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HUMAN RESOURCE FOR HEALTH: STAFFING
Human Resource for health: Staffing
 Philosophy
 Norms: Staff inspection unit(SIU), Bajaj Committee, High power committee,
Indian nursing council (INC)
 Estimation of nursing staff requirement- activity analysis
Recruitment: credentialing, selection, placement, promotion, Retention
Personnel policies Termination
Staff development programme
Duties and responsibilities of various category of nursing personnel
STAFFING
• Definition :-
Staffing is the process of determining and providing the acceptable number and mix of nursing personnel to
produce a desired level of care to meet the patient’s demand.
• Meaning of staffing:-
Staffing is the systematic approach to the problem of selecting, training, motivating and retaining professional
and non professional personals in any organization.
• It involves manpower planning to have the right person in the right place.
• Purpose:-
To provide each nursing unit with an appropriate and acceptable number of workers in each category to perform
the nursing tasks required.
ACTIONS INVOLVED IN STAFFING
1. Identification of the type and amount of services needed by agency, client.
2. Determining the personnel categories that have the knowledge and skills to perform needed services measures.
3. Predicting the number of personnel in each job categories that will be needed to meet anticipated service demands.
4. Obtaining budgeted positions for the number in each job category needed to service for the expected types and number
of clients.
5. Recruiting personnel to fill available positions.
6. Selecting and appointing personnel from suitable applicants.
7. Combining personnel in to desired configuration by unit and shift.
8. Orienting personnel to fulfil assigned responsibilities.
9. Assigning responsibilities for client services to available personnel.
Tips to remember (ID-PORS-COA)
PHILOSOPHY OF STAFFING IN NURSING
1. Nurse Administrators Believe That It Is Possible To Match Employee’s Knowledge And Skills To Patient Care Needs In
A Manner That Optimizes Job Satisfaction And Care Quality.
2. Nurse administrators believe that the technical and humanistic care needs of critically ill patients are so complex that all
aspects of that care should be provided by professional nurses.
3. Nurse administrators believe that the health teaching and rehabilitation needs of chronically ill patients should be
provided by professional and technical nurses.
4. Nurse administrators believe that patient assessment, work quantification and job analysis should be used to determine
the number of personnel in each category to be assigned to care for patients of each type. (Ex. Coronary care,
respiratory failure etc.)
5. Nurse administrator believe that a master staffing plan and policies to implement the plan in all units should be
developed centrally by the nursing heads and staff of the hospital.
6. Nurse administrator believe that staffing plan should be administered at the unit level by the head nurse, so that selected
plan details, such as shift-start time, number of staff assigned on holidays, and number of employees assigned to each
shift can be modified to accommodate the unit workload and workflow
STEPS OF STAFFING IN NURSING
STEPS OF STAFFING
1. Determine the number and types of personnel needed to fulfil the philosophy, meet fiscal planning
responsibilities, and carryout the chosen patient care
2. Recruit, interview, select, and assign personnel based on established job description performance standards.
3. Use organizational resources for induction and orientation
4. Ascertain that each employee is adequately oriented to organizational values and unit norms.
5. Use creative and flexible scheduling based on patient care needs to increase productivity
6. Develop a program of staff education that will assist employees meeting the goals of the organization.
STAFF INSPECTION UNIT IN NURSING
Recommendations of S.I.U
1. The norm has been recommended taking into account the workload projected in the wards
and the other areas of the hospital.
2. The posts of nursing sisters and staff nurses have been clubbed together for calculating the
staff entitlement for performing nursing care work which the staff nurse will continue to
perform even after she is promoted to the existing scale of nursing sister.
3. Out of the entitlement worked out on the basis of the norms, 30%posts may be sanctioned
as nursing sister. This would further improve the existing ratio of 1 nursing sister to 3.6.
Staff nurses fixed by the government in settlement with the Delhi nurse union in may 1990.
4. The assistant nursing superintendent are recommended in the ratio of 1 ANS to every 4.5
nursing sisters. The ANS will perform the duty presently performed by nursing sisters and
perform duty in shift also.
STAFF INSPECTION UNIT IN NURSING
5. The posts of Deputy Nursing Superintendent may continue at the level of 1 DNS per every
7.5 ANS.
6. There will be a post of Nursing Superintendent for every hospital having 250 or beds.
7. There will be a post of 1 Chief Nursing Officer for every hospital having 500 or more beds.
8. It is recommended that 45% posts added for the area of 365 days working including 10%
leave reserve (maternity leave, earned leave, and days off as nurses are entitled for 8 days
off per month and 3 National Holidays per year when doing 3 shift duties).
THE NURSE-PATIENT RATIO AS PER THE S.I.U. NORMS
1. General Wards 1 Staff Nurse/Nursing Sister for every 6 beds (1:6)
1. Special Ward
i. Pediatrics,
ii. Burns,
iii. Neuro surgery,
iv. Cardio thoracic,
v. Neuro medicine,
vi. Nursing home,
vii. Spinal injury,
viii.Emergency wards attached to causality
1 Staff Nurse/Nursing Sister for every 4 beds (1:4)
1. Nursery
1 Staff Nurse/Nursing Sister for every 2 beds (1:2)
1. ICU/ICCU/ICCR Nephrology
1 Staff Nurse/Nursing Sister for every 1 beds (1:1)
1. Labour Room 1 Staff Nurse/Nursing Sister for every labour table
(1:1)
THE NURSE-PATIENT RATIO AS PER THE S.I.U. NORMS
1. O.T.
i. Major
ii. Minor
2 Staff Nurse/Nursing Sister for every functional operation table
including recovery room (2:1)
1 Staff Nurse/Nursing Sister for every functional operation table
(1:1)
1. Casualty
i. Casualty (Main)
Attendance up to 100 patients per day. Thereafter for every additional
attendance of 35 patients per day
i. Burns
Attendance up to 15 patients per day. Thereafter for every additional
attendance of 10 patients per day
i. Orthopaedics
Attendance up to 45 patients per day. Thereafter for every additional
attendance of 15 patients per day
i. Gynae/ Obstetric
Attendance up to 45 patients per day. Thereafter for every additional
attendance of 15 patients per day.
3 Staff Nurses/Nursing Sister for 24 hours, i.e. 1:1 per shift.
1 Staff Nurse/Nursing Sister
3 Staff Nurses/Nursing Sister for 24 hours, i.e. 1:1 per shift.
1 Staff Nurse/Nursing Sister
3 Staff Nurses/Nursing Sister for 24 hours, i.e. 1:1 per shift.
1 Staff Nurse/Nursing Sister
For every additional attendance of 15 patients per day
1 Staff Nurse/Nursing Sister
1. O.P.D. (Injection room)
Attendance up to 100 patients per day
Attendance up to 120-220 patients per day
Attendance up to 221-320 patients per day
Attendance up to 321-420 patients per day
1 Staff Nurse
2 Staff Nurses
3 Staff Nurses
4 Staff Nurses
THE NURSE-PATIENT RATIO AS PER THE S.I.U. NORMS
In addition to the 10% reserve as per the existent rules, 45% posts may be added for offs also where services are
provided for 365 days in a year/ 24 hours.
1. Name of Department
OPD
i. Blood bank
ii. Paediatric
iii. Immunization work
iv. Eye
v. ENT
vi. Pre anaesthetic
vii. Cardiac lab
viii. Bronchoscopy lab
ix. Vaccination anti rabis
x. Family planning
xi. Medical
xii. Surgical
xiii. Dental
xiv. Central sample collection centre
xv. Orthopaedic
xvi. Gynae
xvii. Obstetrics
xviii. Skin
xix. V D centre
xx. Chemotherapy
xxi. Neurology
xxii. Microbiology infection control
xxiii. Psychiatry
xxiv. Burns
i. 1
ii. 2
iii. 2
iv. 1
v. 1
vi. 1
vii. 1
viii. 1
ix. 1
x. 2
xi. 1
xii. 1
xiii. 1
xiv. 1
xv. 2
xvi. 2
xvii. 3
xviii. 2
xix. 2
xx. 2
xxi. 1
xxii. 2
xxiii. 1
xxiv. 2
BAJAJ COMMITTEE
• The Ministry of Health and Family welfare, Government of India set-up a committee on Health Manpower, Planning,
Production and Management in 1986
• Chairmanship :- Prof. JS Bajaj , Professor of Medicine, AIIMS, and New Delhi.
 Recommendation
1. A national policy on education in health science must be enunciated and the major focus should be on policy
guidelines for health manpower developments.
2. A realistic health manpower survey should be carried out.
3. The effective vocalization of health and health related courses should be started and educational infrastrure and
technology should be improved.
4. Establishment of an education commission for health sciences (ECHS) on the lines of
UGC.
5. Establishment of health science universities in varies states and union territories.
6. Establishment of health manpower cells at centre and in the states.
7. Vocationalization of education at 10+2 levels as regards health related fields with appropriate incentives, so that good
quality paramedical personnel may be available in adequate numbers.
BAJAJ COMMITTEE
HOSPITAL NURSING SERVICES
SI.
NO.
CATEGORIES PATIENT RATIO
1. NURSING SUPERINTENENDENTS 1:200
2. Dypt. NURSING SUPERINTENENDENTS 1:300
3. DEPARTMENT NURSING SISTERS 7:1000+1 Addl:1000 beds
4. WARD NURSING SUPERVISORS 8:200 + 30% leave reserve
5. STAFF NURSE FOR WARDS
1:3(1:9 for each shift) +
30% leave reserve
6.
FOR OPD,BLOOD BANK,X RAY,DIABETIC
CLINICS ETC
1:100 (1:5 OPD) +
30% leave reserve
7.
For ICU (8 beds ICU)
(8 BEDS/200 BED HOSPITAL)
1:3(1:8 for each shift) +
30% leave reserve
8.
FOR SPECIALIZED DEPTTS AND
CLINICS,OT,LABOUR ROOM
8:200 +
30% leave reserve
BAJAJ COMMITTEE
COMMUNITY NURSING SERVICES
SI.
NO.
CATEGORIES PATIENT RATIO
1.
1 COMMINITY HEALTH CENTRE
1,000,00 population in
plain areas
2. 1 PRIMERY HEALTH SERVICES
30,000 population in plain
areas
3. 1 PRIMERY HEALTH SERVICES
20,000 population in
difficult areas
4. 1 SUBCENTER
5,000 population in plain
area
5. 1 SUBCENTER
3,000 population in
difficult areas
BAJAJ COMMITTEE
IT IS ALSO REQUIRED NUSING MANPOWER TO CATER TO THE NEED OF THE RURAL COMMUNITY AS
FOLLOWS:-
SI. NO. CATEGORIES
1. SUBCENTRE ANM/FHW 323882
2. HEALTH SUPERVISOR/LHV 107960
3. PRIMERY HEALTH CENTER/PHN 26439
4. COMMUNITY HEALTH CENTER NURSE MIDWIVES 26439
5. PUBLIC HEALTH NURSING SUPERVISORS 7436
6 NURSE-MIDWIVES 52052
7 DISTRICT PUBLIC HEALTH NURSING OFFICER 900
8 TRADITIONAL BIRTH ATTENDER WILL BE REQUIRED 74361
HIGH POWER COMMITTEE ON NURSING AND
NURSING PROFESSION
INTRODUCTION
The retarded development of nursing and nursing profession seems to be mainly due to the fact that no serious
thought has been given to this discipline by the government over the years. Timely action on the various reports submitted to
the government would have prepared nurses to take care of all areas of health care delivery and would have also avoided
multiplication of other categories like occupational therapists, physiotherapists, social worker, health educator etc. All these
are doing nursing duties.
HIGH POWER COMMITTEE ON NURSING AND
NURSING PROFESSION
RECOMMENDATIONS OF HIGH POWER COMMITTEE ON NURSING AND NURSING PROFESSION
1) Working conditions of nursing personnel
1. Employment
 Uniformity in employment procedures to be made.
 Recruitment rules are made for all categories of nursing posts. The qualifications and experience required or these be
made thought the country.
 There should not be a bond for nursing students as some of the states do not give them employment during the stipulated
period. Keeping in view of the shortage of nurses in hospitals and community health field states should create posts and
appointment these nurses in the appropriate positions.
HIGH POWER COMMITTEE ON NURSING AND
NURSING PROFESSION
2. Job description
Job description of all categories of nursing personnel is prepared by the central government to provide guidelines.
3.Working hours
The weekly working hours should be reduced to 4o hrs per week. Straight shift should be implemented in all states.
extra working hours to be compensated either by leave or by extra emoluments depending on the state policy .nurses to be
given weekly day off and all the gazetted holidays as per the government rules.
4.Work load/ working facilities
 Nursing norms for patient care and community care to be adopted as recommended by the committee.
 Hospitals to develop central sterile supply departments, central linen services, and central drug supply system. Group D
employees are responsible for housekeeping department.
 Policies for breakage and losses to be developed and nurses not are made responsible for breakage and losses.
HIGH POWER COMMITTEE ON NURSING AND
NURSING PROFESSION
5. Pay and allowances
Uniformity of pay scales of all categories of nursing personnel is not feasible. However special allowance for nursing
personnel, ie; uniform allowance, washing, mess allowance etc should be uniform throughout the country.
6. Promotional opportunities
For promotion to the post of ward sister, post basic Bsc Nursing is made an essential qualification. The principle of
possessing higher qualification than the category to be supervised, should apply fro all levels and categories of nursing
personnel in the rural and urban areas. The committee recommends that along with education and experience, there is a need
to increase the number of posts in the supervisory cadre, and for making provision of guidance and supervision during
evening and night shifts in the hospital.
 Each nurse must have 3 promotions during the service period.
 Promotion is based on merit cum seniority.
 Promotion to the senior most administrative teaching posts is made only by open selection.
 In cases of stagnation, selection grade and running scales to be given.
HIGH POWER COMMITTEE ON NURSING AND
NURSING PROFESSION
7. Carrier development:-
Provision of deputation for higher studies after 5 yrs of regular services be made by all states. The
policy of giving deputation to 5 -10 % of each category be worked out by each state. Every nursing personnel must have an
opportunity to attend at least one refresher course every 2 years.
