Breach An infraction or violation of the law, which is either intentional (an act of commission) or unintentional (an omission).
Type of Breach Observed
Once all the templates were collected, the recorded breaches of confidentiality were classified into three categories according to their description as follows:
1. Confidentiality breaches related to the custody of clinical histories and records (admission forms, clinical and nursing report sheets, laboratory tests and other complementary examinations, and any other type of record containing patient data), as well as computer access to such records.
2. Confidentiality breaches related to the consultation and/or disclosure of clinical and/or personal data to medical personnel not involved in the patient’s clinical care, as well as people external to the hospital.
3. Situations in which the improper disclosure of the patient’s clinical data resulted from inadequate infrastructure, equipment, or poor organization of the hospital.
Breach severity
In addition, we ranked the severity of the breaches described above from low to high severity as follows:
1. Minor confidentiality breaches are defined as those in which sensitive patient data is not properly safeguarded or handled (excluding the following categories), but which do not result in observable consequences. This includes the custody of clinical histories and records or breaches due to inadequate hospital infrastructure.
2. Minor confidentiality breaches committed repeatedly: more than once.
3. Severe confidentiality breaches are defined as the disclosure of sensitive data, as well as incidents that result in some kind of observable consequence. These breaches correspond to situations where clinical patient data are disclosed to third parties or to medical personnel not involved in the patient’s care, as well as those that are committed intentionally, or related to the patient’s sexual life, mental or other stigmatizing illnesses, and racial or ethnic background. Such breaches are considered to be particularly severe as these data are of a highly private nature.
4. Serious confidentiality breaches that occur repeatedly: more than once.
Area where the breach was observed
In order to reduce the number of areas where the observations were recorded, we grouped the areas into categories based on their similarity as follows:
1. Meeting areas (offices, classrooms, etc.) and specific areas where healthcare is provided (exam rooms, treatment rooms, operating rooms, etc.).
2. Nursing stations on hospital wards.
3. Patient rooms, which are usually occupied by two patients and their respective companions.
4. Other public areas: corridors, elevators, hospital entrances, stairs, and locker rooms.
Personnel involved in the breaches
The observers were required to record the staff member who committed the breach of confidentiality. Once all the data were collected, it was found that two or more staff were often responsible for the confidentiality breach. The personnel were classified as follows:
1. Physicians
2. Residents
3. Nursing staff
4. Nursing assistants
5. Orderlies
6. Administrative personnel
7. Students
Career Opportunity
Nursing is one of the fast growing professions in the health care field Nursing Council Act came to existence in 1948 to constitute a council of nurses to safeguard the quality of nursing education in the country.
There are six levels of nursing education in India today.
They are:
Multi-Purpose Health Worker Female training (ANM or MPHW-F)
Female Health Supervisor training (HV or MPHS-F)
General nursing and midwifery (GNM)
BSc. Nursing
MSc. nursing
MPhil and PhD
CARRIER OPPORTUNITY
· Home Health Care Agencies
· Public Health Offices
· Wellness Centers
· Industries
· Helicopters
· Military
· Cruise Ships
· Schools
· Hospice
· Nursing Homes
· Clinics/Offices
career opportunities
· Medical Surgical – Care for a variety of ill or injured patients and patients who are undergone surgery.
· Critical Care- care of critically ill and injured patients of all ages.
· Labor and Delivery - Care for mothers and babies before, during, and after delivery.
· Pediatrics - Care for ill or injured children
· Geriatrics - Care for elderly ill or injured patients.
· Cardiac Care - Care for patients with issues involving their hearts.
· Orthopedic - Care for patients with illnesses or injuries to muscles and bones.
· Dermatology - Care for patients with skin conditions.
· Neurology - Care for patients with illnesses or injuries involving the nervous system.
· Same Day Surgery/Post Anesthesia Care Unit Recovery Room - Care for patients immediately before or after surgery.
Advance Education adds options-
· Researcher - Involved with research studies to increase the knowledge base of the nursing profession.
· Nurse Practitioner - Diagnoses and treats a wide variety of patients.
· Clinical Nurse Specialist - Provides care to patients with complex illnesses or injuries and often responsible for the continuing education of staff nurses.
· Nurse Anesthetist - Provides anesthesia to patients during surgical and non-surgical procedures.
· Nursing Professor - Teaches nursing students in nursing schools.
· Nurse Midwives - Care for women during pregnancy and deliver their babies.
Introduction:
The idea of continuing education in nursing is as old as organized nursing, but concept of lifelong learning for the practitioner has developed slowly. The history of continuing education in nursing has shown that educational institutions generally have been slow to accept responsibility for assisting the practitioner who wishes to add to her nursing knowledge and skill.
Definition:
"Continuing education is any extension of for reading, study and training to young persons and adults following their completion of or withdrawal from full-time school and college”.
Educational activities primarily designed to keep registered nurses abreast of their particular field of interest and do not lead to any formal advanced standing in the profession.
