Handbook for Directors of Nursing in Long-Term Care

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Format: Paperback
Pub. Date: 1997-11-18
Publisher(s): Cengage Learning
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Summary

This book provides the theory, principles, methods and tools for the nurse manager or leader of a long-term care facility. It is a complete source of information and instruction on every aspect of nursing administration. The book contains more than 150 guidelines, flow sheets, communication, assessment and feedback procedures that can be implemented with little or no modification by the novice or experienced directors in every kind of long-term care facility. Faculty and students of nursing management will rely on this book as a step-by-step how to on subjects ranging from development of a mission statement, selection of a nursing theory, construction of a policy and procedure manual, hiring, interviews, inservice education, selection of an information system, conflict resolution and decision-making to performance evaluation, continuing quality assurance, strategic planning and marketing, and analysis of effectiveness. The student will learn how a nursing director can analyze leadership style, select a nursing delivery system, prepare for survey, construct the departmental budget, compute infection rate, and prepare an annual report.

Table of Contents

Quick Reference Topics xiv(4)
List of Figures and Tables
xviii(4)
Preface xxii(3)
Introduction xxv
PART I Structures and Pracesses of Nursing Administration 1(86)
CHAPTER 1 From Mission to Managing
3(27)
Mission and Vision Statements
3(2)
Content of the Statement
3(1)
Analysis of the Statement
4(1)
From Vision to Nursing Philosophy, Purposes, and Objectives
5(3)
Content of a Nursing Philosophy Statement
5(2)
Reviewing the Philosophy Statement
7(1)
Purposes, Objectives, and Goals Statements
7(1)
The Manual of Nursing Practice: Policies, Protocols, and Procedures
8(8)
Writing and Revising the Manual of Practice
11(1)
Guidelines for Revision
12(4)
Table of Organization
16(1)
Bylaws and Committees
17(4)
Permanent Nursing Committees
19(1)
Guidelines for Managing Committee Meetings
20(1)
Annual Report
21(2)
The 24-Hour Nursing Report (24HNR)
23(6)
Guidelines for the 24HNR
24(1)
Aspects and Item Coding of the 24HNR
24(5)
References
29(1)
CHAPTER 2 From Theory to Structure
30(26)
Philosophic, Anthropologic, and Developmental Theories
31(2)
Concepts of Health
32(1)
Selecting a Theory for Practice
33(2)
Nursing Theories
34(1)
Practice Theory vs. Management Theory
35(1)
Ethics and Practice
35(3)
An Ethical Nursing Practice Model
37(1)
Ethics Committees
37(1)
Nursing Delivery Systems
38(5)
Types of Delivery Systems: Advantages and Disadvantages
40(3)
Staffing Models
43(8)
Operative Definitions and Formulas
43(2)
Computing Full-Time Equivalence (FTE)
45(3)
Computing Nursing Care Hours (NCH) Provided
48(1)
Staffing Waivers
49(1)
Ancillary Nursing Staff
49(1)
Float Pool
50(1)
Flex Time
51(1)
Scheduling
51(3)
Scheduling Staffing Policies
52(2)
References
54(2)
CHAPTER 3 Organizations and Leadership: Structures and Processes
56(31)
Leaders and Managers: Similarities and Differences
56(2)
Organization Theory
58(1)
The Scientific Method of Management
58(1)
Organizational Design
59(4)
Autonomy and Empowerment
60(1)
Centralized and Decentralized Organizational Design
61(1)
Participatory Management
62(1)
Organizational Culture and Climate
63(3)
Maturity and Trust
64(2)