8. Accommodation:-
As far as possible, the nursing staff should be considered for priority allotment of accommodation near to
work place. Hospitals should not build nurse's hostel for trained nurses. Apartment type of accommodation is built where
married/unmarried nurses can be allowed to live. Housing colonies for hospital s must be considered in long run.
9. Transport:-
During odd hours, calamities etc arrangements for transport must be made for safety and security of nursing
personnel.
HIGH POWER COMMITTEE ON NURSING AND
NURSING PROFESSION
10. Special incentives:-
Scheme of special incentives in terms of awards, special increment for meritorious work for nurses
working in each state/district/PHC to be worked out.
11. Occupational hazards:-
Medical facilities as provided by the central govt. by extended by the state govt. to nursing
personnel till such times medical services are provided free to all the nursing personnel. Risk allowance to be paid to nursing
personnel working in the rural $ urban area.
12. Other welfare services:-
Hospitals should provide welfare measures like crèche facilities for children of working staff,
children education allowance, as granted to other employees, be paid to nursing personnel.
HIGH POWER COMMITTEE ON NURSING AND
NURSING PROFESSION
 Additional Facilities For Nurses Working In The Rural Areas
 Family accommodation at sub centre is a must for safety and security of ANM's /LHV.
 Women attendant, selected from the village must accompany the ANM for visits to other villages.
 The district public health nurse is provided with a vehicle for field supervision.
 Fixed travel allowance with provision of enhancement from time to time.
 Rural allowance as granted to other employees is paid to nursing personnel
HIGH POWER COMMITTEE ON NURSING AND
NURSING PROFESSION
 NURSING EDUCATION
Nursing education to be fitted into national stream of education to bring about uniformity, recognition and
standards of nursing education. The committee recommends that:-
1. There should be 2 levels of nursing personnel –
a) professional nurse (degree level) and
b) auxiliary nurse (vocational nurse).
Admission to professional nursing should be with 12 yrs of schooling with science. The duration of course should be 4
yrs at the university level. admission to vocational /auxiliary nursing should be with 10 yrs of schooling .The duration of
course should be 2 yrs in health related vocational stream.
2. All school of nursing attached to medical college hospitals is upgraded to degree level in a
phased manner.
HIGH POWER COMMITTEE ON NURSING AND
NURSING PROFESSION
3. All ANM schools and school of nursing attached to district hospitals be affiliated with
senior secondary boards.
4. Post certificate BSc Nursing degree to be continued to give opportunities to the existing
diploma nurses to continue higher education.
5. Master in nursing programme to be increased and strengthened.
6. Doctoral programmes in nursing have to be started in selected universities.
7. Central assistance be provided for all levels of nursing education institutions in terms of
budget( capital and recurring)
8. Up gradation of degree level institutions be made in a phased manner as suggested in
report.
9. Each school should have separate budget till such time is phased to degree/vocational
programme. The principal of the school be the drawing and the disbursing officer.
HIGH POWER COMMITTEE ON NURSING AND
NURSING PROFESSION
10. Nursing personnel should have a complete say in matters of selection of students.
Selection is based completely on merit. Aptitude test is introduced for selection of
candidates.
11. All schools to have adequate budget for libraries and teaching equipments.
12. All schools to have independent teaching block called as School Of Nursing with
adequate class room facilities, library room, common room etc as per the requirements of
INC.
13. Adequate accommodations are provided to students. A maximum of 3 students to share a
room. Rooms to be furnished with light, study table , chair etc. Adequate dining room,
toilets and bathrooms facilities to be provided in each hostel as per norms recommended.
14. Students should learn under supervision in the wards. Tutors/clinical instructors must go
to the ward with students. Students should not be used for the service of the hospital.
HIGH POWER COMMITTEE ON NURSING AND
NURSING PROFESSION
15. Community nursing experience should be as per INC requirements. Necessary transport
and accommodation at PHC be made available for safety, security and meaningful
learning of students.
16. INC requirements for staffing the schools and meeting the minimum requirements are
followed by all schools as these are statutory requirements.
17. Speciality courses at post-graduate level be developed at certain special centres of
excellence eg; AIIMS.
18. Institutes like National Institute of Health and Family welfare, RAK College of Nursing
and several others may develop courses on nursing administration for senior nursing
leading to doctorate level.
19. Provision for higher training abroad and exchange programmes is made.
HIGH POWER COMMITTEE ON NURSING AND
NURSING PROFESSION
CONTINUING EDUCATION AND STAFF DEVELOPMENT
 Definite policies of deputing 5-10% of staff for higher studies are made by each state. Provision for training reserve is
made in each institution.
 Deputation for higher study is made compulsory after 5 yrs.
 Each nursing personnel must attend 1 or 2 refresher course every year.
 Necessary budgetary provision be made,
 A National Institute for Nursing Education Research and Training needs to be established like NCERT, for development
of educational technology, preparation of textbooks, media, / manuals for nursing.
HIGH POWER COMMITTEE ON NURSING AND
NURSING PROFESSION
 NURSING SERVICES: HOSPITALS/INSTITUTIONS (URBAN AREAS)
Definite nursing policies regarding nursing practice be available in each institution .These
policies include:-
a) Qualification/recruitment rules
b) Job description/job specifications
c) Organisational chart of the institutions
d) Nursing care standards for different categories of patients.
1. Staffing of the hospitals should be as per norms recommended.
2. District hospitals /non teaching hospitals may appoint professional teaching nurses in the ratio of 1; 3 as soon as nurses
start qualifying from these institutions.
3. Students not to be counted for staffing in the hospitals.
HIGH POWER COMMITTEE ON NURSING AND
NURSING PROFESSION
4. Adequate supplies and equipments, drugs etc be made available for practice of nursing. The committee strongly
recommends that minimum standards of basic equipment needed for each patient be studied , norms laid down and
provided to enable nurses to perform some of the basic nursing functions . Also there should be a separate budget head for
nursing equipment and supplies in each hospitals/ PHC. The NS and PHN should be a member of the purchase and
condemnation committee.
5. Nurses to be relieved from non -nursing duties.
6. Duty station for nurses is provided in each ward.
7. Necessary facilities like central sterile supplies, linen, drugs are considered for all major hospitals to improve patient care.
Also nurses should not be made to pay for breakage and losses. All hospitals should have some systems for regular
assessment of losses.
8. Provision of part time jobs for married nurses to be considered. (min 16-20hrs/week)
9. Re-entry by married nurses at the age of 35 or above may also be considered and such nurse be given induction courses
for updating their knowledge and skills before employment.
HIGH POWER COMMITTEE ON NURSING AND
NURSING PROFESSION
10. Nurses in senior positions like ward sisters, Asst. nursing superintendents, Deputy NS;
N.S must have courses in management and administration before promotions.
11. Nurses working in speciality areas must have courses in specialities. Promotion
opportunities for clinical specialities like administrative posts are considered for
improving quality nursing services.
The committee recommends that Gazetted ranks be allowed for nurses working as ward sister and above (minimum
class II gazetted). Similarly the post of Health Supervisor (female) is allowed gazetted rank and district public health nurse
be given the status equal to district medical/ health officers.
HIGH POWER COMMITTEE ON NURSING AND
NURSING PROFESSION
COMMUNITY NURSING SERVICES
• Appointment of ANM/LHV to be recommended.
• ANM/LHV promoted to supervisory posts must undergo courses in administration and management.
• Specific standing orders are made available for each ANM/LHV to function effectively in the field.
• Adequate provision of supplies, drugs etc are made.
• Recording system be simplified.
• Posts of public health nurses and above are given gazetted status.
HIGH POWER COMMITTEE ON NURSING AND
NURSING PROFESSION
Norms recommended for nursing service and education hospital setting
1. Nursing Superintendent -1: 200 beds (hospitals with 200 or more beds).
2. Dy. Nsg. Superintendent. - 1: 300 beds ( wherever beds are over 200)
3. Asst. Nsg . Superintendent - 1: 100
4. Ward sister/ward supervisor - 1:25 beds 30% leave reserve
5. Staff nurse for wards -1:3 ( or 1:9 for each shift ) 30% leave reserve
6. For nurses OPD and emergency etc - 1: 100 patients ( 1 bed : 5 out patients) 30% leave reserve
7. For ICU -1:1(or 1:3 for each shift) 30% leave reserve
• For specialised depts. such as operation theatre, labour room etc- 1: 25 30% leave reserve.
HIGH POWER COMMITTEE ON NURSING AND
NURSING PROFESSION
Community nursing services
• 1 ANM for 2500 population ( 2 per sub centre)
• 1 ANM for 1500 population for hilly areas
• 1 health supervisor for 7500 population( for supervision of 3 ANM's)
• 1 public health nurse for 1 PHC ( 30000 population to supervise 4 Health Supervisors )
• 1 Public Health Nursing Officer for 100000 population ( community health centre)
• 2 district public health nursing for each district.
• Teaching staff for schools/colleges of Nsg. as per INC
• 1 Nurse Teacher to 10 students for post graduate programmes.
The Nurse-patient Ratio as per the norms of TNAI and INC
(The Indian Nursing Council, 1985)
The norms are based on Hospital Beds.
1. Chief Nursing Officer :1 per 500 beds
2. Nursing Superintendent :1 per 400 beds or above
3. D.NS. :1 per 300 beds and 1 additional for every 200 beds
4. A.N.S. :1 for 100-150 beds or 3-4 wards
5. Ward Sister :1 for 25-30 beds or one ward. 30% leave reserve
6. Staff Nurse :1 for 3 beds in Teaching Hospital in general ward& 1 for 5 beds in Non-teaching
Hospital +30% Leave reserve
7. Extra Nursing staff to be provided for departmental research function.
8. For OPD and Emergency :1 staff nurse for 100 patients (1 : 100 ) + 30% leave reserve
9. For Intensive Care unit: (I.C.U.)- 1:l or (1:3 for each shift ) +30% leave reserve.
10. It is suggested that for 250 bedded hospital there should be One Infection Control Nurse (ICN).
11. For specialised departments, such as Operation Theatre, Labour Room, etc. 1:25 +30% leave reserve. norms
are not based on Nursing Hours or Patient's Needs here.
INDIAN NURSING COUNCIL
Indian nursing council (INC) s a autonomous body under the government of India and was constituted by canter
government under the Indian Nursing council Act 1974 of parliament. It was established in the 1949 for the purpose o
providing uniform standards in nursing education and reciprocity in nursing registration through out the country.
INDIAN NURSING COUNCIL
Functions of Indian Nursing Council :-
1. Establish and monitor uniform standards of nursing education for various courses.
2. To recognise qualifications under section 10(2)(4) of INC act 1947 for the purpose of registration and employment in
India and abroad.
3. Providing approval of registration to nurses passing from India and foreign under section 11 (2) (a) of INC act 1947.
4. Prescribe syllabus and regulations for nursing programme.
5. Power to withdraw the recognition of qualification under section 14 of act in case the institution fails to maintain it’s
standard.
6. Act as advisory to state nursing council, government in various important rsegards.
INDIAN NURSING COUNCIL
INDIAN NURSING COUNCIL
INDIAN NURSING COUNCIL
INDIAN NURSING COUNCIL
INDIAN NURSING COUNCIL
INDIAN NURSING COUNCIL
ESTIMATION OF NURSING STAFF REQUIREMENTS: ACTIVITY
ANALYSIS
 PATIENT CLASSIFICATION SYSTEM:- (PCS)
It quantifies the quality of nursing care, essential to staffing nursing units of hospitals and
nursing homes, health care agency or educational organization.
 CHERECTORSTICS OF P.C.S.
1. Differentiate intensity of care among definite classes.
2. Measure and quantify care to develop a management engendering standard.
3. Match nursing resources to patient care requirement.
4. Related to time and effort spent on associated activity.
5. Be economical and convenient to repot and use.
6. Be mutually exclusive, continuing new item under more then one unit.
7. Be open to audit.
8. Be understood by those who plan, schedule and control the work.
9. Be individually standardized as to the procedure needed for accomplishment.
10.Separate requirement for registered nurse from those of other staff.
ESTIMATION OF NURSING STAFF REQUIREMENTS: ACTIVITY
ANALYSIS
 PURPOSES OF P.C.S.
1. Establishment of time as unit of measurement of quality and quantity of nursing
staff needed.
2. Programme costing and formulation of nursing budget.
3. Tracking changes in patient care needs.
4. Determining the quality. Of care by adjusting nursing services.
ESTIMATION OF NURSING STAFF REQUIREMENTS: ACTIVITY
ANALYSIS
COMPONENTS OF P.C.S.
1. Grouping patient’s categories:-
A/c to Johanson using categorizing method each
patient is categorized on independent element of care, each element is scored, scores
are summarised and patient is placed in a categories based on total numerical value
obtained.
2. Set of guidelines describing the describing the way in which patient will be
classified, the frequency of classification and method of data reporting.
3. Estimation of average amount of time required for care patient in each category.
PATIENT CARE CLASSIFICATION
Using 4 levels of nursig Care intensity:-
CALCULATING STAFFING NEEDS
* NCHPPD:- NURSING CARE HOUR FOR PATIENT PER DAY
COMPUTING NOUMBER OF NURSES ASSIGNED
ON WEEKLY BASIS1. Finding total no. of nsg. Hrs. needed/week:-
Example:-
- Avredge pt. censes :- 15/day
- average nsg. Hrs/pt/24 hrs :- 1/day
- days in week :- 6 days
- 15x1x6= 90 hrs /week needed
Avredge pt. censes x average nsg. Hrs/pt/24 hrs x days in week
COMPUTING NOUMBER OF NURSES ASSIGNED
ON WEEKLY BASIS
1. Find out number of total working days per nurse per year:-
-Total days/year:- 365 days
- Day off (1/week):- 52 day off
- CL :- 12
- PL :- 30
- Sat. off (1/month):- 12
- Public holiday :- 18
- SL :- 8
TOTAL = 132 days non working/233 days working/year
* Total working days/nurse/year= 233 days
* If 8hrs./nurse/day then 8x233= 1864 hrs/year/nurse working hrs.
* 24 hrs/day x 365 day= 8760 total hrs./year
* Minimum nurse requirement:- 8760/1864= 4.70 nurse/8 hrs.
