2. Organizing
Learning outcomes
• Describe the term organizing
• Discuss the traditional principles of
organization in relation to the management
function of organizing
• Discuss the common methods of
organizing and delivering nursing care
2
5. Definitions…….
• The management function of assembling
and coordinating human, financial,
physical, information and other resources
needed to achieve organizational goals
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6. Definitions…….
• Organizing is the management function
that involves the process of
determining what tasks are to be done;
who is to do them; how the tasks are
to be grouped; who reports to whom
and where decisions are to be made.
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7. The Traditional Principles of
Organization
The Traditional Principles of
Organization are:
• A well-defined hierarchy of authority
• Unity of command
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8. Principles……
• Span of control
• Authority equal to responsibility
• Downward delegation of authority but not
responsibility
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9. Major activities in organizing
Two major activities in organizing are:
• Coordinating
• Delegating
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10. The Process of Organizing
Steps in organizing
• Reflecting of plans and objectives
• Establishing major tasks to be performed
• Dividing major tasks into sub tasks
• Specifying job responsibilities
• Delegating the authority necessary for task
accomplishment
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11. Process………
• Specifying reporting and authority
relationships
• Allocating and deploying resources in a
coordinated manner
• Evaluating results of organizing strategy
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12. Organizing nursing care
Nursing care delivery systems
• Nursing care is delivered amidst a
number of different structural designs
in health care facilities
Each design has its own strengths
and weaknesses 12
13. Cont’d
• The purpose of a nursing care
delivery system is to provide a
structure that enables nurses to
deliver nursing care to meet the
needs of unique groups of patients.
13
14. Factors influencing the choice of
nursing care delivery system
• Organizational goals
• Availability of nursing personnel (consider
the numbers and skills)
• Level of hospital revenue
• Changes in acuity of patients
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15. Factors……cont’d
• Demands of health care consumers for
quality care at a reduced rate
• Demands by nurses, physicians and other
health care professionals for more
effective delivery systems
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16. Common Types of nursing care
delivery systems
Common types of nursing care
delivery systems include:
• Functional Method / Nursing
• Case method / nursing / assignment
• Primary Nursing
• Team nursing / Modular nursing
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17. Types….Cont’d
Individual task
• Describe each nursing care delivery
system listed
• Explain advantages and disadvantages
of each nursing care delivery system
listed
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18. Common types…..Cont’d
Functional method / Nursing
• The most common method used in
hospitals
• Used where large numbers of patients are
to be cared for by a limited number of
nurses
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19. • Different tasks in a unit / ward is assigned
one or more nursing functions for a
number of patients in a ward.
• All the responsibilities and authority flow
from the charge nurse / manager
downwards to the staff members working
in a unit.
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20. Cont’d
• This method implements classical
scientific management principles; What
are these scientific management
principles? (Review scientific
management theory)
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21. Advantages
• The main advantage of this method is its
efficiency; a heavy workload can be
completed in a relatively short period of
time
• Method of choice in times of severe staff
shortages, emergency and disaster
situations
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22. Advantages Cont’d
• Each staff member gains competency
in one or two tasks in which one
specializes
• Preferred method when a number of
patients need only routine care.
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23. Disadvantages
• Main disadvantage: uses the assembly
type of division of labour; with the result
that it is mechanistic and impersonal.
• Emphasizes more on technical aspects of
nursing care
• Work repetitious and boring
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24. • Failure to interpret the significance of a
particular reaction to treatment
• Patients are not nursed holistically
• Care is fragmented
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25. Case method / nursing /
assignment
• One nurse is accountable for the total
care of one or more patients for the
period of her work shift
• Mainly used in private duty nursing;
extensively used in intensive care
units
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26. • in seriously or critically ill patients in a
general ward
• to nurse immediate post-operative
patients and in barrier nursing
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27. • Coordination of different services to
provide the care for one or two
patients is done by the nurse
assigned to them.
