Leadership management

3. Subject: Effective Leadership and
Management in Nursing
Summarization of chapters
11 to 15

4. Chapters name
•11- Delegating Successfully
•12- Building and Managing Teams
•13- Handling Conflict
•14- Managing Time
•15- Budgeting and Managing Fiscal
Resources

5. Chapter no 11
Delegating Successfully

6. Objectives
• Explain delegation and distinguish between responsibility, accountability, and
authority.
• Describe how effective delegation benefits the delegator, the delegate, the unit,
and the organization.
• Explain how following the five rights of delegation can reduce nurses’ fears
about delegation.
• Evaluate the delegation process, including the steps in delegation, key
behaviors for successful delegation, and the implications of accepting
delegation.
• Assess the factors that contribute to ineffective delegation.

7. Delegation, Responsibility,
Accountability
• Delegation is the process by which responsibility and authority for performing
a task (function, activity, or decision) are transferred to another individual who
accepts that authority and responsibility
• Responsibility denotes an obligation to accomplish a task,
• Accountability is accepting ownership for the results or lack thereof.
Responsibility can be transferred, but accountability is shared.

8. Principles for delegation
• The nursing profession determines the scope and standards of nursing practice.
• The RN takes responsibility and accountability for the provision of nursing
practice.
• The RN directs care and determines the appropriate utilization of resources
when providing care.
• The RN may delegate tasks or elements of care but does not delegate the
nursing process itself.
• The RN considers facility/agency policies and procedures and the knowledge
and skills, training, diversity awareness, and experience of any individual to
whom the RN may delegate elements of care.

9. Cont..
• The decision to delegate is based upon the RN’s judgment concerning the care
complexity of the patient, the availability and competence of the individual
accepting the delegation, and the type and intensity of supervision required.
• The RN acknowledges that delegation involves the relational concept of
mutual respect.
• Nurse leaders are accountable for establishing systems to assess, monitor,
verify, and communicate ongoing competence requirements in areas related to
delegation

10. Cont..
• The organization/agency is accountable to provide sufficient resources to
enable appropriate delegation.
• The organization/agency is accountable for ensuring that the RN has access to
documented competency information for staff to whom the RN is delegating
tasks.
• Organizational/agency policies on delegation are developed with the active
participation of registered nurses.

11. Benefits of delegation
• Benefits to the nurses
• Benefits to the delegate
• Benefits to manager
• Benefits to the organization

12. Five rights of delegation
• Right task
• Right circumstances
• Right person
• Right direction and communication
• Right supervision

13. The delegation process
• Define the task.
• Decide on the delegate.
• Determine the task.
• Reach agreement.
• Monitor performance and provide feedback.

14. Key behavior in delegating tasks
• Describe the task using “I” statements.
• Discuss the importance to the organization.
• Explain the expected outcome and timeline for completion.
• Identify any constraints for completing the task.
• Validate understanding of the task and your expectations.

15. Ineffective delegation
• Organizational culture
• Lake of resources(financial and educational resources)
• An insecure delegator(fear to competition, fear of liability, fear to loss of
control, fear of overburdening others, fear of decreased personal job
satisfaction)
• An unwilling delegate
• Under delegation
• Reverse delegation
• Over delegation

16. Conclusion
Delegation is a skill that can be learned. Like other skills, successfully
delegating requires practice. Sometimes it seems it might be easier to do it
yourself—but it is not. Once you learn how to delegate, you will extend your
ability to accomplish more by using others’ help. By delegating appropriately,
managers can role model this behavior and teach their staff to do likewise. It is
the best use of their time. No one in healthcare today can afford not to delegate.

17. Chapter no 12
Building and
managing teams

18. Objectives
• Describe how groups and teams function.
• Explain the norms and roles in groups and teams.
• Describe various methods of team building.
• Discuss factors that influence team management.
• Explain why the nurse manager’s leadership skills are essential to team
performance.
• Discuss how to lead groups, task forces, and patient care conferences.