FACTORS OF STAFFING
1. QUALITY
2. QUANTITY
3. UTELIZATION OF PERSON
RECRUITMENT
Recruitment is interpreted as the procedure of exploring and obtaining applicants
for the jobs from among whom the right people can pick out. It is the process of detecting and
appealing capable applicants for employments. The processes are commences when new
recruits are sought and end when their applications are presented. The result is a pool of
applicants from which new employees are picked out.
RECRUITMENT
 DEFENITION:-
Jerry and Franklin; “Recruitment is the foundation that feeds the
managerial pool: without it managerial personnel dries up and survival of an enterprise is
threatened.”
 TYPES OF RECRUITMENT:-
1. Planned:- Arise from changes in organization and recruitment policy
2. Anticipated:- By studying trends in the internal and external organization
3. Unexpected:- Arise due to accidents, transfer and illness
RECRUITMENT
LINKAGE OF RECRUITMENT TO HUMAN RESOURCES ACQUISITION
MANPOWER PLANNING
JOB ANALYSIS
RECRUITMENT
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RECRUITMENT
BASIC ELIMENTS OF SOUND RECRUITMENT POLICY
1.Discovery and Cultivation of employment Market
2. Use of Attractive literature and publicity
3. Use of scientific entrance test
4. Tapping capable candidate from within the service. (Departmental placement)
5. Placement program for right man to right job
6. Follow up probationally programme.
RECRUITMENT
PURPOSE AND IMPORTENCE OF RECRUITMENT
1. Determine present and future requirements of the organization in conjugation with
personnel planning and job analysis.
2. Increases the pool of job candidates.
3. Improves success rate of selection process by separating over and under eligible
candidates as per job profile.
4. Will reduces the employee drop out unexpectedly.
5. Meet organization’s legal and social obligations.
6. Identifying and grooming candidates for a desired role.
7. Evaluate effectiveness of various recruitment techniques and sources for all types of job
applicants.
RECRUITMENT
OBJECTIVES OF RECRUITMENT
1. Attract multidimensional skilled and experiences for present and future organizational
strategies.
2. Induct outsiders as a leader in organization.
3. Infuse fresh blood at all levels.
4. Develop organizational Culture to attract competent people.
5. Devise proper methodology for assessing psychological traits.
6. Search talent globally.
7. Design entry pay that competes on quality.
8. Anticipate and find people for positions.
RECRUITMENT
PRINCIPLES OF RECRUITMENT
 Recruitment should be done from a central place, i.e. Administrative office/Nursing
service administration.
1. Appointment and termination is sole right and liability of concern authority.
2. Only desired post should be filled to meet the HR demands of organization. Over and under
recruitment is not advisable.
3. A predefined job description and work analysis must be ready before recruitment.
4. Recruitment procedure must be designed by a well experienced and capable person in a view to
meet the mission and vision demands of organization.
5. A internal promotion or external recruitment can be a choice to fulfil the desired post.
6. Recruitment should be done on the basis of defined qualification and set standards.
7. A recruitment policy should be followed.
8. Promotion policy must be well described and made understood to all.
9. Institution reserves the rights to revise policies as per requirements.
RECRUITMENT
SOURCES OF RECRUITMENT
SOURCES OF RECRUITMENT
INDIRECT/ EXTERNAL SOURCES
DIRECT/INTERNAL SOURCES
RECRUITMENT
SOURCES OF RECRUITMENT
I.) INTERNAL SOURCES
1.) Present employees :-
Promotion of present employee from his/her present post to higher
post based on ability and performance.
2.) Employee referrals:-
A employee refers a new candidate for a said post based on his
relationship and capabilities known to him which can be an assert to organization.
3.) Former employees:-
Part time recruitment of retired employees based on there request or
candidate recommended by them.
4.) Previous applicants:-
One who is in waiting list can be called based on CV submitted by
them who fulfil demands of said post.
RECRUITMENT
SOURCES OF RECRUITMENT
II.) EXTERNAL SOURCES
1. Professional or trade association:-
Many organizations provide placement and selection
facility.
2. Advertisement:- Contents job title, required qualification, designation, norms, sometimes
salary packages and other info. Seeking for applicant to apply for desired post.
3.Employee exchange:- A/c to employee exchange act 1959 employee exchange is applicable
to all industries having 25 or above employee. This act as preliminary screening and proof of
employee’s details verified and provides a ling for further opportunities.
4. Campus recruitment:- Recruitment of fresh passed students from conducting a placement
drive at educational institute itself by various employers to find new candidates as per
organizational demands.
5. Walk in, write in and talk in recruitment.
RECRUITMENT
SOURCES OF RECRUITMENT
II.) EXTERNAL SOURCES
6. Consultants:- Are corporate agencies providing job assistance and consultancy to job
seekers and same time arranges job interviews as demanded by employers.
7. Contractual:- Recruitment for a specific time period of contract and after completion of
contract tenure it comes to end automatically.
CREDENTIALING
 CREDENTIALING
Credentialing is the process of establishing of licensed professionals, organizational
members and assessing their background and legitimacy. It may granting and reviewing
specific clinical privileges and medical or allied health staff membership.
Definition
It is the process of establishing the qualifications of licensed professionals,
organizational members or organizations, and assessing their background and legitimacy.
 PURPOSES OF CREDENTIALING
1. Prevent a problem before it’s occurrence.
2. Reviewing and verifying information.
3. Research qualifications and background of individual companies.
CREDENTIALING
 CREDENTIALING SIGNIFICANCE
It is very significant because it shows that an individual or company performing a
service is qualified to do so.
 CREDENTIALING LEGAL PROTECTION
It is a good idea to have credentialing process to protect you and your business from a
lawsuit or other legal problems.
 HEALTH CARE CREDENTIALING
Health care credentialing is a system used by various organizations and agencies to ensure
that their health care practitioners meet all the necessary requirements and are appropriately
qualified. The credentials may vary depending on the specified area of the practitioner.
CREDENTIALING
CREDENTIALING COMPONENTS
1.) Appointment:-
Evaluation and selection of nursing staff.
2.) Clinical privileges:-
Declaration of specific nursing services may managed within the
institute.
3.) Periodic reappraisal:-
Continuing review and evaluation of each member of the nursing staff.
CREDENTIALING
CRITERIA FOR SELECTION OF NURSING STAFF
• Proof of licensure
• Education and training
• Specialty board certification
• Previous experience
• Recommendations
Clinical prerveledged criteria:-
Includes the proof of speciality training and of
performance of nursing procedure or speciality care during training and previous
appointments.
SELECTION
It is process of choosing best applicant among eligible applied for a post.
 Selection includes:-
1. Interviewing
2. Employer's offer
3. Acceptance by applicant
4. Signing of a contract or written offer
SELECTION
The process of selection leads to employment of persons having the ability and qualification to
perform the jobs which have fallen vacant in an organization. The basic purpose of selection is
rejection of unskilled candidates and choosing a right type of person on various positions in the
organization.
 SELECTION POLICIES
1. Application form
2. Selection committee:- Includes HOD college of nursing, professor, representative of local
controlling authority, representative of nursing division of state, an educational psychologist. It
includes:-
 Personal interview of candidate
 Test of previous achievements both written and oral
 It should be made clear to them that final acceptance for the course will be subject to a satisfactory
medical report and assessment during a preliminary training period.
SELECTION
3. Orientation programme
4. Development of master rotation plan
5. Parent teacher association
STEPS IN SELECTION
1. Interview by Personnel Department
2. Pre-employment tests(written/oral/Practical)
3. Interview by departmental head
4. Decision of administrator to accept or reject
5. Medical Examination
6. Check of reference
7. Issue of appointment letter
8. Placement
STEPS IN SELECTION
1. INTERVIEW
It is the most intricate and difficult part of the selection process. It can be divided
into four parts:-
1. The warm-stage
2. The drawing-out stage
3. The information stage
4. The forming an-opinion stage
 Objective of an interview:-
1. Employer obtain all information regarding candidate.
2. Briefing candidate regarding organization and job profile.
STEPS IN SELECTION
2. PRE IMPLOYEMENT TEST
a) Test for general ability-intelligence:- IQ test
b) Aptitude test:- Testing for abilities of potential development.
c) Test of achievement:- Test for professional proficiency achievement reported
by candidate.
d) Personality test:- to know personality traits.
3. Final approval by head of institution:-
4. References
5. Medical examination
6. Joining report by employee
PLACEMENT
Placements are a credit bearing part of a degree course. If a student opts out of a
placement or there is no placement available, this means that placement is not guaranteed.
Importance:-
• To fairly and without any element of discrimination evaluate job applicants in
view of individual differences.
• To employ qualified and competent hands
• To place job applicants in the best interest of the organization
 Help in human resource and manpower planning
 Reduce recruitment cost.
Placement team:-
1. Placement coordinator
2. Academic tutors with each of separate speciality
PROMOTION
Promotion policy is one of the most controversial issues in every organization. The unions
generally favours promotions on the basis of seniority.
Definition:-
A change for better prospects from one job to another job is deemed by the
employee as a promotion.
PROMOTION
 Nature and scope of promotion
“Seniority v/s merit” concept.
 Factors implying promotion:-
1. Increase in salary
2. Increase in prestige
3. Upward movement in hierarchy of job
4. Additional supervisory responsibility
5. A better future
PROMOTION POLICY
The management usually favours on the basis of merits and the unions opposite to that
favours seniority promotional criteria. However, in practice, both seniority and ability criteria
should be taken into consideration.
Promotion policy includes:-
1. Charts, diagrams showing job relationship and ladder of promotion
2. Definite system for making a waiting list
3. Notification of all existing vacancies to all employees
4. Eight factors must be basis for promotion:-
Achievement
Experience
Seniority
Initiative
PROMOTION POLICY ADVANTAGES
Recognition in ladder of promotion
Knowledge and experience according to vacancy
Record of loyalty and cooperation
Outstanding service in terms of quality as well as quantity
Loyalty amongst employees
Increase satisfaction
generates motivation
provide ample of opportunities
Increases productivity
RETENTION
Definition:-
Ability of an organization to retain the staff to avoid turnover and to improve the
productivity of institute or organization.
Why it is important:-
1. Key skills, idea, knowledge and experience remains within organization. Client
relationship and networks are also preserved along with income generated by them.
2. Loosing key skill workers will inversely harm institute by making them available for
extreme competitors eventually results in benefits to rivals.
3. Direct cost involved in loosing employee. We need to train new one and it cost a lot.
RETENTION
PRINCIPLES TO HELP FOSTER STAFF RETAINTION
1. Respectful collegial communication and behaviour
2. Communication rich culture
3. A culture of accountability
4. Presence of adequate number of qualified nurses
5. Presence of expert, competent, credible, visible leadership
6. Shared decision making at all levels
7. Encouragement of professional practice and continuous growth/development
8. Recognition of value of nursing’s contribution
9. Recognition of nurses for there meaningful contribution to practice.
PERSONNEL POLICIES
POLICY:-
Policy is a statement of predominant guidelines.
 It is a set of rules that defines a manner in which a organization deals with human
resources.
 It is statement of accepted personal principles and the resulting course of administrative
action by which a specific organization pattern determines the pattern of employment
condition.
Importance of personnel policy
 It represents a guarantee of fair and equitable treatment to employees.
 It is a safeguard. It relieves a responsibility of making a personal decision.
OBJECTIVES OF PERSONNEL POLICY
1. Ensure best man for job.
2. Guaranteed fairness in discipline maintenance.
3. Staff welfare and faculty development.
4. All steps to avoid extra working hours.
5. Ensure greatest practicable degree of permanent and continue employment.
6. Maintain standards of remuneration.
7. Maintain high levels of working conditions.
8. Provide proper orientation.
9. Encourage social and recreational facilities for employees.
10. Develop appropriate scheme for employee welfare.
TYPES OF POLICY
A) IMPLIED POLICY:-
1. Policy which is not written but established by pattern of decision by experience of events
and times followed by precedent.
2. May have +ve /-ve effects.
3. A superior authority do not need to issue policy statement to fellow.
 Basically in this a person with authority will guide only a standard norm and a fellow
should take independent decision based on understanding.
B) EXPRESSED POLICY :-
1. Declared verbally or written.
2. Oral policy is more flexible then written.
ELEMENTS OF PERSONNEL POLICY STATEMENT
1. Operating procedure policy
2. Employee conduct policy
3. Equipments use regulations and manuals
4. Professionalism
5. Employer’s authority
POLICIES RELATED TO NURSING PRACTICES
FACATORS AFFECTING PERSONNEL POLICIES
1. Low of country
2. Social values and customs
3. Management philosophy and values
4. Stage of development
5. Financial position of firm
6. Type of workforce.
TERMINATION
TERMINATION:-
Employee termination is the process by which an organization ends an
individual’s employment against his/her will.
CAUSES OF TERMINATION:-
1. Poor job performance
2. Incompatibility with organization
3. Inability to perform job responsibility
4. Conflict with senior or felloe employees
5. Misconduct
6. Incidence of employment separation
7. Poor performance:- lack of punctuality, abscentism, failure to produce desired results.
8. Resisting change
CAUSES OF TERMINATION
9. Negativism
10. Insubordination
11. Violating values of organization
12. Questionable character and ethical laps
13.Criminal acts
14. Behavioural causes:-
Abscentism and tardiness
Unsatisfactory performance
Lack of qualification and ability
Changed job requirements
Gross misconduct
Breech of company norms and policy
TERMINATION PROCESS
1. Be honest
2. Be compassionate
3. Be quick
STAFF DEVELOPMENT
PROGRAMME
Meaning
 Staff development is the process directed towards the personal & professional growth
of the nurses and other personnel while they are employed by a health care agency.
 Personal and Professional Development (CPPD) is the new name for the Staff
Development.
DEFINITION S.D.P.
Staff development includes all training and education undertaken by an
employer to improve the occupational and personal knowledge, skills, and attitudes
of employment.
A process consisting of orientation, in-service education and continuing
education for the people of promoting the development of personnel within any
employment setting, consistent with the goals and responsibilities of the
employment.( ANA)
Needs for staff Development:
 social change and scientific advancement
 advancement in the field of science like medical science and
technology.
 to provide the opportunity for nurses to continually acquire and
implement the knowledge, skills, attitudes, ideals and valued
essentials for the maintenance of high quality of nursing care.
