For BSc and MSc Nursing
(As per the Syllabus of Indian Nursing Council)
Jogindra Vati PhD (Nursing), MSc (Medical Surgical Nursing) BSc (Nursing) RNRM, Master in Arts (Public Administration)
Formerly Faculty at National Institute of Nursing Education (N.I.N.E) PGIMER, Chandigarh
Professor-cum-Principal Sri Guru Harkrishan Sahib College of Nursing Mohali, Punjab India
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Principles and Practice of Nursing Management and Administration
First Edition: 2013
9789350902820
Printed at
3Dedication
The nursing administration requires a continuous change particularly after the dawn of high-tech and globalization in India. This has created several challenges for the nursing organizations and also put a demand for professionally trained nurse managers. Efficient utilization of human, physical and technological resources has become an essential requirement for the success of any health organization and so for the nursing organizations. The nurse managers who are energetic, dynamic and fully convergent with the environment of management and the latest concepts and practices of management can achieve this. It can be said that nursing organization is like an orchestra team. It is for the management to make music or a noise out of it. If there is an effective and efficient management, the result is sweet and melodious music; otherwise the result is chaotic and awful noise.
To achieve the professional competence, nurse managers, both present and future are required to be fully equipped with foundation of nursing management and principles of management particularly those which have their applications in Indian scenarios. A comprehensive understanding of bases of management and planning process will increase their competency. Moreover nursing management is an integral part of baccalaureate education, graduate education. A number of nurses are involved in managerial activities in hospital, community, educational institutions and other settings.
This requires the availability of integrated basic reading of materials to them. The present text makes an attempt to give comprehensive approach to the foundation of nursing management and can be treated as the framework of nursing service management. The efforts in this book have been aimed at articulating and systematizing the defined framework or foundation for management of nursing services. The book provides a comprehensive introduction to nursing management for undergraduate, graduate, and practice nurses. At the master's level the text provides not only substantive content related to management but also practical applications based on evidences and author's experiences in teaching nursing management at various educational levels. The chapters have been sequenced to facilitate ease in reading and understanding.
THE ORGANIZATION OF THE TEXTBOOK
This textbook is divided into ten units, with each unit focusing on one of the major domains of nursing management.
Unit 1: Framework of Nursing Management and Administration focusing on introducing the students to the concept of nursing, nursing management and administration and related ethical, legal issues. There is also a detailed description of standards in nursing and quality assurance and quality management in subsequent chapters. Trends and issues related to nursing practice and management provides the broad outlook of nursing management. The role of regulatory body and accreditation and nursing audit gives a strong base for essence of nursing management, has been included in the section of the textbook.
Unit 2: Planning is the one of the important elements of the nursing management. This unit has been divided into eight chapters. Each chapter is discussed elaborately. Mission, philosophy, vision, aims and objectives are the pillars of planning. Strategic planning, plans serve as a framework for decisions and are important to avoid waste, confusion and errors. More detailed information is provided in the process of decision-making and problem-solving. Qualitative method of planning and management by objectives are emphasized in this section.
Unit 3: Health Care Delivery System and Planning Process moves the students into the greater understanding of Indian Administrative System, Health System in India and Fundamentals of Health Planning. The information is provided on National health planning, planning commission, five year plans, national health committees, national health programmes and national health policies.
Unit 4: Organizing next to the planning provides in-depth presentation of organizing and organization. The basics of organization structure and organization charts are discussed in details. This part covers topics like committees, coordination, organizational climate, organizational effectiveness which is the important aspects of organizing. Conflict management and organizational change management is also newer concept in nursing management and a challenge to nurse managers.
Unit 5: Human Resource Management and Staffing addresses overview of personnel management and administration. This unit has been divided into 14 chapters. Staff which is the most distinct and important component of any health organization is covered under fundamentals of staffing. Staffing norms and staffing patterns are elaborated in Indian context. Nursing Manpower planning is considered as being central in personnel administration; various aspects of manpower planning process are presented at national and organizational level and also highlighted various approaches of forecasting nursing manpower requirements. Job analysis gives the opportunity to design and redesign the job structure 5to the nurse managers is discussed in detail. It highlighted how to conduct job analysis and develop job descriptions. This part of the book tries to clear the fog surrounding the recruitment, selection, retaining employees, placement, and allocation, promotion, transfers, staff development, and performance appraisal process. Assignment, scheduling and nursing care delivery system form one of the core aspects of this part of the book. How to reduce staff turnover and absenteeism for the improvement of unit staffing aspect is also touched. Since an organizational environment is vital for the staff satisfaction, reduction of turnover and to increase output, the chapters like personnel policies, discipline and grievances, and occupational health and safety are written in a lucid and organized way.
