WEEK 13 ensure safe continuity of care and the

DOCUMENTATION IN PSYCHIATRIC MENTAL delivery of best clinical practices.

HEALTH NURSING PRACTICE
Purposes of Documentation in the Nursing
Definition of Terms Practice
• Documentation 1. Communication
- is an extremely essential nursing function to - The record serves as the vehicle by which
monitor and maintain the standard of care different health professionals who interact
given to the patient. with a client communicate with each other.

• Record 2. Planning Client Care

- also called a chart or client record - Each health professional uses data from the
- is a formal, legal document that provides client's record to plan care for that client. A
evidence of a client's care and can be written primary care provider, for example, may
or computer based. order a specific antibiotic after establishing
that the client's temperature is steadily rising
• Recording and that laboratory tests reveal the presence
- also called charting or documenting, of a certain microorganism
- is the process of making an entry on a client
record. 3. Auditing Health Agencies
- An audit is a review of client records for
• Critical Pathway quality assurance purposes
- Also known as care pathway, integrated care
pathway, clinical pathway, or care map 4. Accrediting agencies
- is one of the main tools used to manage the - The accrediting body may review client
quality in healthcare concerning the records to determine if a particular health
standardization of care processes. agency is meeting its stated standards.
- It has been shown that their implementation
reduces the variability in clinical practice and 5. Research
improves outcomes. - The information contained in a record can be
- Clinical pathways aim to promote organized a valuable source of data for research. The
and efficient patient care based on evidence- treatment plans for a number of clients with
based medicine, and aim to optimize the same health problems can yield
outcomes in settings such as acute care and information helpful in treating other clients.
home care.
6. Education
• Case Management - Students in health disciplines often use client
- It is a collaborative process of assessment, records as educational tools. A record can
planning, facilitation, care coordination, frequently provide a comprehensive view of
evaluation and advocacy for options and the client, the illness, effective treatment
services to meet an individual's and family's strategies, and factors that affect the
comprehensive health needs through outcome of the illness.
communication and available resources to
promote patient safety, quality of care, and 7. Reimbursement
cost effective outcomes. - Documentation also helps a facility receive
reimbursement from the government. For a
• Handoff report facility to obtain payment through Medicare,
- Nurse bedside shift report, or handoff, has the client's clinical record must contain the
been defined in the literature as a process of correct diagnosis-related group (DRG) codes
exchanging vital patient information, and reveal that the appropriate care has been
responsibility, and accountability between the given.
off-going and oncoming nurses in an effort to
8. Legal Documentation format, such as human needs or functional
- The client's record is a legal document and is health patterns. The time parameters for a
usually admissible in court as evidence. In flow sheet can vary from minutes to months.
some jurisdictions, however, the record is In a hospital intensive care unit, for example,
considered inadmissible as evidence when the a client's blood pressure may be monitored
client objects, because information the client by the minute, whereas in an ambulatory
gives to the primary care provider is clinic a client's blood glucose level may be
confidential. recorded once a month.