Need cont……
 As part of an individual's long-term career growth.
 To add or improve skills needed in the short term
 Being necessary to fill gap in the past performance
 To change or correct long-held attitudes of employee
 To move ahead or keep up with change.
 Fast changing technologies
 Need to increase the productivity and quality of the work.
 To motivate employees and to promote employee loyalty
 Fast growing organizations.
Goals:
1. Assist each employee (nurse) to improve performance in his/her
position.
2. Assist each employee (nurse) to acquire personal and professional
abilities that maximize the possibility of career advancement.
OBJECTIVES
 To increase employee productivity.
 To ensure safe and effective patient care by nurses.
 To ensure satisfactory job performance by personnel.
 To orient the personnel to care objectives, job duties,
personnel policies, and agency regulations.
Objectives cont…..
 To help employees cope with new practice role.
 Help employees cope with new practice role.
 Help nurses to close the gap between present abilities and the
scientific basis for nursing practice that is broadening through
research.
Function of Staff Development
Provide Educational activities for all nurses employed by the health
care agency directed towards change behavior related to role
expectations.
It concerned with growth and development of personnel from their
initial contact with a healthcare agency until termination of service
STAFF DEVELOPMENT PROGRAM, HEALTH CARE
ORGANIZATION MODEL
Assessing
Competency Maintaining
Competency
Developing
competency
Steps of staff development program
Assess the educational needs of all staff members
Set priority
Develop general objectives for the staff development programme
Determine the resources needed to reach the desired objectives
Develop a master calendar for an entire year
Develop and maintain staff development record system
Establish files on major educational topics
Regularly evaluate the staff development program
RESOURCES
 Public libraries, audiovisual program in addition to many books and
computers, research activities and speakers to community groups.
 Schools and universities
 Association
 Health and inter service agency
 Other nursing homes
 One’s own staff
ADMINISTRATIVE STRUCTURE OF A
STAFF DEVELOPMENT PROGRAM
Administrative philosophy, policies & practices of health care
agency.
 Policies, practices and standards of nursing & other health
professionals.
 Human & material resources
 Physical facilities
 Financial resources
Centralization v/s Decentralization:
Qualification of Staff development
ROLE:
Applies adult learning principles when helping employees learn new
skills or information.
Coaches’ employees readily regarding knowledge and skill deficits.
Actively seeks out teaching opportunities.
Uses teaching techniques that empower staff.
Is sensitive to the learning deficits of the staff and creatively
minimizes these deficits.
Frequently assess learning needs of the unit.

Types of Staff Development:
 Induction Training.
 Job Orientation.
 In service education
 Continuing education
 Training for special function
TYPES CONT…
Induction Training
Need of induction training
 Increased retention of newly hire employees,
 Improved employee morale and
 Increased productivity.
Steps in induction
1. Tour of facilities
2. Introduction to the other employees, superiors
and subordinates.
3. Description of organizational functions.
4. Departmental visit
5. Orientation to philosophy goals and objectives
6. Administration policies and procedures
INDUCTION CONT….
 Techniques used in induction
 Forms of induction
 Ø Internship
 Ø Preceptorship
 Ø Mentorship
TYPES CONT…
Job Orientation.
"A good beginning is half the battle!"
MEANING
The process of creating awareness with an individual of his/her roles,
responsibilities and relationships in the new work situation.
COMPONENTS
 A new employee to his or her job setting so that he / she is
aware of his/ her job responsibility and expectation.
 Present employee to the job responsibilities of his/ her
expanded/ enriched role.
 The old employees to the policy changes.
Types of orientation
 General orientation
 Specific orientation
IMPORTANCE OF ORIENTATION PROGRAMME
 Provides essential, relevant and necessary information
 Helps employee to gain confidence,
 Lessen the time for the employee to learn about new situations related to his/her job setting.
 Helps the new employee to develop a sense of belonging
 Eliminates
 Learning by trail and error
 Passing of incorrect information by old employees and peers.
 Reduces misinterpretation
 Mistakes and confusion
 Apprehension
 Help new employee in solving initial problems and adjust the new situation/environment,
 Acquaints her with personnel services readily with in the institution/community
CONTENT OF AN ORIENTATION PROGRAMME
 The origination and its environment
 Policies, rules and regulation
 Personnel
 Services
 Functions to be undertaken
TYPES CONT..
IN SERVICE EDUCATION
Definition
In service education is a planned educational experience provided in
the job setting and closely identified with services in order to help
person perform more effectively as a person and as a worker.
Concept of in-
service education
Closely identified
with services
Help a
person’s to
improve
performanc
e effectively
Planned education
activities
Provided in
a job
setting
Need
 Social changes and scientific advancement
 Changes and advancement in the field of service
 increased the demand of nursing services.
 Consumer demand quality care
 Rapid changes in medical and nursing practice create a need for in service
education.
 Increase number of the people seeking health care as the population enlarges
makes it necessary for the nurses to function at her highest potential as quickly
as possible.
 As health care delivery system become more complex, the need for continues
skill training also increased.
OBJECTIVE
 To provide for and promote the personal growth and development of
the workers
 To stimulate and develop occupational
 To proved for job satisfaction
 identifying and meeting current bearing needs
 To disseminate new information from body of nursing knowledge and
health science through verity of channels.
To acquire up to date knowledge and to make confidence among the
nurses.
 To retain experience personnel to foster there continue education.
Steps in In-service
education
Assessment
Pinpoint needs, prioritize needs, set
training objectives, and develop criteria
Implementation
Climatic check, actual conduction of
training with ongoing monitoring
Evaluation
Establishment of criteria, pre test to the participants, post test following
completion of the training or program.
Observation on transfer of learning to the job, follow up studies for
assessment of extent of retention of learning.
TYPES CONT…
CONTINUING EDUCATION
DEFINITION
 Continuing education is all the learning activities that occur after an
individual has completed his basic education
- cooper
 The education which builds a previous education is called continues
education
-Shannon
Aims of continuing education
 1.Improvement of professional practice
 2.To motivate the staff to seek the latest knowledge
 3.To keep the nurses with the latest development of technologies
 4.It develops interest, job satisfaction and confidence
PURPOSE OF CONTINUING EDUCATION.
 Enable a worker to move from satisfactory to excellent performance
 Provides exposure to new concepts, procedural refinements, innovative
product applications, or acquisition of increased expertise
 Ensure professional development
 Increase ability in order to solve the problem in a clinical teaching/
administrative area.
 Improve the ability to communicate or participate in research work.
NEED OF CONTINUING EDUCATION
 To ensure safe and effective nursing care
 Changing health care delivery system,
 Development of nurses by updating their knowledge
 For career advancement
 Professional are altered as society changes and as technologies
emerge
 To acquire specialized skill for professional.
TRAINING FOR SPECIFIC
FUNCTION
DEFINITION
This is concerned with developing expert technical or manual skills,
communication and helps the personnel to perform their functions
effectively.
Objectives
1. To help the nursing personnel to perform correct methods and
procedures with understanding.
2. Establishing standards and quality of nursing services.
3. Procedure to skill nurses to skilled nurses.
Types of skills
  Psychomotor skill
  Cognitive skill
  Teaching skills
  Affective skill
  Communication skill
  Supervisory skills
Need for skill training
 Individual nurse needed to have greater freedom to choose the specific field of
nursing in which she would work.
 Good work to be recognized and reward.
 A venues of advancement and promotion need to be better development
 Fear of making mistakes
Guidelines for skill training
 1.Set the stage, using equipment similar to that provided for the worker
in the work situation.
 2.Create in worker a learning attitude,
 3.Give reasons why the procedure is carried out in this way in this
agency;
 4.Break the activities in to logical steps, necessary to carry out the
procedure.Demonstrate step by step.
 5.Make certain that the person has learnt by requiring a return
demonstration
 6. Provide written out lines for references.
 7. Arrange for follow up (supervision
Standards of staff development
programme (ANA)
Standard 1 – organization and administration
 The nursing service department and the nursing staff development unit
philosophy, purpose and goals address the staff development needs of
nursing personnel.
Standard II – human resources
 Qualified administrative, educational and support personnel are
provided to meet the learning and developmental needs by nursing
services personnel.
Standards III – learner
 Nursing staff development educators assist nursing personnel in
identifying their learning needs and planning learning activities to meet
those needs.
Standard IV – program planning
 Provides the unit systematically, plans and evaluate the overall nursing staff
development program in response to health care needs.
Standard V – educational design
 Educational offering and learning experience are designed through the use of
educational process and incorporate adult education and learning principles.
Standard VI – material resources and facilities
 Material sources and facilities are adequate to achieve the goals and implement
the functions of the overall nursing staff development unit.
Standard VII – records and reports
 The nursing staff development unit establishes and maintains a record keeping
and report system
Standard VIII – evaluation
 Evaluation is an integral ongoing and systematic process, which
includes measuring the impact on the learning
Standard IX – consultation
 Nursing staff development educators use the consultation
process to facilitate and enhance achievement of
individual,departmental and organizational goals.
Standard X – climate
 Nursing staff development educators foster a climate which
promotes open communication, learning and professional
growth.
Standard XI – systematic enquiring
 Nursing staff development educators encourage systematic
inquiry and applications of the results into nursing practice.
Potential difficulties in staff development & training activities
Lack of time
Inadequate resources at disposal
Under-funded training budgets
Conflicting priorities
Lack of Clarity about what should be done
Failure to identify, or accept the need.
Shortfall in training skill or experience
Fear that trained employee will leave the organization
or will be poached by competitor.
Cynical attitude to Staff development-Not directly measurable. Treated as
Cost not investment.
METHODS OF DELIVERING SDP
INDUCTION JOB
ORIENTATIO
N
IN- SERVICE CONTINUING
EDUCATION
Physical tour of
the facilities
Group
discussion
Seminar
Hand book and
pamphlet
Orientation
Seminar
Discussion
Hand out or
book and
pamphlets
Orientation
Skill training
Continuing
education
Leadership
training
Lecture
Demonstration
Seminar
Debate
Journal club
Book review
Correspondence
course
Formal course
Clinical
research
TRAINING
FOR SKILL
Demonstratio
n
Discussion
Role-play
method.
Induction orientation In-service Continuing Management Organization
Training Education education training development
DUTIES AND RESPONCIBILITY OF VARIOUSE
CATEGORIES OF NURSING PERSONNELS
GENERAL ROLE OF REGISTERED NURSES IN HOSPITAL
1.) ADMINISTRATOR
 Recruitment and retention of physicians
 Overseeing quality
 Improvement of processes for efficient delivery of patient care
 Setting standards
 Creating financial and business strategies
 Budgets
DUTIES AND RESPONCIBILITY OF VARIOUSE
CATEGORIES OF NURSING PERSONNELS
2. MANAGER
 Planning
 Gives directions
 Gives rewards fairly
 Nursing care of individuals, groups, families and communities
 Supervising and evaluates other nurses performance.
DUTIES AND RESPONCIBILITY OF VARIOUSE
CATEGORIES OF NURSING PERSONNELS
3. COUNSELOR
 Help new employees
 Take new employees round the hospital
 Show them different departments and explain their functioning
 Explains rules and regulations of hospital and of cafeteria
 Issue lockers and uniforms
 Introduce them to the administrator and medical superintend
 Helps in reviewing training needs
 Improving better communication between employees and employers
 Helps in solving personal and official problems of employees
 External and internal stress, lack of training, difficulties in job, emotional deprivation can be tackled under employee
counselling.
 Create a better harmonious hospital staff environment.
DUTIES AND RESPONCIBILITY OF VARIOUSE
CATEGORIES OF NURSING PERSONNELS
Problems to be handled by the Counsellor
1. Emotional Problem
2. Behavioural Problem
3. Personal Problem
4. Environmental Problem
5. Organizational Problem
DUTIES AND RESPONCIBILITY OF VARIOUSE
CATEGORIES OF NURSING PERSONNELS
1. Emotional Problem
fear, anger, and jealousy, which are harmful to the well-being and development of individual employee in hospital
setting.
2. Personal Problems
Housing, transportation, admission of children in schools etc.
3. Behavioural and Organisational problems
 Lack of group cohesiveness
 Role conflict
 feeling of inequality,
 role ambiguity,
 role over load,
 lack of supervisory support,
DUTIES AND RESPONCIBILITY OF VARIOUSE
CATEGORIES OF NURSING PERSONNELS
 constraints of rules and regulations,
 job mismatch,
 inadequacy of role authority,
 absenteeism,
 job dissatisfaction,
 labour turnover and job stress
DUTIES AND RESPONCIBILITY OF VARIOUSE
CATEGORIES OF NURSING PERSONNELS
4. CHANGE AGENT
 Identifying the problem
 Assessing the client‘s motivations and capacities for change
 Determining alternatives
 Assessing resources
 Determining appropriate helping roles
 Establishing and maintaining a helping relationship
 Recognizing phases of the change process
5. RESEARCHER
 Participates in scientific investigation
 Helps develop knowledge about health and promotion of health over the full life span
 Care of person with health problems and disabilities
DUTIES AND RESPONCIBILITY OF VARIOUSE
CATEGORIES OF NURSING PERSONNELS
6. CASE MANAGER
 Coordinates the activities of other members of health care team
 (Nutritionists and physical therapist)
7. COLLABORATOR
 The nurse initiates nursing actions within the health team
8. HEALTH EDUCATORS
 Educating individuals and communities about behaviours that can prevent diseases,
injuries, and other health problems
 Organize an event, such as a lecture, class, demonstration or health screening
 Plan programs that are consistent with the goals and objectives of their employers
DUTIES AND RESPONCIBILITY OF VARIOUSE
CATEGORIES OF NURSING PERSONNELS
9. ADVISOR
 Act as advisor in Tech-Serve project on matters relating to hospital management improvement in provincial hospitals,
based on previous experience.
 Contribute to the development of provincial hospital planning and facilitating the implementation of Standard Based
Management in the Provincial Hospitals.
 Technical assistance to EPHS workshops conducted at the provincial and central level as well as participate in visits to
provincial hospitals for purposes of training
 Travel regularly to the provincial hospitals for the purpose of supporting, training, and monitoring the activities of the
hospital leadership.
