PALMR - supervisors, coordinators, department heads

Leadership Management Research - all communication passes thru the middle

leaders
c. FIRST - focuses on operations
Management - art of getting things done with and
through the people so that the GOALS if the organization - head nurses are also called unit managers
can be achieved
Leadership – use of one’s skills to influence others and
Different styles of leadership “ADL”
to perform to the best of their ability
Autocratic – leader focused; best during emergency
- members voices are not heard
“AIRCUBES”
Democratic – members have a voice in decision making
Assertiveness ( Aggressive or Assertive)
- leaders act as facilitator; best used in
- sending direct messages
compliance by the members
- standing up for your own rights without
Laissez Faire – member focus, decides
stepping the rights of others
- best used when members are matured enough
Ingratiation
- leaders act as monitor; manager is new in the
- making others feel good/ look good before
unit
making a request
Contingency Theory - leadership style
Rationality
- may or not be effective depending on
- relying on a detailed plan, reason nor logic
Situation
Coalition – backing up a request together with your co-
workers
Upward Appeal Authority vs. Power
- using a name of a superior, formally or Authority – legitimate right to give command
informally
- officially sanctioned responsibly
Blocking (black mail)
Power – obtain, retain and motivate
- threatening somebody to damage his
opportunity or advancement or not being friendly
to another until he grants the request Sources of Power “ Lr C2 Cries”
Exchange (utang na loob) Legitimate Power – people who holds a position in the
- reminding somebody of a previous favor or Organization
return of favors
Reward Power – ability to give incentives and benefits
Sanction
Coercive – give fear and punishment
- could be positive or negative
Connection – someone you know
- either giving / preventing incentives, benefits or
Referent – pertains to charisma
promotion
Information – people who knows
Expert – people with special skills and ability
TYPES OF LEADER
Self – eminates from self due to maturity, experience,
1. Formal – holds a position in an organization
gender
Three Levels
a. TOP – focuses on organization
- monitors entire organization
- president, ceo, coo, board of directors, chief of
nurse, assistant chief nurse

Functions in Management
1. PLANNING - knowing where you are and where you
b. MIDDLE - coordinates with the TOP and First
want to be
leaders
2 types of Planning: b. Operational Expense Budget
a. Strategic Planning - day to day expense
- also called as “long term planning” - used for operations
- good for 3-5 years; should not exceed 5 years c. Personnel Expense Budget
- type of plan that benefits the organization - salary
b. Operational Planning - full time employee
- short term planning - prepared ahead of time
- usually changed annually d. Cash Budget
- benefits the operations - available all the time for emergency purposes
1st Activity in Planning - emergency funds
SWOT Analysis - unexpected
 Strength
 Weakness 2. ORGANIZING – a formal structure of organization
 Opportunity and create the job qualification and
 Threats description.
Planning formula: Organizational Structure
What? : action is necessary - work distribution
Where? : will it take place Elements of Organizational Structure
When? : will it take place a. Levels of Authority - depends on the size of org.
Who? : will do it b. Lines of Communication
How? : will it be done Solid Line Communication
- direct communication
TOOLS IN PLANNING (Hierarchy of Planning) - superior subordinate relationship
Mission - reason for existence
Vision – agency wants to achieve; futuristic Principle Management:
Philosophy – statements of beliefs; values and principles a. Unity of Command
Goals – general assessments of aims and purposes – command
Objectives – specific statements of aims and purposes - only one person can give orders ( immediate superior)
that are used to carry out goals. b. Scalar Chain
Policies ( not subj to regulations) – plans reduced to - chain of command
statements that helps the organization in
decision making - follow the hierarchy

Procedures – step by step instructions - reporting relationship

Rules (subject to regulations) – guidelines for action - complaints

and non action ; do’s and don’ts
Budget – systematic way of meeting expenses
- focuses on revenues and expenses
Income losts

Broken Line Communication

- indirect
4 Common types of Budget - except for doctor’s order pertaining to patient care
a. Capital - represent coordinated relationship
- usually expensive
- for long term use
c. Span of Control - number of workers that directly - oldest method
report to superior
- manager can use either centralized or
- number of workers that is superior handle decentralized
- limited capacity to control - not following a system
- manager’s own decision
Major Forms of Organizational Structure
a. Centralized - central; pertaining to the center b. Cyclic Staffing
- 1 person who has the responsibility for decision - schedule repeats itself
making
- create base schedule
Advantages Disadvantages
i. Better interpersonal i. Costly c. 40 hours
relationship ii. More danger in - mandated by law in PH
ii. Staff has voce in breakdown of
decision making communication - supported by Philippines Code PB 442
iii. More ideas, better iii. Problems to role
creaitivity communication due d. Seven Days ( used during pandemic)
iv. Communication to same positions
departmentaly and - work for a minimum of 10 hours/ day
interdepartmentaly - for 7 days a week followed by 7 days off

