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CHAPTER II: PLANNING FOR THE NURSING SERVICE

Planning Defined as pre-determining a course of action order to arrive at a district result. It is continuous process assessing, establishing goals and objectives, implementing and evaluating them, and subjecting these to change as new facts are known. While planning is largely conceptual, its results are clearly visible. Principles of Planning 1. Planning is always based and focused in the vision, mission, philosophy and clearly defined objectives of the organization. 2. Planning is a continuous process. Provision for proper analysis would indicate a revision or flexibility to be done to make it more effective. 3. Planning should be pervasive within the entire organization covering the various departments, arrives and the various levels of management to provide maximal cooperation and harmony. 4. Planning utilizes all available resources. 5. Planning must be precise in its scope and nature. It should be realistic and focused on its expected outcomes. 6. Planning should be time-bound, i.e., with short and long range plans. 7. Projected plans must be documented for proper dissemination to all concerned for implementation and evaluation as to the extent with its achievement. Importance of Planning
1. Planning leads to the achievement of goods and objectives.

2. 3. 4. 5. 6. 7. 8. 9.

Planning giving meaning to work. Planning provides for effective use of available resources and facilities. Planning helps on coping with crises. Planning is cost effective. Planning is based on past and future activities. Planning leads to the realization of the need for change. Planning provides the basis for control. Planning is necessary for effective control.

Why Managers Fail to Plan Effectively? 1. Lack of Knowledge of the philosophy goals and objectives of the agency. 2. Lack of understanding of the significance of the planning. 3. Lack of confidence in formulating plans.

Scope of Planning 1. Top Management - Nursing Directors, Chief Nurse, Directors of Nursing - Covers over-all goal management of the organizations of Nursing Services. 2. Middle Management - Nursing Supervisor - Direct the activities to actually implement the broad operating policies of the organization. 3. Lower of First Level - Head Nurse or Senior Nurses - Do the daily and weekly plans for the administration of direct patient care in their respective units. Major Aspects of Planning 1. 2. 3. 4. Planning should contribute to objectives. Planning precedes all other processes of management. Planning pervades all levels. Planning should be efficient.

Characteristics of a Good Plan 1. Be precise with clearly-worded objectives, including desired results and methods for evaluation. 2. Be guided by policies and/or procedures affecting the planned action; 3. Indicate priorities 4. Develop actions that are flexible and realistic in terms of available personnel, equipment, facilities, and time; 5. Develop a logical sequence of activities; 6. Include the most practical methods for achieving each objective 7. Pervade the whole organization. Elements of Planning Forecasting - Helps the managers look into the future and decide in advance where the agency would like to be and what is to be done in order to get there. Setting the Vision, Mission, Philosophy, Goals, and Objectives
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A VISION statement outlines the organizations future role and function. A MISSION statement outlines the agencys reason for existing (whether hospital or healthcare), who target clients are (poor, the needy, the middle

or upper class), and what services will be provided (in-patient, out-patient, emergency). A PHILOSOPHY describes vision. It is statement of belief and values that direct ones life or ones practice. In an organization, philosophy is a sense of purpose of the organization and the reason behind its structure and goals. GOALS and OBJECTIVES differ in that goals are more general and they cover a broad area. OBJECTIVES tend to be more specific and concrete.

Time Management Principles 1. Planning anticipates the problems that will arise from actions without thought. 2. Tasks to be accomplished should be done in sequences and should be prioritized according to the importance. 3. Setting deadlines in ones work and adhering to them is an excellent. 4. Deferring, postponing, or putting off decisions, actions, or activities can become a habit which oftentimes lost opportunities and productivity, generating personal or interpersonal crises. 5. Delegation permits a manager to take authority for decision making and to assign tasks to the lowest level possible consistent with his/her judgment, facts and experience. Time-saving Techniques, Devices and Methods to Better Use of Time 1. Conduct an inventory of your activities. 2. Set goals and objectives and write them down. 3. With the use of calendars, executive planners, logs or journals, write what you expect to accomplish yearly, monthly, weekly, or daily. 4. Break down large projects to smaller parts 5. Devote a few minutes at the beginning of each day of planning, 6. Organize your work space so it is functional. 7. Close your door when you need to concentrate. 8. Learn to delegate 9. In a meeting, define the purpose clearly before starting. 10. Take or return phone calls during specified time. 11. Develop effective decision-making skills. 12. Take rest breaks and make good use of your spare time. Nursing Service Policies Examples of Nursing Service Policies 1. 2. 3. 4. Accidents care, reporting, precautions to prevent occurrence Admissions receiving, consent, notifying doctor, care of patients. Autopsies obtaining inform consent Breakage- classification, responsibility reporting

5. 6. 7. 8.

Bulletin board location, posting of information Committees types, membership, functions Complaints how handled, action taken Consent informed consent taken by whom, from whom, shared decisionmaking with patient and family and/or significant others together with members of the health team. 9. Death notification, care and identification, care or personal belongings, death certificate 10. Discharge time, clearances, discharge planning accomplishment of patient 11. Doctors orders - written, verbal by telephone 12. Equipment and Supplies list of expendable and non-expendable items, care, lending, requesting, repairing 13. Fire regulations drills, prevention 14. Nursing Care a. Administration and Preparation b. Charting c. Daily Assessment d. Emergency Drug Supply e. Kardex f. Medications g. Property of patients h. Private Duty Nurse i. Reasonable and Due Care j. Referrals k. Safety Devices 15. Reports form, responsibility 16. Reporting On or Off-Duty information given when leaving unit 17. Meeting - frequency, purpose, types, membership, minutes Interdepartamental Policies Examples of Interdepartamental Policies 1. Admissions 2. Transfers 3. Discharges 4. Blood bank 5. Cashier 6. Dietary 7. Laboratory 8. Personnel Department 9. Pharmacy 10. Social Service 11. X-ray

Nursing Procedures Examples of Contents in a Procedure Manual 1. Admission of Patients 2. A.M. Care 3. Bath: Bed bath, TSB 4. Bed Making Occupied and Unoccupied 5. Bladder, Catheterization of 6. Bladder, Insertion of Foley Catheter 7. Blood, Administration of 8. Body, Care After Death (Routine of Infectious Disease) 9. Chest, Closed Drainage of 10. Care of Unit after Discharge of patient 11. Cleansing enema 12. Discharge of patient 13. Douche, Vaginal 14. Dressings, Sterile, Dry 15. Emergency Cart 16. Evening and Morning Care 17. Feeding Patients Incl. Nasogastric feeding 18. Heat, Cold- Application of Locally 19. Hygiene, Oral 20. Intake and Output 21. Lifting and Carrying of Patients 22. Lumbar Puncture 23. Medications Administration oral, rectal, parenteral, topical 24. Moving Patient from bed to chair, from bed to stretcher, from stretcher to bed 25. Oral Hygiene 26. Oxygen Administration of 27. Pre- Operative Preparation of Patients 28. Restraints, Application of 29. Specimen, Collection of Disposition 30. Thorancentesis 31. Thoracostomy, Care of Patient with