 Act as a resource to provide models of best practice for hospital management through research, training, document
translation, and any other means as needed.
 Participate in and sometimes leading quality assurance and performance improvement activities as required by the
hospitals.
DUTIES AND RESPONCIBILITY OF VARIOUSE
CATEGORIES OF NURSING PERSONNELS
 Collect statistical data as needed for the purposes of monitoring hospital performance and providing comparative
information on hospital performance.
10. ADVOCATOR
THANKING YOU
KEEP MANAGING

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HUMAN RESOURCES FOR HEALTH: STAFFING

  • 1. HUMAN RESOURCE FOR HEALTH: STAFFING Human Resource for health: Staffing  Philosophy  Norms: Staff inspection unit(SIU), Bajaj Committee, High power committee, Indian nursing council (INC)  Estimation of nursing staff requirement- activity analysis Recruitment: credentialing, selection, placement, promotion, Retention Personnel policies Termination Staff development programme Duties and responsibilities of various category of nursing personnel
  • 2. STAFFING • Definition :- Staffing is the process of determining and providing the acceptable number and mix of nursing personnel to produce a desired level of care to meet the patient’s demand. • Meaning of staffing:- Staffing is the systematic approach to the problem of selecting, training, motivating and retaining professional and non professional personals in any organization. • It involves manpower planning to have the right person in the right place. • Purpose:- To provide each nursing unit with an appropriate and acceptable number of workers in each category to perform the nursing tasks required.
  • 3. ACTIONS INVOLVED IN STAFFING 1. Identification of the type and amount of services needed by agency, client. 2. Determining the personnel categories that have the knowledge and skills to perform needed services measures. 3. Predicting the number of personnel in each job categories that will be needed to meet anticipated service demands. 4. Obtaining budgeted positions for the number in each job category needed to service for the expected types and number of clients. 5. Recruiting personnel to fill available positions. 6. Selecting and appointing personnel from suitable applicants. 7. Combining personnel in to desired configuration by unit and shift. 8. Orienting personnel to fulfil assigned responsibilities. 9. Assigning responsibilities for client services to available personnel. Tips to remember (ID-PORS-COA)
  • 4. PHILOSOPHY OF STAFFING IN NURSING 1. Nurse Administrators Believe That It Is Possible To Match Employee’s Knowledge And Skills To Patient Care Needs In A Manner That Optimizes Job Satisfaction And Care Quality. 2. Nurse administrators believe that the technical and humanistic care needs of critically ill patients are so complex that all aspects of that care should be provided by professional nurses. 3. Nurse administrators believe that the health teaching and rehabilitation needs of chronically ill patients should be provided by professional and technical nurses. 4. Nurse administrators believe that patient assessment, work quantification and job analysis should be used to determine the number of personnel in each category to be assigned to care for patients of each type. (Ex. Coronary care, respiratory failure etc.) 5. Nurse administrator believe that a master staffing plan and policies to implement the plan in all units should be developed centrally by the nursing heads and staff of the hospital. 6. Nurse administrator believe that staffing plan should be administered at the unit level by the head nurse, so that selected plan details, such as shift-start time, number of staff assigned on holidays, and number of employees assigned to each shift can be modified to accommodate the unit workload and workflow
  • 5. STEPS OF STAFFING IN NURSING STEPS OF STAFFING 1. Determine the number and types of personnel needed to fulfil the philosophy, meet fiscal planning responsibilities, and carryout the chosen patient care 2. Recruit, interview, select, and assign personnel based on established job description performance standards. 3. Use organizational resources for induction and orientation 4. Ascertain that each employee is adequately oriented to organizational values and unit norms. 5. Use creative and flexible scheduling based on patient care needs to increase productivity 6. Develop a program of staff education that will assist employees meeting the goals of the organization.
  • 6. STAFF INSPECTION UNIT IN NURSING Recommendations of S.I.U 1. The norm has been recommended taking into account the workload projected in the wards and the other areas of the hospital. 2. The posts of nursing sisters and staff nurses have been clubbed together for calculating the staff entitlement for performing nursing care work which the staff nurse will continue to perform even after she is promoted to the existing scale of nursing sister. 3. Out of the entitlement worked out on the basis of the norms, 30%posts may be sanctioned as nursing sister. This would further improve the existing ratio of 1 nursing sister to 3.6. Staff nurses fixed by the government in settlement with the Delhi nurse union in may 1990. 4. The assistant nursing superintendent are recommended in the ratio of 1 ANS to every 4.5 nursing sisters. The ANS will perform the duty presently performed by nursing sisters and perform duty in shift also.
  • 7. STAFF INSPECTION UNIT IN NURSING 5. The posts of Deputy Nursing Superintendent may continue at the level of 1 DNS per every 7.5 ANS. 6. There will be a post of Nursing Superintendent for every hospital having 250 or beds. 7. There will be a post of 1 Chief Nursing Officer for every hospital having 500 or more beds. 8. It is recommended that 45% posts added for the area of 365 days working including 10% leave reserve (maternity leave, earned leave, and days off as nurses are entitled for 8 days off per month and 3 National Holidays per year when doing 3 shift duties).
  • 8. THE NURSE-PATIENT RATIO AS PER THE S.I.U. NORMS 1. General Wards 1 Staff Nurse/Nursing Sister for every 6 beds (1:6) 1. Special Ward i. Pediatrics, ii. Burns, iii. Neuro surgery, iv. Cardio thoracic, v. Neuro medicine, vi. Nursing home, vii. Spinal injury, viii.Emergency wards attached to causality 1 Staff Nurse/Nursing Sister for every 4 beds (1:4) 1. Nursery 1 Staff Nurse/Nursing Sister for every 2 beds (1:2) 1. ICU/ICCU/ICCR Nephrology 1 Staff Nurse/Nursing Sister for every 1 beds (1:1) 1. Labour Room 1 Staff Nurse/Nursing Sister for every labour table (1:1)
  • 9. THE NURSE-PATIENT RATIO AS PER THE S.I.U. NORMS 1. O.T. i. Major ii. Minor 2 Staff Nurse/Nursing Sister for every functional operation table including recovery room (2:1) 1 Staff Nurse/Nursing Sister for every functional operation table (1:1) 1. Casualty i. Casualty (Main) Attendance up to 100 patients per day. Thereafter for every additional attendance of 35 patients per day i. Burns Attendance up to 15 patients per day. Thereafter for every additional attendance of 10 patients per day i. Orthopaedics Attendance up to 45 patients per day. Thereafter for every additional attendance of 15 patients per day i. Gynae/ Obstetric Attendance up to 45 patients per day. Thereafter for every additional attendance of 15 patients per day. 3 Staff Nurses/Nursing Sister for 24 hours, i.e. 1:1 per shift. 1 Staff Nurse/Nursing Sister 3 Staff Nurses/Nursing Sister for 24 hours, i.e. 1:1 per shift. 1 Staff Nurse/Nursing Sister 3 Staff Nurses/Nursing Sister for 24 hours, i.e. 1:1 per shift. 1 Staff Nurse/Nursing Sister For every additional attendance of 15 patients per day 1 Staff Nurse/Nursing Sister 1. O.P.D. (Injection room) Attendance up to 100 patients per day Attendance up to 120-220 patients per day Attendance up to 221-320 patients per day Attendance up to 321-420 patients per day 1 Staff Nurse 2 Staff Nurses 3 Staff Nurses 4 Staff Nurses
  • 10. THE NURSE-PATIENT RATIO AS PER THE S.I.U. NORMS In addition to the 10% reserve as per the existent rules, 45% posts may be added for offs also where services are provided for 365 days in a year/ 24 hours. 1. Name of Department OPD i. Blood bank ii. Paediatric iii. Immunization work iv. Eye v. ENT vi. Pre anaesthetic vii. Cardiac lab viii. Bronchoscopy lab ix. Vaccination anti rabis x. Family planning xi. Medical xii. Surgical xiii. Dental xiv. Central sample collection centre xv. Orthopaedic xvi. Gynae xvii. Obstetrics xviii. Skin xix. V D centre xx. Chemotherapy xxi. Neurology xxii. Microbiology infection control xxiii. Psychiatry xxiv. Burns i. 1 ii. 2 iii. 2 iv. 1 v. 1 vi. 1 vii. 1 viii. 1 ix. 1 x. 2 xi. 1 xii. 1 xiii. 1 xiv. 1 xv. 2 xvi. 2 xvii. 3 xviii. 2 xix. 2 xx. 2 xxi. 1 xxii. 2 xxiii. 1 xxiv. 2
  • 11. BAJAJ COMMITTEE • The Ministry of Health and Family welfare, Government of India set-up a committee on Health Manpower, Planning, Production and Management in 1986 • Chairmanship :- Prof. JS Bajaj , Professor of Medicine, AIIMS, and New Delhi.  Recommendation 1. A national policy on education in health science must be enunciated and the major focus should be on policy guidelines for health manpower developments. 2. A realistic health manpower survey should be carried out. 3. The effective vocalization of health and health related courses should be started and educational infrastrure and technology should be improved. 4. Establishment of an education commission for health sciences (ECHS) on the lines of UGC. 5. Establishment of health science universities in varies states and union territories. 6. Establishment of health manpower cells at centre and in the states. 7. Vocationalization of education at 10+2 levels as regards health related fields with appropriate incentives, so that good quality paramedical personnel may be available in adequate numbers.
  • 12. BAJAJ COMMITTEE HOSPITAL NURSING SERVICES SI. NO. CATEGORIES PATIENT RATIO 1. NURSING SUPERINTENENDENTS 1:200 2. Dypt. NURSING SUPERINTENENDENTS 1:300 3. DEPARTMENT NURSING SISTERS 7:1000+1 Addl:1000 beds 4. WARD NURSING SUPERVISORS 8:200 + 30% leave reserve 5. STAFF NURSE FOR WARDS 1:3(1:9 for each shift) + 30% leave reserve 6. FOR OPD,BLOOD BANK,X RAY,DIABETIC CLINICS ETC 1:100 (1:5 OPD) + 30% leave reserve 7. For ICU (8 beds ICU) (8 BEDS/200 BED HOSPITAL) 1:3(1:8 for each shift) + 30% leave reserve 8. FOR SPECIALIZED DEPTTS AND CLINICS,OT,LABOUR ROOM 8:200 + 30% leave reserve
  • 13. BAJAJ COMMITTEE COMMUNITY NURSING SERVICES SI. NO. CATEGORIES PATIENT RATIO 1. 1 COMMINITY HEALTH CENTRE 1,000,00 population in plain areas 2. 1 PRIMERY HEALTH SERVICES 30,000 population in plain areas 3. 1 PRIMERY HEALTH SERVICES 20,000 population in difficult areas 4. 1 SUBCENTER 5,000 population in plain area 5. 1 SUBCENTER 3,000 population in difficult areas
  • 14. BAJAJ COMMITTEE IT IS ALSO REQUIRED NUSING MANPOWER TO CATER TO THE NEED OF THE RURAL COMMUNITY AS FOLLOWS:- SI. NO. CATEGORIES 1. SUBCENTRE ANM/FHW 323882 2. HEALTH SUPERVISOR/LHV 107960 3. PRIMERY HEALTH CENTER/PHN 26439 4. COMMUNITY HEALTH CENTER NURSE MIDWIVES 26439 5. PUBLIC HEALTH NURSING SUPERVISORS 7436 6 NURSE-MIDWIVES 52052 7 DISTRICT PUBLIC HEALTH NURSING OFFICER 900 8 TRADITIONAL BIRTH ATTENDER WILL BE REQUIRED 74361
  • 15. HIGH POWER COMMITTEE ON NURSING AND NURSING PROFESSION INTRODUCTION The retarded development of nursing and nursing profession seems to be mainly due to the fact that no serious thought has been given to this discipline by the government over the years. Timely action on the various reports submitted to the government would have prepared nurses to take care of all areas of health care delivery and would have also avoided multiplication of other categories like occupational therapists, physiotherapists, social worker, health educator etc. All these are doing nursing duties.
  • 16. HIGH POWER COMMITTEE ON NURSING AND NURSING PROFESSION RECOMMENDATIONS OF HIGH POWER COMMITTEE ON NURSING AND NURSING PROFESSION 1) Working conditions of nursing personnel 1. Employment  Uniformity in employment procedures to be made.  Recruitment rules are made for all categories of nursing posts. The qualifications and experience required or these be made thought the country.  There should not be a bond for nursing students as some of the states do not give them employment during the stipulated period. Keeping in view of the shortage of nurses in hospitals and community health field states should create posts and appointment these nurses in the appropriate positions.
  • 17. HIGH POWER COMMITTEE ON NURSING AND NURSING PROFESSION 2. Job description Job description of all categories of nursing personnel is prepared by the central government to provide guidelines. 3.Working hours The weekly working hours should be reduced to 4o hrs per week. Straight shift should be implemented in all states. extra working hours to be compensated either by leave or by extra emoluments depending on the state policy .nurses to be given weekly day off and all the gazetted holidays as per the government rules. 4.Work load/ working facilities  Nursing norms for patient care and community care to be adopted as recommended by the committee.  Hospitals to develop central sterile supply departments, central linen services, and central drug supply system. Group D employees are responsible for housekeeping department.  Policies for breakage and losses to be developed and nurses not are made responsible for breakage and losses.
  • 18. HIGH POWER COMMITTEE ON NURSING AND NURSING PROFESSION 5. Pay and allowances Uniformity of pay scales of all categories of nursing personnel is not feasible. However special allowance for nursing personnel, ie; uniform allowance, washing, mess allowance etc should be uniform throughout the country. 6. Promotional opportunities For promotion to the post of ward sister, post basic Bsc Nursing is made an essential qualification. The principle of possessing higher qualification than the category to be supervised, should apply fro all levels and categories of nursing personnel in the rural and urban areas. The committee recommends that along with education and experience, there is a need to increase the number of posts in the supervisory cadre, and for making provision of guidance and supervision during evening and night shifts in the hospital.  Each nurse must have 3 promotions during the service period.  Promotion is based on merit cum seniority.  Promotion to the senior most administrative teaching posts is made only by open selection.  In cases of stagnation, selection grade and running scales to be given.
