B.Sc nursing 4th year topic for management subject

1. Vidyakirna college of nursing
Bangalore
Sub- Nursing management
Topic- Hospital and patient care units including ward
management
Presented by – Mrs. sulekha Deshmukh

2. 1st
•Hospital and patient
care units including
ward management

3. Introduction
• Hospital is an integral part of a social and medical
organization, the function of which is to provide for the
population complete health care, both curative and
preventive and whose out patient service reach out to the
family and its environment, the hospital is also a centre for
the training of health workers and biosocial research

4. Objectives of hospital
• To deliver care to all patient irrespective of any status
• To promote and restore health, and prevent illness and
complication
• To cure[ to make some body healthy after illness] illness
• To create awareness about health problem
• To detect, diagnose and treat illness at the earliest
• To maintain standards and provide quality care

5. • To educate and train the health care providers
• To enhance staff development activities
• To promote biomedical research

6. Organization and function of hospital
• Reception – it receive patient with illness and directs to OPD
• Members- receptionist and nurse
• Function- - clarify the enquiry
- guide the patient to various departments
- maintain various registers and records

7. • Out patient department -
• - registration
• History collection and physical examination
• Consultation with doctor
• Reference
• Referral system
• Initial admission procedure

8. In patient department

9. • Admission and discharge of patients
• Provision of medical and nursing care
• Investigation
• Health education
• Infection control
• Material management
• Staff development

10. Administrative department

11. • Administrative officer
• Assistant officer
• Manager
• Secretary
• Clerks
• Accountants
• Class iv workers

12. Function of administrative department
• Staffing
• Maintenance of the hospital building
• Budgeting for the hospital
• Supervision
• Controlling and coordination among various function
• Medical and nursing audit[an official examination ]
• Performance appraisal

13. • Patient welfare activities
• Quality assurance [ any systematic process of determining
whether a service meets specified requirements]
• Accreditation[ official approval given by an organization
when somebody achieves a certain standard]
• Reporting

14. Nursing department

15. Nurse patient ratio
NPR for
teaching
hospital -1:5
NPR for non
teaching
hospital-1:3
General ward
1:6
Special ward
1:6
NICU- 1:1 ICU- 1:1 LR- 1:1

16. • Major OT- 2:1
• Minor OT- 1:1

17. Function of Nursing superintendent
• Staffing
• Preparation of duty roster
• Supervision and monitoring
• Prepare job description
• Conduct nursing rounds
• Nursing audit
• Performance appraisal
• Public relations

18. Central sterile and supply department
• Supply sterile equipment to the department
• Maintaining incoming, stock and outgoing registers

19. Classification of hospital
• 1- based on the ownership
• Public hospital
• Voluntary hospital
• Private hospital
• Corporate hospital

20. • 2- based on the license to treat
• General hospital
• Special hospital

21. • 3- based on the size
• Teaching hospital- 500 beds
• District hospital- 200 beds
• Taluka hospital- 50 beds
• Primary health centers- 4-30 beds

22. • 4- based on the system
• Allopathic
• Ayurveda
• Homeopathic
• Unani
• Sidha
• Naturopathy
• Yoga

23. Ward management
• Wards are the local units of hospital
• head nurse
• Ward incharge
• Staff nurse
• Interns students
• Attendant
• sweepers

24. Responsibilities of head nurse
• Plan the duty roster
• Monitoring and supervision
• Conduct nursing round
• Maintenance of registers
• Ward meeting
• Performance appraisal
• Staff development

25. • Material management
• Recording and reporting
• Staff and patient welfare
• Teaching

26. Responsibility of ward in- charge
• Reporting
• Plan and implement patient care
• Ward maintenance
• Ward round

27. Responsibility of ward staff nurse
• Provide individual care
• Recording and reporting
• maintain nurse record
• Supervise class iv
• Ward maintenance
• Material management
• Supervise and teach interns and students
• Team work

28. Factors affecting good ward management
• Good knowledge of ward management
• Well planned work schedules
• Punctuality
• Good supervision
• Adequacy of supplies and equipment
• Nurse patient ratio
• Staff development activities
• Team work

29. Material management

30. Definition
• Material management is a scientific technique, concerned
with planning organization and control flow of material,
from their initial purchase to destination. The material
management in the healthcare system is concerned with
providing the drug, and equipment needed by health care
personnel to deliver service .

