nursing administration topics

1. Nursing
Rounds

2. Introduction
There are several methods that can be used effectively
in clinical teaching.
Nursing rounds are conducted by the head nurse or
nurse teacher with the members of her staff or students
for a clear understanding of the disease and the effect
of nursing care for each patient.

3. Types of nursing rounds
• Nurse , matrons’ rounds
Senior nurses to achieve key aspects of their role,
ensuring professional and clinical nursing standards.
• Nurse management rounds
Nurse in charge of the shift seeing each patient which
gives an overview of the condition and needs

4. • Patient comfort rounds
Carried at 2 hours intervals, before patient
goes for sleep
• Teaching rounds
To learn direct patient contact with
facilitation from an experienced nurse teacher
and to teach and evaluate nursing care

5. Purpose of nursing rounds
To observe the physical and mental condition of the
patient and the progress made from day to day.
To observe work of staff.
To specific observation of the patient and give report
to doctor regarding it., for example-wounds, drainage,
bleeding.
To introduce patient to personnel and vice versa.
…..

6. To teach nursing students or hospital staff regarding
specific condition.
To check any preventable condition in patient such
as bedsore, foot drops etc.
To check emergency equipment near the patient for
safety and working order.
To compare the disease condition of different
patients so that the students gains better insight.
To prescribe any modification in nursing action.

7. Ways of conducting rounds
When ward rounds are conducted , the teacher goes
to the patient’s room with the group of nurses.
Outside of the door, out of his hearing ,they discuss
the objectives , after which they go in to and see the
patient and talk for a few moments with him.
They then move on to the next patient.
….

8. The discussion must necessarily by brief including
only the outstanding points if the purpose is to visit all
the patient in the ward.
Nursing rounds are done in a reporting style
regarding the patient’s condition , nursing care,
medical care and prognosis.

9. Advantage of nursing rounds
This method is a mean of testing the knowledge of
students and their relation with all the patient on the
floor.
The students, who are informed prior to rounds,
benefit the maximum in a real life teaching method.
No other type of round is subtitute for nursing rounds.
…..

10. It is very valuable for the head nurses to go on regular
nursing rounds with a clinical instructor.
An intelligent nurse with creative abilities may find
many other ways of successfully assisting students
nurses to develop nursing skills.
Round helps in orienting a new nurse / student to the
patient.
….

11. Rounds are interesting strategies involving the
students, teacher and the patient.
They offers a real life learning situation.
Through rounds, evaluation of nursing activity
hurdles faced by nurse in nursing care can be appraised.

12. Disadvantage of nursing rounds
The confidentiality of the patient is hampered.
The patient may overhear the discussion and may not
like the way that he is being talked about.
If group is large the teacher may not able to speak
loudly enough to be heard.
Distractions are present in the ward.
….

13. An unprepared nursing round has little teaching
learning value.
The value of nursing rounds depends on the quality
and presentation of the nurse teacher/head nurse.

14. Nursing Manuals

15. It is a good practice to compile all the rules/ guidelines
concerning the management and procedure in a manual that can
be made available for reference. These directives generally fall
under the following 3 headings.
1. Procedure issued by the administrative office and referring
mainly to regulations. This is essential for maintaining
discipline.
2.Procedure manuals.eg. Lab procedure manuals
3.Unit procedure outline , the procedures to be used in unit.
1.
.
.

16. The contents of the manual , particularly in relation
to the specific procedure, will be more acceptable if
compiled following a group discussion.
It is important that manual should be kept up to date and
old procedure should be removed when new materials is
issued.

17. Standing Orders/Nursing Protocols

18. Standing orders are specific instruction regarding
treatment for condition that nurses and other health
workers may encounter in home, school and industries
where a doctor is not readily available.
The standing order are intended to provide treatment
only in emergencies and temporarily in the absence of
a doctor, they should be limited.

19. Purpose of standing order
To meet emergency situation in rural area.
To deliver care at home, school, community.
To provide temporary treatment in the absence of a
doctor.
To promote health services in community.

20. General standing order instruction
Standing order instructions should be issued jointly by
an authorized medical officer and a nurse or a
committee with a nurse representative.
The community health nurse working in rural areas
may be only qualified professional person readily
available to the family , so standing instruction must be
used with caution and discretion.

21. Standing orders are thus to promote health services in
the community.
The medical officer is legally responsible for issuing
standing orders, and he should have faith in the sound
judgment of his staff.
They reduce danger in acute condition.
They create the feeling of responsibility among the
members of the health team.

22. Role of the nurse in standing order
The community health nurse should be skillful in
recording the history and physical examination in order
to detect abnormality.
The community health nurse should be prompt in
detecting appropriate action for particular situation.
The nurse should maintain a record of vitals and other
care given to the patient.
….

23. The nurse should have thorough knowledge to
identify the actual problem of the patient and to plan
appropriate nursing intervention.
The nurse should intervene with services according to
the given community standing orders.
The nurse should develop a good therapeutic
relationship with the individual and family.
The nurse should use referral system if it is possible.

24. The nurse should inform the health officer
immediately if there is a communicable disease.
He/she should keep the medication safe and ready to
follow standing orders.
He/she should ensure a safe and healthy environment
for patient.
Recording and reporting is a essential part of
community health services.

25. Types of standing order
1.Institutional standing orders:-
They are meant, keeping in mind available resources
,staff position and the objectives of a medical institution
or hospital.
Eg :Standing order of PHC can be different from those
of district hospital.

26. 2.Specific standing order:-
These orders are meant for trained medical personnel,
mainly the nurses.
Technical knowledge and specific skills are require to
implement these orders.
Eg:-giving care at home ,injections , oxygen therapy.

27. 3.General standing orders:-
Owning to a large population , vast geographical area
and the shortage of resources , some standing order are
used to propagate health care messages to the masses.
Eg-preventive measures against AIDS.

28. Advantages of standing order
Community standing orders provides timely treatment
during emergencies.
They enhances the quality of health services.
They provide a feeling of confidence and responsibility
in the nursing staff and other health workers.
They help to decentralize the health responsibilities.
They help to strengthen the primary services in the
community.

29. Thank you