MANAGEMENT OF NURSING SERVICES IN HOSPITAL AND COMMUNITY, PLANNING A HOSPITAL AND PATIENT CARE UNITS

1. Pradeep.Abothu M.Sc.,(N)
Associate professor
Dept of Child Health Nursing

2. NURSING SERVICES
Nursing services play a vital role in healthcare
settings, encompassing a wide range of patient care
activities. Nurses are an integral part of the healthcare
team, providing holistic care, promoting health,
preventing illness, and assisting individuals and
communities in maintaining optimal well-being. This
topic aims to explore the essential aspects of nursing
services and their significance in the healthcare system.

3. According to the World Health
Organization (WHO), nursing services can be
defined as the “autonomous and collaborative
care of individuals of all ages, families, groups,
and communities, sick or well, and in all
settings. It includes the promotion of health,
prevention of illness, and the care of ill,
disabled, and dying people.”
DEFINITION

4. Promoting health and wellness
Preventing illness
Providing patient care
Collaborating with the
healthcare team
Advocating for patients
Supporting end-of-life care
Continuous professional
development
OBJECTIVES

5.  Promoting Health and Wellness: Nursing services aim to
promote and maintain the health and well-being of
individuals, families, and communities. This involves
providing education and guidance on healthy lifestyle choices,
preventive measures, and immunizations.
 Preventing Illness: Nurses play a crucial role in preventing
illness through various strategies, such as health screenings,
early detection of diseases, and promoting healthy behaviors.
They also educate patients and caregivers about disease
management and risk reduction.
 Providing Patient Care: Nursing services involve direct
patient care, including assessing patient needs, planning and
implementing care plans, administering medications,
monitoring vital signs, and managing symptoms. Nurses
ensure that patients receive the necessary medical
interventions and emotional support.

6.  Collaborating with the Healthcare Team: Nurses work
collaboratively with other healthcare professionals, including
doctors, therapists, and technicians, to ensure comprehensive and
coordinated care for patients. They actively participate in
interdisciplinary discussions and contribute to the decision-
making process.
 Advocating for Patients: Nursing services include advocating
for the rights and needs of patients. Nurses act as patient
advocates, ensuring that patients’ voices are heard, their
preferences are respected, and they receive the best possible care
and treatment.

7.  Supporting End-of-Life Care: Nurses provide compassionate
care and support for patients and their families during the end-
of-life stage. They help manage symptoms, address emotional
and spiritual needs, and ensure a dignified and comfortable
transition.
 Continuous Professional Development: Nursing services
involve ongoing professional development to enhance
knowledge, skills, and competencies. Nurses engage in lifelong
learning, attending conferences, pursuing advanced
certifications, and staying updated with the latest evidence-
based practices.

8. PLANNING
HOSPITALAND PATIENT
CARE UNITS

9. HOSPITAL
 Hospitals are essential healthcare institutions that provide
medical services, diagnostics, treatment, and care for
patients.
 They serve as a crucial component of the healthcare
system, accommodating a wide range of medical
conditions and providing comprehensive care.

10. A hospital is defined as “an integral part of a social
and medical organization whose function is to provide for
the population complete healthcare, both curative and
preventive, and whose outpatient services reach out into the
family in its home environment.” - WHO
DEFINITION

11.  General hospitals: These hospitals offer a wide range of
services and care for various medical conditions.
 Specialized hospitals: These hospitals focus on specific medical
specialties or conditions, such as cardiac hospitals, children’s
hospitals, or cancer centres.
 Teaching hospitals: These hospitals are affiliated with medical
schools and are involved in medical education and research.
 Public hospitals: These hospitals are government-funded and
provide medical services to the general population.
 Private hospitals: These hospitals are privately owned and
operated, often offering specialized and high-quality care.
CLASSIFICATION

12.  Diagnosis and treatment: Hospitals provide facilities for
diagnosing medical conditions through laboratory tests, imaging,
and other diagnostic procedures. They also offer a range of
treatment options, including surgeries, medications, and therapies.
 Emergency care: Hospitals have emergency departments to
provide immediate medical care for critical conditions and
accidents.
FUNCTIONS OF HOSPITAL

13.  Inpatient care: Hospitals admit patients for extended
care, providing 24/7 nursing care, monitoring, and
treatment.
 Outpatient care: Hospitals offer outpatient services
for consultations, follow-ups, minor procedures, and
treatments that do not require admission.

