

Purposes of Interview
1. It seeks to obtain enough information to
determine applicant’s suitability for the
position.
2. The applicant obtains adequate information
to make intelligent decision about accepting
the job should it be offered
3. The interviewer seeks to conduct the
interview in such a manner that regardless
of the result the applicant will continue to
have respect for and goodwill toward the
organization

Types of Interviews
1. Structured: requires greater planning
2. Semi-structured: requires some planning,
the flow is focused. flexibility on the
approach
STAFFING
The process of having appropriate number
of mixes of healthcare providers available to
care for the actual or projected number of
patients to achieve cost-effective, quality
patient care.
-
Note: The nurse care model gives the
framework within which to analyze their
needs to set their staff budget.
-
Staffing Budget for a unit is defined in full
time equivalents
Full-time equivalents – is the total number
of full-time hours of workers. A full-time
employee works 8 hours per shift.
-


Staffing Requirements are determined by:
 Patient’s Acuity
 Length of time that care is given
 Level of care for each patient
 Patient Classification
3.
Predicting Staffing Needs
 Is there current nursing shortage
 Supply and demand factors leading to the
shortage
Aging workforce with imminent
retirement
Inadequate nursing education enrollments
 Brought about by inadequate
resources to provide nursing
education to those interested in
pursuing nursing career
 “graying” of the nursing faculty also
contributes to shortage
 Employee Recruitment, Selection, Placement,
Indoctrination
I.
RECRUITMENT

Is the process of actively seeking out or
attracting applicants existing positions and
should be an ongoing process.
o
Interview (as a selection tool)
-A verbal interaction between the individual for a
particular purpose.
-It focuses whether or not the candidate will be a
good team leader rather than on the candidate’s
caregiving skills

Unstructured: requires little planning
because the goals for hiring is not clear

Limitations of Interviews
1. Subjectivity
2. Belief that interviewing is just about talking
to people
3. Belief that interviewing is just about good
conversations

Legal Aspects of Interviewing
1. Make sure that the application form does
not contain questions that violate various
employment acts. Unlawful questions must
be avoided.
2. Inquiries regarding age, marital status,
children, race, sexual preference, financial
or credit status, race of origin, religion,
these deemed discriminatory.
Interviewing Tips for Applicants
1. Prepare in advance for the interview
2. Obtain copies of the philosophy and
organizational chart of the organization to which
you are applying.
3. Schedule an appointment for the interview
4. Dress professionally and conservatively
5. Practice responses to potential interview
questions in advance.
6. Arrive early on the day of interview
7. Greet the interviewer formally and do not sit
down before she does unless given permission
to do so.
1
8.
9.
10.
11.
12.
13.
14.
15.
Shake the interviewer’s hand upon entering the
room and smile
During interview, sit quietly, be attentive, and
take notes only if absolutely necessary.
Do not chew gum, fidget, slouch, or play with
your hair, keys or writing pen
Ask appropriate questions
Avoid a question “what can you do for me”
Answer interview questions honestly and
confidently.
Shake the interviewer’s hand at the close of the
interview and thank him for her time.
Send a brief thank you note to the interviewer
within 24 hours of the interview
VI.
VII.
VIII.
*As predictor of job performance and overall
effectiveness, the STRUCTURED INTERVIEW is more
reliable than the unstructured interview*
*Use a team approach
*Develop a structural format for each job
classification
*Use scenarios to determine DECISION-MAKING
ability
*Conduct multiple interview
II.
SELECTION
 The process of choosing from among applicants the
best qualified individual for the job or position
 The process involves:
o Verifying the applicant’s qualification
o Checking for work history
o Deciding if a good match exists between
applicant’s qualification and the
organization’s expectation
Notes: Speeding through the selection and hiring process is
a critical leadership mistake because it increases the risk for
hiring the wrong person
III.