  • 19. HIGH POWER COMMITTEE ON NURSING AND NURSING PROFESSION 7. Carrier development:- Provision of deputation for higher studies after 5 yrs of regular services be made by all states. The policy of giving deputation to 5 -10 % of each category be worked out by each state. Every nursing personnel must have an opportunity to attend at least one refresher course every 2 years. 8. Accommodation:- As far as possible, the nursing staff should be considered for priority allotment of accommodation near to work place. Hospitals should not build nurse's hostel for trained nurses. Apartment type of accommodation is built where married/unmarried nurses can be allowed to live. Housing colonies for hospital s must be considered in long run. 9. Transport:- During odd hours, calamities etc arrangements for transport must be made for safety and security of nursing personnel.
  • 20. HIGH POWER COMMITTEE ON NURSING AND NURSING PROFESSION 10. Special incentives:- Scheme of special incentives in terms of awards, special increment for meritorious work for nurses working in each state/district/PHC to be worked out. 11. Occupational hazards:- Medical facilities as provided by the central govt. by extended by the state govt. to nursing personnel till such times medical services are provided free to all the nursing personnel. Risk allowance to be paid to nursing personnel working in the rural $ urban area. 12. Other welfare services:- Hospitals should provide welfare measures like crèche facilities for children of working staff, children education allowance, as granted to other employees, be paid to nursing personnel.
  • 21. HIGH POWER COMMITTEE ON NURSING AND NURSING PROFESSION  Additional Facilities For Nurses Working In The Rural Areas  Family accommodation at sub centre is a must for safety and security of ANM's /LHV.  Women attendant, selected from the village must accompany the ANM for visits to other villages.  The district public health nurse is provided with a vehicle for field supervision.  Fixed travel allowance with provision of enhancement from time to time.  Rural allowance as granted to other employees is paid to nursing personnel
  • 22. HIGH POWER COMMITTEE ON NURSING AND NURSING PROFESSION  NURSING EDUCATION Nursing education to be fitted into national stream of education to bring about uniformity, recognition and standards of nursing education. The committee recommends that:- 1. There should be 2 levels of nursing personnel – a) professional nurse (degree level) and b) auxiliary nurse (vocational nurse). Admission to professional nursing should be with 12 yrs of schooling with science. The duration of course should be 4 yrs at the university level. admission to vocational /auxiliary nursing should be with 10 yrs of schooling .The duration of course should be 2 yrs in health related vocational stream. 2. All school of nursing attached to medical college hospitals is upgraded to degree level in a phased manner.
  • 23. HIGH POWER COMMITTEE ON NURSING AND NURSING PROFESSION 3. All ANM schools and school of nursing attached to district hospitals be affiliated with senior secondary boards. 4. Post certificate BSc Nursing degree to be continued to give opportunities to the existing diploma nurses to continue higher education. 5. Master in nursing programme to be increased and strengthened. 6. Doctoral programmes in nursing have to be started in selected universities. 7. Central assistance be provided for all levels of nursing education institutions in terms of budget( capital and recurring) 8. Up gradation of degree level institutions be made in a phased manner as suggested in report. 9. Each school should have separate budget till such time is phased to degree/vocational programme. The principal of the school be the drawing and the disbursing officer.
  • 24. HIGH POWER COMMITTEE ON NURSING AND NURSING PROFESSION 10. Nursing personnel should have a complete say in matters of selection of students. Selection is based completely on merit. Aptitude test is introduced for selection of candidates. 11. All schools to have adequate budget for libraries and teaching equipments. 12. All schools to have independent teaching block called as School Of Nursing with adequate class room facilities, library room, common room etc as per the requirements of INC. 13. Adequate accommodations are provided to students. A maximum of 3 students to share a room. Rooms to be furnished with light, study table , chair etc. Adequate dining room, toilets and bathrooms facilities to be provided in each hostel as per norms recommended. 14. Students should learn under supervision in the wards. Tutors/clinical instructors must go to the ward with students. Students should not be used for the service of the hospital.
  • 25. HIGH POWER COMMITTEE ON NURSING AND NURSING PROFESSION 15. Community nursing experience should be as per INC requirements. Necessary transport and accommodation at PHC be made available for safety, security and meaningful learning of students. 16. INC requirements for staffing the schools and meeting the minimum requirements are followed by all schools as these are statutory requirements. 17. Speciality courses at post-graduate level be developed at certain special centres of excellence eg; AIIMS. 18. Institutes like National Institute of Health and Family welfare, RAK College of Nursing and several others may develop courses on nursing administration for senior nursing leading to doctorate level. 19. Provision for higher training abroad and exchange programmes is made.
  • 26. HIGH POWER COMMITTEE ON NURSING AND NURSING PROFESSION CONTINUING EDUCATION AND STAFF DEVELOPMENT  Definite policies of deputing 5-10% of staff for higher studies are made by each state. Provision for training reserve is made in each institution.  Deputation for higher study is made compulsory after 5 yrs.  Each nursing personnel must attend 1 or 2 refresher course every year.  Necessary budgetary provision be made,  A National Institute for Nursing Education Research and Training needs to be established like NCERT, for development of educational technology, preparation of textbooks, media, / manuals for nursing.
  • 27. HIGH POWER COMMITTEE ON NURSING AND NURSING PROFESSION  NURSING SERVICES: HOSPITALS/INSTITUTIONS (URBAN AREAS) Definite nursing policies regarding nursing practice be available in each institution .These policies include:- a) Qualification/recruitment rules b) Job description/job specifications c) Organisational chart of the institutions d) Nursing care standards for different categories of patients. 1. Staffing of the hospitals should be as per norms recommended. 2. District hospitals /non teaching hospitals may appoint professional teaching nurses in the ratio of 1; 3 as soon as nurses start qualifying from these institutions. 3. Students not to be counted for staffing in the hospitals.
  • 28. HIGH POWER COMMITTEE ON NURSING AND NURSING PROFESSION 4. Adequate supplies and equipments, drugs etc be made available for practice of nursing. The committee strongly recommends that minimum standards of basic equipment needed for each patient be studied , norms laid down and provided to enable nurses to perform some of the basic nursing functions . Also there should be a separate budget head for nursing equipment and supplies in each hospitals/ PHC. The NS and PHN should be a member of the purchase and condemnation committee. 5. Nurses to be relieved from non -nursing duties. 6. Duty station for nurses is provided in each ward. 7. Necessary facilities like central sterile supplies, linen, drugs are considered for all major hospitals to improve patient care. Also nurses should not be made to pay for breakage and losses. All hospitals should have some systems for regular assessment of losses. 8. Provision of part time jobs for married nurses to be considered. (min 16-20hrs/week) 9. Re-entry by married nurses at the age of 35 or above may also be considered and such nurse be given induction courses for updating their knowledge and skills before employment.
  • 29. HIGH POWER COMMITTEE ON NURSING AND NURSING PROFESSION 10. Nurses in senior positions like ward sisters, Asst. nursing superintendents, Deputy NS; N.S must have courses in management and administration before promotions. 11. Nurses working in speciality areas must have courses in specialities. Promotion opportunities for clinical specialities like administrative posts are considered for improving quality nursing services. The committee recommends that Gazetted ranks be allowed for nurses working as ward sister and above (minimum class II gazetted). Similarly the post of Health Supervisor (female) is allowed gazetted rank and district public health nurse be given the status equal to district medical/ health officers.
  • 30. HIGH POWER COMMITTEE ON NURSING AND NURSING PROFESSION COMMUNITY NURSING SERVICES • Appointment of ANM/LHV to be recommended. • ANM/LHV promoted to supervisory posts must undergo courses in administration and management. • Specific standing orders are made available for each ANM/LHV to function effectively in the field. • Adequate provision of supplies, drugs etc are made. • Recording system be simplified. • Posts of public health nurses and above are given gazetted status.
  • 31. HIGH POWER COMMITTEE ON NURSING AND NURSING PROFESSION Norms recommended for nursing service and education hospital setting 1. Nursing Superintendent -1: 200 beds (hospitals with 200 or more beds). 2. Dy. Nsg. Superintendent. - 1: 300 beds ( wherever beds are over 200) 3. Asst. Nsg . Superintendent - 1: 100 4. Ward sister/ward supervisor - 1:25 beds 30% leave reserve 5. Staff nurse for wards -1:3 ( or 1:9 for each shift ) 30% leave reserve 6. For nurses OPD and emergency etc - 1: 100 patients ( 1 bed : 5 out patients) 30% leave reserve 7. For ICU -1:1(or 1:3 for each shift) 30% leave reserve • For specialised depts. such as operation theatre, labour room etc- 1: 25 30% leave reserve.
  • 32. HIGH POWER COMMITTEE ON NURSING AND NURSING PROFESSION Community nursing services • 1 ANM for 2500 population ( 2 per sub centre) • 1 ANM for 1500 population for hilly areas • 1 health supervisor for 7500 population( for supervision of 3 ANM's) • 1 public health nurse for 1 PHC ( 30000 population to supervise 4 Health Supervisors ) • 1 Public Health Nursing Officer for 100000 population ( community health centre) • 2 district public health nursing for each district. • Teaching staff for schools/colleges of Nsg. as per INC • 1 Nurse Teacher to 10 students for post graduate programmes.
  • 33. The Nurse-patient Ratio as per the norms of TNAI and INC (The Indian Nursing Council, 1985) The norms are based on Hospital Beds. 1. Chief Nursing Officer :1 per 500 beds 2. Nursing Superintendent :1 per 400 beds or above 3. D.NS. :1 per 300 beds and 1 additional for every 200 beds 4. A.N.S. :1 for 100-150 beds or 3-4 wards 5. Ward Sister :1 for 25-30 beds or one ward. 30% leave reserve 6. Staff Nurse :1 for 3 beds in Teaching Hospital in general ward& 1 for 5 beds in Non-teaching Hospital +30% Leave reserve 7. Extra Nursing staff to be provided for departmental research function. 8. For OPD and Emergency :1 staff nurse for 100 patients (1 : 100 ) + 30% leave reserve 9. For Intensive Care unit: (I.C.U.)- 1:l or (1:3 for each shift ) +30% leave reserve. 10. It is suggested that for 250 bedded hospital there should be One Infection Control Nurse (ICN). 11. For specialised departments, such as Operation Theatre, Labour Room, etc. 1:25 +30% leave reserve. norms are not based on Nursing Hours or Patient's Needs here.
  • 34. INDIAN NURSING COUNCIL Indian nursing council (INC) s a autonomous body under the government of India and was constituted by canter government under the Indian Nursing council Act 1974 of parliament. It was established in the 1949 for the purpose o providing uniform standards in nursing education and reciprocity in nursing registration through out the country.
  • 35. INDIAN NURSING COUNCIL Functions of Indian Nursing Council :- 1. Establish and monitor uniform standards of nursing education for various courses. 2. To recognise qualifications under section 10(2)(4) of INC act 1947 for the purpose of registration and employment in India and abroad. 3. Providing approval of registration to nurses passing from India and foreign under section 11 (2) (a) of INC act 1947. 4. Prescribe syllabus and regulations for nursing programme. 5. Power to withdraw the recognition of qualification under section 14 of act in case the institution fails to maintain it’s standard. 6. Act as advisory to state nursing council, government in various important rsegards.
  • 42. ESTIMATION OF NURSING STAFF REQUIREMENTS: ACTIVITY ANALYSIS  PATIENT CLASSIFICATION SYSTEM:- (PCS) It quantifies the quality of nursing care, essential to staffing nursing units of hospitals and nursing homes, health care agency or educational organization.  CHERECTORSTICS OF P.C.S. 1. Differentiate intensity of care among definite classes. 2. Measure and quantify care to develop a management engendering standard. 3. Match nursing resources to patient care requirement. 4. Related to time and effort spent on associated activity. 5. Be economical and convenient to repot and use. 6. Be mutually exclusive, continuing new item under more then one unit. 7. Be open to audit. 8. Be understood by those who plan, schedule and control the work. 9. Be individually standardized as to the procedure needed for accomplishment. 10.Separate requirement for registered nurse from those of other staff.
  • 43. ESTIMATION OF NURSING STAFF REQUIREMENTS: ACTIVITY ANALYSIS  PURPOSES OF P.C.S. 1. Establishment of time as unit of measurement of quality and quantity of nursing staff needed. 2. Programme costing and formulation of nursing budget. 3. Tracking changes in patient care needs. 4. Determining the quality. Of care by adjusting nursing services.
  • 44. ESTIMATION OF NURSING STAFF REQUIREMENTS: ACTIVITY ANALYSIS COMPONENTS OF P.C.S. 1. Grouping patient’s categories:- A/c to Johanson using categorizing method each patient is categorized on independent element of care, each element is scored, scores are summarised and patient is placed in a categories based on total numerical value obtained. 2. Set of guidelines describing the describing the way in which patient will be classified, the frequency of classification and method of data reporting. 3. Estimation of average amount of time required for care patient in each category.
  • 45. PATIENT CARE CLASSIFICATION Using 4 levels of nursig Care intensity:-
  • 46. CALCULATING STAFFING NEEDS * NCHPPD:- NURSING CARE HOUR FOR PATIENT PER DAY
  • 47. COMPUTING NOUMBER OF NURSES ASSIGNED ON WEEKLY BASIS1. Finding total no. of nsg. Hrs. needed/week:- Example:- - Avredge pt. censes :- 15/day - average nsg. Hrs/pt/24 hrs :- 1/day - days in week :- 6 days - 15x1x6= 90 hrs /week needed Avredge pt. censes x average nsg. Hrs/pt/24 hrs x days in week
  • 48. COMPUTING NOUMBER OF NURSES ASSIGNED ON WEEKLY BASIS 1. Find out number of total working days per nurse per year:- -Total days/year:- 365 days - Day off (1/week):- 52 day off - CL :- 12 - PL :- 30 - Sat. off (1/month):- 12 - Public holiday :- 18 - SL :- 8 TOTAL = 132 days non working/233 days working/year * Total working days/nurse/year= 233 days * If 8hrs./nurse/day then 8x233= 1864 hrs/year/nurse working hrs. * 24 hrs/day x 365 day= 8760 total hrs./year * Minimum nurse requirement:- 8760/1864= 4.70 nurse/8 hrs.
