chapter 1 introduction to the nursing management dr fadwa alhalaiqa

CHAPTER 1CHAPTER 1

Introduction to the nursing Introduction to the nursing managementmanagement

Dr Fadwa AlhalaiqaDr Fadwa Alhalaiqa

Copyright © 2009 by Mosby, Inc., an affiliate of Elsevier Inc. 2

Learning OutcomesLearning Outcomes

1.1. Describe the forces that are Describe the forces that are changing the health care system.changing the health care system.

2.2. Discuss changes in paying for health Discuss changes in paying for health care.care.

3.3. Explain how quality initiatives can Explain how quality initiatives can reduce medical errors.reduce medical errors.

4.4. Describe how evidence-based Describe how evidence-based practice is changing nursing.practice is changing nursing.



5.5. Explain how to become a Magnet-Explain how to become a Magnet-certified hospital.certified hospital.

6.6. Explain what emerging technologies Explain what emerging technologies mean for nursing.mean for nursing.

7.7. Describe how cultural, gender, and Describe how cultural, gender, and generational differences affect generational differences affect management.management.



8.8. Explain why preparation is the best Explain why preparation is the best defense against violence and defense against violence and disasters.disasters.

9.9. Discuss the changes and challenges Discuss the changes and challenges that nurses face now and into the that nurses face now and into the future.future.


Continuing Changes Continuing Changes in Health Carein Health Care

including:including: How we pay for health careHow we pay for health care A focus on qualityA focus on quality Rapid changes in technologyRapid changes in technology Threats from violence and disasters. Threats from violence and disasters.

Cultural, gender, and generational Cultural, gender, and generational differences also affect the delivery of differences also affect the delivery of health carehealth care

Health care not accessible to everyoneHealth care not accessible to everyone Costs are skyrocketingCosts are skyrocketing


Paying for Health CarePaying for Health Care

The Patient Protection and The Patient Protection and Affordable Care Act (PPACA), Affordable Care Act (PPACA), signed into law March 23, 2010, signed into law March 23, 2010, promises to provide affordable promises to provide affordable and adequate care for more and adequate care for more Americans once it is Americans once it is implemented.implemented.


The Institute of Medicine (IOM) The Institute of Medicine (IOM) published a report in 1999 reporting published a report in 1999 reporting that that 98,000 Americans die each year from 98,000 Americans die each year from

preventable medical mistakes.preventable medical mistakes. The report focused attention on eliminating The report focused attention on eliminating

errors. errors. As a result, the Centers for Medicare and As a result, the Centers for Medicare and

Medicaid Services have linked payment to Medicaid Services have linked payment to quality of care since 2008, making pay for quality of care since 2008, making pay for performance the norm.performance the norm.


Quality InitiativesQuality Initiatives Many quality initiatives to reduce errors Many quality initiatives to reduce errors

and improve care have emerged: and improve care have emerged: Quality management is a preventive approach Quality management is a preventive approach

that addresses problems before they become that addresses problems before they become crises. crises.

Continuous improvement of products and Continuous improvement of products and services perfect the process. One example is services perfect the process. One example is the use of patient satisfaction surveys to the use of patient satisfaction surveys to evaluate how well hospitals are meeting their evaluate how well hospitals are meeting their clients’ needs. clients’ needs.


- Public reporting of health care organizations, - Public reporting of health care organizations, such as the Agency for Healthcare Research such as the Agency for Healthcare Research and Quality (AHRQ), is another strategy to and Quality (AHRQ), is another strategy to improve quality.improve quality.


Quality ManagementQuality Management

Is a preventive approachIs a preventive approach Involves continuous evaluation and Involves continuous evaluation and

improvementimprovement Is implemented through patient Is implemented through patient

satisfaction surveyssatisfaction surveys


The Leapfrog GroupThe Leapfrog Group

Consortium of public and private Consortium of public and private purchaserspurchasers

Leverages purchasing powerLeverages purchasing power Rewards organizations for quality Rewards organizations for quality

measuresmeasures


BenchmarkingBenchmarking

Compares an organization's data with Compares an organization's data with similar organizationssimilar organizations

Uses outcome indicators to compare Uses outcome indicators to compare performance across organizationsperformance across organizations

Uses results to address weaknesses Uses results to address weaknesses and enhance strengthsand enhance strengths


Evidence-Based Practice Evidence-Based Practice (EBP)(EBP)

Evidence-based practice (EBP) is Evidence-based practice (EBP) is a strategy to improve quality by a strategy to improve quality by usingusing The best available knowledge integrated The best available knowledge integrated

with with Clinical experience and Clinical experience and

The patient’s values and The patient’s values and preferences to provide carepreferences to provide care


Evidence-Based Practice Evidence-Based Practice (EBP)(EBP)

EBP decision-making stepsEBP decision-making steps1.1. Identifying the clinical questionIdentifying the clinical question

2.2. Finding evidence to answer the Finding evidence to answer the questionquestion

3.3. Evaluating the evidenceEvaluating the evidence

4.4. Applying the evidenceApplying the evidence

5.5. Evaluating the outcomeEvaluating the outcome


Nurses may find it helpful in Nurses may find it helpful in evaluating research findings to place evaluating research findings to place it into seven categories: it into seven categories: AnecdotalAnecdotal TestimonialTestimonial Statistical Statistical Case studyCase study Nonexperimental design researchNonexperimental design research Quasi-experimental design researchQuasi-experimental design research Randomized control trialRandomized control trial


