Supervision is a process that involves a manager meeting regularly and interacting with worker(s) to review their work. It is carried out as required by legislation, regulation, guidance, standards, inspection requirements and requirements of the provision and the service.

1. SUPERVISION AND
MANAGEMENT,
DISCIPLINE, SELF
EVALUATION
Presented by:
Reena Sharma
M.sc.(Nursing) 2nd year
Shimla Nursing College
Presented to:
Ms. Savita Kumari
Associate Professor
Medical Surgical Nursing
Shimla Nursing College

2. INDEX
SR.NO CONTENT
1. Supervision and management
2. Discipline
3. Self evaluation or Peer evaluation
4. Patient satisfaction
5. Utilization review
6. Conclusion
7. Summarization
8. Recapitalization
9. Bibliography

3. INTRODUCTION
Supervision means overseeing
the employee at work. It is a
necessary concomitant of their
hierarchical organization in
which each level of subordinate
to the one immediately above
the it and subject to its orders.

4. The term "supervision" has its origin in Latin:
Super meaning "above”; vision/ video , meaning " over seeing “
It refers to:
Directing
Investigating
Guiding
Helping and
Advising the subordinate in performance with the purpose of
achieving the established objectives

5. Supervision has been defined as the cooperative
relationship between a leader and one or more
persons to accomplish a particular purpose.
Supervision is a kind of teaching which involves
advising, helping, inspiring, leading and liberating.
Jean Barrett
DEFINITION

6. OR
Supervision is described as a watching, overseeing
and Critical intense directing of a course of action of
particular activity. it is the act, process or function of
supervising.
Department of health, 1993

7. OBJECTIVES
• To help subordinate to do their job skill fully an efficiently.
• To develop subordinates capacity to the fullest extent
• To promote team work.
• To promote moral an motivation among workers.

8. PURPOSE
To improve the quality of work/ performance
To accomplish work
To evaluate performance and provide feedback
To improve staff efforts individually and collectively

9. Cont…
To bring personal and professional growth
To encourage teamwork
To improve the quality of nursing care

10. Good supervision generates and guaranties quality of
services rendered.
Good supervision coordinates and unifies efforts of
the nursing staff.
Supervision fosters the ability of each staff member
to think and act for herself/ himself i.e. it promotes
effectiveness of individual staff member.
It is based on the needs of the individual.
PRINCIPLES

11. It respects the individuality of the staff members.
Supervision of graduate staff nurses differs from that of students.
Supervision strives to make the ward a good learning situation.
Supervision is well planned.
Supervision should focus on continued staff growth and
development.
Supervision is responsible for checking and guidance.
Cont..

12. scope
Motivation
Staff
development
In-service
education
Performance
appraisal

13. Types of supervision

14. • Do not loose temper or abuse.
• Use democratic approach and avoid autocratic methods.
• Give workers a chance to reply.
• Do not talk too much and too fast.
• Be human in behavior.
• Do not take it granted that the worker has understood
everything told to him.
• Do not give instructions in a haphazard way.

15. Patient records and reports(case sheet or file).
Patient history sheets, treatment records, result of investigation
General order book, Round books.
Medicine ledger books.
Dangerous drug records and registers.
Nursing care plans, Nurse’s notes.
Admission and discharge register; death register.
Procedure manual.
Indent/ requisition registers for drugs and supplies.

17. Technical methods are some of the basic supervisory skills which
need to be trained
Creative supervision provides maximum adaptation to the
situation.
For example instead of an orientation period of two weeks
for each new staff member , a variable plan in both
contents and time according to the needs of each
individual should be formulated.
For example techniques of service study
,group conferences , group discussions. etc.

18. In cooperative supervision: There is a full
participation of each member of the group in
planning , action and decision.
In authoritarian supervision: Responsibility
centers entirely on the supervisor, with the
staff following his/ her staff orders.

19. • Scientific supervision relies on objective
study and measurement than personnel
judgment or opinion.
• Whereas intuitive supervision needs to
maintain the interpersonal relationship .