  • 49. FACTORS OF STAFFING 1. QUALITY 2. QUANTITY 3. UTELIZATION OF PERSON
  • 50. RECRUITMENT Recruitment is interpreted as the procedure of exploring and obtaining applicants for the jobs from among whom the right people can pick out. It is the process of detecting and appealing capable applicants for employments. The processes are commences when new recruits are sought and end when their applications are presented. The result is a pool of applicants from which new employees are picked out.
  • 51. RECRUITMENT  DEFENITION:- Jerry and Franklin; “Recruitment is the foundation that feeds the managerial pool: without it managerial personnel dries up and survival of an enterprise is threatened.”  TYPES OF RECRUITMENT:- 1. Planned:- Arise from changes in organization and recruitment policy 2. Anticipated:- By studying trends in the internal and external organization 3. Unexpected:- Arise due to accidents, transfer and illness
  • 52. RECRUITMENT LINKAGE OF RECRUITMENT TO HUMAN RESOURCES ACQUISITION MANPOWER PLANNING JOB ANALYSIS RECRUITMENT S E L E C T I O N P L A C E M E N T
  • 53. RECRUITMENT BASIC ELIMENTS OF SOUND RECRUITMENT POLICY 1.Discovery and Cultivation of employment Market 2. Use of Attractive literature and publicity 3. Use of scientific entrance test 4. Tapping capable candidate from within the service. (Departmental placement) 5. Placement program for right man to right job 6. Follow up probationally programme.
  • 54. RECRUITMENT PURPOSE AND IMPORTENCE OF RECRUITMENT 1. Determine present and future requirements of the organization in conjugation with personnel planning and job analysis. 2. Increases the pool of job candidates. 3. Improves success rate of selection process by separating over and under eligible candidates as per job profile. 4. Will reduces the employee drop out unexpectedly. 5. Meet organization’s legal and social obligations. 6. Identifying and grooming candidates for a desired role. 7. Evaluate effectiveness of various recruitment techniques and sources for all types of job applicants.
  • 55. RECRUITMENT OBJECTIVES OF RECRUITMENT 1. Attract multidimensional skilled and experiences for present and future organizational strategies. 2. Induct outsiders as a leader in organization. 3. Infuse fresh blood at all levels. 4. Develop organizational Culture to attract competent people. 5. Devise proper methodology for assessing psychological traits. 6. Search talent globally. 7. Design entry pay that competes on quality. 8. Anticipate and find people for positions.
  • 56. RECRUITMENT PRINCIPLES OF RECRUITMENT  Recruitment should be done from a central place, i.e. Administrative office/Nursing service administration. 1. Appointment and termination is sole right and liability of concern authority. 2. Only desired post should be filled to meet the HR demands of organization. Over and under recruitment is not advisable. 3. A predefined job description and work analysis must be ready before recruitment. 4. Recruitment procedure must be designed by a well experienced and capable person in a view to meet the mission and vision demands of organization. 5. A internal promotion or external recruitment can be a choice to fulfil the desired post. 6. Recruitment should be done on the basis of defined qualification and set standards. 7. A recruitment policy should be followed. 8. Promotion policy must be well described and made understood to all. 9. Institution reserves the rights to revise policies as per requirements.
  • 57. RECRUITMENT SOURCES OF RECRUITMENT SOURCES OF RECRUITMENT INDIRECT/ EXTERNAL SOURCES DIRECT/INTERNAL SOURCES
  • 58. RECRUITMENT SOURCES OF RECRUITMENT I.) INTERNAL SOURCES 1.) Present employees :- Promotion of present employee from his/her present post to higher post based on ability and performance. 2.) Employee referrals:- A employee refers a new candidate for a said post based on his relationship and capabilities known to him which can be an assert to organization. 3.) Former employees:- Part time recruitment of retired employees based on there request or candidate recommended by them. 4.) Previous applicants:- One who is in waiting list can be called based on CV submitted by them who fulfil demands of said post.
  • 59. RECRUITMENT SOURCES OF RECRUITMENT II.) EXTERNAL SOURCES 1. Professional or trade association:- Many organizations provide placement and selection facility. 2. Advertisement:- Contents job title, required qualification, designation, norms, sometimes salary packages and other info. Seeking for applicant to apply for desired post. 3.Employee exchange:- A/c to employee exchange act 1959 employee exchange is applicable to all industries having 25 or above employee. This act as preliminary screening and proof of employee’s details verified and provides a ling for further opportunities. 4. Campus recruitment:- Recruitment of fresh passed students from conducting a placement drive at educational institute itself by various employers to find new candidates as per organizational demands. 5. Walk in, write in and talk in recruitment.
  • 60. RECRUITMENT SOURCES OF RECRUITMENT II.) EXTERNAL SOURCES 6. Consultants:- Are corporate agencies providing job assistance and consultancy to job seekers and same time arranges job interviews as demanded by employers. 7. Contractual:- Recruitment for a specific time period of contract and after completion of contract tenure it comes to end automatically.
  • 61. CREDENTIALING  CREDENTIALING Credentialing is the process of establishing of licensed professionals, organizational members and assessing their background and legitimacy. It may granting and reviewing specific clinical privileges and medical or allied health staff membership. Definition It is the process of establishing the qualifications of licensed professionals, organizational members or organizations, and assessing their background and legitimacy.  PURPOSES OF CREDENTIALING 1. Prevent a problem before it’s occurrence. 2. Reviewing and verifying information. 3. Research qualifications and background of individual companies.
  • 62. CREDENTIALING  CREDENTIALING SIGNIFICANCE It is very significant because it shows that an individual or company performing a service is qualified to do so.  CREDENTIALING LEGAL PROTECTION It is a good idea to have credentialing process to protect you and your business from a lawsuit or other legal problems.  HEALTH CARE CREDENTIALING Health care credentialing is a system used by various organizations and agencies to ensure that their health care practitioners meet all the necessary requirements and are appropriately qualified. The credentials may vary depending on the specified area of the practitioner.
  • 63. CREDENTIALING CREDENTIALING COMPONENTS 1.) Appointment:- Evaluation and selection of nursing staff. 2.) Clinical privileges:- Declaration of specific nursing services may managed within the institute. 3.) Periodic reappraisal:- Continuing review and evaluation of each member of the nursing staff.
  • 64. CREDENTIALING CRITERIA FOR SELECTION OF NURSING STAFF • Proof of licensure • Education and training • Specialty board certification • Previous experience • Recommendations Clinical prerveledged criteria:- Includes the proof of speciality training and of performance of nursing procedure or speciality care during training and previous appointments.
  • 65. SELECTION It is process of choosing best applicant among eligible applied for a post.  Selection includes:- 1. Interviewing 2. Employer's offer 3. Acceptance by applicant 4. Signing of a contract or written offer
  • 66. SELECTION The process of selection leads to employment of persons having the ability and qualification to perform the jobs which have fallen vacant in an organization. The basic purpose of selection is rejection of unskilled candidates and choosing a right type of person on various positions in the organization.  SELECTION POLICIES 1. Application form 2. Selection committee:- Includes HOD college of nursing, professor, representative of local controlling authority, representative of nursing division of state, an educational psychologist. It includes:-  Personal interview of candidate  Test of previous achievements both written and oral  It should be made clear to them that final acceptance for the course will be subject to a satisfactory medical report and assessment during a preliminary training period.
  • 67. SELECTION 3. Orientation programme 4. Development of master rotation plan 5. Parent teacher association
  • 68. STEPS IN SELECTION 1. Interview by Personnel Department 2. Pre-employment tests(written/oral/Practical) 3. Interview by departmental head 4. Decision of administrator to accept or reject 5. Medical Examination 6. Check of reference 7. Issue of appointment letter 8. Placement
  • 69. STEPS IN SELECTION 1. INTERVIEW It is the most intricate and difficult part of the selection process. It can be divided into four parts:- 1. The warm-stage 2. The drawing-out stage 3. The information stage 4. The forming an-opinion stage  Objective of an interview:- 1. Employer obtain all information regarding candidate. 2. Briefing candidate regarding organization and job profile.
  • 70. STEPS IN SELECTION 2. PRE IMPLOYEMENT TEST a) Test for general ability-intelligence:- IQ test b) Aptitude test:- Testing for abilities of potential development. c) Test of achievement:- Test for professional proficiency achievement reported by candidate. d) Personality test:- to know personality traits. 3. Final approval by head of institution:- 4. References 5. Medical examination 6. Joining report by employee
  • 71. PLACEMENT Placements are a credit bearing part of a degree course. If a student opts out of a placement or there is no placement available, this means that placement is not guaranteed. Importance:- • To fairly and without any element of discrimination evaluate job applicants in view of individual differences. • To employ qualified and competent hands • To place job applicants in the best interest of the organization  Help in human resource and manpower planning  Reduce recruitment cost. Placement team:- 1. Placement coordinator 2. Academic tutors with each of separate speciality
  • 72. PROMOTION Promotion policy is one of the most controversial issues in every organization. The unions generally favours promotions on the basis of seniority. Definition:- A change for better prospects from one job to another job is deemed by the employee as a promotion.
  • 73. PROMOTION  Nature and scope of promotion “Seniority v/s merit” concept.  Factors implying promotion:- 1. Increase in salary 2. Increase in prestige 3. Upward movement in hierarchy of job 4. Additional supervisory responsibility 5. A better future
  • 74. PROMOTION POLICY The management usually favours on the basis of merits and the unions opposite to that favours seniority promotional criteria. However, in practice, both seniority and ability criteria should be taken into consideration. Promotion policy includes:- 1. Charts, diagrams showing job relationship and ladder of promotion 2. Definite system for making a waiting list 3. Notification of all existing vacancies to all employees 4. Eight factors must be basis for promotion:- Achievement Experience Seniority Initiative
  • 75. PROMOTION POLICY ADVANTAGES Recognition in ladder of promotion Knowledge and experience according to vacancy Record of loyalty and cooperation Outstanding service in terms of quality as well as quantity Loyalty amongst employees Increase satisfaction generates motivation provide ample of opportunities Increases productivity
  • 76. RETENTION Definition:- Ability of an organization to retain the staff to avoid turnover and to improve the productivity of institute or organization. Why it is important:- 1. Key skills, idea, knowledge and experience remains within organization. Client relationship and networks are also preserved along with income generated by them. 2. Loosing key skill workers will inversely harm institute by making them available for extreme competitors eventually results in benefits to rivals. 3. Direct cost involved in loosing employee. We need to train new one and it cost a lot.
  • 77. RETENTION PRINCIPLES TO HELP FOSTER STAFF RETAINTION 1. Respectful collegial communication and behaviour 2. Communication rich culture 3. A culture of accountability 4. Presence of adequate number of qualified nurses 5. Presence of expert, competent, credible, visible leadership 6. Shared decision making at all levels 7. Encouragement of professional practice and continuous growth/development 8. Recognition of value of nursing’s contribution 9. Recognition of nurses for there meaningful contribution to practice.
  • 78. PERSONNEL POLICIES POLICY:- Policy is a statement of predominant guidelines.  It is a set of rules that defines a manner in which a organization deals with human resources.  It is statement of accepted personal principles and the resulting course of administrative action by which a specific organization pattern determines the pattern of employment condition. Importance of personnel policy  It represents a guarantee of fair and equitable treatment to employees.  It is a safeguard. It relieves a responsibility of making a personal decision.
  • 79. OBJECTIVES OF PERSONNEL POLICY 1. Ensure best man for job. 2. Guaranteed fairness in discipline maintenance. 3. Staff welfare and faculty development. 4. All steps to avoid extra working hours. 5. Ensure greatest practicable degree of permanent and continue employment. 6. Maintain standards of remuneration. 7. Maintain high levels of working conditions. 8. Provide proper orientation. 9. Encourage social and recreational facilities for employees. 10. Develop appropriate scheme for employee welfare.
  • 80. TYPES OF POLICY A) IMPLIED POLICY:- 1. Policy which is not written but established by pattern of decision by experience of events and times followed by precedent. 2. May have +ve /-ve effects. 3. A superior authority do not need to issue policy statement to fellow.  Basically in this a person with authority will guide only a standard norm and a fellow should take independent decision based on understanding. B) EXPRESSED POLICY :- 1. Declared verbally or written. 2. Oral policy is more flexible then written.
  • 81. ELEMENTS OF PERSONNEL POLICY STATEMENT 1. Operating procedure policy 2. Employee conduct policy 3. Equipments use regulations and manuals 4. Professionalism 5. Employer’s authority
  • 82. POLICIES RELATED TO NURSING PRACTICES
  • 83. FACATORS AFFECTING PERSONNEL POLICIES 1. Low of country 2. Social values and customs 3. Management philosophy and values 4. Stage of development 5. Financial position of firm 6. Type of workforce.
  • 84. TERMINATION TERMINATION:- Employee termination is the process by which an organization ends an individual’s employment against his/her will. CAUSES OF TERMINATION:- 1. Poor job performance 2. Incompatibility with organization 3. Inability to perform job responsibility 4. Conflict with senior or felloe employees 5. Misconduct 6. Incidence of employment separation 7. Poor performance:- lack of punctuality, abscentism, failure to produce desired results. 8. Resisting change
  • 85. CAUSES OF TERMINATION 9. Negativism 10. Insubordination 11. Violating values of organization 12. Questionable character and ethical laps 13.Criminal acts 14. Behavioural causes:- Abscentism and tardiness Unsatisfactory performance Lack of qualification and ability Changed job requirements Gross misconduct Breech of company norms and policy
  • 86. TERMINATION PROCESS 1. Be honest 2. Be compassionate 3. Be quick
  • 88. Meaning  Staff development is the process directed towards the personal & professional growth of the nurses and other personnel while they are employed by a health care agency.  Personal and Professional Development (CPPD) is the new name for the Staff Development.
  • 89. DEFINITION S.D.P. Staff development includes all training and education undertaken by an employer to improve the occupational and personal knowledge, skills, and attitudes of employment. A process consisting of orientation, in-service education and continuing education for the people of promoting the development of personnel within any employment setting, consistent with the goals and responsibilities of the employment.( ANA)
  • 90. Needs for staff Development:  social change and scientific advancement  advancement in the field of science like medical science and technology.  to provide the opportunity for nurses to continually acquire and implement the knowledge, skills, attitudes, ideals and valued essentials for the maintenance of high quality of nursing care.