14.  Rehabilitation services: Hospitals provide rehabilitation
programs to assist patients in recovering and regaining
functionality after injuries or illnesses.
 Preventive care: Hospitals promote preventive measures
such as vaccinations, health screenings, and health education
to prevent diseases and promote well-being.

15. Hospital utilization refers to the measurement and
assessment of the capacity and usage of hospital services. It
involves tracking various factors that indicate the extent to
which a hospital’s resources are being utilized to provide
medical care to patients. Here are some key aspects of hospital
utilization:
Bed Occupancy Rate:
The bed occupancy rate is a fundamental measure of
hospital utilization. It represents the percentage of hospital beds
that are occupied by patients at a given time.
Average Length of Stay (ALOS):
The average length of stay measures the average
number of days a patient spends in the hospital for a
particular condition or treatment
HOSPITAL UTILIZATION

16. Outpatient Visits:
The number of outpatient visits indicates the utilization of
outpatient services. It includes consultations, follow-up
appointments, diagnostic procedures, and treatments that do not
require inpatient admission.
Surgical Procedures:
Tracking the number and types of surgical procedures performed
in a hospital provides valuable information on surgical service
utilization.
By monitoring and analyzing hospital utilization indicators,
healthcare organizations can identify trends, make informed
decisions regarding resource allocation, improve patient flow,
optimize operational efficiency, and enhance the overall quality of
care.

17.  Line services: These are the core services directly
involved in patient care, including medical departments
such as cardiology, oncology, neurology, and surgery.
 Supportive services: These services provide assistance to
line services, including laboratory services, radiology,
pharmacy, and medical records.
ASPECTS OF HOSPITAL
SERVICES

18.  Auxiliary services: These services support the overall
functioning of the hospital, including administration, finance,
human resources, housekeeping, and maintenance.

19. PLANNING A NURSING UNIT OF A HOSPITAL

20. NURSING UNIT
Planning a nursing unit within a hospital
is crucial for ensuring efficient and effective
patient care delivery. It involves strategic
considerations, resource allocation, and
establishing workflows. By thoughtfully
planning the nursing unit, healthcare
organizations can optimize patient outcomes,
enhance staff satisfaction, and provide a
supportive environment for high-quality nursing
care.

21. NEED FOR PLANNING A NURSING UNIT
Planning a nursing unit is essential to ensure effective and
efficient patient care delivery within a hospital. It helps create a
structured and organized environment for nursing staff to provide
high-quality care.
Here are some key reasons highlighting the need for planning a
nursing unit:
Optimal Resource Allocation: Planning allows for the appropriate
allocation of resources, including staffing, equipment, supplies, and
space, based on patient needs and the scope of services provided by
the nursing unit. This helps prevent resource shortages or wastage
and promotes efficient utilization of available resources.

22. Patient-Centered Care: Planning ensures that the nursing
unit is designed and structured to meet the specific needs of
patients. It facilitates the provision of safe, personalized,
and holistic care, promoting positive patient outcomes and
experiences.
Workflow Efficiency: A well-planned nursing unit
establishes clear workflows and processes, reducing the
likelihood of errors, delays, and confusion. It helps
streamline activities, enhance communication and
coordination among nursing staff, and optimize the
delivery of care.

23. Staff Satisfaction and Retention: Adequate planning
considers the workload, skill mix, and professional
development opportunities for nursing staff. By providing a
supportive and well-designed environment, it enhances job
satisfaction, reduces burnout, and promotes staff retention
within the nursing unit.