20. FUNCTIONS OF SUPERVISION
Administrative
Helping Communicative
Educative
Evaluative

21. Stage one: Preparation for supervision
 Study of documents
 Identification of priority for supervision
 Preparation of supervision schedule

22. Cont…
Stage two: Supervision
 Establishing Contacts
 Review of the objectives, targets and norms
 Review the job description
 Observe the nursing staff’s motivation
 Observe for any actual or potential conflicts
Consult and discuss with other

23. Stage Three: Follow up of supervision
 Reorganization of time
 Organizing in-service training programmes
Initiating changes in logistic support or support
system
Initiating actions for organizing welfare activities.
Counseling and guidance regarding career
development and professional Growth
Cont…

24. FACTORS OF EFFECTIVE SUPERVISION
Human Relation Skill
Technical and managerial knowledge
Leadership position
Improved upward relations
Relief from Non-supervisory duties
General and lose supervision

25. QUALITIES OF A GOOD SUPERVISOR
Tact
Thoroughness
Fairness
Enthusiasm
Emotional control Teaching ability
Initiative

26. TECHNIQUES AND TOOLS OF SUPERVISION
Observation
Nurses reports
Nursing round
Job descriptions
Supervisory rounds
Individual and group conference
Check list
Rating scales

28. Give autonomy to staff depending upon personalities,
expertise, capabilities,
 Have knowledge, competence, experience and characteristics.
Be professionally and technically competent.
Provide necessary counseling, guidance and training to staff.
Encourage staff in decision making.
Communicate with worker freely.

29. Cont…
Provide good leadership.
Ensure good planning, organizing and coordination.
Create suitable climate for productive work.
Encourage innovation allowing free ideas, share
positive experience specially.
Understand the situation and problems.
Adopt positive and supportive attitude rather an
attitude for inspection.

30. FRUITS OF SUPERVISION
Patient satisfaction
Personnal
development
Public endorsement.
Job enthusiasm Public support.
Growth of the
supervision

31. Orientation of
newly posted
staff
Assessment
of the
workload of
individuals
and groups
Arranging
for the flow
of materials

32. Coordination
of the efforts
Promotion
of
effectiveness
of workers
Raising the
level of
motivation
Cont..

33. Upward responsibilities
 Identifies the activities the hospital authorities or the
district hospital or the district health authorities want to be
done.
Arrange to carry out these activities
Keep your higher authorities informed about what is being
done.
Suggest measures for improving efficiency of workers.
Responsibilities of the nursing supervisor

34. Act as liaison between higher authorities on the health
management and the nursing personnel , interpreting the
requirements of the district health authorities and the hospital
authorities to workforce vice versa.
Refers matters to your supervisors for their timely and
appropriate interventions without bothering them
unnecessarily at the same time.
Cont..

35. Downward responsibilities
For selecting , orienting and training new staff
nurses and new students.
To demonstrate them concerned decorum manners
tact and courtesy in their working areas in day to day
dealing.
Help them in effectively humanely communicating
with their client and all others concerned.
Cont..

36.  Build good interpersonal relationship among the workers.
Help nurse performers in performing different procedures
effectively
Assign duties and responsibilities to nurse performers.
Arrange for their day offs and plan for their rotation.
Making contingency plans for emergency in advance.
Appraise the nurses performance , give feedback guide
and counsel them.
Cont..

37. DISCIPLINE

38. INTRODUCTION
Discipline is action or inaction that is regulated to
be in accordance with a particular system of
governance. Discipline is commonly applied to
regulating human and animal behaviour to its
society or environment it belongs.

39. DISCIPLINE
Discipline comes from the Latin
word “disciplina” which means
teaching, learning and growing .

40. • It is the bridge between goal and
accomplishment.
Jim Rohn
DISCIPLINE

41. Force that prompts the individuals,
organizations, nations to observe rules
and regulations which are necessary for
the effective and efficient running of
the group, organization or nation.
DISCIPLINE

42. DISCIPLINE
Discipline in an organization can be defined
as an orderly conduct by employees of an
organization to adhere to the rules and
regulations as well as policies guiding the
activities and running of the organization.