19. Group
A group is an
aggregate of
individuals who
interact and mutually
influence each other. Types of
group
Formal
group
Informal
group
Task
group
Real
/comman
d group

20. Team
• Teams are real groups in which
individuals must work
cooperatively with each other in
order to achieve some
overarching goal.

21. Group and team process
• The schematic depicts the effects of organizational and individual background
factors on group leadership, including dynamics (tasks, activities, interactions,
attitudes) and processes (forming, storming, norming, performing, adjourning).
Elements of the required group system and processes influence each other and
the emergent group system and social structure.
• According to Homans’s framework, the three essential elements of a group
system are activities, interactions, and attitudes

23. Building teams
Team building focuses on both task and relationship aspects of a group’s
functioning and is intended to increase efficiency and productivity.
Following are the important for team building
• Assessment
• Team building activities

24. Assessment
• The most important initial activities in team building are data gathering and
diagnosis.
• the group’s context (organizational structure, climate, culture, mission, and
goals); the characteristics of the group’s work, including group members’
roles, styles, procedures, job complexity; and the team, its problem solving
style, interpersonal relationships, and relations with other groups.

25. Team building activities
Team-building activities, originally designed to improve interpersonal workplace
relationships, have expanded to include meeting goals and accomplishing tasks
Team STEPPS involves three phases:
• Assessing the need
• Training on-site
• Implementing and sustaining training

26. Managing teams
Managing teams differs from team building and depends on the
• Task,(additive, disjunctive, divisible, or conjunctive)
• Group size and composition,
• Productivity and cohesiveness,
• Development and growth,
• Shared governance

27. The nurse manager as team leader
• Communication
• Evaluating team performance

28. Leading committees and task force
• Committees are generally permanent and deal with recurring problems.
Membership on committees is usually determined by organizational position
and role
• Formal committees are part of the organization and have authority as well as
a specific role.
• Informal committees are primarily for discussion and have no delegated
authority.
• Task forces are adhoch committees appointed for a specific purpose and a
limited time.

29. Guidelines for conducting meetings
• Preparation.
• Participation
• Place and Time
• Member Behavior

30. Member behaviors
Group members should adhere to the following:
• Be prepared for the meeting, having read pertinent materials ahead of time.
• Ask for clarification as needed.
• Offer suggestions and ideas as appropriate.
• Encourage others to contribute their ideas and opinions.
• Offer constructive criticism as appropriate.
• Help the discussion stay on track.
• Assist with implementation as agreed.

31. Cont…
A leader can increase meeting effectiveness greatly by doing the following:
• Not permitting one individual to dominate the discussion
• Separating idea generation from evaluation
• Encouraging members to refine and develop the ideas of others (a key to the
success of brainstorming)
• Recording problems, ideas, and solutions on a white board or flip chart •
Checking for understanding
• Summarizing information and the group’s progress periodically
• Encouraging further discussion
• Bringing disagreements out into the open and facilitating their reconciliation

33. Managing task force
• Preparing for the First Meeting
• Conducting the First Meeting
• Managing Subsequent Meetings and Subgroup
• Completing the Task Force’s Report

34. Conclusion
Nurses may be members of teams as well as leaders. Understanding how groups
and teams function (or do not) is essential to contribute to the organization, to be
successful in your position, and to garner satisfaction from your work.

35. Chapter no 13
Handling conflict

36. Objectives
• Explain how the various types of conflict can be positive or negative.
• Describe the conflict process.
• Describe approaches that can be used to manage conflict

37. Conflict
Conflict is defined as the consequence of real or perceived differences in
mutually exclusive goals, values, ideas, attitudes, beliefs, feelings, or actions
• (a) within one individual (intrapersonal conflict)
• (b) between two or more individuals (interpersonal conflict)
• (c) within one group (intragroup conflict)
• (d) between two or more groups (intergroup conflict)

38. Interprofessional conflicts
Working in high-stress jobs, nurses often have conflicts with other healthcare
professionals, administrators, or coworkers
The DESC script from the Agency for Healthcare Research and Quality may be
helpful (Agency for Healthcare Research and Quality, 2015):
• D: Describe the specific situation or behavior; provide concrete data
• E: Express how the situation makes you feel (e.g., uncomfortable), and what
your concerns are.
• S: Suggest other alternatives and seek agreement.
• C: Consequences should be stated in terms of impact on established goals;
strive for consensus