24. FUNCTIONS OF A NURSING UNIT:
A nursing unit within a hospital serves
various functions that contribute to the overall
patient care and well-being. Here are some primary
functions of a nursing unit:
• Patient Assessment and Monitoring: Nursing
staff in the unit are responsible for conducting
initial patient assessments, collecting health
information, and continuously monitoring patients’
conditions. They document vital signs, administer
medications, and ensure patient safety.

25.  Care Planning and Implementation: Nursing units
develop individualized care plans for each patient,
considering their specific needs, diagnoses, and treatment
goals. They implement these care plans, including
medication administration, wound care, rehabilitation, and
patient education.
 Collaborative Interdisciplinary Care: Nursing units
collaborate with other healthcare professionals, such as
doctors, therapists, and social workers, to ensure
coordinated and comprehensive care. They actively
participate in care conferences, contribute to treatment
plans, and communicate patient progress and concerns.

26.  Patient and Family Education: Nursing staff in the
unit play a vital role in educating patients and their
families about their conditions, treatments, and self-
care techniques. They provide information on
medication management, lifestyle modifications, and
disease prevention strategies.

27.  Emotional Support: Nursing units offer emotional support
to patients and their families during challenging times.
Nurses provide comfort, empathy, and counselling to help
patients cope with their medical conditions, alleviate anxiety,
and promote emotional well-being.

28. PLANNING A NURSING UNIT
Planning a nursing unit involves several key
considerations to ensure optimal functioning and patient care.
Here are some important aspects to address during the planning
process:
 Space and Layout: Determine the physical space
requirements of the nursing unit, including patient rooms,
nursing stations, medication rooms, and storage areas. Ensure
the layout promotes efficient workflows, patient privacy, and
easy access to essential resources.

29.  Staffing and Skill Mix: Assess the staffing needs based on
patient acuity, unit workload, and scope of services provided.
Determine the appropriate skill mix, including registered
nurses, licensed practical nurses, nursing assistants, and other
support staff, to meet patient care requirements.
 Equipment and Supplies: Identify the necessary equipment,
devices, and supplies needed to support patient care within
the nursing unit. Ensure availability and maintenance of
essential medical equipment, monitoring devices, medication
carts, and appropriate supplies for infection prevention and
wound care.

30.  Policies and Procedures: Develop standardized policies and
procedures for nursing unit operations, including admission
and discharge processes, medication administration protocols,
infection control measures, and safety guidelines. Regularly
review and update these policies to align with best practices
and regulatory requirements.
 Communication and Information Systems: Establish
effective communication channels within the nursing unit,
including electronic health record systems, nurse call
systems, and communication devices. Ensure clear
communication channels among nursing staff, patients,
families, and other healthcare team members.

31. ADMINISTRATION OF A NURSING UNIT
The administration of a nursing unit involves
managerial responsibilities to ensure smooth
operations and optimal patient care delivery. Here are
some key aspects of nursing unit administration:
 Leadership and Supervision: Nursing unit
administrators provide leadership, guidance, and
supervision to the nursing staff. They facilitate
effective communication, address staff concerns,
promote teamwork, and maintain a positive work
environment.

32.  Staff Recruitment and Development:
Administrators are responsible for recruiting,
selecting, and orienting nursing staff to the unit. They
also oversee staff training and development
initiatives to enhance skills, competence, and
professional growth.
 Workforce Management: Nursing unit
administrators handle staffing schedules, ensuring
adequate coverage to meet patient care demands.
They manage workload distribution, monitor staff
performance, address staffing issues, and promote a
healthy work-life balance.

33.  Quality Assurance and Performance
Improvement: Administrators implement quality
assurance programs and performance
improvement initiatives within the nursing unit.
They monitor key performance indicators,
conduct audits, and implement strategies to
enhance the quality and safety of patient care.
 Budgeting and Resource Management:
Administrators collaborate with the hospital’s
financial department to manage the nursing unit’s
budget.

34.  They allocate resources efficiently, monitor
expenditures, and ensure cost-effective practices
while maintaining high-quality care.
 By addressing these aspects of planning,
administration, and functions of a nursing unit,
hospitals can establish well-organized nursing
units that provide optimal patient care while
supporting nursing staff in their roles.