43. To obtain a willing acceptance of the rules, regulations
and procedures of an organization so that
organizational goals can be achieved.
To impart an element of certainty despite several
differences in informal behaviour patterns and other
related changes in an organization.
To develop among the employees a spirit of tolerance
and a desire to make adjustments.

44. AIMS AND OBJECTIVES OF DISCIPLINE
To give and seek direction and responsibility.
To create an atmosphere of respect for the human
personality and human relations.
To increase the working efficiency and morale of
the employees.

45. Importance of discipline
Creation of favourable work environment
Establishment of code of conduct.
Morale building.

46. Cont..
Encourage individual excellence.
Improve group performance.
Develop harmonious working.
It provides a code of conduct for
the guidance of the group

47. Positive discipline
Negative discipline
Self controlled discipline
Enforced discipline

48. Positive discipline (self discipline)
A sense of duty to observe the rules and
regulations.
The desirable behaviour is being awarded with
acknowledgement among peers, prize, token of
appreciation.

49. Negative discipline (corrective or punitive discipline)
A type of imposed discipline to keep control.
If the students do not abide the rules and
regulations of the institution, they are
reprimented in the form of fine imposition,
leave cancellation. cancelling monthly night
stays etc.

50. Self controlled discipline
The employees brings his or her behavior into
agreement with the organization’s official behavior
code.
As a result human beings are induced to work for a
peak performance under self controlled discipline.

51. Enforced discipline
In this a managerial action enforces
employee compliance with the organizations
rules and regulations.
it is a common discipline imposed from the
top.

52. Principle s of disciplinary action
Have a positive attitude
Investigate carefully
Be prompt
Protect privacy
Focus on the act
Enforce rules consistently

53. Cont…
Be flexible
Advise the employee
Take corrective, consistent action

54. Varying disciplinary measures.
Deferring settlement of employee grievances.
Misjudgment in promotion and placements.
Lack of well defined code of discipline.
Misuse through dividing people.
Inappropriate supervision.
Inattention to personal problems.
Causes of indiscipline

55. Cont..
Inappropriate supervision.
Improper/ partial division among employees.
Inadequate attention to personal problems.
Favouritism.
Lack of communication.
Lack of leadership.
Low morale and motivation among staff.
Bad habits.

56. ERRORS IN DISCIPLINIG EMPLOYEES
Delay in
administering
discipline.
Ignoring rule
violation
Failure to
document
disciplinary
actions
accurately.
Imposing
discipline
disproportionate
to the
seriousness of
the offense.

57. Agreement as to disciplinary rules.
 The discipline committee.
 Investigation by the human resource
management.

58. Types of penalties
 Warning ( oral/written).
 Fine.
 Suspension.
 Withholding increment.
 Demotion.
 Discharge.
 Dismissal.

59. Oral warning
 If the misconduct is not very
serious or when an offender is
first offender.
Invites, talks, caution and
warn to desist from such
actions.

60. Types of penalties
Written Warning
When the offence
committed cannot be
warned verbally a written
warning is issued to the
employee.

61. Example of a Written Warning
Date: April 17 .2021
To: The Employee
From: The Manager
Subject: Written Warning
We are quite concerned because today you were thirty minutes late to work and
offered no justification for this. According to our records, a similar offense occurred on
Jan 20, 2021. At that time, you were informed that failure to report to work on time is
unacceptable. I am, therefore, notifying you in writing that you must report to work on
time. It will be necessary to terminate your employment if this happens again.
Please sign this form to indicate that you have read and understand this warning.
Signing is not an indication of agreement.
Name
Date

62. Types of penalties
FINE
It is either for damage or loss of
goods entrusted to employee, or by
of punishment for misconduct.
No fine should be above 3% of the
wages and recovery should be in
installments

63. Withholding increments
The offender may not be
paid any allowance or
bonus due to him to punish
him for an offence or
indiscipline committed.
Cont..

64. Suspension
If an offense is strong the employee
is suspended without pay.
depending on the level of offense
the suspension may take up to two
months or more without pay.
Cont..

65. Demotion
This is also a serious penalty, for
irresponsibility or incompetence.
Cont..

66. Discharge ( termination of appointment )
Terminating the services of an
employee according to the
standing orders or according
to other established terms and
conditions of employment.
Cont..

