Cross-Sectional Analysis of Administration and Management Outcomes of Different Nursing Services

Hierarchal Organization in a Health Care setting

UNITED STATES OF AMERICA

Director of General Health Services Addl. DGHS (P. Health) Asst. DG (Community)

Addl. DGHS (Nursing)

Asst. DG (Educ. And Res)

Add. DGHS (Medical)

Asst. DG (Hospital) Deputy ADG DADNS Dy. Nsg. Supt Asst. Nsg. Supt Ward Sister Staff Nurse

Deputy ADG Community Nurse P. Health Nurse Lady Health Visitor Aux. Health Midwives

Deputy ADG DADNS Principal Senior Tutor Tutor Clinical Instructor

Nursing Service Organization

Director Service Chief Nursing Officer Nursing Superintendent Deputy Nursing Superintendent

Assistant Nursing Superintendent

Ward Sister Clinical Supervisor Staff Nurse Student Nurse

Organization format varies from institution from institution

Assessment The United States of America has categorized authority of Nurse Managers; they categorized according to Community Nursing, Nursing Education and Research, and Nursing Service in the Hospital. This categorization enables the country to clearly plan and implement intervention, if any problem occurs on each field, limitation due to conflicting problems is lessen. On the Nursing Service in the Hospital, usually the state has that kind of organization build up, because other priorities in the hospital are handled by others.

EUROPE
Modern Matrons Nurse Lead Nurse Lead

Clinical Nurse Manager Senior Sister; Charge Nurse; Senior Ward Manager Sister Charge Nurse; Ward Manager Junior Sister; Charge Nurse; Ward Manager

Senior Staff Nurses

Staff Nurses Health Care Assistant

United Kingdom

Assessment In Europe, specifically in United Kingdom authority usually comes from two individual Modern Matron and Nurse Lead, there is clear definition of delegation of authority, all workers in the health field from Senior Sister Nurse up to Health Care Assistant follows an order from one head. This kind of chart follows one command from one superior; this is usually use for uniformity of care.

Middle East
Regional Director Health Affairs Deputy Hospitals Deputy Primary Health Care Primary Health Care Supervisors Hospital Managers Health Centre Manager Catchment Area Health Worker Sectoral Coor.

Health Worker Human Resource/ Administrator Person in Charge/ Nurse Administrator Clinical Nurse Managers Staff Nurses

Care Assistant

Ancillary Staff

Saudi Arabia

Assessment In the Middle East specifically in Saudi Arabia, the government handles all state/ government hospitals, all authorities in each hospitals are delegated by the government.
Private hospitals in Saudi Arabia are very rare and they are usually focused on one health field, for example, one private hospital is only focused on kidney care. The line of authority is what we usually find in other health institution, where the nurse managers down to care assistant is handled by one Nurse Administrator; however the Nurse Administrator is under one agency which is Human Resource Administrator. Human resource Administrator also handles physicians and other health field.

ASIA
Chief of Hospital Admin Officer Chief Nurse/ IV/III Chief Nurse III/II Nurse III Nurse II Nurse I Nurse Attendant NURSE III Nurse II Nurse I Nurse Attendant NURSE III Nurse II Nurse I Nurse Attendant Chief of Clinics

Assessment In Asia specifically the Philippines, authority are delegated to different nurse managers; in line with that all aspects that is within the concern of a nurse are handled by nurse managers.

This kind of delegation enables that different department will be acted upon different nurse managers, thus this will ensure efficiency in nursing service

Nursing Staff Ratio

UNITED STATES OF AMERICA

Norms
1 Nursing sister for 3:6 staff nurses. 1 ANS for 4:5 nursing sisters. 1 DNS for 7:5 ANS. 1 Nursing supdt for 250-500 beds. 1 CNO for 500 or more beds

Assessment: USA clearly identified certain numbers of patient per category of disease, this is to ensure safety in taking care of patients.

Europe
1:5 : Critical Patients

1:8: Non-Critical Patients

Assessment:

There is a clear presentation of shortage on Nurses

Middle East

1:8 Critical Patients

1:12 Non Critical Patients
Assessment: There is a clear presentation of shortage on Nurses

Asia
1: 12 Critical Patient (averaged) 1:18 Non Critical Patient (averaged)
Assessment:
There is a clear presentation of shortage on Nurses

Modalities of Nursing Care

Approach usually stated by the Nursing Service

United States of America

Case method or Total Patient Care And Modular Nursing

EUROPE
Case method or Total Patient Care And Case Management

Middle East
Team Nursing And Functional Method

Asia
Case method or Total Patient Care And Functional Method

Evaluation of Nurses

United States of America

Nursing Performance Evaluation

the evaluation is typically done on a regular basis, which may be quarterly, semi-annually, or annually. A supervisor will generally evaluate the performance of his employee, and the review will then be interpreted by a boss or manager.
All aspects of work will be reviewed, including work habits and ethics.

Performance reviews are a common procedure used by employers in many professions. A nursing performance evaluation will typically be documented on a paper form, which will typically be hand signed by the appraiser, as well as the nurse. An evaluation form will include a field for comments in most cases as well. Work habits and performance may be rated using a number system. Typically, "1" may be the poorest or unsatisfactory rating, with a "5" being the highest performance rating.

Self appraisal is done in United States of America, this is where you should detail your yearlong successes.
Committees youve served on, classes youve taken or seminars youve attended are all achievements that belong in this section. Also be sure to highlight specific areas within your specialty.

Nurses, for instance, should detail their expertise with clinicalcare matters such as changing dressings, inserting IVs or teaching patients how to care for themselves.

EUROPE
Performance Appraisal
Performance Appraisal is done annually, they measure the nurse competencies.
These competencies included: Quality standards Work habits Supervision/leadership Staff relations and Interpersonal Skills Attendance and Punctuality Problem Solving Oral Communication

Productivity results Coordination Innovation and Record Keeping Taking additional courses, keeping current with emerging technology and reading healthcare journals are also measured by the United Kingdom Nurse Association Self Appraisal is done yearly by nurses employed in the hospital.

MIDDLE EAST
Performance Appraisal is usually done by different agencies regulated by the government. They also take credit on certain things that nurses took annually: Educational Background Seminars and Continuous Training Work Ethics Staff Review Self Appraisal
Through this evaluation the promotion and raise of salary is monitored professionally

Asia
In Philippines performance appraisal usually varies from institution to institution. In R.I.T.M, performance appraisal are done annually, there is specific checklist completed by the nurse managers. This checklist includes Training and Seminars Co-workers review Educational Background Late/ and Overtime Errors

http://en.wikipedia.org/wiki/Nursing_in_the_United_Kingdom
Hospital Service Manual, Republic of the Philippines Health Care System in Saudi Arabia (http://applications.emro.who.int/emhj/V17/10/17_10_2011_0784_0793.pdf0\ ) http://www.scribd.com/doc/160238473/Organizing-Nsg-Service http://www.nationalnursesunited.org/pages/ratios-assessment http://epetitions.direct.gov.uk/petitions/19157 http://www.ukessays.com/essays/nursing/nursing-shortages.php

http://www.mannmuseum.com/nurse-shortage-in-saudi-arabia/
http://allnurses.com/international-nursing/nurse-patient-ratio-504662.html http://www.wisegeek.com/what-is-a-nursing-performance-evaluation.htm

http://unpan1.un.org/intradoc/groups/public/documents/CAFR AD/UNPAN010080.pdf