Job Description
Purposes of Job Description
a. Prevents job malpractice
b. for delegation
c. used for evaluation
d. used for staffing – assigning of competent people to fill
the roles of organization

Negligence – omission of an act persuant to a duty

- carelessness
- everybody can commit negligence
- unliscensed
Elements of Negligence
a. Existence of duty
b. Failure to meet standard
c. Forseeability of harm/ proximate cause
d. Injury - if no injury; no negligence
- most common material

NURSING CARE SYSTEM/ MODALITIES OF

NURSING CARE
- used to deliver nursing care
Malpractice – professional/ licensed
- also called as patterns of nursing care
- stepping beyond one’s authority
- same elements with negligence
a. Case Nursing
- total care nursing
3. STAFFING PROCESS
- used in private duty nursing
4 common methods:
- 1:1 ratio
a. Conventional
 - idea used in the ICU but not the common 4 Pointers
practice
a. Position of the staff
b. Functional Nursing
- if licensed or not
- tasks delegated among the staff
b. Consider the ward
c. Team Nursing
- coming from; where to go
- group of nurses assigned to a group of nurses
c. Incapabilities depends on the position
wherein there is a team leader that assesses the
situation - unlicensed; simple
d. Primary Nursing (idea used in WARD) - licensed; complicated
- a 24 hour continuous coordinated d. Consider the condition of patient
comprehensive nursing service of 5-6 patients
from admission to discharge
TELEMETRY
- Primary Nurse; shifting to associated primary
nurse - compound word
- many nurses; 5-6 patients; 1 nurse per shift - cardiac monitors
- Primary nurse; responsible for making NCP - patients with cardiac problems
not changeable, except if there are Communication
changes to patient’s condition, provided
- sending of messages
with a report to the primary
- sender to receiver and vice versa
e. Modular Nursing
- hoping message is understood
- combination of team and primary nursing
Communication Elements
- only difference is the GEOGRAPHICAL ASS.
a. Message
- used during disaster, calamities, epidemic,
pandemic b. Encoding
f. Case Management c. Transmitting (channels)
- utilizing healthcare delivery system where in d. Decoding
The GOALS are: e. Feedback/Action
 To deliver quality care
 To promote quality Barriers in Communication:
 To decrease
fragmentation and a. Physical
contain costs - environmental
- nursing homes - too noisy
- nurses are called case manager - distance
b. Socio- Psychologic
- state of mind
4. DIRECTING - trust
2 Aspects of Directing: Echolalia - repeating what others are saying
a. Technical
- includes tasks, procedures, materials and c. Semantic
equipments
- misinterpretation of signs and symptoms
- show, teach, demonstrate, perform with nurse
GRAPEVINE COMMUNICATION
b. Interpersonal
- chismis is 75% accurate
- attitudes, behaviors, styles of direction giving
- beneficial since it gives manager the
- verbalization of feelings opportunity to solve the problem

WHAT and WHO of delegation: CONFLICT

 - misunderstanding/disagreement between 2 or Basis of evaluation:
more person, management
Standard – predetermine level care
Conflict Resolution Strategies:
Criteria – characteristics used to meet level of
1. Avoidance – do not solve the problem care
2. Dominance and Suppression 3 types of standard:
- “ I am the manager, you have no choice” i. Structure – includes facilities, equipments,
materials, and management systems
3. Restriction/ Power
ii. Process – plans and procedures
- “ I am the manager here, I will do what’s best iii. Outcome - results
for everybody”
4. Majority Rule
b. Determine compliance standards and care
- “ Let us divide the house” Nursing Audit Performance Appraisal
5. Smoothing (Funds)
Evaluates Patient Evaluates Staff
- “ unacceptable appears to acceptable” a. Informal
2 types - incidental, performance
6. Compromise a. Concurrent b. Formal
- evaluate as the care is given
- meeting halfway
b. Retrospective
7. Collaboration - source of evaluation is patient’s
chart
- working hard in hand in solving the problem
- find the best solution c. Identify strength and weakness
d. Act to reinforce strengths and take corrective
Brainstorming – all ideas are acceptable actions for weaknesses