  • 91. Need cont……  As part of an individual's long-term career growth.  To add or improve skills needed in the short term  Being necessary to fill gap in the past performance  To change or correct long-held attitudes of employee  To move ahead or keep up with change.  Fast changing technologies  Need to increase the productivity and quality of the work.  To motivate employees and to promote employee loyalty  Fast growing organizations.
  • 92. Goals: 1. Assist each employee (nurse) to improve performance in his/her position. 2. Assist each employee (nurse) to acquire personal and professional abilities that maximize the possibility of career advancement.
  • 93. OBJECTIVES  To increase employee productivity.  To ensure safe and effective patient care by nurses.  To ensure satisfactory job performance by personnel.  To orient the personnel to care objectives, job duties, personnel policies, and agency regulations.
  • 94. Objectives cont…..  To help employees cope with new practice role.  Help employees cope with new practice role.  Help nurses to close the gap between present abilities and the scientific basis for nursing practice that is broadening through research.
  • 95. Function of Staff Development Provide Educational activities for all nurses employed by the health care agency directed towards change behavior related to role expectations. It concerned with growth and development of personnel from their initial contact with a healthcare agency until termination of service
  • 96. STAFF DEVELOPMENT PROGRAM, HEALTH CARE ORGANIZATION MODEL Assessing Competency Maintaining Competency Developing competency
  • 97. Steps of staff development program Assess the educational needs of all staff members Set priority Develop general objectives for the staff development programme Determine the resources needed to reach the desired objectives Develop a master calendar for an entire year Develop and maintain staff development record system Establish files on major educational topics Regularly evaluate the staff development program
  • 98. RESOURCES  Public libraries, audiovisual program in addition to many books and computers, research activities and speakers to community groups.  Schools and universities  Association  Health and inter service agency  Other nursing homes  One’s own staff
  • 99. ADMINISTRATIVE STRUCTURE OF A STAFF DEVELOPMENT PROGRAM Administrative philosophy, policies & practices of health care agency.  Policies, practices and standards of nursing & other health professionals.  Human & material resources  Physical facilities  Financial resources
  • 101. ROLE: Applies adult learning principles when helping employees learn new skills or information. Coaches’ employees readily regarding knowledge and skill deficits. Actively seeks out teaching opportunities. Uses teaching techniques that empower staff. Is sensitive to the learning deficits of the staff and creatively minimizes these deficits. Frequently assess learning needs of the unit. 
  • 102. Types of Staff Development:  Induction Training.  Job Orientation.  In service education  Continuing education  Training for special function
  • 104. Need of induction training  Increased retention of newly hire employees,  Improved employee morale and  Increased productivity.
  • 105. Steps in induction 1. Tour of facilities 2. Introduction to the other employees, superiors and subordinates. 3. Description of organizational functions. 4. Departmental visit 5. Orientation to philosophy goals and objectives 6. Administration policies and procedures
  • 106. INDUCTION CONT….  Techniques used in induction  Forms of induction  Ø Internship  Ø Preceptorship  Ø Mentorship
  • 107. TYPES CONT… Job Orientation. "A good beginning is half the battle!"
  • 108. MEANING The process of creating awareness with an individual of his/her roles, responsibilities and relationships in the new work situation.
  • 109. COMPONENTS  A new employee to his or her job setting so that he / she is aware of his/ her job responsibility and expectation.  Present employee to the job responsibilities of his/ her expanded/ enriched role.  The old employees to the policy changes.
  • 110. Types of orientation  General orientation  Specific orientation
  • 111. IMPORTANCE OF ORIENTATION PROGRAMME  Provides essential, relevant and necessary information  Helps employee to gain confidence,  Lessen the time for the employee to learn about new situations related to his/her job setting.  Helps the new employee to develop a sense of belonging  Eliminates  Learning by trail and error  Passing of incorrect information by old employees and peers.  Reduces misinterpretation  Mistakes and confusion  Apprehension  Help new employee in solving initial problems and adjust the new situation/environment,  Acquaints her with personnel services readily with in the institution/community
  • 112. CONTENT OF AN ORIENTATION PROGRAMME  The origination and its environment  Policies, rules and regulation  Personnel  Services  Functions to be undertaken
  • 114. Definition In service education is a planned educational experience provided in the job setting and closely identified with services in order to help person perform more effectively as a person and as a worker.
  • 115. Concept of in- service education Closely identified with services Help a person’s to improve performanc e effectively Planned education activities Provided in a job setting
  • 116. Need  Social changes and scientific advancement  Changes and advancement in the field of service  increased the demand of nursing services.  Consumer demand quality care  Rapid changes in medical and nursing practice create a need for in service education.  Increase number of the people seeking health care as the population enlarges makes it necessary for the nurses to function at her highest potential as quickly as possible.  As health care delivery system become more complex, the need for continues skill training also increased.
  • 117. OBJECTIVE  To provide for and promote the personal growth and development of the workers  To stimulate and develop occupational  To proved for job satisfaction  identifying and meeting current bearing needs  To disseminate new information from body of nursing knowledge and health science through verity of channels. To acquire up to date knowledge and to make confidence among the nurses.  To retain experience personnel to foster there continue education.
  • 118. Steps in In-service education Assessment Pinpoint needs, prioritize needs, set training objectives, and develop criteria Implementation Climatic check, actual conduction of training with ongoing monitoring Evaluation Establishment of criteria, pre test to the participants, post test following completion of the training or program. Observation on transfer of learning to the job, follow up studies for assessment of extent of retention of learning.
  • 120. DEFINITION  Continuing education is all the learning activities that occur after an individual has completed his basic education - cooper  The education which builds a previous education is called continues education -Shannon
  • 121. Aims of continuing education  1.Improvement of professional practice  2.To motivate the staff to seek the latest knowledge  3.To keep the nurses with the latest development of technologies  4.It develops interest, job satisfaction and confidence
  • 122. PURPOSE OF CONTINUING EDUCATION.  Enable a worker to move from satisfactory to excellent performance  Provides exposure to new concepts, procedural refinements, innovative product applications, or acquisition of increased expertise  Ensure professional development  Increase ability in order to solve the problem in a clinical teaching/ administrative area.  Improve the ability to communicate or participate in research work.
  • 123. NEED OF CONTINUING EDUCATION  To ensure safe and effective nursing care  Changing health care delivery system,  Development of nurses by updating their knowledge  For career advancement  Professional are altered as society changes and as technologies emerge  To acquire specialized skill for professional.
  • 125. DEFINITION This is concerned with developing expert technical or manual skills, communication and helps the personnel to perform their functions effectively. Objectives 1. To help the nursing personnel to perform correct methods and procedures with understanding. 2. Establishing standards and quality of nursing services. 3. Procedure to skill nurses to skilled nurses.
  • 126. Types of skills   Psychomotor skill   Cognitive skill   Teaching skills   Affective skill   Communication skill   Supervisory skills
  • 127. Need for skill training  Individual nurse needed to have greater freedom to choose the specific field of nursing in which she would work.  Good work to be recognized and reward.  A venues of advancement and promotion need to be better development  Fear of making mistakes
  • 128. Guidelines for skill training  1.Set the stage, using equipment similar to that provided for the worker in the work situation.  2.Create in worker a learning attitude,  3.Give reasons why the procedure is carried out in this way in this agency;  4.Break the activities in to logical steps, necessary to carry out the procedure.Demonstrate step by step.  5.Make certain that the person has learnt by requiring a return demonstration  6. Provide written out lines for references.  7. Arrange for follow up (supervision
  • 129. Standards of staff development programme (ANA) Standard 1 – organization and administration  The nursing service department and the nursing staff development unit philosophy, purpose and goals address the staff development needs of nursing personnel. Standard II – human resources  Qualified administrative, educational and support personnel are provided to meet the learning and developmental needs by nursing services personnel. Standards III – learner  Nursing staff development educators assist nursing personnel in identifying their learning needs and planning learning activities to meet those needs.
  • 130. Standard IV – program planning  Provides the unit systematically, plans and evaluate the overall nursing staff development program in response to health care needs. Standard V – educational design  Educational offering and learning experience are designed through the use of educational process and incorporate adult education and learning principles. Standard VI – material resources and facilities  Material sources and facilities are adequate to achieve the goals and implement the functions of the overall nursing staff development unit. Standard VII – records and reports  The nursing staff development unit establishes and maintains a record keeping and report system
  • 131. Standard VIII – evaluation  Evaluation is an integral ongoing and systematic process, which includes measuring the impact on the learning Standard IX – consultation  Nursing staff development educators use the consultation process to facilitate and enhance achievement of individual,departmental and organizational goals. Standard X – climate  Nursing staff development educators foster a climate which promotes open communication, learning and professional growth. Standard XI – systematic enquiring  Nursing staff development educators encourage systematic inquiry and applications of the results into nursing practice.
  • 132. Potential difficulties in staff development & training activities Lack of time Inadequate resources at disposal Under-funded training budgets Conflicting priorities Lack of Clarity about what should be done Failure to identify, or accept the need. Shortfall in training skill or experience Fear that trained employee will leave the organization or will be poached by competitor. Cynical attitude to Staff development-Not directly measurable. Treated as Cost not investment.
  • 133. METHODS OF DELIVERING SDP INDUCTION JOB ORIENTATIO N IN- SERVICE CONTINUING EDUCATION Physical tour of the facilities Group discussion Seminar Hand book and pamphlet Orientation Seminar Discussion Hand out or book and pamphlets Orientation Skill training Continuing education Leadership training Lecture Demonstration Seminar Debate Journal club Book review Correspondence course Formal course Clinical research TRAINING FOR SKILL Demonstratio n Discussion Role-play method.
  • 134. Induction orientation In-service Continuing Management Organization Training Education education training development
  • 135. DUTIES AND RESPONCIBILITY OF VARIOUSE CATEGORIES OF NURSING PERSONNELS GENERAL ROLE OF REGISTERED NURSES IN HOSPITAL 1.) ADMINISTRATOR  Recruitment and retention of physicians  Overseeing quality  Improvement of processes for efficient delivery of patient care  Setting standards  Creating financial and business strategies  Budgets
  • 136. DUTIES AND RESPONCIBILITY OF VARIOUSE CATEGORIES OF NURSING PERSONNELS 2. MANAGER  Planning  Gives directions  Gives rewards fairly  Nursing care of individuals, groups, families and communities  Supervising and evaluates other nurses performance.
  • 137. DUTIES AND RESPONCIBILITY OF VARIOUSE CATEGORIES OF NURSING PERSONNELS 3. COUNSELOR  Help new employees  Take new employees round the hospital  Show them different departments and explain their functioning  Explains rules and regulations of hospital and of cafeteria  Issue lockers and uniforms  Introduce them to the administrator and medical superintend  Helps in reviewing training needs  Improving better communication between employees and employers  Helps in solving personal and official problems of employees  External and internal stress, lack of training, difficulties in job, emotional deprivation can be tackled under employee counselling.  Create a better harmonious hospital staff environment.
  • 138. DUTIES AND RESPONCIBILITY OF VARIOUSE CATEGORIES OF NURSING PERSONNELS Problems to be handled by the Counsellor 1. Emotional Problem 2. Behavioural Problem 3. Personal Problem 4. Environmental Problem 5. Organizational Problem
  • 139. DUTIES AND RESPONCIBILITY OF VARIOUSE CATEGORIES OF NURSING PERSONNELS 1. Emotional Problem fear, anger, and jealousy, which are harmful to the well-being and development of individual employee in hospital setting. 2. Personal Problems Housing, transportation, admission of children in schools etc. 3. Behavioural and Organisational problems  Lack of group cohesiveness  Role conflict  feeling of inequality,  role ambiguity,  role over load,  lack of supervisory support,
  • 140. DUTIES AND RESPONCIBILITY OF VARIOUSE CATEGORIES OF NURSING PERSONNELS  constraints of rules and regulations,  job mismatch,  inadequacy of role authority,  absenteeism,  job dissatisfaction,  labour turnover and job stress
  • 141. DUTIES AND RESPONCIBILITY OF VARIOUSE CATEGORIES OF NURSING PERSONNELS 4. CHANGE AGENT  Identifying the problem  Assessing the client‘s motivations and capacities for change  Determining alternatives  Assessing resources  Determining appropriate helping roles  Establishing and maintaining a helping relationship  Recognizing phases of the change process 5. RESEARCHER  Participates in scientific investigation  Helps develop knowledge about health and promotion of health over the full life span  Care of person with health problems and disabilities
  • 142. DUTIES AND RESPONCIBILITY OF VARIOUSE CATEGORIES OF NURSING PERSONNELS 6. CASE MANAGER  Coordinates the activities of other members of health care team  (Nutritionists and physical therapist) 7. COLLABORATOR  The nurse initiates nursing actions within the health team 8. HEALTH EDUCATORS  Educating individuals and communities about behaviours that can prevent diseases, injuries, and other health problems  Organize an event, such as a lecture, class, demonstration or health screening  Plan programs that are consistent with the goals and objectives of their employers
  • 143. DUTIES AND RESPONCIBILITY OF VARIOUSE CATEGORIES OF NURSING PERSONNELS 9. ADVISOR  Act as advisor in Tech-Serve project on matters relating to hospital management improvement in provincial hospitals, based on previous experience.  Contribute to the development of provincial hospital planning and facilitating the implementation of Standard Based Management in the Provincial Hospitals.  Technical assistance to EPHS workshops conducted at the provincial and central level as well as participate in visits to provincial hospitals for purposes of training  Travel regularly to the provincial hospitals for the purpose of supporting, training, and monitoring the activities of the hospital leadership.  Act as a resource to provide models of best practice for hospital management through research, training, document translation, and any other means as needed.  Participate in and sometimes leading quality assurance and performance improvement activities as required by the hospitals.
  • 144. DUTIES AND RESPONCIBILITY OF VARIOUSE CATEGORIES OF NURSING PERSONNELS  Collect statistical data as needed for the purposes of monitoring hospital performance and providing comparative information on hospital performance. 10. ADVOCATOR