31. Cont…
• It is the process of coordinating and controlling the activities
in an organization responsible for purchasing material, their
scheduling from supply or any other internal sources, their
handling, storage and movement through the organization
up to the delivery.

32. Aims of material management

33. Aims..
• To get the right quality of
supplies
• To get the right quantity
of supplies
• At the right time
• At the right place
• For the right cost

34. Objectives
• to reduce cost of material
• Ensure a good support with suppliers
• Effective and efficient handling of material at all stage and in
all sections
• Low purchase price
• Maintaining continuous supply
• Maintaining quality

35. • Cordial relationship with supplier
• Product improvement
• Interdepartmental harmony
• Economic forecasting

36. Need

37. • To have adequate material on hold when needed
• To pay the lowest possible prices, consistent with quality and
value of material
• To minimize the inventory investment
• To operate effectively

38. Principles
Planning Organizing Staffing
Directing Controlling Reporting
Budgeting
Sound
purchasing
method

39. Principles Con……
Skillful and hard poised negotiation
must not increase the cost
Simple inventory control program

40. Function
material planning and budgeting
Purchasing
Inventory control
Cost reduction
Value analysis
Receiving and inspection
Stocking and distribution
disposal

41. Procedures
• Taking inventory regularly and systematically
• Requisitioning at indenting according to actual need
• Receiving and inspecting incoming items
• Storing items for use
• Proper use of items

42. Process
1-Budgeting and material planning
2-Demand forecasting
3-Procurement
4-Receipt inspection and payment
5-Storage
6-Inventory control
7-Issue and distribution

43. Process…..
8-Usage
9- Maintenance
10- Disposal and condemnation
11- Collusion
12- Pilferage

44. 1-Budgeting and material planning
• Based on the data of past level of performance and on
anticipated /plans, capital equipment, consumables and
supplies to be procured during the year ahead can be
projected department wise. This is the material budget
which should be prepared annually. Standardization of
budget endures grater relative use of the standard item in
relation to similar item available in the market, non
duplication of inventory, lower purchase cost and more
efficient use of materials

45. 2-Demand forecast
• Estimation of right amount of each material is the most
crucial factor for maximizing availability with minimum
wastage.
• Materials in a hospital may be requisitioned : for an urgent
/immediate use or in anticipation of need, on a one time
basis or repeatedly and continuously to replenish the stock
as a single unit or a bulk requirement

46. 3- Procurement
• An effective procurement system aims at purchasing of items
acceptable quality, in appropriate quantities at the minimum
price and within the available time. Purchase may be made
by the individual department of the hospital or by a single
purchase department. Centralized purchasing has the
advantages in that quantity discounts are possible because
of standardization and bulk order.

47. Objective of procurement system
• Acquire needed supplies as inexpensively as possible
• Obtain high quality supplies
• Assure prompt and dependable delivery
• Distribute the procurement workload to avoid period of
idleness and overwork
• Optimize inventory management through scientific
procurement procedure.

48. • Steps in purchasing
• Draw up specification
• Invite quotation
• Make a comparison of offers
• Shortlist offers
• Negotiate for better items
• Taking care to list out all requirement of the institution

49. • Seek an order
• Acknowledgement[receipt] and follow up for early supply

50. 4- Receipt, inspection, acceptance and payment
• While taking delivery from the road transporters, railways,
customs, check containers for deficiency and damages. If
packing is damaged, insist on open delivery, checking
quantity of packages, individual items, weights, packing
slip/challan.
• Any damage /loss should be registered immediately through
a claims statement
• Cross check with purchase order

51. • On receipt of the hospital checks supplies for discrepancies
in quantity, quality, product specification ect.
• Record shortage, incorrect damaged material, out dated
supply and take action accordingly.
• All supplies should be inspected and certified by the
purchase/ store department
• Carry our all necessary documentation, day book of receipt,
purchase register and bin card

53. 5- Storage
• Storage and preservation are an important part of
storekeeping function proper storage ensures that till the
time of issue for usage the supplies are adequately
preserved to prevent loss or damage.
• The department stores should be conveniently located to
facilitate easy receipt of materials from suppliers and easy
dispatch of supplies to the wards and department . The
material should adequately protected from fire, pests, water
sewage etc.