Reporting - no participation of manager 2 Aspects:

a. Technical

4 Approaches in Problem Solving b. Interpersonal

Win Lose Solve the problem at the expense of others
Lose Win Solve the problem at own expense
Lose Lose Solve the problem but both parties sacrifices
Win Win Solve the problem and both parties benefits
Manager Members or
or self others
RESEARCH
Scientific Method Research
Change Management
Nursing Research Research in Nursing
- any alteration in the status quo deals with clinical problems Issues
present situation
Change Process Evidenced – Based Practice
a. Perceive the need to change - current “best” evidence
b. Initiate a group interaction – meeting the group latest findings
c. Implement the plan – one step at a tie to prevent
resistance
Importance of Research
d. Evaluation of over all result
1. Professionalism
2. Accountability
5. CONTROLLING
3. Social Relevance of Nursing
evaluating/ reviewing/ checking/ determining/ comparing
4. Research and Decision Making
- seeing to it that what is planned is done
4 Basic Steps
*Ultimate goal of research
a. Develop Standards and Criteria
- improve the practice of the profession
 Nursing care = client care or patient care or 16. Interpreting the results
healthcare or nursing care

Phase V. Disseminating Phase

Sources of Knowledge
17. Communicating the findings
Tradition
18. Utilizing the findings into practice
- generation to another generation
Authority
- people who are considered experts
Logical Reasoning
- use of logic and reason
Experience and Trial and Error
Scientific Method

5 Major Steps of the Research Process

Phase I. Conceptual Phase
1. Formulating & Delimiting of the Problem
2. Reviewing of Related Literature
- synthesis of previous studies
Purpose: to get an idea or background of the study
3. Undertaking a clinical fieldwork
- to get the idea and background of the study
4. Defining Framework & Conceptual definitions
- graphical representation of concepts and
relationship of concepts
PROBLEM
5. Formulating the hypothesis
Sources of Research Problem
Nursing Literature
Phase II. Design and Planning Phase
- from nursing journals
6. Selecting the research design
Ideas from External Sources
7. Developing the protocols for the intervention
- not your own thinking
8. Identifying the population on how to measure research
problems Theory
9. Designing the sampling plan - could be an existing theory or own theory
10. Specifying the methods on how to measure research * Experience & Clinical Fieldwork
variables
(richest in information)
11. Developing a method on how to safeguard
- experience in clinical areas
human/animal rights
- issues found in clinical areas
12. Reviewing and finalizing the plan
Social Issues
- issues in the society that could affect the nursing
Phase III. Empirical Phase
profession
13. Collecting the data
Scientific Research
14. Reporting the data for analysis
- previous researches
- already made
Phase IV. Analytic Phase
15. Analyzing the data
Criteria of Good Research Problem
Significance of the Study
- addressed to the people and society HYPOTHESIS
- adjust the significance of the study to the profession - tentative prediction of the relationship between
variables
Availability of the Subjects
DIVIDED INTO 4 PARTS:
- rare cases are often not used
1. Independent Variables
Limitation of the Study
- cause/fixed/all manipulation
- considering of limitations
2. Dependent Variables
Time Allotment & Research Ability
- effect/varies
- considers the time that was given and ability to do the
research 3. Relationship
Limitations of Tools 4. Population to which it applies
Major Forms of Data Collection - most neglected but most important
1. Use of existing data a. Identifying Population
2. Self reports - includes characteristics
- use of interviews and questionnaires b. Identify the set
- most widely used form in data collection - if 2 or more; concentrate on characteristics
- gathered either orally or written
- validity and accuracy; most critical
disadvantages

Examples:
Older patients are more at risk to fall than younger
3. Observation
Population: Younger and older patients
- observation of the participants
Independent: Age
NON – PARTICIPANT OBSERVER
Dependent: Risk for Fall
- does not give intervention
- mere spectator
Girls are less sexually active then boys
Phenomena
Population: Girls and Boys
- characteristic & condition of the subjects
Independent: Gender
1. Ammenable Observation
Dependent: Sexually Active
2. Activities & Behaviors of the subjects
3. Skills and Attainment & Performance
Educational attainment is not related to the compliance of
4. Environmental Characteristics PTB patients; no characteristics
5. Biophysical measures Population: PTB Patients
IN VIVO – directly Independent: Educational Attainment
IN VITRO – measurement is made outside
CRITERIA: Dependent: Compliance
1. Validation
2. Reliability TYPES OF RESEARCH:
3. Sensitivity 1. According to Motive
- purpose why you’re doing the research
Interest of Researcher a. Pure/ Basic Research
Novelty – newness/freshness of ideas – to gain new knowledge or increase your knowledge
b. Applied – to use the knowledge into practice - further analysis of issues and events
- deeper description of issues/event
2. According to levels of Investigation II. Experimental
Level I – Exploratory “opinion” > quality; census; 1. True Experimental
– identify variables - strict control over variables
Level II – Descriptive “describe” > relationship; 2. Quasi Experimental - just like; lacks randomization
similarity or differences; facts & issues; study;
- control overcomes the experiment
analysis
Elements of Experimental Research
– whether variables are associated/related
1. Randomization – no idea about subjects
a. Descriptive – describe the variables as it is
2. Manipulation -
b. Correlational – describe the relationship of variables to
each other 3. Control
c. Comparative – compare variables to each other
Level III – Experimental “effect” > manipulation 2 Sets of Subjects whether True Exp or Quasi Exp
- find out cause and effect of variable EG CG
EM Placebo
Others
Without therapeutic;
Consists of sterile water, sugar, anything with therapeutic
Without comparison
With comparison