Magnet Recognition Magnet Recognition ProgramProgram

Certifies health care organizations for Certifies health care organizations for nursing excellencenursing excellence

14 Forces of Magnetism14 Forces of Magnetism Patient safety improves when forces Patient safety improves when forces

are metare met


• ““Forces of Magnetism”:Forces of Magnetism”:

1.1. Quality of nursing leadershipQuality of nursing leadership

2.2. Organizational structureOrganizational structure

3.3. Management styleManagement style

4.4. Personnel policies and programsPersonnel policies and programs

5.5. Professional model of careProfessional model of care

6.6. Quality of careQuality of care


1.1. Quality improvementQuality improvement

2.2. Consultation and resourcesConsultation and resources

3.3. AutonomyAutonomy

4.4. Community and the health care Community and the health care organization partnershipsorganization partnerships

5.5. Nurses as teachersNurses as teachers

6.6. Image of nursesImage of nurses

7.7. Interdisciplinary relationsInterdisciplinary relations

8.8. Professional developmentProfessional development


Electronic Health Records Electronic Health Records (EHR) (EHR)

Includes health information from all Includes health information from all medical sourcesmedical sources

Can be accessed by multiple Can be accessed by multiple authorized providers at different authorized providers at different locationslocations


Barriers Versus Benefits of Barriers Versus Benefits of EHREHR

BarriersBarriers Privacy and confidentiality concernsPrivacy and confidentiality concerns Costs of implementing and operatingCosts of implementing and operating

BenefitsBenefits Reduced redundanciesReduced redundancies Improved efficiencyImproved efficiency Decreased medical errorsDecreased medical errors Lower health care costsLower health care costs


Other Benefits of EHROther Benefits of EHR

Allows for collective data analysisAllows for collective data analysis Facilitates a common nursing Facilitates a common nursing

languagelanguage Supports evidence-based decision Supports evidence-based decision

makingmaking


Other Technological Other Technological ChangesChanges

Virtual care (telehealth)Virtual care (telehealth) RoboticsRobotics Communication technology, including Communication technology, including

social mediasocial media


Cultural and Generational Cultural and Generational DifferencesDifferences

Cultural diversity is increasing in the Cultural diversity is increasing in the U.S. populationU.S. population

Diversity in the nursing populationDiversity in the nursing population EthnicityEthnicity GenderGender GenerationsGenerations


GenderGender

Female nurses outnumber male Female nurses outnumber male nursesnurses

Nursing shortages might be Nursing shortages might be alleviated if more men were entering alleviated if more men were entering the professionthe profession


Generational DiversityGenerational Diversity

Four generations work side-by-side:Four generations work side-by-side: TraditionalsTraditionals Baby boomersBaby boomers Generation XGeneration X Generation Y (millenials)Generation Y (millenials)

Each generation has different values Each generation has different values and expectationsand expectations

Generational differences can be Generational differences can be leveraged to produce better leveraged to produce better outcomesoutcomes


Violence Prevention and Violence Prevention and Disaster PreparednessDisaster Preparedness

Nearly 500,000 nurses victim of Nearly 500,000 nurses victim of workplace violenceworkplace violence

Other threats affecting nurses Other threats affecting nurses include:include: DisastersDisasters TerrorismTerrorism PandemicsPandemics


Staff Training for DisastersStaff Training for Disasters

Computer simulationsComputer simulations Video demonstrationsVideo demonstrations Disaster drillsDisaster drills Preparation a mustPreparation a must

Mass casualty event probably will occurMass casualty event probably will occur


LEARNING OUTCOME 9LEARNING OUTCOME 9 Discuss the changes and challenges Discuss the changes and challenges

that nurses face now and in the that nurses face now and in the futurefuture


Aging Patients, Aging Aging Patients, Aging NursesNurses

Aging patients increase the demand Aging patients increase the demand for health carefor health care

As aging nurses retire, the nursing As aging nurses retire, the nursing shortage will grow worseshortage will grow worse

Demand for nurses will continue to Demand for nurses will continue to growgrow


Changes Facing NursesChanges Facing Nurses

Change will become the one constantChange will become the one constant Nurses becoming full partners in Nurses becoming full partners in

health carehealth care Focus of nursing education changingFocus of nursing education changing

Apply knowledgeApply knowledge Clinical reasoningClinical reasoning Integrating classroom and clinicalIntegrating classroom and clinical

Focus on quality controlFocus on quality control


Changes Facing NursesChanges Facing Nurses

Access to care is affecting policy Access to care is affecting policy decisionsdecisions

Every nurse must be prepared to Every nurse must be prepared to managemanage

Organizations must provide Organizations must provide management training for all nursesmanagement training for all nurses


The Nurse ManagerThe Nurse Manager

Balances the needs of administrators Balances the needs of administrators and employeesand employees

Functions as coach, teacher, and Functions as coach, teacher, and facilitatorfacilitator

Motivates and inspires othersMotivates and inspires others


Nurse managers today are Nurse managers today are challenged tochallenged to

Monitor and improve quality careMonitor and improve quality care Manage with limited resourcesManage with limited resources Help design new systems of careHelp design new systems of care Supervise teams of professionals and Supervise teams of professionals and

nonprofessionals from a variety of nonprofessionals from a variety of culturescultures

Teach personnel how to function well in Teach personnel how to function well in the new system.the new system.

The nurse manager balances the needs of The nurse manager balances the needs of administrators, colleagues in other administrators, colleagues in other

disciples, and employeesdisciples, and employees. .

chapter 1 introduction to the nursing management dr fadwa alhalaiqa

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