IV.
V.
EDUCATIONAL AND CREDENTIAL REQUIREMENTS
To determine if the relationship exist between these
requirement and success on the job.
REFERENCE CHECK AND BACKGROUND SCREENING
PREEMPLOYMENT TESTING

Human resource development gives
STANDARDIZED TEST to measure skills,
intellect, personality or characteristics
IX.
X.
PHYSICAL EXAMINATION
 Provides a record of PHYSICAL CONDITION of
the applicant at the time of hiring.
 This can be used to identify applicants who
are potentially have unfavorable attendance
record or may file excessive claims aside
from what the organization can provide.
MAKING THE DECISION
FINALIZING SELECTION
 Follow-up applicants as soon as possible
 Candidates not offered should be notified as
early as possible, and reasons be provided
when appropriate
 Applicants offered the position should be
informed in writing of the benefits, salary,
and placement.
 Applicants accept the job offers should be
informed as to the preemployment
procedures
 Applicants who are offered positions should
be requested to confirm in writing their
intention in writing
PLACEMENT
INDOCTRINATION
 The planned, guided adjustment of an
employee to the organization and the work
environment
 Purposes:
o Establish favorable employee
attitude towards the organization,
unit and department.
o Provide necessary information and
education for success in the position
o Instill the feeling of belongingness
and acceptance
 Phases of Indoctrination
A. Induction
 Takes place after the employee
has been selected but before
performing the job.
 Educate the employee about the
organization and employment
and personnel policies
B. Orientation
 Takes place in the staff
development department
 To make the employees
feel like a part of the
team.
 This will prevent burnout
and help new employee
become independent
2
C.
more quickly in their new
job.
Socialization
a.
 STAFF DEVELOPMENT
*Accountability: means you are
answerable to an authority for the activity
-A Cost-effective method of increasing productivity
 Training – an organized method of
ensuring that people have knowledge and
skills for the specific purpose to perform
the duties of the job
 Learning Concepts in Meeting the learning
of the Staff
o Readiness to Learn
o Motivation to Learn
o Reinforcement
o Task Learning Span of Memory
o Knowledge of Results

*Responsibility: means you perform the
activity
*The key role of the nurse manager is to
delegate responsibilities to a QUALIFIED
AND COMPETENT PERSON
*Delegate: THE RISK TASK, TO THE RIGHT
PERSON, WITH CLEAR DIRECTION
o
‫־‬
‫־‬
‫־‬
‫־‬
‫־‬
Evaluation of Staff Development Activities
o Learner’s reaction
o Behavior Change
o Organizational Impact
o Cost-effectiveness
‫־‬
 OVERCOMING MOTIVATIONAL DEFICIENCIES
A. Positive Sanction
-Can be used as an interactional or
educational process of
socialization
o
‫־‬
‫־‬
‫־‬
B. Negative Sanction
-Provides cues that enables people
to evaluate their performance
consciously and to modify
behavior when needed.
‫־‬
‫־‬
‫־‬
o
-Bullying, making fun of a new
graduate’s awkwardness with
certain skills or belittling new
employees to use nursing care plan
are inappropriate
-The act of issuing orders, assignment, instructions
to accomplish the organization’s goals and objectives
*NURSING CARE PLAN is a tool directing, it outlines
the nursing care to be provided to a patient*

Elements of Directing
Why there is a Need to Delegate?
Delegation can save money
Helps building skills of subordinate
Motivate people to perform higher level tasks
Train people to prepare for greater responsibilities
Allow next in line staff to do the job in the absence
of the manager
Groom successors since nobody is indispensable
Why Managers do not want to Delegate
Mistakes in delegation is costly
Failure to delegate wisely increases management
cost and contributes to personnel dissatisfaction
Fear on the part of the management to fully
comprehend the tasks to be accomplished
Fear of losing control of the staff
Fear of failing to get others do the work
Fear of criticisms
How to Delegate a Task
Clearly understand the complexity of the task. Know
specifically what needs to be done.
‫ ־‬Know the time required to complete the task. Use
an average time, rather than the shortest time.
‫־‬
‫־‬
 ROLES AND FUNCTIONS OF DIRECTING
Delegation: is getting work done through
others by transferring responsibility for
an activity to another without transferring
accountability for the activity
‫־‬
‫־‬
‫־‬
‫־‬
‫־‬
Know the skill level required to perform the task.
Avoid equating skills with titles.
Verify that the staff member has the skill level to
perform the task and has experience performing the
task.
Determine if the staff member has the time to
perform the task.
Develop contingency plan if the desired outcome
isn’t achieved
Establish a level of supervision required for the task.
Set criteria for evaluating the outcome of the task
3
‫־‬
‫־‬
‫־‬
o
o
o

