Funded under USAID Cooperative Agreement No. 663-A-00-00-0358-00.
Produced in collaboration with the Ethiopia Public Health Training Initiative, The Carter
Center, the Ethiopia Ministry of Health, and the Ethiopia Ministry of Education.
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©2005 by Amsale Cherie and Ato Berhane Gebrekidan
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TABLE OF CONTENTS
Preface ............................................................................... i
Acknowledgement ..............................................................ii
Table of Contents ..............................................................iv
CHAPTER ONE: Introduction to Nursing Service
Management ........................................ 1
Definition of management and nursing service
administration .................................................................... 2
Types of managers ........................................................... 6
Managerial Skills ............................................................... 7
Managerial roles ............................................................... 8
Health Service Organizational Model .............................. 10
Learning activities ........................................................... 11
CHAPTER TWO: Philosophy of Nursing Service
Management ......................................... 12
Organizational philosophy and philosophy of nursing
service administration ........................... 13
Goals ………….. .............................................................. 15
Institutional Goals ........................................................... 16
Nursing Department Goals ............................................. 16
Nursing Unit Goals .......................................................... 17
Organizational Climate .................................................... 18
Learning Activities: .......................................................... 18
CHAPTER THREE: Organization and organizational
structure ................................................ 19
Systems Theory .............................................................. 20
Organizational Structure ................................................. 25
Organizational Characteristics ........................................ 27
Organizational Principles ................................................ 29
Organizational Concepts ................................................. 29
Types of Formal Organization Structures ....................... 31
Line and Staff Pattern/Relationship/in an organization ... 34
Matrix Organizational Structure ...................................... 35
Functional Line and Staff Pattern .................................... 36
Systems of Nursing Service Delivery .............................. 38
Team Nursing ............................................................... 40
Primary Nursing .............................................................. 43
Case Management .......................................................... 45
Learning Activities ........................................................... 46
CHAPTER FOUR: Functions of Management ................ 48
Definitions ............................................................... 48
Management Functions of a Nurse Manager .................. 49
Planning ............................................................... 50
Types of Planning ........................................................... 51
Organizing ............................................................... 58
Establishing Objectives ................................................... 60
Delegation ............................................................... 63
Staffing ............................................................... 67
Directing ............................................................... 67
Coordinating ............................................................... 69
Controlling ............................................................... 69
Learning Activities ........................................................... 70
CHAPTER FIVE: Decision Making ................................. 71
Decision Making .............................................................. 71
Types of Decisions .......................................................... 72
Steps of logical Decision Making .................................... 74
Factors Influencing Decision Making .............................. 74
Implications for Nurse Managers .................................... 75
Decision Making Tools .................................................... 76
Barriers to Effect Decision-Making .................................. 78
Learning Activities ........................................................... 80
CHAPTER SIX: Theories of Leadership and
Management.......................................... 81
Leadership and Management Theories .......................... 81
Early Leadership Theories .............................................. 84
Behavioral Theories ........................................................ 86
Authoritarian-Democratic-and Laissez-Faire Styles ........ 86
Management Theories .................................................... 93
Contemporary Leader-Manager Theories ....................... 97
Motivating Staff ............................................................. 101
Motivation Theories ....................................................... 102
Transformational Leadership ........................................ 106
Nurses Role-as-a Leader .............................................. 108
Obtaining and Using Power .......................................... 114
Bases of Power ............................................................. 114
Application to Nursing ................................................... 116
Learning Activities ......................................................... 119
CHAPTER SEVEN: Managing Resources ................... 121
Human Resource Management .................................... 121
Retaining Employees .................................................... 127
Methods and Techniques of Training ............................ 129
Performance Appraisal ................................................. 130
Budgeting ............................................................. 134
Standard Cost ............................................................. 138
Zero-Based Budgeting .................................................. 138
Supplementary Budgets ................................................ 140
Budgeting Process ........................................................ 141
Cost Implication to Budgeting ....................................... 143
Per Diem ............................................................. 146
Material Management ................................................... 149
Managing Equipment .................................................... 150
Managing Time ............................................................. 152
Preparing duty roster .................................................... 153
Learning activities ......................................................... 154
CHAPTER EIGHT: Evaluating Health Activities ........... 155
Evaluation ............................................................. 155
Roles of Evaluation ....................................................... 155
Levels of Evaluation ...................................................... 156
Steps of Evaluation ....................................................... 156
Types of Evaluation ...................................................... 157
Learning Activity ............................................................ 158
CHAPTER NINE: Communication ................................ 159
Communication ............................................................. 159
The Message ............................................................. 160
The Communication Process ........................................ 161
Blocks to Communication ............................................. 172
Communication Networks ............................................. 176
CHAPTER TEN: Group Dynamics ............................... 178
Group Dynamics ........................................................... 178
Task Behaviors of a Group ........................................... 181
Phases of Small Groups ................................................ 185
Techniques for Decision Making in Small Groups ........ 188
Brainstorming ............................................................. 189
Nominal Group Technique ............................................ 190
Delphi Method ............................................................. 192
Team Work ............................................................. 194
Conflict within teams ..................................................... 198
Standards ............................................................. 199
Learning Activities ......................................................... 200
CHAPTER ELEVEN: Conflict Resolution ..................... 202
Conflict Resolution ........................................................ 202
Types of Conflict ........................................................... 204
Interpersonal Conflicts .................................................. 204
Inter-group Conflicts....................................................... 204
Personal Group Conflicts .............................................. 205
Conflict Resolution Theory ............................................ 207
Manifest behavior .......................................................... 209
Conflict Resolution or Suppression ............................... 210
Win-Win Strategies ....................................................... 212
Conflict Management/Styles of Approaching Conflict/ ... 214
Avoidance ............................................................. 215
Accommodation ............................................................ 218
Collaboration ............................................................. 223
Learning Activities ......................................................... 224
CHAPTER TWELVE: Management of Change ............ 226
Management of Change ............................................... 226
Purpose of Change ....................................................... 226
Factors that cause change ............................................ 227
Lewin’s 3 Step model of the change management ....... 232
Making the change process effective ............................ 237
Managing resistances to change .................................. 241
Learning Activities ......................................................... 243
CHAPTER FORTEEN: Project Plan Management ....... 245
Project Plan Management ............................................. 245
Developing Detailed Project Activities .......................... 251
Learning Activity ............................................................ 259
CHAPTER FIFTEEN: Quality Assurance/Improvement 260
History of Quality Assurance ......................................... 260
Quality Assurance Process ........................................... 264
References ............................................................. 269
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