39. Conflict process model
Antecedent conditions
• Incompatible Goals
• Role Conflicts
• Structural Conflict
• Competition for Resources
• Values and beliefs
Perceived and felt conflict
Conflict behaviors
Conflict resolved or suppressed
outcomes

40. Thomas and Kilmann (1974) developed
the now-classic Thomas-Kilmann
Conflict Mode Instrument, a tool for self-
assessing one’s preferred approach to
conflict resolution

41. Managing conflicts

42. Conflict responses
There is a wide variety of conflict responses or conflict styles
• Confronting
• Negotiating
• Collaborating
• Compromising
• Competing
• Accommodating
• Avoiding
• Withdrawing
• Smoothing
• Forcing
• Resisting

43. Alternative dispute strategies
• Conflicts that have the potential to lead to legal action are often negotiated
using alternative dispute resolution (ADR) (Sander, 2009)
• Mediation is a form of ADR that involves a third-party mediator to help settle
disputes. Mediation agreements can satisfy all parties, cost less and take less
time than legal remedies, and lead to improved interprofessional relationships

44. Conclusion
Managing conflict is an essential skill for the manager and, indeed, all nurses.
Avoiding unnecessary conflict or allowing conflict to fester and remain
unresolved undermines the manager’s effectiveness, can result in dissatisfied
staff and turnover, and potentially harms patients. Resolving conflict, on the
other hand, can lead to better outcomes, both with immediate and future
situations, and encourages the manager to resolve conflict in the future.

45. Chapter no 14
Managing time

46. Objectives
• Critique time-wasters.
• Examine goals and determine priorities.
• Develop ways to control interruptions.
• Incorporate time management strategies into meeting activities.
• Summarize methods to respect time for yourself and others.

47. Introduction
Time can be used proactively or reactively.If you focus your energy on people
and events over which you have some direct or indirect control, you are using a
proactive approach.
If, on the other hand, you spend most of your time on what concerns you most
about other people and events, your efforts are less apt to be effective. For
example, you can set and follow your goals and priorities, or you can spend your
time worrying, blaming, or making excuses about what you do not accomplish.

48. Time wasters
A time-waster is something that prevents a person from accomplishing the job or achieving the goal.
Common time-wasters include the following:
• Interruptions, in person or by phone calls, text messages, and email alerts
• Meetings, both scheduled and unscheduled
• Lack of clear-cut goals, objectives, and priorities
• Lack of daily and/or weekly plans
• Lack of personal organization and self-discipline
• Lack of knowledge about how one spends one’s time
• Failure to delegate
• Working on routine tasks
• Ineffective communication
• Waiting for others and thus not using transition time effectively
• Inability to say no

50. How we manage time effectively
• Time logs are written or
digital records of what
you do every minute of
the day and are useful in
analyzing your time.

51. Setting goals

52. Cont..
It is useful to think of individual or personal goals in categories, such as the
following:
• Department or unit
• Interpersonal (at work)
• Professional
• Financial
• Family and friends (outside of work)
• Vacation and travel
• Physical
• Lifestyle
• Community
• Spiritual

53. Determining priorities Daily planning and scheduling
Grouping activities and minimizing
routine work
Personal organization and self-
discipline
Setting goals

54. Determining priorities
To establish priorities, take into consideration both short- and long-term goals.
Categorize them according to the following:
• What you must do
• What you should do if possible
• What you could do if you have time to spare

55. Cont..
Activities can be identified according to the
following:
• Urgent and important
• Important but not urgent
• Urgent but not important
• Busywork
• Wasted time

56. Controlling
interruptions
Phone calls, voice mail,
email and text massages
Paperwork
In personal
interruptions

57. Controlling time in meetings
• Do not meet simply because you always meet on Monday morning. If no
meeting is needed, cancel it.
• Invite only key people to initial meetings. Others can be sent the minutes or
invited to future meetings.
• Establish the meeting’s goal and outcomes expected at the outset.
• Send information before the meeting so time is not spent reading it.
• Set a time limit for all meetings. Routine meetings should last no more than 1
hour. If more time is needed, schedule another meeting.
• Determine the agenda and keep to the topic.
• Follow up with actions assigned.