Clearly communicate the task to your staff member.
Confirm that the staff members accept responsibility
to perform the task.
Determine the support and the equipment the staff
member needs to perform the task
Activities that Center on Professional Judgement that
an R.N. CANNOT DELEGATE
‫ ־‬Assessing the patient
‫ ־‬Formulating nursing diagnosis and planning
patient care
‫ ־‬Performing interventions that require
professional knowledge and special skills to
perform
Tasks that CAN BE DELEGATED
‫ ־‬Nurse practice act and regulations
‫ ־‬Job Description
‫ ־‬Patient Needs
‫ ־‬Policies and procedures
Common Delegation Errors
1. Under-delegating
‫ ־‬Stems from manager’s assumption
that delegation maybe interpreted
as the lack of ability on his part to
do the job correctly or completely.
‫ ־‬Manager has trust issue
‫ ־‬Insecure
‫ ־‬When manager lacks experience on
the job, there is the excessive need
to control and be perfect
*If leadership is a journey, then respect
for its constituent is the fuel and good
stewardship is its compass*
2.
Over-delegating
‫ ־‬The culprit is usually poor
management of time and insecurity
in the part of the nurse-manager in
her ability to perform tasks.
*Supervision begins once the task is delegated to
a member of the staff*
o
2 Types of Supervision
a. Direct Supervision
‫ ־‬May occur when a nurse is performing
a procedure for the first time or when
a complex procedure that has serious
side effects is performed.
‫ ־‬The nurse-managers observe and
directs the staff member through each
step of the task
b. Indirect Supervision
‫ ־‬Occurs when the nurse manager
oversees the performance of a task
o
Close Supervision is Done When
‫ ־‬It has potential for serious harm to the
patient
‫ ־‬Task is complex
‫ ־‬Tasks require steps other than those
that are normally followed
‫ ־‬Task may have an unpredictable
outcome
‫ ־‬Task is not performed frequently
‫ ־‬The staff member has not performed
frequently
o
Principles of Good Supervision
‫־‬
Can produce attitudes which are both
positive and negative.
Produces positive attitudes when the
employee is conscious of the benefits to
herself which she attributes to the influence
of the supervisor
Produce negative attitude when the reaction
of the workers is resistance to discipline or
actual fear of demotion or discharge
Good supervision is focused on improvement
of work rather than upgrading the worker.
Is based on (??)
‫־‬
‫־‬
3.
Improper Delegating
‫ ־‬Delegation of tasks and
responsibilities beyond which the
person cannot perform properly.
‫־‬
‫־‬
b.
Supervision
 Is the active process of DIRECTING,
GUIDING AND INFLUENCING the outcome
of an individual’s performance of an
activity or task
It entails motivating and encouraging the
staff to participate in activities to meet
goals and objectives and personal
development

Good Supervision Focuses on Development
of 3 Areas
a. Conceptual – enhance knowledge
through adequate information and
feedback.
4
b.
c.
Technical – refinement of skills through
in-service trainings and seminars
Interpersonal – develop communication
skills through constant dialogues and
conferences
*Good Supervision is cooperatively planned
by both management and staff, and accepts
both challenge or change*

Good Supervision uses a DEMOCRATIC
PROCESS to facilitate
‫ ־‬Effective communication
‫ ־‬Continuous improvement of staff
‫ ־‬Respect for individuality of each
staff member, Brings about
harmonious relationship and a
Conducive social, psychological,
and physical atmosphere
*Ultimate Goal of good supervision is to
PROVIDE SAFE, EFFECTIVE, QUALITY CARE*

