management 37 Modern Approach to Management 38 Significance, Elements and Principles of Administration 38 Functions of Administration 39 Principles and Functions of Management 40 Chapter 4: Role of a Nurse Administrator and Manager in a Hospital 43 Introduction 43 Role of Nurse Administrator in Hospital 43 Role of Nurse Manager in Hospital Unit 45 Unit III: Functions of Administration Chapter 5: Planning 51 Concept, Definition, Principles, Goals and Objectives of Planning 51 Operational Planning 54 Strategic Planning and Proactive Planning 55 Strategic Plan and Nursing Service Administration 55 Proactive Planning 56 Organizational Planning 56 Sound Organizational Planning for Nursing Services Administration 57 Managerial Planning 57 Philosophy, Mission and Vision of Nursing Service Administration 58 Planning for Change 58 Lewin s Model of Change 58 Planning a New Venture 60

Contents xv Chapter 6: Innovations in Nursing Service Administration 64 Program Evaluation and Review Technique (Pert) 64 Critical Path Method (Cpm) 65 Gantt Chart 66 Management by Objectives (Mbo) 66 Unit IV: Organization Chapter 7: Organizational Structure 73 Concept, Definition, Principles, Goals, Objectives of Organization 73 Organizational Structure 75 Organizational Chart 75 Organizational Chart of the Nursing Service Department 76 Chapter 8: Organizational Process 78 Definition of Organizational Process 78 Formal Organization 78 Informal Organization 82 Chapter 9: Organizational Theories 85 Concept of Organizational Theories 85 Organizational Effectiveness 85 Organizational Climate 87 Organizational Culture 88 Chapter 10: Organizing Nursing Services and Patient Care 92 Patient Classification System (Pcs) 92 Methods of Patient Assignment: Advantages and Disadvantages 94 Case Method (Patient Method of Assignment) 95 Functional Method of Patient Assignment 95 Team Method of Patient Assignment 96 Modular Method of Nursing 96 Primary Nursing Method of Patient Assignment 97 Advance Methods or Alternative Methods of Patient Assignment 98 Planning and Organizing Hospital, Hospital Unit and Ancillary Services 99 Planning Intensive Critical Care Unit (Icu) in a Hospital 100 Chapter 11: Power and Politics in an Organization 104 Concept of Power 104 Politics 105 Role of Nurse Administrator to Deal with the Effects of Politics in Organization 106 Unit V: Staffing Chapter 12: Staffing and Scheduling 111 Introduction 111 Concept, Definition, Philosophy of Staffing and Scheduling 111 Staffing Norms: Staff Inspection Unit (Siu), Bajaj Committee, High Power Committee, Indian Nursing Council (Inc) 114

xvi Newer Trends in Management of Nursing Services and Education Staffing Norms by Staff Inspection Unit (Siu) 115 Staffing Norms by High Power Committee on Nursing and Nursing Profession (1987 1989) 115 Staffing Norms by Bajaj Committee, 1986 116 Estimation of Nursing Staff Requirement: Activity Analysis 116 Chapter 13: Staffing Process 120 Recruitment, Selection, Placement, Promotion 120 Recruitment 120 Sources of Recruitment 121 Recruitment from Internal Sources 121 Recruitment from External Sources 122 Factors Influencing Recruitment 122 Selection Process 123 Orientation and Placement 124 Promotion 124 Retention of Employees 124 Personnel Policies 127 Termination 128 Staff Development Program 129 Orientation Program 130 Skill Training Program 130 Continuing Education Program 132 Leadership and Management Training 133 Supervision 134 Job Description of Nursing Personnel 135 Unit VI: Directing Chapter 14: Leadership 143 Introduction 143 Concept and Definition of Leadership 143 Leadership Theories and Styles, Qualities of Leader and Assertiveness 144 Characteristics of Autocractic Leader 144 Characteristics of a Democratic Leader 144 Characteristics of Laissez-Faire Leader 145 Characteristics of Situational Leader 145 Situational Leadership Style 145 Fiedler s Leadership Contingency Theory 145 Blake Mouton Management Grid Theory 145 Path-Goal Theory 145 Supportive Leadership 145 Directive Leadership 146 Newer Approaches in Leadership Theories (Contemporary Theories) 146 Types of Leadership 146 Transactional Leadership Style 147 Transformational Leadership Style 147