Leadership Role and Style
66(2)
Leadership Models
68(7)
Transformational Nursing Leadership
75(1)
Time Management
76(8)
Sources of Time Use
76(1)
The Nature of Time Use: Urgency
77(1)
Logging Time Use
77(3)
Setting Priorities
80(1)
Delegating
80(3)
How Nursing Staff Spend Their Time
83(1)
References
84(3)
PART 2 Leadership Effectiveness and Staff Development 87(70)
CHAPTER 4 Effective Leadership: Interpersonal Strategies
89(29)
The New Director of Nursing
90(1)
Middle Managers and First-Line Managers
91(4)
Middle Manager: Supervisor
92(1)
First-Line Manager: Head Nurse Charge Nurse
93(2)
Power and Effectiveness
95(1)
Concepts of Power
95(1)
Communication
96(3)
Effective Listening
97(1)
Messaging
97(2)
Group Dynamics
99(5)
Roles in a Group
100(1)
Analysis of Group or Team Effectiveness
101(3)
Change and Continuity
104(3)
Strategies of Change
105(2)
Conflict
107(5)
Conflict Resolution
108(1)
Principled Negotiation
109(1)
Brainstorming
109(3)
Problem Identification and Decision Making
112(2)
Critical Thinking
113(1)
Analyzing Alternatives
114(1)
Assertiveness
114(2)
Becoming Assertive
114(2)
References
116(2)
CHAPTER 5 Staff Development
118(39)
Job Descriptions
118(2)
Competencies
120(3)
Career Ladders
122(1)
Recruitment and Retention
123(7)
The Employment Interview
124(2)
Hiring Graduate Nurses
126(1)
Hiring Graduates of Foreign Nursing Schools
127(1)
Retention
127(3)
The Orientation Program
130(3)
The Orientation Packet
131(1)
Skills Inventory
132(1)
Agency or Contract Staff Orientation
133(1)
Staff Development: Motivation
133(1)
Praising and Rewards
134(1)
Staff Development: In-Service Education
134(3)
Teaching Strategies and Lesson Plans
135(1)
Program Evaluation
136(1)
Staff Development: Protocols and Referrals
137(7)
Role Models, Mentors, and Preceptors
141(3)
Performance Evaluation
144(7)
Rating Scales
144(1)
Annual Performance Evaluation
145(6)
Discipline
151(2)
Written Warning
152(1)
Job Satisfaction
153(2)
Measuring Job Satisfaction
153(2)
References
155(2)
PART 3 Information, Budgeting, and Clinical Management Systems 157(134)
CHAPTER 6 Information Systems
159(33)
Computer Information Systems (CIS)
160(5)
NIS Pros and Cons
161(1)
Computer Access: A Security Issue
162(1)
Entry and Access Technologies
163(1)
Implementing a CIS
164(1)
Computer Assisted Instruction (CAI)
164(1)
Resident Assessment Systems
165(5)
Admission Assessment
166(1)
Mental Status Assessment
167(1)
The "Alphabet Soup" of Legislated Instruments
168(2)
Patient Classification Systems (PCS)
170(4)
Prototype and Factor Evaluation PCS
170(2)
RUGS: A Patient Classification System for LTC
172(1)
Patient Classification Systems
173(1)
Costing-Out Nursing Services
173(1)
The Nursing Department Budget
174(1)
Budgeting
175(13)
Cost Centers and Cost Reports
175(1)
Capital and Operating Budgets
175(4)
Types of Budget Processes
179(1)
Budget Preparation
180(3)
Cost Accounting
183(1)
Reimbursement: Medicare and Medicaid
183(2)
Monitoring Costs
185(3)
Material Management
188(1)
Inventory Control
188(1)
References
189(3)
CHAPTER 7 Managing Clinical Care
192(51)
Resident Rights
192(11)
Advance Directives
194(2)
Guardianship and Conservatorship
196(1)
Abuse, Mistreatment, and Neglect Laws
197(2)
Complaint Grievance Protocol
199(1)
Clothing and Personal Belongings Management
200(3)
Documentation of Care: Policies and Protocols
203(16)
New Admissions
204(1)
Nursing Care Plan and Kardex
204(7)
Resident Care Data Form
211(2)
The Monthly Summary of Nursing Care
213(3)
Medicare Documentation