58. Respecting time
• The key to using time-management techniques is to respect one’s own time as
well as that of others
• You should continually ask, “What is the best use of my time right now?”
Then you should answer in three ways:
• For myself and my goals
• For my staff and their goals
• For the organization and its goals

59. Tools for managing time
• Recognize that there will never be enough time to accomplish everything you
want.
• Use a time log to identify and reduce timewasters.
• Use a planning system to list goals, determine priorities, and schedule
activities.
• Monitor interruptions and decide on ways to minimize them.

60. Conclusion
Efforts to manage time may seem to take more time, but the reverse is true. Any
activity that helps set goals, determine priorities, organize activities, and
minimize interruptions will pay off in increased efficiency and effectiveness.

61. Chapter no 15
Budgeting and managing
fiscal resources

62. Objectives
• Describe how the budgeting process works.
• Differentiate among different approaches to budgeting.
• Describe components of an operational budget.
• Demonstrate how to plan a salary and non salary budget.
• Explain the nurse manager’s role with capital budgeting.
• Demonstrate how to monitor and control budgetary performance.
• Describe how staff affects budgetary performance.

63. Introduction
Budgeting is the process of planning and working to meet or exceed the goals of
the plan. purpose is to allow management to project activities into the future so
that the objectives of the organization are coordinated and met. , a budget helps
management control the organization. Demands for patient safety,
reimbursement changes with healthcare reform, technological advances, and the
changing roles of healthcare providers require that budgets be constructed as
accurately as possible and for nurse managers to understand financial
implications . In fact every one have budgets even though he or she may not
identify the process as such the budget is not written or agreement form but
budget exist in an individuals mind and they use him or her money properly and
accurately .The first step of budgeting process is use income effectively.

64. Definition
• A budget is a tool for planning ,quantifying the plans and controlling cost
for definite period of time.
• A budget is a plan that show .you how you can spend your money
effectively and efficiently

65. The budgeting process
• A budget is a quantitative statement, usually in monetary terms, of the plans
and expectations of a defined area over a specified period of time. Budgets
provide a foundation for managing and evaluating financial performance.
• The budget process also help ensure that the resources needed to achieve these
objective are available at the appropriate time and that operation are carried
out within the resources available.
• Goals and objectives help identify the organization’s priorities and direct the
organization’s efforts.

66. Cont..
To plan, the organization must know the following:
• Demographics of the population served, community influences, societal
trends, and competitors
• Sources of revenue, especially with changes in reimbursement due to
enactment of healthcare reform
• Statistical data, including:
○ Number of admissions or patient appointments
○ Average daily census
○ Average length of stay
○ Patient acuity
○ Projected volume base for ambulatory or procedure-based units or home care
visits

67. Cont..
• Wage increases of market adjustments
• Price increases, including inflation rate, for supplies and other costs
• Costs for new equipment or technologies (e.g., communication devices, IV
pumps, monitoring equipment)
• Staff mix (e.g., RNs, LPNs, UAPs)
• Regulatory changes (e.g., legislation mandating nurse-to-patient ratios, state
board of health regulations) for the budgetary period
• Organizational changes (e.g., decentralization of pharmacy or respiratory
therapy services) that result in salary and benefit dollars being charged in
portion to the unit

68. Timetable for budgeting process
• Depending on the size and complexity of the organization, the budgeting
process takes between 3 and 6 months. The process begins with the first-level
manager.
• The manager seeks information from staff about area of needed improvement
and reviews the unit productivity.
• The manager use this information to prepare the budget proposal.
• Then subsequent manager evaluates the budget proposal making adjustment as
needed.
• By the time the budget is approved by executive management .

69. Con…..
• The final step in the process is approval by aboard of director or
designated shareholder .
• In budget process timetable that the budget is approved a few month
before the beginning of the new fiscal year.
• The nurse manager must prioritize budget requests for the entire
organization in written form.