Contents xvii Qualities of a Leader 147 Assertiveness 148 Creating a Motivational Climate: Motivation, Concept and Theories Motivation 149 Definitions of Motivation 149 Meaning of Motivation 149 Theories of Motivation (Content Theory and Process Theory) 149 Content Theory of Motivation 149 Process Theory of Motivation 151 Role of Nurse Administrator in Creating Motivating Climate 153 Organizational Communication Strategies 154 Enhancing Communication Skills 156 Effective Communication Skill and Role of Nursing Service Administrator 156 Chapter 15: Organizational Behavior and Human Relations 159 Group Dynamics 159 Characteristics of Groups 160 Stages of Development of Group 160 Human Relations 162 Public Relation in the Context of Nursing 163 Decision-Making 165 Delegation 167 Relationship Between Authority and Responsibility 168 Advantages and Disadvantages of Delegation 168 Conflict Management 171 Conflict Sources for Nurses 172 Role of Nurse Administrator in Conflict Management 174 Negotiation 175 Elements of Negotiation 175 Negotiating Process 176 Negotiation Techniques 176 Effective Negotiation Skills 176 Collective Bargaining 177 Characteristics of Collective Bargaining 178 Professional Associations and Unions 179 Trade Union 180 Health Care Labor Laws in India 181 Unit VII: Controlling Chapter 16: Quality Assurance 187 Introduction 187 Quality Control 187 Difference between Quality Control and Quality Assurance 188 Quality Assurance 188 Quality Audit 190 Nursing Audit 191 Quality Improvement 192

xviii Newer Trends in Management of Nursing Services and Education Quality Improvement Models 193 Future Trends in Quality Improvement in Nursing Practice 194 Chapter 17: Performance Appraisals 198 Introduction 198 Objectives 198 Performance Appraisal Tools (Methods) 200 Multiple People s Evaluation Methods 201 Importance of Mentoring and Coaching 201 Discipline 204 Disciplinary Strategies 206 Grievance Procedure 207 Unit VIII: Material Management Chapter 18: Material Management 215 Introduction 215 Concepts, Principles and Procedures of Material Management 215 Planning and Procurement Procedures 217 Inventory Control 218 Condemnation and Disposal 219 Planning Equipments and Supplies for Nursing Care: Unit and Hospital 220 Essential Equipments for a Fifty Bedded District Hospital (Who) 221 Unit IX: Financial Administration Chapter 19: Budget 227 Introduction 227 Budget: Definition, Concept, Philosophy of Budgeting 228 Types of Budgeting 229 Budget Estimate, Revised Estimate 230 Steps in Budgeting 231 Preparation of Independent Budget 231 Revised Budgets 233 Plan and Non-Plan Expenditure (India) 233 Audit 233 Terms Used in Budgeting 234 Budgeting at Various Units and Levels 237 Unit X: Legal and Ethical Issues Chapter 20: Law and Ethics 243 Legal and Ethical Issues in Nursing 243 Definition of Law and Ethics 243 Ethical Committee 244 The Code of Nursing Ethics and Professional Conduct 246 Code of Ethics for Nurses in India (as Per Indian Nursing Council) 246 Code of Professional Conduct for Nurses in India 247