54. • Principle of storage
• Store must be of adequate space
• Divide the store In to homogenous section with separate
areas mark for different group of items e.g. stationary, drugs,
furniture etc
• No material should be stocked on the floor as it may be
affected by dampness, ants etc.

55. • Categories items in a group based on their generic name/
application store similar items contiguously
• Keep heavy items as low and as near to the door as possible
for easy retrieval. Light items may be placed on top shelves
• Daily and periodical cleaning should be carried out
• Daily and periodical verification of stock should be carried
out to ensure correctness of stock

56. • Proper method of handling should be followed to avoid
damages of the material
• Preservation material should be applied to protect the items
• Hazardous material should be segregated and stocked in a
separate store house away from other store house
• Safety precaution should be taken and safety application
should be provided .
• First in and first out principle to be followed

57. 6- inventory control
• It is the process of having the necessary equipment and
supplies available at the appropriate time. It means stocking
adequate number and kind of store, so that the materials are
available whenever required . Scientific inventory control
results in optimal balance

58. • Function of inventory control
• To provide maximum supply service, consistent with
maximum efficiency and optimum investment
• It increase productivity and efficiency
• Avoid stock out and balance stock
• Balancing supply and demand

59. • Method of inventory control
• ABC ANALYSIS- it involves classifying items by using value as
measure, it help us in segregating the items and tell us how
much the item are valued and what extent they should be
controlled in the best interest of the organization, the main
objective of this analysis is to frame policy guidelines
regarding control of items.

60. • Ved analysis – V category items means vital items which
require a large safety stock, E CATEGORY items means
essential items which require medium safety stock, D
category items means desirable items which require a small
safety stock. VED ANALYSIS is applicable to a large extent in
spare parts management

61. • Method of inventory control [FSN ANALYSIS]
• 1- Fast moving items – are used at a rapid rate, items have
moved at least once in a year
• 2- slow moving items- are used consistently but at slow rate
items which have moved at least once in a period of one or
two years.
• 2- non moving items – should be reviewed periodically to
prevent date expiry , obsolescence and damage in store it
may remain in the stock for several months.

62. 7 issue / distribution
• Items held in inventory by the stores may be issued through
indents to user department on a periodical basis or as and
when necessary.

63. 8 - usage
• Every effort must be made at all levels in the organization to
utilize supplies in order to avoid any from wastage.
Monitoring of consumption should be effected through
monthly supply usage reports to work which summarize
items consumed department wise. Material cost can be
decreased by appropriate selection of materials, cheaper
substitutes and standardization of supplies.

64. 9- maintenance
• Proper maintenance of equipment, furniture and fixtures not
only ensure their almost continuous availability for use an
extended life and productivity for the items, thus resulting in
lower material costs.

65. 10- disposal
• Each hospital should also have a condemnation to review
used materials that are to be disposed off. At times it is
possible to recycle or reuse materials or find some other use
for the item. If no further use can be found for disposables
used consumables and damaged equipment it may still have
value as scrap

66. 11- collusion
• Frauds involving buyer vendor collusion can account for a
significant percentage of avoidable material cost. For
commission either In cash or kind purchase personnel may
compromise the interest of the hospital .
• The vender finances such as payment by infiltrating the
price, overstating the quantity or through fraudulent
payments.

67. • Such frauds can be prevented by intensive internal audit and
by involving two or more department or persons in
purchases transactions.
• It is for this purchases that many hospital set up separate
department for purchase and for stores

68. 12 pilferage[pilferage is a thief who steals
small amount or item without permission]
• Items may be pilfered by the transporters, receiver, stores
personnel or the users. Control of hospital theft is possible
with intensive vigilance

69. Role of a nurse in maintain material management

70. • Ensuring regular and adequate flow of supply of necessary
equipment, supplies, drug and solution
• Monitoring and sustaining the quality and safety of the
material used including drug and solution, regular checking
of expiry dates of drugs, contribute toward safety
• Indenting, receiving, storing, checking and timely
replenishing of all necessary equipment, supplies, drug and
solution

71. • Maintaining of emergency stocks
• Maintaining inventory and stock of all items and supplies
• Arranging and assisting in audit of materials
• Participating in the policy making for material management.