70. Approaches for budgeting
Formats of budget depending upon
• organizational structures Cost centers. Managers are responsible for
predicting, documenting, and managing the costs (staffing, supplies) of the
area of responsibility.
• Revenue centers. Managers are responsible for generating revenues.
• Profit centers. Managers are responsible for generating revenues and
managing costs so that the department shows a profit, which means that
revenues exceed costs.
• Investment centers. Managers are responsible for generating revenues and
managing costs and capital equipment.

71. Types of budget
• Incremental budget:
• The zero-based budget
• Fixed or variable
• Operating budget
1.The revenue budget.
2.The expense budget.

72. Incremental budget:
• Incremental budget (line-by-line) is the process of creating a new budget by
making minor changes to the current budget .An incremental budget uses the
current year’s budget as a baseline which finance team then adjust by
incremental amount.
• Then either addition or subtraction can b performed to the current budget to
create a new budget plan.
• The advantage of the line-by-line budget easy to prepare easy to understand.
• The disadvantage of this method is that it discourages cost efficiency.

73. The zero-based budget
• The zero-based budget approach assumes the base for projecting next year’s
budget is zero . Zero base budget is to start the budget with a lower base for
example ,80 percent of the current expenses . Manager is responsible to justify
any budgetary expenses requested above the 80 percent base.
• The advantage of zero-based budgeting is that every expense is justified.
• The disadvantage is that the process is time-consuming and may not be
necessary . For this reason organization may not use this process every year.

74. Fixed or variable
In a fixed budget, the budgeted amounts are set without regard to changes that
may occur during the year, such as patient volume or program activities, that
have an impact on the cost assumptions originally used for the coming year.
In contrast, the variable budget is developed with the understanding that
adjustments to the budget may be made during the year based on changes in
revenues, patient census, utilization of supplies, and other expenses.

75. The operating budget
The operating budget, also known as the annual budget, an operating budget is
a detailed projection of what a company expects its revenue and expenses will b
over a period of time . The counting period or fiscal year of the organization, a
specified 12-month period during which the operational and financial
performance of the organization is measured . Operating budget near the end of
the year to show expected activity during the following
Revenue budget.
Expense budget.

76. The revenue budget
The revenue budget represents the patient care income expected for the budget
period.
The healthcare provider will be reimbursed based on a variety of methods,
including the following
• Reimbursement of a predetermined amount, such as fixed costs per case
(Medicare recipients)
• Bundled payments (e.g., total knee replacement paid with predetermined fee
to cover the operation, hospital stay, and outpatient therapy)
• Negotiated rates, such as per diems (a specified reimbursement amount per
patient, per day)
• Negotiated discounts
• Capitation (one rate per member, per month, regardless of the service
provided).

77. The expense budget
• The expense budget is defined as the cost one is required to spend on obtaining
something . Simply saying it cost money to make money common expenses
include payment to suppliers ,employee wages .
• A cost center is the smallest area of activity within an organization for which
costs are accumulated.
• CLASSIFICATION OF COSTS
• Fixed costs are costs that will remain the same for the budget period regardless
of the activity level of the organization, such as rental payments and insurance
premiums.
• Variable costs depend on and change in direct proportion to patient volume
and patient acuity, such as patient care supply expenses.

78. Determining the salary and nonsalary
budget
• Salary cost include expenses related to personal .Non salary cost include
supplies and other operation or procedures expenses.
• 1.The salary budget.
• 2.The supply and nonsalary expense budget.

79. The Salary Budget.
• The salary or personal budget project the salary cost that will be paid and
charged to the cost center in the budget period.
• Managing the salary budget is directly related to the manager’s ability to
supervise and lead the staff.
• Salary expenses factors such as benefits ,shift differentials ,overtime ,on
call expenses , and bonuses affect the salary budgets.

80. The No nsalary Expenses Budgets.
• The supply and non salary expense budget ,identifies patient related
supplies needed to operate the nursing units .
• In addition to supplies other operating expenses ,such as office supplies
,rental fees ,maintenance costs , and equipment also be paid out of the
nursing units from the non salary budgets.