c.
Responsibilities of Supervisors
‫ ־‬Duty to teach and motivate the
staff
‫ ־‬Facilitate their work performance
‫ ־‬Be available for consultation
‫ ־‬Perform assessment and
evaluation of work performance
including environmental conditions
and supervisions
Staff Development
 Is planned experience to help employees perform
effectively and efficiently and to enrich their
competence in practice, education,
administration, and research.
o
o
Functions of Staff Development
‫ ־‬Maintain staff efficiency and
effectiveness
‫ ־‬Create quality employees
‫ ־‬Meet staff needs and address their
problem
‫ ־‬Motivate them and improve their
self-confidence, knowledge and
skills, improve performance
In-service Training
‫ ־‬Is education for employees to help
them develop skills in a specific
discipline or occupation
o
Continuing Education
‫ ־‬Is a specific learning activity
generally characterized by
ISSUANCE OF A CERTIFICATE OR
(CEU) for the purpose of
documenting attendance at a
designated seminar or course of
instruction
d. Coordination
‫ ־‬Links the different components of
an organization and leads them
toward goal achievement
‫ ־‬Creates harmony on all activities
to facilitate success of work.
e.
Collaboration
‫ ־‬Manager and health care staff
together with the other
members of the healthcare
team all participate in decision
making process.
f.
Communication
‫ ־‬The aim is to have people;
stop something they are now
doing,
do something they are not now
doing,
or change the way they are
now doing something.
-Anonymous
‫־‬
The art of conversation is not
only the ability to say the right
thing at the right place and
time, but to leave unsaid the
wrong thing at the most
tempting moment.
*Takes place after an individual begins her
work responsibilities*
5


CRITICAL THINKING
‫ ־‬The cognitive process of examining underlying
assumptions, interpreting and evaluating
arguments, exploring and analyzing alternatives
thereby developing a reflective criticism for the
purpose of reaching a justifiable reasoned
conclusion and correct judgement.
‫ ־‬It is a higher-level cognitive process that
includes: creativity, problem solving, and
decision making.
DECISION MAKING
‫ ־‬The process of identifying and choosing a
particular course of action from among
several choices
‫ ־‬Is an end-point of critical thinking which
leads to problem solution
 Define the problem
 Assess all options
 Weigh all options against a set of
criteria/standards
 Test possible options
 Consider consequences of the decision
 Make final decision
 Tools in Decision Making
a. Probability Theory
‫ ־‬Design to address the presence of risk or
uncertainty by looking for predictable
patterns based on historical data
thereby reducing the uncertainty.
-Patients are serviced equally that is,
they experience the same amount of
delay
d. Linear Programming
-uses matrix algebra to determine the
best way to use limited resources
 CONTROLLING
‫ ־‬Phase of management process, performance is
measured against predetermined standards, and
actions is taken to correct discrepancy between the
standards and actual performance
‫ ־‬The use of formal authority to assure the
achievement of goals and objectives
*The control or coordinating function of management can be
a critical determinant of organizational success*

FUNCTIONS OF CONTROL
1. Serves both as a means and an end
2. Effective use of resources
3. Provides professional reinforcements
4. Maintains activity and expectations

PRINCIPLES OF CONTROLLING
There must be:
1. A critical few, meaning that fewer people
involved in control brings about the best
result. Unity of direction/unity of command is
at play.
2. A defined Point of Control or a centralization
or decentralization of authority. The level of
ARA (Authority, Responsibility, Accountability)
designated to the nurse leader or manager in
terms of problem solving and decision making
3. Self-Control or Discipline, which translates to
personal acceptance of responsibility and
accountability.

TYPES OF CONTROL
a. Feedforward Control – focus on operations
before they begin. Goal is to prevent
anticipated problems.
 Example: Preparing supplies for the
scheduled surgery, safety system training
programs, budget.
b. Decision Tree
‫ ־‬Enables the planner to visualize the
alternative courses of action.
c.
‫־‬
Queuing Theory
A powerful tool that helps hospitals and
clinics uncork chronic problems in the
flow of the patients in ER, OPD
 Queuing Disciplines
1) First in First out
-Patients are served according to
their order of arrival
2) Last in First out
-the last patient to arrive on the
queue is the one who is actually
serviced first
3) Processor Sharing
6
b.
Concurrent Control – refers to processes as
they are happening
 This includes any type of material or
supplies for the therapeutic use which
requires direct supervision
c.

