Time management & delegation.drjma


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Time management & delegation.drjma

  2. 2. ORGANIZATIONBeing organized is the key to effective Time Management! DRJMA
  3. 3. STEPS TO ORGANIZATION Prioritization Delegation (Assignment & Supervision) DRJMA
  4. 4. PRIORITIZATION“Prioritization is defined as deciding which needs or problems require immediate action and which ones could be delayed until a later time because they are not urgent.” (LaCharity, Kumagai, & Bartz, 2006, p. 4) DRJMA
  5. 5. PRIORITIZATIONPrioritize the tasks in order of importance  Is it life threatening or potentially life threatening if the task is not done?  Would another patient be endangered if I do this now or leave this task for later?  Is this task or process essential to patient or staff safety  Is this task or process essential to the medical or nursing plan of care?How much time will each task require?  Try to leave tasks that are not urgent, but take more time for lastTickler List  Check Boxes of tasks  To-Do List DRJMA
  6. 6. LEVELS OF PRIORITIZATIONFirst Level  “ABC’s plus V”: airway, breathing, cardiac/circulation, vital signs(LaCharity, Kumagai, & Bartz, 2006, p. 5) DRJMA
  7. 7. LEVELS OF PRIORITIZATIONSecond Level  Immediately subsequent to the 1st level  Mental status changes, untreated medical issues, acute pain, acute elimination problems, abnormal lab results, and risks(LaCharity, Kumagai, & Bartz, 2006, p. 5) DRJMA
  8. 8. LEVELS OF PRIORITIZATIONThird Level  Health problems other than the first two levels  Long-term issues in health education, rest, coping, and so on(LaCharity, Kumagai, & Bartz, 2006, p. 5) DRJMA
  9. 9. DELEGATION“ According to the ANA Code of Ethics for Nurses with Interpretive Statement, (ANA 2001) the nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurses’s obligation to provide optimum patient care.” (Kelly-Heidenthal & Marthaler, 2005, p. 2) DRJMA
  10. 10. DELEGATION“Delegation is defined as the transfer of responsibility for the performance of an activity from one individual to another while retaining accountability for the outcome.” (Kelly-Heidenthal & Marthaler, 2005, p. 6)a.k.a. “Assignment” DRJMA
  11. 11. DELEGATION“Delegation is needed because of the advent of cost containment, the shortage of nurses, increases in patient acuity levels, an elderly chronic population, and advances in healthcare technology.” (Kelly-Heidenthal & Marthaler, 2005, p. 3) DRJMA
  12. 12. DELEGATIONAfter creating your prioritized “To Do” list, decide which tasks can be delegatedThis can be a written or mental listCharge Nurse, PCA’s, physical therapists, respiratory therapist, etc…What are some tasks that can be delegated??? DRJMA
  13. 13. FLORENCE NIGHTINGALE“But then again to look to all these things yourself does not mean to do them yourself…But can you insure that it is done when not done by yourself?” (Nightingale, 1859, p. 17) DRJMA
  14. 14. THE 4 RIGHTS OF DELEGATION Right Circumstances  Rules & regulations of your area of practice  Patient condition & preferred patient outcomes Right Task Assigned to the Right Person  Licensure, certification, & role description  Strengths & weaknesses Right Direction/Communication  Clear & concise communication Right Supervision DRJMA
  15. 15. THE 4 RIGHTS OF DELEGATION Right Supervision  Ask for the team member’s input first  Give credit for all that has been accomplished  Offer observations and concerns  Ask for the delegate’s ideas on how to resolve the problem  Agree on a course of action and plan for the future DRJMA
  16. 16. OBSTACLES TO DELEGATION What should you do when a delegate refuses to complete a task? DRJMA
  17. 17. UNDERDELEGATIONNew nurses often underdelegate  Fear of older staff resentment  Seek to demonstrate capabilities  Perfectionism or “Control Freaks”Avoid underdelegation  Overwhelmed & frustration  “Burnout” of assistive staff DRJMA
  18. 18. OVERDELEGATIONOverdelegation may place patient at risk  Uncomfortable performing unfamiliar duties; dependence  Disorganization  Inclined to avoid responsibility or immerse themselves in triviaAvoid overdelegation  Leads to asking staff, such as PCAs & LPNs, to perform duties that are not within their scope of practice  “Burnout” of assistive staff DRJMA
  19. 19. OBSTACLES TO DELEGATION Fear of being disliked Inability to give up control Inability to determine what to delegate and to whom Past experience with delegation that did not turn out well Lack of confidence to move beyond being a novice nurse DRJMA
  20. 20. OBSTACLES TO DELEGATION Tendency to isolate oneself and choosing to complete tasks all alone Lack of confidence in delegating to staff that were previously one’s peers Inability to prioritize using Maslow’s Hierarchy of Needs and the Nursing Process DRJMA
  21. 21. OBSTACLES TO DELEGATIONThinking of oneself as the only one who can complete the task the way it is supposed to be doneInability to communicate effectivelyInability to develop working relationships with other team membersLack of knowledge of the capabilities of staff including competency, skill, experience, level of education, job description, and so on. DRJMA
  22. 22. OBSTACLES TO DELEGATION What should you do when a delegate refuses to complete a task? DRJMA
  23. 23. ORGANIZATION: MORE TIPS Make a Schedule: Create deadlines for tasks to be accomplished Create reasonable deadlines as a guideline to accomplish tasks in a timely manner Don’t procrastinate Prevent Fires instead of Fighting Fires all day!!! DRJMA
  24. 24. SAYING “NO”“Heavy Patient Assignment”Can I refuse a patient assignment?What should I do? DRJMA
  25. 25. ELIMINATE UNNECESSARYWORK Duplicate documentation – charting by exception Social Talk in Hallways, nurses’ lounge, cafeterias, etc… Avoid re-writing report or lab values, etc. DRJMA
  26. 26. TIME ALLOCATION Idle 5% 0% Transaction Documentation Processing 20% 15% Transportation 6% Administration 7% Direct Patient Care Hotel Services 35% 12% DRJMA
  27. 27. TIME MANAGEMENT ISSUES??? Keep a Time Log or Time Allocation Diary Assists with tracking daily routines and identification of tasks that can be delegated or eliminated Follow each task to completion DRJMA
  28. 28. DOCUMENTATION:DEALING WITH INTERRUPTIONS Delegate tasks… Close door… Visitors will need to wait… Ask HUC to hold non-urgent calls… Document while in patient’s room… DRJMA
  29. 29. REFERENCESKelly-Heidenthal, P., & Marthaler, M. T. (2005). Delegation of nursing care. Clifton Park, NY: Thomson Delmar Learning.LaCharity, L. A., Kumagai, C. K., & Bartz, B. (2006). Prioritization, delegation, and assignment: Practice exercises for medical- surgical nursing. St. Louis, MO: Mosby Elsevier.Nightingale, F. (1859). Notes on nursing: What it is and what it is not. London, England: Harrison & Sons. DRJMA