Organizing nursing service unit

1. Mrs. Anu Abraham,
Professor,
Lourdes College of Nursing

2. INTRODUCTION
The concept of organization comes
from business and management.
Organization originally meant the process
of organizing an organization. Organizing
is one of the functions in the managerial
theory of leadership, and it is now
considered an important leadership
strategy. Organization refers to the
institution itself and the setting in which
the leader functions

3. MEANING
The term organization is
derived from the word ‘ organism’ which
means a structure of body divided into
parts that are held together by a fabric
of relationship as one organic whole.
Organization is the act of organizing or
the state of being organized. It also
refers to an organized structure as a
whole.

4. According to Urwick…
 Organization as a structure
 Organization as a group of people
 Organization as a process

5. DEFINITIONS
 An identifiable group of people
contributing their efforts towards the
attainment of goals is called an
organization
-Mc
Farland
 A group of people who are cooperating
under the direction of leadership for the
accomplishment of a common end

6. PRINCIPLES
 Hierarchy
 Span of control
 Integration Vs disintegration
 Centralization Vs decentralization
 Unity of command
 Delegation

7. Organization as a system
Organization in which most of the
managers operate is a system,
comprised of many interrelated
subsystems. The term system can be
defined as a whole, set of connected
things or parts. It is also viewed as a
collection of interrelated parts which
receives inputs, acts upon them in an
organized or planned manner and
thereby produces certain outputs.

8. Classic system elements
Input
Input
Input
Throughput Output Outcome
Feedback

9. Characteristics of organization as
a system
• Organizations, as a open system constantly seek
and import on both human and material forms
and transform these inputs into products and
services using internal, social and technological
processes.
• Organizations export their products to external
environments and these outputs usually become
inputs of other organizations.
• Organizations become more complex due to
structural differences and specializations,
therefore the coordination and control become
more elaborate.

10. Contd…
 Feedback about the environmental
responses is used to keep the system in
pace with regard to its goals and
functioning of its subunits.
 Organization as a system depends upon
effective functioning of the parts called
subsystems
 Organization seeks equilibrium or a
stable state both internally and
externally.

11. Hospital as an open system
Hospital being a part of a large
system of health care delivery system is
an open sub system. Health care
delivery system as a large system
transforms the general resources into
special services to meet their demand
and needs , i.e the health of the people
at large.

12. Subsystems in hospital
 The activities of the hospital are
divided into four major components
1. General administration
2. Clinical and nursing
3. Supportive services
4. Utility services

13. •Financial
•Material
•personal
Medical
services, In
patients, Out
patients, nursing
services: In
patients, Out
patients
Emergency
•Dietary
•Linen
•Public relation
•Housekeeping
•Fire services
•others
•Laboratories
•Pharmacy
•Research
medical records
•Engineering
•others
geCLIENT
General
administration
Supportive
services
Utility
service
s
Medical and
nursing
services
SUBSYSTEM IN HOSPITAL

14. Nursing department as a
system
 Power authority sub-system
 Communication sub-system
 Work flow sub-system
 Rewards and punishment sub-system
 Role sub-system
 Social sub-system
 Individual personality sub-system

15. Sub systems goals
Nursing
department
(As a
system)
Sub –
systems
Goals
Nursing unit
Communication
Nursing
Nursing staffing
Nursing Roles
Work environment
Sub-
system

16. Elements in organizational
process
Departmentation
DecentralizationDelegation

17. Principles of nursing organization
Unity of objectives
Hierarchy or scalar or chain of command
Span of control
Authority and responsibility
Delegation of authority
Integration vs disintegration
Centralization and decentralization
Unity of command
Coordination
Division of work and specialization
Principle of flexibility
Principle of simplicity
Principle of balance and of continuity
Principle of leadership and efficiency

18. Functions of nursing organization
 Increases managerial and administrative efficiency
 It assigns the job to all the persons according to their
abilities and tasks
 Increases production and productivity
 Establish harmonious relationship between superiors and
subordinates
 Encouragement of specialization
 Training and development
 Better coordination
 Provides opportunity for growth and diversification
 Increases morale
 Provides optimum use of technological improvement
 job satisfaction
 Optimum use of resources

19. Features of nursing
organization
 Hierarchy or scalar principle
 Unity of command
 Span of control
 Division of labor and specialization
 Authority
 Delegation of authority
 Responsibility
 Accountability
 Centralization
 Decentralization

20. NURSING DELIVERY
SYSTEMS
 Nursing delivery systems are types
of organizations at the unit level. The
nurse-leader must consider all the
components of organization,
regardless of the delivery system in
which she functions.

