TIME MANAGEMENT& DELEGATION            DR. JAMES M. ALO, RN,MAN,MAP,PHD
ORGANIZATIONBeing organized is the key to effective Time Management!                          DRJAMESMALO
STEPS TO ORGANIZATION              Prioritization              Delegation              (Assignment & Supervision)         ...
PRIORITIZATION“Prioritization is defined as deciding  which needs or problems require  immediate action and which ones cou...
PRIORITIZATIONPrioritize the tasks in order of importance     Is it life threatening or potentially life threatening if t...
LEVELS OF PRIORITIZATIONFirst Level    “ABC’s plus V”:      airway, breathing, cardi      ac/circulation, vital      sign...
LEVELS OF PRIORITIZATIONSecond Level                Immediately subsequent                 to the 1st level             ...
LEVELS OF PRIORITIZATIONThird Level   Health problems     other than the first     two levels   Long-term issues in     ...
DELEGATION“   According to the ANA Code of Ethics for     Nurses with Interpretive Statement, (ANA     2001) the nurse is ...
DELEGATION“Delegation is defined as the transfer of responsibility for the performance of an activity from one individual ...
DELEGATION“Delegation is needed because of the advent of cost containment, the shortage of nurses, increases in patient ac...
DELEGATIONAfter creating your prioritized “To  Do” list, decide which tasks can be  delegatedThis can be a written or men...
FLORENCE NIGHTINGALE“But then again to look to all these things yourself does not mean to do them yourself…But can you ins...
THE 4 RIGHTS OF DELEGATION Right Circumstances     Rules & regulations of your area of practice     Patient condition & ...
THE 4 RIGHTS OF DELEGATION Right Supervision    Ask for the team member’s input first    Give credit for all that has be...
OBSTACLES TO DELEGATION What should you do when a delegate refuses to complete a task?                                    ...
UNDERDELEGATIONNew nurses often underdelegate   Fear of older staff resentment   Seek to demonstrate capabilities   Per...
OVERDELEGATIONOverdelegation may place patient at risk   Uncomfortable performing unfamiliar duties;     dependence   Di...
OBSTACLES TO DELEGATION Fear of being disliked Inability to give up control Inability to determine what to delegate and   ...
OBSTACLES TO DELEGATION Tendency to isolate oneself and choosing    to complete tasks all alone Lack of confidence in dele...
OBSTACLES TO DELEGATIONThinking of oneself as the only one who can   complete the task the way it is supposed to   be done...
OBSTACLES TO DELEGATION What should you do when a delegate   refuses to complete a task?                                  ...
ORGANIZATION: MORE TIPS  Make a Schedule:  Create deadlines for tasks to be accomplished  Create reasonable deadlines as a...
SAYING “NO”“Heavy Patient Assignment”Can I refuse a patient assignment?What should I do?                                  ...
ELIMINATE UNNECESSARYWORK Duplicate documentation – charting by  exception Social Talk in Hallways, nurses’  lounge, cafet...
TIME ALLOCATION                                   Idle                                   5% 0%                   Transacti...
TIME MANAGEMENT ISSUES???  Keep a Time Log or Time Allocation Diary  Assists with tracking daily routines and   identifica...
DOCUMENTATION:DEALING WITH INTERRUPTIONS Delegate tasks… Close door… Visitors will need to wait… Ask HUC to hold non-urgen...
REFERENCESKelly-Heidenthal, P., & Marthaler, M. T. (2005). Delegation of  nursing care. Clifton Park, NY: Thomson Delmar  ...
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Time management & delegation.drjma

  1. 1. TIME MANAGEMENT& DELEGATION DR. JAMES M. ALO, RN,MAN,MAP,PHD
  2. 2. ORGANIZATIONBeing organized is the key to effective Time Management! DRJAMESMALO
  3. 3. STEPS TO ORGANIZATION Prioritization Delegation (Assignment & Supervision) DRJAMESMALO
  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) DRJAMESMALO
  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 DRJAMESMALO
  6. 6. LEVELS OF PRIORITIZATIONFirst Level  “ABC’s plus V”: airway, breathing, cardi ac/circulation, vital signs(LaCharity, Kumagai, & Bartz, 2006, p. 5) DRJAMESMALO
  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) DRJAMESMALO
  8. 8. LEVELS OF PRIORITIZATIONThird Level  Health problems other than the first two levels  Long-term issues in health education, rest, copi ng, and so on(LaCharity, Kumagai, & Bartz, 2006, p. 5) DRJAMESMALO
  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) DRJAMESMALO
  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” DRJAMESMALO
  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) DRJAMESMALO
  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??? DRJAMESMALO
  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) DRJAMESMALO
  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 DRJAMESMALO
  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 DRJAMESMALO
  16. 16. OBSTACLES TO DELEGATION What should you do when a delegate refuses to complete a task? DRJAMESMALO
  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 DRJAMESMALO
  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 DRJAMESMALO
  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 DRJAMESMALO
  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 DRJAMESMALO
  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. DRJAMESMALO
  22. 22. OBSTACLES TO DELEGATION What should you do when a delegate refuses to complete a task? DRJAMESMALO
  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!!! DRJAMESMALO
  24. 24. SAYING “NO”“Heavy Patient Assignment”Can I refuse a patient assignment?What should I do? DRJAMESMALO
  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. DRJAMESMALO
  26. 26. TIME ALLOCATION Idle 5% 0% Transaction Documentation Processing 20% 15% Transportation 6% Administration 7% Direct Patient Care Hotel Services 35% 12% DRJAMESMALO
  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 DRJAMESMALO
  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… DRJAMESMALO
  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. DRJAMESMALO

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