216(2)
The Nursing Discharge Note
218(1)
Protocols for Clinical Management
219(17)
The CNA Assignment
219(1)
Behavior and Psychoactive Medication Documentation
219(1)
Bladder Retraining Documentation
219(5)
Change of Condition Notification
224(1)
DNR Orders Notification
224(1)
Diagnostic Protocols (DP)
224(2)
Falls At-Risk Assessment and Physical Restraints
226(1)
Restraint Removal Monitoring
226(2)
Food Intake Guidelines
228(2)
Occurrences
230(2)
Pressure Sore Notification and Documentation
232(1)
The Team Conference
233(3)
Teaching Strategies and Resident Compliance
236(2)
Self-Medication Administration
237(1)
Compliance
237(1)
Special Care Units (SCU)
238(3)
Psychosocial Interventions
238(1)
Segregating the Cognitively Impaired: Pros and Cons
239(1)
AIDS Special Care Units
240(1)
Subacute Care Units (SACU)
240(1)
References
241(2)
CHAPTER 8 Quality Assurance Systems, Risk Management, and Infection Control
243(48)
Assuring the Quality of Nursing Care
244(3)
Outcomes, Indicators, and Thresholds
245(2)
Regulations and Quality Assurance
247(7)
Licensure and Certification of Nursing Homes
247(1)
The Omnibus Budget Reconciliation Act of 1987
248(1)
The Survey Process
249(4)
The Exit Conference
253(1)
Resident-Centered and Unit Management QA Protocols
254(23)
Risk Management
277(2)
Implications for Nursing
278(1)
Materials Safety Data Management (MSDM)
279(1)
Infection Control Quality Assurance
279(11)
Infection Control Program
281(1)
Surveillance, Notification, Data Collection, and Analysis
282(5)
Exposure Control Plan and Universal Precautions
287(1)
Hepatitis B Vaccine Declination
288(1)
Other Issues and Aspects of Infection Control Management
288(2)
References
290(1)
PART 4 Professionalism: Planning for Excellence 291(44)
CHAPTER 9 Professional Issues, Strategic Planning, and Marketing
293(28)
Practice Acts and Professional Responsibility
293(2)
Professional Certification and Standards
295(1)
Advanced Practice
295(2)
Law and Legal Issues
297(4)
Professional Misconduct and Negligence
298(2)
Law and the Chart
300(1)
Labor Relations
301(4)
Collective Bargaining
301(2)
Workplace Issues
303(2)
Consultants
305(1)
The Medical Director
306(2)
DON Contract, Compensation, and Bonuses
308(1)
Strategic Planning
308(3)
Certificate of Need
310(1)
New Ventures
311(2)
Relocation
311(1)
Architectural and Design Issues
311(2)
Marketing
313(3)
Market Segmentation
314(1)
Marketing Nursing Services
314(2)
Resident Satisfaction
316(2)
Measuring Satisfaction
317(1)
References
318(3)
CHAPTER 10 Reflections on Survival and Growth: Nursing Research and Magnet Nursing Homes
321(14)
The Nursing Home as a Clinical Campus
322(1)
Affiliation Issues
322(1)
Research in Long-Term Care
323(6)
The Elderly Person as Research Subject
324(1)
Research Approval
324(2)
Informed Consent
326(2)
Priorities for Nursing Research
328(1)
A "Magnet" Nursing Home
329(3)
Nursing Units of Excellence Program
329(3)
Final Thoughts About Directing the Work of Nursing
332(1)
References
333(2)
APPENDIX A "NURSING FACILITY:" PHILOSOPHY OF THE DEPARTMENT OF NURSING 335(2)
APPENDIX B "NURSING FACILITY:" DEPARTMENT OF NURSING--POLICIES, STANDARDS, PROTOCOLS, AND PROCEDURES MANUAL TABLE OF CONTENTS 337(3)
APPENDIX C INFORMATION RESOURCES 340(9)
Government 340(1)
Professional Organizations 341(1)
Industry, Interest, and Advocacy Groups 342(1)
Research Dissemination 343(1)
Nursing Books and Journals 344(5)
GLOSSARY 349(6)
INDEX 355

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