Unit 6: Directing the heart of the nursing management process, helps the nurse managers to supervise and control the activities of nursing staff. This unit comprises of seven chapters and focuses on fundamentals of directing, effective supervision, motivation, communication, public relation, human relation, and collective bargaining.
Unit 7: Leadership major attributes and one of the most effective tools of managerial accomplishments and for successful nursing organization. It includes the chapters on nursing leadership, group dynamics, power and politics, team management, time management and stress management. Leadership chapter familiarizes with the background and classical studies on leadership and exemplified with evidences. Various methods for development of leaders and their leadership behaviors are discussed in detail. Group dynamics the study of groups and group processes is a separate chapter of this unit of the book. It covers various aspects of groups, group dynamics, group norms and group cohesiveness and thus provides well grounded knowledge for the nurse managers. Power and politics inextricably interwoven with the fabric of an organization's life are discussed in detail. It describes various techniques of managing organizational politics. Team management, time management and stress management are the reflections of an effective leadership quality of a nurse manager, provides related theoretical dimensions in subsequent chapters.
Unit 8: Material Management unfolds concepts, principles and procedures of material management. This unit has four chapters and focusing on procurement, inventory control and planning equipment and supplies. The procurement process and the key steps in the process of purchasing are highlighted. There is a detailed description of inventory, inventory management and accounting system, inventory control, types of inventory costs, inventory classification and models. Various aspects and nursing activities in relation to equipment and supplies management is the focus of this section.
Unit 9: Fiscal Management the life blood of the administration, critically examine the usefulness of fiscal management and administration, budget, budgetary process, audit, health economics, economics evaluation techniques, and critical pathways and health care reforms in controlling the utilization of resources. Nursing finance, health care financing and steps of planning budget has the focus in the introductory chapter; Budget and budgeting process, nursing budget, Zero Base Budgeting, Performance budgeting, Programme Planning Budgeting System and Midterm appraisal is also included in subsequent chapters. Knowledge of the cost determination which is necessary to keep a check on the cost of product, services /control on wastages, accounting which aims at keeping records of various transactions and used to study the various aspects of cost, internal and external audit is discussed in detail. Health economics a subject of increasing significance which is based on principle that resources are scarce relative to the demands made on them and economic evaluation techniques has been elaborated.
Unit 10: Nursing Informatics an emerging field of integrating information and computer science with nursing to enable nurses to collect and manage data, process data into information and knowledge, and make knowledge-based decisions about patient care. This part has been divided into five chapters and the readers are provided with the information on concept of nursing informatics, information technology, patients’ records, electronic records, information system, and communication system including e-nursing, telemedicine and telenursing.
It is hoped that this book would be able to create an improvement and objective criticism will be appreciated and incorporated in the later editions of this treatise.
Jogindra Vati
6Acknowledgments
From the inception with profound love I owe my sincere gratitude to the God “The Almighty”, for his immense unconditional grace and love showered upon me throughout my life and for giving me strength, perseverance and blessings to pursue this task and accomplish it successfully.
Projects like this one take time and certainly require support. My family deserves much of the credit for the gifts of their love, wisdom and work ethics which endured and inspired me in my difficult times, keep me motivating and putting up with my endless writing this particular book. I want to thank members of the M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, team who have encouraged, guided and provided time to time support for writing this project. I specially thank to Mr Bhupesh Arora (General Manager Publishing), whose constant and untired effort and persuasion enabled me to bring this treasure of my knowledge and opened a new door in the world of writing. The Indian Nursing Council's syllabus, suggested by him acted as a useful baseline to decide contents of the book.
To my colleagues who helped me formulate ideas when they did not even know they were helping, I offer my thanks. I will be forever grateful to my students, friends, teachers who shaped my career in nursing and enriched my teaching experience in nursing management and research.