Contents xix Legal System: Types of Law, Law of Tort, and Liabilities 247 Liabilities 248 Legal Issues in Nursing 248 Examples of Allegations in Lawsuits Involving Nurses 249 Legal Issues in Hospital Nursing Administration 249 Legal Issues in Educational Administration 249 Nurses Role in a Medicolegal Case 250 Legal and Ethical Issues in Nursing Practice 251 Nursing Regulatory Mechanisms Licensure, Renewal, Accreditation 251 License 253 Renewal of Licence 254 Accreditation 254 Principles of Accreditation 254 The National Assessment and Accreditation Council (Naac) India 254 National Accreditation Board for Hospitals (Nabh) 254 Patient s Rights 255 Consumer Protection Act (Cpa) 256 Hospital Infection Control 256 Standard Safety Measures 258 Standard Safety Measures in Hospital 258 Classification of Waste Category 1 259 Color Coding for Segregation of Bmw 259 Standard Precautions 259 The Role of Nurse Administrator in Facilitating Standard Safety Measures in Hospital 260 Unit XI: Nursing Informatics Chapter 21: Introduction to Nursing Informatics 267 Current Trends in Nursing Informatics 267 General Purposes of Nursing Informatics (Ni) 268 Use of Computers in Hospital and Community 268 Patient Record System 270 Medical Records 270 Nursing Records and Reports 271 Reports 273 Management Information and Evaluation System (Mies) 275 Nursing Management Information System (Nmis) 276 E-Nursing 276 Telemedicine 277 Application of Telehealth Care 278 Telenursing 279 Unit XII: Nursing Unit Management Chapter 22: Introduction to Ward Management 287 Planning Physical Facilities and Floor Space 287 Time Planning Daily/Weekly Plan 290

xx Newer Trends in Management of Nursing Services and Education Causes of Time Wasting in an Organization 291 Methods Utilized to Plan Time by the Head Nurse 291 Roles of Head Nurses in Time Planning 292 Factors Involved in Good Ward Management 293 Maintaining Therapeutic Environment 295 Role of a Head Nurse in Student Education Nursing Rounds, Nursing Care Conference 295 Unit XIII: Educational Administration Chapter 23: Applications of Principles of Administration in Nursing Education 301 Applications of Principles of Planning in Nursing School Administration 301 Applications of Principles of Organization in Nursing School Administration 303 Applications of Principles of Staffing in Nursing School Administration 303 Recruitment 304 Selection of Faculty 304 Orientation and Placement of the Faculty 305 Promotion of the Faculty 305 Retention of Faculty Member 305 Personnel Policies 305 Staff Development Program 306 Supervision 306 Developing Job Description for Nursing Faculty 306 Application of Principles of Directing in Nursing School Administration 306 Application of Principles of Controlling in Nursing School Administration 307 Application of Principles of Budget in Nursing School Administration 310 Unit XIV: Issues and Challenges Chapter 24: Issues and Challenges in Nursing Administration 317 Introduction 317 Issues and Challenges in Nursing Service Administration 318 Issues and Challenges in Educational Administration 320 Nursing Leadership in Education 322 Chapter 25: Emergencies and Disaster Management 326 Introduction 326 Reconstruction Phase (Restoration of Pre-Disaster Condition) 328 Role of Nurses in Disaster Management 328 Role of Nurse in Rehabilitation 329 Post Disaster Phase After 3 Weeks 330 Role of Nurse Administrator in Disaster Management 330 Chapter 26: Nursing Standards 333 Introduction 333 Standards: Concept and Definition 333 Importance of Standard 334 Characteristics and Sources of Standard 334

Contents xxi Levels and Types of Standard 334 Framework of Standards 335 Steps in Developing Standards 335 Unit XV: Nursing as a Profession Chapter 27: Nursing as a Profession 341 Introduction to Nursing as Profession 341 Regulatory Bodies: Inc, Snc Acts 343 Chapter 28: Professional Advancement 346 Introduction to Professional Advancement 346 Continuing Nursing Education (Cne) 346 Career Opportunities 348 Membership in Professional Organization 349 Role of a Nurse in Participating Research Activities 350 Publication of Research Report 351 Glossary 357 Previous Years Question Papers 373 Index 397