Control Group - compare the result of EG to the CG

4. According to time frame
i. Cross Sectional
- the one time study
Opinion Exploratory; Survey - research done once
X ii. Longitudinal
Manipulation Exploratory - repetitive studies
X - cannot be done once to establish the result
Descriptive iii. Retrospective
- Historical - the study of the past to explain the present
- Case study iv. Prospective
- Methodological - the study of the present to predict the future
- Analytical - example is global warming

3. According to approach or design POPULATION

I. Non- Experimental - entire aggregate of cases that researches would
1. Historical “history” Eligibility Criteria
- the study of the past - exact criteria
- describes issues in the past Accessible Population
2. Survey - entire aggregate of cases that is within reach
- use of interviews and questionnaires to gather Target Population/ Universe
public opinion
- generalization
3. Case Study
Sampling
- indept or in details study of persons or entities
- process used to get a representative of the
4. Methodological “methods” population
- study of methods, tests, and procedures Sampling Plan
5. Analytical I. Non- probability II. Probability
 1. Convenience/ Accidental 1. Simple - informing him of the nature and the cause of
Sampling 2. Stratified accusation against him; asking him to
2. Quota 3. Cluster appear/answer in a specified date and time
3. Purposive/ Judgement 4. Systematic = kth of list
4. Snowball Privacy “private”
- anything that is private is covered by privacy
Formula for Systematic Sampling
- includes private moment, parts, properties
K = N = population size
N sample size

Slovin’s Formula
n= N
1 + Ne2

E = margin of error

Different levels of Measurement

4 BASIC RIGHTS OF RESEARCH SUBJECT
- assignment of numbers according to rules
1. Right not to be harmed
1. Nominal Data “name”
Beneficence – do good
- categorical
Non-Malificence – do no harm
- name the category
- to prevent and protect
2. Ordinal Data “order”
2. Right to full disclosure
- categorical
Veracity – thruthfullness
- ranking of events
3. Right to self-determination
3. Interval Data
Autonomy – pt has right to decide on their own
- numerical
Priority: Document – legas basis: code
of - also shows ranking of events with equal
ethics intervals and the zero is not absolute

4. Right to anonymity, confidentiality, and privacy 4. Ratio Data

- no to disclosure of information and cases - numerical

- professionally and directly involved/ law - shows ranking of events with equal intervals
and the zero is absolute
Subpoena Duces Tecum (appear in court)
- applicable only to documents
2 types of Data Analysis
- applicable only to object evidences
1. Descriptive Analysis
Subpoena Ad Testificandum
a. Frequency of Distribution
- court order asking a person to appear in court to
testify - use of tables and graphs

Ordinary Witness - tables and graphs are the ones that

communicates to the readers
- testify on matters where in they have personal
knowledge info. acquired thru your senses b. Measures of Central Tendency

Expert Witness - includes the mean, median and mode

- field of expertise Mean – average

Summon Median – middle most value

– a notice informing the accuse that there is a Mode – frequently appears

case filed against him
c. Measures of Variability
- includes simple rank, range, variance and
standard deviation or the distance from the mean

2. Inferential Statistics “population focused on set”

a. ANOVA = 3 or more set compared to 1 variable
– analysis if variance
b. Chi – square = 1 set of pop; studying 2 or more
variables focused on frequency
c. T- test
i. Student T test or Independent = 2 sets of pop
compared to 1 variable
ii. Paired T test = 1 set of pop; studying dependent
groups or results
Pearson R – 1 set; studying 2 or more variable focused
on interval or ratio data
Paired = If 1 set only, find before and after
Pearson R = numbers
Chi- square = not numbers, no before and after