6.
Feedback Control – focus on the result of
operations which guide future planning,
inputs, and process designs. (Weekly,
monthly, annual reports)
THE CONTROL PROCESS
A. Establish and specify criteria and performance
standards.
1. Standards
‫ ־‬Any guideline established as basis for
measurement.
‫ ־‬Precise, explicit statement of expected
result for a product, service, machine,
individual or organizational unit.
2. Time Control
‫ ־‬Relates to deadline and time constraints
‫ ־‬Material Controls: relates to inventory
and materials needed.
‫ ־‬Cost Controls: help ensure that cost
standards are met
‫ ־‬Employee Performance Control: focus on
the actions and behaviors of individuals
and groups of employees
(Ex. Tardiness of Employee, absences,
accidents, quality and quantity of work)
‫ ־‬Budget Control: refer to cost or expenses
related standards.
B. Monitor and Measure Performance of Nursing Care
Services and Evaluate it against the Standards through
Records, Reports and Observations

Techniques Monitoring and Measuring Service
1. Nursing Rounds: Nurses pay particular
attention to issues of patient care and nursing
practice. This will also find out if the needs
and problems of patient are met or unmet.
2.
3.
*Identify the quantity of materials used and production
output*
3.
4.
5.
Financial Control
‫ ־‬Facilitates achieving the
organization’s profit
‫( ־‬Example: Budgeting)
Operations Control
‫ ־‬Assess how efficiently and effectively
an organization’s transformation
processes create goods and services.
‫ ־‬This includes TQM (Total Quality
Management), and inventory
management control.
Statistical Process Control
‫ ־‬Is the use statistical method and
procedures to determine whether
production operations are being
performed correctly.
The Just-in-Time System
‫ ־‬The timely application of materials
for use in case nurses need it for
patient care.
‫ ־‬Communication, coordination, and
cooperation are required form
supervisors and employee to deliver
the smallest possible quantities at
the latest possible date at all stages
Quality Assurance: monitors compliance of
nursing personnel with established standards
in terms of nursing care given to patients
Nursing Audit: consist of documentation of
the quality of nursing care in relation to the
standards established by the nursing
department
 Purposes of Nursing Audit
‫ ־‬It prioritizes nursing care by promoting
optimum nursing care
‫ ־‬It can identify differences in the
organization and administration of
nursing care, and may be used to
correct such deficiencies through
continuing education and
administrative change
C. Compare Performance with Standards, Models or Criteria
to Determine Deviation or Differences in Performance
1.
‫־‬
2.
‫־‬
‫־‬
Program Evaluation and Review Technique (PERT)
Employ a matric that uses a network of activities
presented in a chart, including time management,
budget, goals or product desired.
Benchmarking
Seeks out the best so as to improve its performance
Provides standard or point of reference in measuring
or judging such factors as quality, values and costs.
D. Enact Remedial Measures or Steps to Correct Deviations
or Errors
‫־‬
Correction of Deviations or errors
7



‫־‬
‫־‬
Better selection and training of subordinates
Changing the number of personnel
Adding more materials or resources to
minimize or eliminate errors
Use of the master control plans depicting its
functions, goals and objectives
Take necessary action
 Supervisor take immediate corrective action

CHARACTERISTICS OF CONTROL PROCESS
1. Control process is cyclical which means it is
never finished
2. Controlling often leads to management
expecting employee to change
3. Control is both anticipatory and retrospective
4. Ideally each person in the health care delivery
views control as his or her responsibility
5. controlling builds on planning, organizing, and
leading.

ELEMENTS OF CONTROLLING
1. Performance Appraisal
‫ ־‬Is a method of acquiring and processing
information needed to improve the
individual’s performance and
accomplishment
‫ ־‬It consists of setting standards and
objectives, reviewing progress having on
going feedback between the appraiser and
the one who is being appraised, planning
for reinforcement, deletion of identified
behavior as necessary.
‫ ־‬The purpose if evaluation is to assess the
appropriateness, adequacy, effectiveness
of the services
 Performance Appraisal Tools
a. Trait Rating – this method of ratting a
person against a set standard which may
be the job description, desired behavior
and personal trait.
b. Job Dimension – it focuses on job
requirements and the quality work
performance
c. Behaviorally Anchored Rating Scale –
focuses on desired behaviors to improve
performance.
d. Checklist – composed of behavioral
statements that represents desirable
behavior
e. Peer Review – a collegial evaluation of
the performance done to promote
f.
excellence in practice and offer
information, support, guidance, criticism
and direction to one another.
Self-Appraisal – this tool allows the
employee to evaluate his own
performance, this will remind your boss
all the good things you did.