Note: students you have to add more definition from book.
Need for continuing education:
• Rapid technological advances related to knowledge explosion have greatly altered the practice Of nursing
• The gap between scientific knowledge and its application grows Wider each year as a result of multiple influences
• Elimination of certain illnesses, particularly the communicable diseases New drugs to cure some illnesses and alter the course of many
• Surgeries are being performed successfully in area that would not have been attempted 10-20 years ago
• Organ transplants are no more a novelty
• Complex and intricate machinery can extend lives
All these advances require more highly skilled nursing care in a great variety of settings
• Continuing education is an accepted way of life
Some continuation training in service for nurses would promote the well-being of Major reason for continuing education in nursing: the improvement in professional practice.
Life-long learning in nursing relates not only to professional practice but also to the development of the as an individual and as responsible.
In-Service Education
"Planned instructional or training program provided by an employing agency in the employment setting and is designed to increase competence in a specific area.
In-service education is one aspect of continuing education, but the terms are not interchangeable
CONTINUING PROFESSIONAL DEVELOPMENT
· Take on new responsibilities
· Conduct research
· Write article/ book/journal paper
· Paper presentation at conference
· Team teaching
· Act as mentor
· Study for higher degree
· International exchange
· Attend workshops
Type
• Orientation to introduce new recruits to the basic of the job So that they can perform their job effectively
• Continuing education for of knowledge, skills, and attitudes
• Management skills and leadership training Staff development program is directed toward expanding to the fullest all the potential of an individual
• Individual interest promotion programs
• Future oriented to prepare learners for the future activities
THE PLANNING FORMULA
What is to be done?
Why is it necessary?
How is it to be done?
Where is it to done?
When is it to be done?
Who should do the job?
STAGES
Analysis — Design — Development — Implementation — Evaluation
Analysis
• Analyze needs
• Goals
• Priorities Resources Constraints
• Alternate delivery Systems
• Determine and sequence of training program (by task and job analysis)
Design
· Emphasizes what will be taught
• Determine training approach
• Develop learning objective
• Performance measures
• Training program specification
Development
· Emphasizes on how the content will be taught
• Develop curriculum guide
• Lesson plan
• Supportive teaching aids
• Revise material
Implementation
• Implement training plan
• Conduct training
• Formative evaluation
• Document training results
Evaluation
• Conduct summative evaluation
• Analyze collected information
• Initiate corrective action
• Quality patient care
BENEFITS OF CONTINUING EDUCATION
• New/improved knowledge and skills
• Attitude change
• Better performance
• Increased job satisfaction
• High motivation
CONTENT AREAS
* General Programs
• Nursing Process
• Intravenous Therapy
• Communication
• Ethics
* Hospital Specific Programs
• Maternity
• Pediatrics
• Surgical
Orthopedics
* Area Specific Programs
• CVP care
• Neonatal
• CPR Ventilator
• Dialysis
Control
Control is the managerial functions concerned with making sure that plans succeed; it means measuring and correcting the performance of employees to ensure that the planned objectives of an organization are achieved.
Planning and controlling are closely related. However, control means more than measuring, for in many instances it requires revised planning, additional organizing, and better methods of directing.
It sees to it that the right things happen, in the right ways, and at the right time.
A process of monitoring , comparing ,correcting performance and taking action to ensure desired results.
Elements of Control
The process of control has three elements-
· Standards that represent the desired performance.
· Comparison of actual results with the standards
· Corrective action
Importance of controlling
Protecting the workplace
Empowering Employees
Planning
The control process is the three step process of measuring actual performance, comparing actual performance against standard and taking managerial action to correct deviations or to address inadequate standards.
The control process assumes that performance standards already exists and they do.
Step-1 Measuring
Four approaches managers use to measure and report actual performance are-
1. Personal observations
2. Statistical reports
3. Oral reports
4. Written reports
Step-2 comparing
The comparing step determines he variation between actual performance and a standard.
Acceptable range of variation
Step-3 taking managerial action
Three possible course of action managers can do
1. Do nothing
2. Correct the actual performance
3. Revise the standards
Guidelines Relating to Control are:
· Action is the essence of control.
· Plans and budget are important elements in implementing effective control because they outline.
· Control action can be taken only be the individuals who hold delegated responsibility and authority for the operation affected.
· The success of an organization and its parts depends on the degree of difference between what should b done and what is done.
· To be effective, a control system must be understandable and flexible and point out where corrective action should be taken.
· Four activities can be controlled: quality, quantity, cost and use of time.
" Constraints/Difficulties in Control are:
· The response of people to standards, measures reports or other forms of control depends on the total situation.
· Controls may cause dispute among parts of an organization when the people involved lack confidence in the measurements.
DIRECTING
Introduction
Plan put into action Activities Delegation – transferring responsibility Updating policy Utilize the policy updates Supervision Roles in Supervision Guides Direct Facilitates Motivates Teaches.
