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Learning objectives
At the end of this unit, the learner will be able
to;
Define system
Differentiate among various types of nursing
care delivery systems
List the advantages and disadvantages of
various types of nursing care delivery systems
Discuss about the different types of
organizational structure
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Organization
Organization- is a group of people under
formal or informal rules working together
for common goal.
Organization is has two concepts, both
structure and process.
A. Organization process-refers to the
method used to achieve ognal goal.
B. Organization structure-refers to the
lines of authority, communication and
delegation.
Organizational concept
Organizational characteristics
Organizational characteristics
Organizational characteristics
Organizational principle
Organization structure
Organization structure
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Organization structure
Organization structure
The orgn chart does not show the degree
of authority, i.e. a manager has over
subordinates.
For example, a manager with authority of
head nurse may lack authority hire or fire
the worker.
Organizational structure can be informal
or formal.
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Line pattern/relationship
Line and staff pattern/relationship
Matrix orgnal structure
Functional line and staff pattern
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1. Line pattern/relationship
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1. Line pattern/relationship
1. Line pattern/relationship
Advantage
Easy to orient new employee
Easy to manage workers
Well established division of labor
There is a clear cut work specialization
and role separation
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1. Line pattern/relationship
Disadvantage
Makes employee task narrow, repetitive
performance and communication difficulties
among specialists due to specialization.
Workers tend to resist innovative change
and resist recommendation from outsiders
b/c of rigidity.
Causes passivity and dependency in staff
members and autocratic b/r in manager.
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1. Line pattern/relationship
Disadvantage
The strong chain of command and
concentration of authority at the top of
hierarchy causes lower level employees to
refer difficult problems to their immediate
superior.
Manager talks more than to listen.
Weak integration of d/t divisions or dpts.
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System
System is a set of elements standing in
inter-relation and work together for
common goal.
There are two type of system. These are;
A. Open system:-interact with the out side
envt. Relevant for the given orgns.
B. Closed system:-self contained, no
interaction with the external envt. Not
relevant for a given orgns.
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System theory
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System theory
Characteristics of system
1. Input or importation of energy.
2. Through put or process
3. Out put
4. System of cyclic events
5. Negative entropy
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System theory
Characteristics of system
6. Information input/feedback
7. Homeostasis or steady state
8. Differentiation
9. Equi-finality
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System theory
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B. Functional method
B. Functional method
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B. Functional method
Advantage
Specialty of care
Experienced or qualified staff care
Timely care is given for the pt
Care is provided economically and efficiently
Minimum number of professional nurses
required
Tasks are completed quickly
Useful in emergency situations
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B. Functional method
Disadvantage
It may cause burden on the head nurse
It is difficult to identify the responsible person
No continuity of care, due to fragmentation of
care
Decrease personal contact with pt
Decreased job satisfaction
Neglecting the humanity and the individual
needs of the patient
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C. Team nursing
C. Team nursing
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C. Team nursing
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C. Team nursing
Advantage
Span of control decreased
Comprehensive care is provided
Increase cost-effectiveness
Increase job satisfaction
Team sprit is developed
Decreased mgt burden for the head nurse
Experience sharing b/n the team members
Qualified care is given
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C. Team nursing
Disadvantage
It may endanger nsg service if there is conflict or
disagreement
Reduce personnel responsibility
Continuity of care is reduced
Mgt is affected b/c there is a gap b/n manager
and the employee
Insufficient time for planning and communication
Continuity suffers if daily team assignments vary
Team leader must have good leadership skills
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D. Primary nursing
D. Primary nursing
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D. Primary nursing
Advantage
o Increase job satisfaction, Continuity of care
o Improves the quality of care, if the
individual is well qualified
o Allows independent decision making
o Support nurse-client communication
o Encourage discharge planning
o High-quality, holistic patient care
o Establish rapport with patient
o RN feels challenged and rewarded.
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D. Primary nursing
Disadvantage
More RNs needed; not cost-effective
Exhaustive
Need high level qualified and experienced
profession or requires properly trained
nurses to carryout system principles
RN must accept 24-hour responsibility
Primary nurse must be able to practice with
a high degree of responsibility and autonomy
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Most recent.
Evolved from other system.
It is a process of monitoring an
individual patients health care by the
case manger, for the purpose of
maximizing positive outcomes and
containing costs.
This is an all-inclusive, comprehensive
model and is not restricted to hospital
setting.
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A. Case management
A. Case management
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A. Case management
Advantage
Totality of care
Continuity of care
Job satisfaction
Improves nurse responsiveness to clients
changing needs
Independent decision making
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A. Case management
Disadvantage
Exhaustive
Increase personnel cost
It requires highly qualified and
experienced individual
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