67. Dismissal
 It is the permanent termination of the
services of a workman by way of penalty
for a very serious misconduct.
• when the employee gets involved in
fraud, stealing, illegal business etc.
Cont..

68. Misconduct
Any offence or act of commission or
omission on the part of an employee.

69. Minor Misconduct
Absenteeism
Dress code violation
Smoking rule violation
Incompetence
Safety rule violation
Sleeping on the job
Laziness, inefficiency or careless work.

70. Penalty for minor misconduct
Warning.
Fine.
Suspension without pay.

71. Major Misconduct
Drug use at work
Theft
Dishonesty
Physical assault upon a supervisor
Sabotage of company operations
 Committing a minor misconduct 3 times.

72. Penalty for major misconduct
• Suspension without pay.
• Stoppage of one or more allowances.
• Demotion to a lower post.
• Discharge.
• Dismissal.

73. Actions to be taken for misconduct procedures for imposing
punishment
• Three written warnings will be given if continued.
• Stop increment.
• Extension of probation period.
• Reduction to lower post.
• Suspensions.
• Dismissal.
• Termination.

74. Disciplinary action
Involves a penalty against an employee who fails to
meet established standards.

75. Basis for Disciplinary Action
• Unsatisfactory Job Performance.
• Unacceptable Personal Conduct.
• Grossly Inefficient Job Performance

76. Disciplinary Action Process
• Consider external and internal environment
• Organizational goals
• Establish rules
• Communicate rules to employees
• Observe performance
• Compare performance with rules
• Take appropriate disciplinary action

77. Progressive Disciplinary Approach
Improper Behavior
Does this violation warrant disciplinary actions?
Yes
Does this violation warrant more than an oral warning?
Yes
Does this violation warrant more than a written warning?
Does this violation warrant more than a suspension?
Termination
Yes
Yes
Yes
No Disciplinary Action
Oral Warning
Written Warning
Suspension
No
No
No
No

78. COMPONENTS OF A DISCIPLINARYACTION PROGRAM
Codes of conduct.
Authorised penalties.
Records of offences and corrective measures.
Right of appeal.

79. PRINCIPLES OF DISCIPLINARY ACTION
Have a positive attitude.
Investigate carefully.
Be prompt.
Protect privacy.
Focus on the act.

80. PRINCIPLES OF DISCIPLINARY ACTION
 Enforce rules consistently.
 Be flexible.
 Advise the employee.
 Take corrective, consistent action.
 Follow up

81. DEALING WITH DISCIPLINARY PROBLEMS
 Disciplinary conference.
 Disciplinary letter .
 Model standing orders.

82. STAGES OF DISCIPLINARY PROCEEDING ENQUIRY
 Give warning and written explanation from staff.
Warning letter is given if repeating again.
 sent for guidance and counselling.
 if repeated again then asked to give resignation.

83. Disciplinary process:
10) Personal hearing of
charged official
11) Report of enquiry
officer
17) Show cause notice
5) Suspension
3) Decision to start formal
department inquiry
2) Preliminary inquiry
1) Written complaint
9) Recording of evidence
by enquiry officer
8)Written statement of
defense
7) Appointment of enquiry
officer
6) Charge sheet and its
services
13) Reply to show- cause
notice and decision there
on
12) Show- cause notice by
disciplinary authority
14) Review of punishment
order
15) Appeal or revision
16) Reinstatement and
restitution

84. Roles of administrator in discipline
• Encourages employees to be self disciplined in
conforming with established rules and regulations.
• Assists employees to identify themselves with
organizational goals, their increasing the likelihood
that the standards of conduct deemed to be
accepted by the organization and will be accepted
by its employees

85. Cont…
• Periodically assesses the need for existing rules
and regulations and suggests modifications as
necessary.
• Discuss rules and policies with subordinates,
explaining the rationale for their existence and
encouraging questions.
• Humanistically uses discipline as a means of
promoting employee growth.