DIFFINATION
“Direction is the sum total of managerial efforts that is applied for guiding and inspiring the working teams to make better accomplishments in the organization.” •
“Direction is telling people what to do and seeing that they do it to the best of their ability.
It includes making assignments, explaining procedures, seeing that mistakes are corrected, providing on the job instruction and of course issuing orders.”
Principles of Direction :
i) Principle of Maximum Individual Contribution
ii) Principle of Harmony of Objectives:
iii) Principle of Unity of Command:
iv) Principle of Appropriateness of Direction Technique
v) Principle of Managerial Communication.
vi) Principle of Use of Informal Organisationation.
vii) Principle of Leadership
viii) Principle of Follow Through:
ix) Components/Elements of Direction :
Four Rights of Delegation
1. Task The right task should be within the scope of the person’s practice and consistent with the job description.
2. Person The right person should have the appropriate license or certificate, job description.
3. Communication The right communication should be clear, concise, complete and correct.
4. Feedback The right feedback should ask for input, get the person’s recommended solution to the problem and recognize the person’s effort.
Aspects of Delegation
1. Responsibility – denotes obligation
2. Authority – the power to make final decisions and give commands.
3. Accountability – refers to liability
Importance of Directing :
i) It guides and helps the subordinates to complete the given task properly and as per schedule.
ii) It provides the necessary motivation to subordinates to complete the work satisfactorily and strive to do those best.
iii) It helps in maintaining discipline and rewarding those who do well.
iv) Directing involves supervision, which is essential to make sure that work is performed according to the orders and instructions.
v) Different people perform different activities in the organisation. All the activities are interrelated. In order to co-ordinate the activities carried out in different parts and to ensure that they are performed well, directing is important. It thus, helps to integrate the various activities and so also the individual goals with organisational goals.
vi) Directing involves leadership that essentially helps in creating appropriate work environment and build up team spirit.
The important components of direction are as follows
Motivation: It is the process of inspiring and encouraging the people to do work. It is a skill of using the capability of manpower for the organization. It is a mental and physical presence of employee to do work. Effective motivation helps to raise the effective direction. Therefore, motivation is important aspect of direction.
Leadership: It is another important aspect of direction. It is defined as the process of influencing people to perform work effectively. In other words, it influences the behavior of employees or subordinate. According to time, situation and behaviour of followers, a leader must conduct his followers. Therefore, it is an important aspect of direction.
Communication: Communication means transferring information from one person to another. In other words when the information is transmitted from one person to another and information receiver easily take the information, it is known as communication. It includes sending message and receiving message. After sending message receiver receives the message and understands it. Therefore message receiver responds and reacts about the message. In an organization manager must develop an effective communication system so that s/he may give instruction and guidance to the subordinates and motivate them to do the work to the best of their ability.
Coordination: It is also an important aspect of direction. When the coordination activity is not conducted effectively. Direction is not effective. Coordination is the process of linking activity of resources and various departments so that desired goal can be achieved easily. It is inter-related with all managerial function.
Supervision: It is another important aspect of direction. Direction is not only to issue order but also supervising job of subordinates. It is an important function of every manager. So the manager’s duty is to look after their work and examine that whether they have done according to the order issued or not and also help in solving their work problems.
PARTICIPATORY MANAGEMENT
It is the practice of empowering members of a group, such as employees of a company or citizens of a community, to participate in organizational decision making. It is used as an alternative to traditional vertical management structures, which has shown to be less effective as participants are growing less interested in their leader's expectations due to a lack of recognition of the participant's effort or opinion.
PURPOSE OF PARTICIPATORY MANAGEMENT
· Promoting sustainable management practices.
· Increasing social acceptability levels.
· Minimizing social conflicts, for example: eliminating competition.
· Allowing the use of local values and knowledge to be utilized during management.
· Greater job satisfaction which in turn increases productivity
· Reduced costs through increased efficiency and a lesser need for supervision and delegation.
· Participatory Management can lead to the empowerment of employees which in turn could lead to employees taking more risks. These risks can be successful or harmful to the project's productivity level.
DISCIPLINE
INTRODUCTION:
The word Discipline comes from the Latin term disciplina which means teaching, learning and growing. Discipline comes from one meaning " instruction, knowledge."
DEFINITION:
“Discipline can be defined as a training or molding of the mind and character to bring about desired behaviors”. -Basavanthappa.
AIMS AND OBJECTIVES OF DISCIPLINE:
To obtain a willing acceptance of rules, regulations and procedures of organization so that organization goals can be achieved.
PRINCIPLES OF DISCIPLINARY ACTION:
· Have a positive attitude.
· Investigate carefully.
· Be prompt.
· Protect privacy.
· Focus on the act.
· Enforce rules consistently.
· Be flexible.
· Advise the employee.
· Take corrective and constructive action.
· Follow up.
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