COMMON ERRORS IN APPRAISAL
1. Halo Effect
‫ ־‬Tendency to overate the staff based
on the rater’s first impression.
‫ ־‬Evaluation is based on the good
traits or good things one sees in a
person
2. Logical Error
‫ ־‬The first encounter may provide the
rater the qualities or specific traits
which serves as bars to the quality of
performance of the rate
3. Central Tendency Error
‫ ־‬This rates the staff average, used by
rater when the feedback tools are
inadequate and there is no sufficient
time for the rater to observe the
rate.
4. Leniency Error
‫ ־‬There is the propensity to overlook
or observe the weaknesses and
mistakes of the person being
evaluated leading to inaccurate
picture of the job performance
5. Hawthorne Effect
‫ ־‬Behavior of the rate changes simply
because he us observed by the rater
6. Horn’s effect
‫ ־‬Occurs when rating an employee
very low because of error
committed.

o
TOTAL QUALITY MANAGEMENT
Is based on the premise that the individual is the
focal element on which production and service
depend (that is.. it must be a customer-responsive
environment) and that the quest for quality is an
ongoing process
*It is identifying and doing the right things, the right way,
the first time, and problem-prevention planning – not
8
inspection and reactive problem solving – lead to quality
outcome*
o
TQM is also referred to as continuous quality
improvement (CQI), a philosophy developed by Dr.
Edward Deming.
‫ ־‬It assumes that production and service focus on
individual and that quality can always be better.
*a critical component of TQM is the empowerment of
employees by providing positive feedback and
reinforcing attitudes and behaviors that support quality
and productivity*
o
o



TQM identified 5 steps in medication
reconciliation
1. Develop current list of medication
2. Develop list of medications to be prescribed
3. Compare medications in two lists
4. Make clinical decisions based on the
comparison
5. Communicate the new list to appropriate
caregivers and to the patient
Is aimed to embedding awareness of quality in all
organizational process
A management of all its members and aimed at longterm success through customer satisfaction and
benefits to all members of the organization and
society
BASIC PRINCIPLE OF TQM
a. Focus on achieving customer satisfaction
b. Seek continuous and long-term
improvement in all the organization’s
processes
c. Take steps to ensure the full
involvement of all the entire work force
in improving quality
TQM PARADIGM
 TOTAL – involving the entire organization,
the entire chain, and/or product or
outcome life cycle.
 QUALITY – with its usual characteristics,
with all its complexities to meet total client
satisfaction.
 MANAGEMENT – the system of managing
the organizations with steps like Planning,
Organizing, Controlling, Provisioning and
the like.
WHO SHOULD BE INVOLVED IN TQM?
‫ ־‬Everyone in the organization because each
individual is a recipient of the benefits
‫ ־‬Engagement of frontliners staff appears to be
especially critical when sustaining
‫ ־‬Quality improvement efforts: such as
transforming care at bedside
‫ ־‬Engages leaders at all levels of the organization,
empowers frontline staff to improve care process
and engage family members and patients in
decision making about their care

Example: Medication Error




‫־‬
MEDICAL ERRORS: AN ONGOING PROCESS THREAT
TO QUALITY OF CARE
Medical errors – adverse events that could be
prevented given the current state of medical
knowledge
Medication Errors – event that may cause or lead to
inappropriate medication use or harm while the
medication is in the control of the healthcare
professional, patient, and or consumer
Measures:
Reporting and Analyzing Errors
 Need to increase both the mandatory and
voluntary reporting of medical errors
 Organizational culture must be created
that remove blame form the individual
 Focus on how the organization itself can
be modified to reduce the likelihood of
such errors occurring in the future.
*Ignoring the problem of medication errors,
denying their existence, or blaming the individuals
involved in the process does nothing to eliminate
the underlying problems*

FACTORS THAT DETERMINE QUALITY OF HEALTH
CARE
1. Effectiveness – relates to providing care
process and achieving outcomes as supported
by scientific evidence
2. Efficiency – relates to maximizing the quality
of a comparable unit of health care delivered
3. Equity – relates to providing healthcare of
equal quality to those who may differ in
personal characteristics other than their
clinical condition or preferences for care
4. Patient Centeredness – relates to meeting
patient’s needs and preferences and
providing education and support
5. Safety – relates to the actual or potential
bodily harm
9
6.
Timeliness – relates to obtaining needed care
while minimizing delays
10