86. Cont…
• Ensures that rules and regulations are clearly written
and communicated to subordinates.
• Enforces established rules in a fair and consistent
manner.
• Carefully documents employees behavior that
prompts disciplinary action.
• Advises employees in seeking disciplinary action
redresss through informal and formal grievance
procedure.
• Allow employees feedback in the disciplinary
process.

87. SELF EVALUATION

88. INTRODUCTION
• The realization of goals and objectives is based
on the accuracy of the judgements and inferences
made by decision-makers at every stage. To arrive
at a good decision the test, measurements and
evaluation are being used in all situations. Thus
evaluation has become a part and parcel of every
system to determine the achievement of goals in a
given period.

89. TERMINOLOGY:
Evaluation:
Evaluation is an act or process that allows one to make
a judgement about the desirability or value of a
measure.
Self Evaluation:
Self evaluation is an evaluation of ones own abilities
and failings

90. Cont..
Peer Evaluation:
Peer evaluation is a process by which ones colleagues
assess his quality and accuracy.
Patient satisfaction:
Patient satisfaction is defined as the extent of the resemblance
between the expected quality of care and the actual received
care.

91. Meaning of Evaluation
Evaluation is derived from the word valoir
which means “to be worth”. Thus evaluation
is the process of judging the value or worth
of an individual’s achievements or
characteristics.

92. Definition
Evaluation is an act or process that allows one to
make a judgement about the desirability or value
of a measure.
OR
Evaluation is a systematic determination of a
subject's merit, worth and significance, using
criteria governed by a set of standards.

93. SELF-EVALUATION
Self evaluation is defined as judging the quality of one‟s work,
based on evidence and explicit criteria, for the purpose of doing
better work in the future.
OR
Self evaluation is defined as looking at progress, development and
learning to determine what has improved and what areas still need
improvement. Usually involves comparing a "before" situation
with a current situation.
Riley guide

94. PURPOSE
To encourage continuing self- evaluation and reflection and to
promote an ongoing, innovative approach.
To encourage individual professional growth in areas of interest
to the employee
To improve morale and motivation by treating the employee as a
professional in charge of his or her own professional growth.

95. Cont..
To encourage collegiality and discussion about practices among
peers in an organization.
To support employees as they experiment with approaches that
will move them to higher levels of performance

96. BENEFITS
1) Increased confidence in their own learning, in trying out new ideas,
in changing their practice and in their power to make a difference.
2) Enthusiasm for collaborative working, despite initial anxieties
about being observed and receiving feedback
3) Improved team-work and greater flexibility in their use of their
skills
4) Increased awareness of new techniques and greater insight into
thinking
5) Enhanced planning skills to ensure more effective task
management.

97. Tools for self evaluation
Staff annual
professional review
procedures
Peer
support
Coaching
Joint
preparation
Planning
Team
building
Adult
checklist

98. Peer Evaluation:
Peer review is a process by which employees of the
same rank, profession, and setting evaluate one
another’s job performance against accepted standards.
O’ Loughlin and Kaulbach

99. Success of peer evaluation depends on
Short but objective method
Trained observers
Constructive feedback for faulty development
Open communication and trust

100. Methods of Peer Evaluation
Direct observation
Videotaping
Evaluation of course
material
Analysis of portfolios

101. Phases of Peer Evaluation
The peer evaluation process may be developed using
three phases of establishing a peer review programme
 Familiarization
Assignment
Review
Feedback

102. PATIENT
SATISFACTION

103. Introduction
Consumers of health care services demand
quality care patient satisfaction has been as an
indictor of quality services provided by health
care personnel. The most important predictor of
patients overall satisfaction with hospital care
is particularly related to their satisfaction with
nursing care.

104. PATIENT SATISFACTION
• Patient satisfaction is defined as a health care recipients reaction
to salient aspects of the context, process, and result of their
service experience.
Pascoe (1983)
OR
• Patient satisfaction is defined as the extent of the resemblance
between the expected quality of care and the actual received
care.
Scarding (1994)

105. PRINCIPLES OF PATIENT SATISFACTION
Quality of care: The quality patient experience doesn’t happen by accident
but by standardized practice. A consistently great patient experience is not a
matter of attitude, awareness or positive intent but a matter of design and
continuous quality improvement.
Managing anxiety, fear and pain: “Anxiety is the rust of life, destroying its
brightness and weakening its power.” Patients are highly anxious. To create
an exceptional patient experience, we need to focus on preventing or
lessening anxiety for patients and families.