21. CASE METHOD OR TOTAL PATIENT
CARE
 One nurse is accountable for the total care one
or two patients.
 In this method a nurse is expected to provide
complete nursing care to the patient including
general nursing care, treatment, administering
medications, checking diet and other
miscellaneous activities.
Registered
Nurse
Patient

22. Advantages
 More individualized nursing care
 Better nurse-patient relationship
 Comprehensive care
 Patients feel more secure
 Opportunity for nursing education is
superior
 Job satisfaction of the nurse attending
the patient is achieved because

23. Disadvantages
 High cost
 Need qualified professional nurses

24. FUNCTIONAL METHOD
 One nurse is assigned with certain
tasks to be performed for all patients
in the nursing unit.
Head Nurse
Nurse’s AidRegistered
Nurse
Licensed
practical
nurse
Patients

25. Advantages
 Simple to get work done
 Less confusion
 Skill in assigned task
 Procedure manuals are followed
closely
 More production and low cost
 Less equipment needed

26. Disadvantages
 Patient has no assigned nurse
 Fragmentation of patient care
assignment
 Patient’s total needs are not
considered
 Minimizes task development
 Emphasis of things to be done

27. TEAM METHOD
 Care and management of a group of patients are
delegated to a professional nurse who assigns care
of team members.
 Team leader assigned to care for a group of patients
 Delegates the care of each patient to a nurse
 Team leader reports to the charge nurse
 Team leader is responsible for care planning
 Team leader does all documentation
Head Nurse
Team
Leader
Team
Leader
RN LPNNA
PatientsPatients
RNLPN NA

28. Advantages
 Utilization of all team members in
planning executing, decision making
and evaluating which contribute to
members development
 Enhances job satisfaction, results in
better patient care
 Charge nurse has time for overall
supervision

29. Disadvantages
 Unstable staffing patterns make a
team nursing is difficult
 Team leader must have complex skills
and knowledge
 Less individual responsibility and
independence regarding nursing
functions

30. PRIMARY CARE NURSING METHOD
A professional nurse is delegated as
primary care nurse for patients from
admission to discharge
 New patient care approach
 A professional nurse take care of a group of
patients (4 to 6)
 Plans care for complete 24 hours and writes
nursing care plan
 Care for patients from admission to discharge
 Charge nurse assigns new admissions to
primary care nurse

31. PRIMARY CARE NURSING METHOD
Head Nurse
Patients
Primary
nurses

32. Advantages
 Satisfaction for patients and nurses
 Nurses have the opportunity to
function autonomously as
professionals and use their capacities
 Leads to better staff development,
enhanced quality care

33. Disadvantages
 High cost
 Nurses need preparation for and
interest in primary nursing
 The quality of care depend on the
ongoing nursing care plans clarity of
direction and the ability of the primary
care nurse
 Associate nurse may be unwilling to
follow up primary plan of care

34. MODULAR NURSING
 Modular nursing staff are
geographically assigned to patients for
whom they coordinate and provide
comprehensive care

35. MODULAR NURSING METHOD
Head Nurse
Patients
RN-District
Leader and RN
RN-District
Leader
RN-District
Leader and LPN

36. Advantages
 Better communication and cooperation
among staff and less time spent
walking between patients
 Easier for less experienced nurses
because they have other nurses
directly available to them for support
 More nursing productivity
 Less time spent in direct nursing care

37. Disadvantages
 Accountability
 Less patient satisfaction

38. Thank You