81. The capital budget
The capital budget is an important component of the plan to meet the
organization’s long-term goals. This budget identifies physical renovations, new
construction, and new or replacement equipment planned within a specified time
period.
The capital budget is limited to a specified amount and decision must b made
regarding how best to allocate available funds.
The role of nurse manager in the capital budget process is often to identify
capital needs that exist in his or her areas of responsibility .

82. Monitoring and controlling budgetary
performance during the year
The difference between the amount that was budgeted for a specific revenue or
cost and the actual revenue or cost that resulted during the course of activities is
known as the variance.
Nurse manager are commonly ask to justified the reason for variances and
present an action plan to reduce or eliminate these variances.
• 1.Variance analysis
• 2.position control

83. Variance Analysis
• When expenses occur that differ from the budgeted amounts
organizations usually have an established level at which a variance must b
investigated and explained or justified by the manager of the department.
• To asses variance follow these steps.
• 1.Indentify items that are over or under budgeted amounts .
• 2.Find out why the variance occurred, for example one time event or an on
going occurrence.
• Keep note on what you have learned in preparation for next budget.
• Validate the use of overtime or additional personnel.

84. Cont…..
1. Salary variances
With salary expenditures may occur in volume variances , efficiency
variances , and rates variances.
2. Non salary expenditure variances
With non salary expenditure variance may b due to change in patient
volume ,patient mix, supply quantities , more expensive supplies used in
nursing unit due to technology change.

85. Position control
• Another monitoring tool used by nurse manager is the position control.
• The position control is used to compare actual members of employees to
the number of budgeted employees in the nursing units.
• The nurse manager give the update about the position control with
employees name and details of each individual with respect to personnel
changes ,new hires and resignations that take place during the year.

86. Staff impact on budget
• Staff can acutely affect the organizations finances making accurate patient care
documentation very important.
• When misuse off sick time ,excessive overtime ,wasteful use of resources can
result in negative variances.
• The nurse manager play a important role in improving the staff performance
and reduce the negative variances through proper documentation and
reviewing the documentation is for reimbursement.

87. Conclusion
Managing fiscal resources is a challenge for all nurse managers. This is even
truer today as healthcare payment reform continues to evolve . The nurse
manager plays a key role in explaining the unit goals ,organization financial
goals , awareness is essential such as patient quality care and patient safety is
essential.

89. Chapter no 11

90. .
1-The process by which
responsibility and authority are
transferred to another individual.
a) Assignment
b) Order
c) Delegation
d) Principle
2-The act of accepting ownership
for results or the lack thereof.
a) Responsibility
b) Authority
c) Accountability
d) Assignment

91. .
3-A common form of ineffective
delegation that occurs when full
authority is not transferred, responsibility
is taken back, or there is a failure to
equip and direct the delegate
a) Underdelegation
b) Unwilling delegate
c) Reverse delegation
d) None of above
4-The rights of delegation
includes, EXCEPT
a) Right task
b) Right person
c) Right direction
d) Right authority

92. .
5-Poor communication and interpersonal relationships between nurses and
UAPs have been found to result in:
a) Effective delegation
b) Good performance
c) Ineffective delegation
d) All of above

93. Answer key
1-c
2-c
3-a
4-d
5-c

94. Chapterno 12

95. .
1-The final stage of group
development, when a group dissolves
after achieving its objectives is:
a) Storming
b) Adjourning
c) Re-forming
d) Both a & b
2-A type of interdependence in which
members must coordinate their
activities with others in some
designated order known as
a) Sequential interdependence
b) Task force
c) Task group
d) All of above

96. .
3-A group member’s individual,
unspoken objectives that interfere
with commitment or enthusiasm can
be:
a) Additive task
b) Cohesiveness
c) Hidden agendas
d) All of above
4-A group development technique
that focuses on the task and
relationship aspects of a group’s
functioning in order to build team
cohesiveness is:
a) Formal teams
b) Team building
c) Formal group
d) None of above

97. .
5-A type of interdependence in which members must coordinate their activities
with every other individual in the group is:
a) Reciprocal interdependence
b) Pooled interdependence
c) Sequential interdependence
d) Both b&c