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28. Advantages
• Organization of work and the
assignment of nurses to patient is
relatively easy
• Easy to fix the responsibility for care
• Good patient-nurse relationship is
enhanced 28
29. • High level of work satisfaction from
the nurses
• Autonomy to make decisions
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30. Team nursing
• The patients in a unit / ward are
divided into different groups
• Each group of patients is nursed by a
specific team of nurses
• Each team is led by a registered
nurse; the team leader 30
31. The team leader is accountable for the
total care of all the patients in his / her
group; assessing patient care needs
and delegating patient care to
members of the team
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32. • Individualized nursing care plans,
personalized care and nursing care
objectives are emphasized
• Each team member is usually
responsible for the total care of one or
more patients
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33. • The team leader supervises the team
members and reports to the unit
manager.
• Effective communication between the
team members is important for
successful implementation of this
method
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34. Advantages
• The charge nurse’s span of control is
reduced
• Development of valuable leadership
skills
• High morale and increased job
satisfaction
34
35. • because of increased amount of
communication and cooperation
between members of the team and
full utilization of each one’s abilities
• Personalized holistic nursing care
approach; hence patients satisfaction
with care
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37. Disadvantages
• Lack of interpersonal, leadership, or
clinical skills for the role of team
leader
• Poor construction of teams, resulting
in ineffective teams
37
38. • The effectiveness of the team may be
compromised, when the composition
of the team must be changed
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39. Primary Nursing
• The underlying philosophy of primary
nursing is that comprehensive,
continuous, coordinated and
individualized nursing care is
delivered to a patient by a registered
nurse ;
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40. who has the autonomy and authority
to assume the overall and final
accountability for the planning,
delivery and outcome of that care
(Booyens, 2001)
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41. • Registered nurses work as primary
nurses
• These primary nurses are usually
given a case load of four or five
patient
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42. • The primary nurse conducts clinical
assessment, planning,
implementation, coordination and
evaluation of nursing care
• The primary nurse is accountable for
a patient throughout his / her stay in
the hospital,
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43. for his / her follow up care after
discharge if necessary and for his / her
care when the patient is re-admitted
into the same hospital
The primary nurse is responsible for
the care of her / his patients on a 24
hour basis 43
44. • The primary nurse is assisted by a
second registered or senior nurse
called associate nurse
• Primary nursing reflects a
decentralized organized structure
44
45. Advantages
• Enables the nursing process(scientific
approach) to be put into practice
• Patients are more satisfied with the
care
• Cost effective
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46. Disadvantages
• Requires a high proportion of
professional nurses
• Not all registered nurses feel have the
capacity to take on the entire
responsibility of a group of patients
46
47. • Communication problems may arise
between the head nurse and primary
nurse
• Conflict may occur between doctors,
nurses, and between the head nurse
and primary nurse
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48. Modular nursing
• Modular nursing is a modification of
team nursing and primary nursing;
It is sometimes used when they are
not enough registered nurses
available.
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49. • The patients in a unit / ward are
divided according to the layout of the
ward
• Each group of patients (usually 8 –
12) is nursed by a small team of
nurses consisting of two or three staff
members.
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50. • Each team must be led by a senior nurse
or registered nurse, if available.
• The leader’s responsibilities include
giving and receiving shift reports and
offering and asking for help from the
leader of another team.
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51. • The unit manager is responsible for
supervising the nursing care of all
patients and coordinating the work in
the unit
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52. Advantages
• Productivity in nursing care is better
than either team or primary nursing
• There is better communication and
cooperation between the different
staff members
52
53. Disadvantages
• When a patient moves from one bed
or room to another, he / she may fall
into a different patient group and will
need to get accustomed to a new set
of nurses
53
54. There is a division of the final
accountability for patient care between
the manager in charge of the unit and
the leader of each team
54
55. NOTE:
No delivery system is perfect
Most organization use a
combination or modification of
various nursing care delivery
systems to meet the unique
demands of different patient care 55