106. Cont..
Better communication: Some emotions don't make a lot of noise. If we
don’t communicate our caring, patients and families might think we don’t
care.
Personal attention: Patients and families want personalised care and
service.
Staff accountability: All staff must be accountable for their role like:
Clear responsibility Clear performance. Sound measurement and feedback
Courageous conversations Consequence’s reporting.

107. NEED FOR EVALUATING PATIENT SATISFACTION
Data about patient satisfaction equips nurses with useful
information about the structure, process and outcome of
nursing care.
 It is a requirement for therapeutic treatment and is
equivalent to self therapy.

108. Method of monitoring patient satisfaction
Medical staff
Quality assurance committee reviews
Indices of nursing performance
Judgmental method

109. Ten pillar of patient satisfaction
Leadership Vision and Commitment
Process Design and Continuous Improvement
Employee Engagement and Empowerment
Accountability for all category of staff
Monitoring and Feedback
Vertical and horizontal Communication
Staff Development and Training
Reward and Recognition
Service Recovery Dissatisfaction to satisfaction
Patient Focus and Sustainability

110. ADVANTAGES
Improves team work
 Encourage group members involvement and responsibilities
Focuses on the development of judgement skills
 Provides more relevant feed back to the students as it is
generated by their peers.
Give opportunities for the hidden leaders to be selected

111. DISADVANTAGES
Threats to friendship bias
 Time consuming
 Artificially inflated.
Peers feels ill equipped to undertake the assessment.
Reluctance to make judgement regarding their peers

112. Utilization Review

113. Introduction
• The utilization review program includes
determining appropriate hospital length of stay
and necessary treatments for various illnesses
and conditions and reviewing patient medical
records on admission and at intervals during
hospitalization to ensure that the patient receives
appropriate care.

114. Definition
Utilization review is an assessment of the appropriateness and
economy of an admission to a health care facility or a
continued hospitalization. The length of the hospital stay also
is compared with the average length of stay for similar
diagnoses.
Mosbys Medical Dictionary, 8th ed

115. Aims & objectives
The main aim is to curb the exploding health care costs
with conservative use of hospitalization and expensive
diagnostic and treatment procedures.
They work in liason with a business organization to
provide healthcare services to the organization’s
employees at discounted rates.

116. Utilization review nurse
A utilization review nurse is a registered nurse who reviews
individual medical cases to confirm that they are getting the
most appropriate care.
 These nursing professionals can work for insurance
companies, determining whether or not care should be
approved in specific situations, and they can also work in
hospitals.

117. Cont..
At hospital, a utilization review nurse examines patient
cases if the hospital feels that a patient may not be
receiving the appropriate treatment.
To work in this field, it is usually necessary to hold
current nursing license, and have experience in the field.

118. Conclusion
Supervision is observation and providing feedback to
ensure the quality of the program and to enable the
staff to perform to their maximum potential.
Discipline is action or inaction that is regulated to be
in accordance (or to achieve accord) with a particular
system of governance

119. Supervision and management
Disciplines
Self evaluation
Peer evaluation
Patient satisfaction
Utilisation review

120. Recapitulation
• What is supervision?
• Define discipline?
• What is peer evaluation?

122. ASSIGNMENT
• How to dealing with disciplinary problems

123. REFERENCES
 Vati Jogindra “principle and practice of nursing management
administration” 2nd edition jaypee publisher page no. 340-358
 Chatterjee SS. An introduction to management its principles and
techniques.3rd ed, 1963, page no.209-216.
 Basavanthappa BT. Nursing administration.2008 jaypee
brothers.1st ed.page no.333-335.
 https://www.slideshare.net/NcDas/patient-satisfaction-11778155
 https://www.slideshare.net/RahulPandit6/supervision-13615486
 Discipline. Available from URL-www.discipline.google.com