98. Answer key
1-b
2-a
3-c
4-b
5-a

99. Chapterno 13

100. .
1-The consequence of real or
perceived differences in mutually
exclusive goals, values, ideas,
attitudes, beliefs, feelings, or actions
is known as:
a) Conflict
b) Consensus
c) Both a&b
d) None of above
2-The most effective means of
resolving conflict, in which the
conflict is brought out in the open
and attempts are made to resolve it
through knowledge and reason is:
a) Negotiation
b) Mediation
c) Confrontation
d) Suppression

101. .
3-The stage of conflict that occurs
when one person or group defeats the
other is called:
a) Suppression
b) Smoothing
c) Avoiding
d) Compromise
4-The incompatibility between an
individual’s perception of the role
and its actual requirements is:
a) Role conflict
b) Role ambiguity
c) Felt conflict
d) All of above

102. .
5-Use of a third-party mediator to help settle disputes.
a) Mediation
b) Negotiation
c) Forcing
d) Resolution

103. Answer key
1-a
2-c
3-a
4-a
5 -a

104. Chapterno 14

105. .
1-The relating of current behavior,
activities, or operations to an
organization’s or individual’s long-
range goals.
a) Goal setting
b) To-do list
c) Analysis goal
d) Clear-cut goals
2-A journal of specific information
regarding interruptions, analysis of
which may help identify ways to
reduce interruptions.
a) To-do list
b) Interruption log
c) Time logs
d) All of above

106. .
3- Journals of activities that are
useful in analyzing actual time spent
on specific activities known as:
a) Time logs
b) Goal setting
c) Both a&b
d) None of above
4-Something that prevents a person
from accomplishing a job or
achieving a goal.
a) Time management
b) Scheduled meetings
c) Group activities
d) Time-waster

107. .
5-A list of responsibilities to be accomplished within a specific time frame.
a) To-do list
b) Determining priorities
c) Self-discipline
d) All of above

108. Answer key
1-a
2-b
3-a
4-d
5-a

109. Chapterno 15

110. .
1- A quantitative statement, usually in
monetary terms, of the expectations
of a defined area of an organization
over a specified period of time in
order to manage its financial
performance is:
a) Profit
b) Budget
c) Both a&b
d) None of above
2-Paid time, such as vacation,
holidays, and sick days, for which
there is no work output.
a) Fiscal year
b) Direct cost
c) Benefit time
d) All of above

111. .
3- A component of the budget plan
that includes equipment and
renovations needed by an
organization in order to meet long-
term goals.
a) Fixed budget
b) Revenue budget
c) Zero based budget
d) Capital budget
4- The smallest area of activity
within an organization for which
costs are accumulated.
a) Cost center
b) Direct cost
c) Variance
d) All of above

112. .
5- A comprehensive budget that lists
salary and nonsalary items that
reflect patient care objectives and
activity parameters for the nursing
unit.
a) Expense budget
b) Capital budget
c) Fixed budget
d) Variable budget
6- A budget in which amounts are set
regardless of changes that occur
during the year.
a) Variable budget
b) Fixed budget
c) Both a&b
d) None of above

113. .
7- ______________ is an
organization’s statement of expected
revenues and expenses for the
upcoming year.
a) Operating budget
b) Fixed budget
c) Capital budget
d) Expense budget
8- _______________A projection of
expected income for a budget period
based on volume and mix of patients,
rates, and discounts
a) Variable budget
b) Fixed budget
c) Operating budget
d) Revenue budget

114. .
9- _____________ A budget
developed with the understanding
that adjustments to the budget may
be made during the year.
a) Capital budget
b) Fixed budget
c) Variable budget
d) All of above
10- A budgetary approach that
assumes the base for projecting next
year’s budget is zero; managers are
required to justify all activities and
every proposed expenditure is known
as:
a) Zero-based budget
b) Capital budget
c) Fixed budget
d) Variable budget

115. Answer key
1-b
2-c
3-d
4-a
5-a
6-b
7-a
8-d
9-c
10-a