9. Health Care Analysis • Focus Charting

- Information from records may assist health - Focus charting is intended to make the client
care planners to identify agency needs, such and client concerns and strengths the focus of
as overutilized and underutilized hospital care.
services. Records can be used to establish the - Three columns for recording are usually used:
costs of various services. date and time, focus, and progress notes. The
focus may be a condition, a nursing diagnosis,
Documentation Records / Systems a behavior, a sign or symptom, an acute
• Source-Oriented Record change in the client's condition, or a client
- The traditional client record is a source- strength.
oriented record. Each person or department - The progress notes are organized into (D)
makes notations in a separate section or data, (A) action, and (R) response, referred to
sections of the client's chart. For example, the as DAR.
admissions department has an admission - The data category reflects the assessment
sheet; the primary care provider has a phase of the nursing process and consists of
physician's order form, a physician's history observations of client status and behaviors,
sheet, and progress notes; nurses use the including data from flow sheets (e.g., vital
nurses' notes; and other departments or signs, pupil reactivity). The nurse records both
personnel have their own records. In this type subjective and objective data in this section.
of record, information about a particular
problem is distributed throughout the record. • Charting by Exception
- Charting by exception (CBE) is a
• Problem-Oriented Medical Record documentation system in which only
- In the problem-oriented medical record abnormal or significant findings or exceptions
(POMR), or problem-oriented record (POR), to norms are recorded. CBE incorporates 3
established by Lawrence Weed in the 1960s, key elements Guido, 2010):
the data are arranged according to the 1. Flow sheets.
problems the client has rather than the Examples of flow sheets include:
source of the information. Members of the a. Graphic records of a vital sign sheet;
health care team contribute to the problem b. head and face assessment in a daily
list, plan of care, and progress notes. Plans for nursing assessments record;
each active or potential problem are drawn c. Braden assessment of the skin
up, and progress notes are recorded for each
problem. 2. Standards of Nursing Care
- Documentation by reference to the agency's
• PIE printed standards of nursing practice
- The PIE documentation model groups eliminates much of the repetitive charting of
information into three categories. PIE is an routine care.
acronym for problems, interventions, and - An agency using CBE must develop its own
evaluation of nursing care. This system specific standards of nursing practice that
consists of a client care assessment flow sheet identify the minimum criteria for client care
and progress notes. The flow sheet uses regardless of clinical area.
specific assessment criteria in a particular
- Some units may also have unit-specific changing requires more frequent
standards unique to their type of client. documentation than a client whose blood
pressure is constant. As a rule, documenting
3. Bedside access to chart forms. should be done as soon as possible after an
- In the CBE system, all flow sheets are kept at assessment or intervention.
the client's bedside to allow immediate - No recording should be done before providing
recording and to eliminate the need to nursing care.
transcribe data from the nurse's to the
permanent record. • Legibility
- All entries must be legible and easy to read to
• Computerized Documentation prevent interpretation errors. Hand printing
- Electronic health records (EHRs) are used to or easily understood handwriting is usually
manage the huge volume of information permissible. Follow the agency's policies
required in contemporary health care. about handwritten recording.
- That is, the EHR can integrate all pertinent
client information into one record. • Permanence
- Nurses use computers to store the client's - All entries on the client's record are made in
database, add new data, create and revise dark ink so that the re- cord is permanent and
care plans, and document client progress. changes can be identified. Dark ink
- Some institutions have a computer terminal reproduces well on microfilm and in
at each client's bedside, or nurses carry a duplication processes. Follow the agency's
small handheld terminal, enabling the nurse policies about the type of pen and ink used
to document care immediately after it is for recording.
given. - In regards to EHRs, changes are made in
accordance with the software guidelines. It is
• Case Management important for the nurse to understand the
- The case management model emphasizes policies and procedures of the health care
quality, cost effective care delivered within an institution regarding documentation.
established length of stay.
- This model uses a multidisciplinary approach • Accepted Terminology
to planning and documenting client care, - Abbreviations are used because they are
using critical pathways. short, convenient, and easy to use.
- These forms identify the outcomes that Abbreviations are convenient; however, they
certain groups of clients are expected to are often ambiguous. This ambiguity places
achieve on each day of care, along with the the client at risk for medical errors and
interventions necessary for each day. significant harm, possibly even death
(Galliers, Wilson, Randell, & Woodward,
General Guidelines for Recording 2011).
• Date and Time - Ambiguity occurs when an abbreviation can
- Document the date and time of each stand for more than one term, leading to
recording. This is essential not only for legal misinterpretation.
reasons but also for client safety. Record the
time in the conventional manner (e.g.. 9:00 • Correct Spelling
am or 3:15 pm) or according to the 24-hour - Correct spelling is essential for accuracy in
clock (military clock), which avoids confusion recording. If unsure how to spell a word, look
about whether a time was am or pm. it up in a dictionary or other resource book.
Two decidedly different medications may
• Timing have similar spellings; for example, Fosamax
- Follow the agency's policy about the and Flomax.
frequency of documenting, and adjust the
frequency as a client's condition indicates; for • Signature
example, a client whose blood pressure is
- Each recording on the nursing notes is signed reflect the nursing process. Record all
by the nurse making it. The signature includes assessments, dependent and independent
the name and title; for example, "Susan J. nursing interventions, client problems, client
Green, RN" or "SJ Green, RN." Some agencies comments and responses to interventions
have a signature sheet and after signing this and tests, I progress toward goals, and
signature sheet, nurses can use their initials. communication with other members of the
- With computerized charting, each nurse has health team.
his or her own code, which allows the
documentation to be identified. • Legal Prudence
- Accurate, complete documentation should
• Accuracy give legal protection to the nurse, the client's
- The client's name and identifying information other caregivers, the health care facility, and
should be stamped or written on each page of the client. Admissible in court as a legal
the clinical record. Before making an entry, document, the clinical record provides proof
check that the chart is the correct one. Do not of the quality of care given to a client.
identify charts by room number only; check Documentation is usually viewed by juries and
the client's name. Special care is needed attorneys as the best evidence of what really
when caring for clients with the same last happened to the client.
name.
- Record only information that pertains to the Documentation Principles:
client's health problems and care. Any other • The only evidence available years later
personal information that the client conveys • Used to reconstruct the care provided
is inappropriate for the record. Recording • Considered to be an accurate reflection of
irrelevant information may be considered an care provided to the patient
invasion of the client's privacy and/or • Scrutinized by both plaintiff and defense
libelous. A client's disclosure that she was attorneys
addicted to heroin 15 years ago, for example, • Should paint a factual picture of past events
would not be recorded on the client's medical • May reflect upon professional credibility
record unless it had a direct bearing on the
client's health problem. The Medical Record Should Contain the
Following Types of Information:
• Sequence • Thorough history
- Document events in the order in which they • Relevant information regarding diagnosis and
occur; for example, record assessments, then treatment Assessment of suicide/violence <
the nursing interventions, and then the • Consultations regarding medications
client's responses. Update or delete problems prescribed with dosages and any observable
as needed. side effects. If there are observable side
effects, documentation that the behavioral
• Conciseness health provider has contacted the prescribing
- Recordings need to be brief as well as provider.
complete to save time in communication. The • Informed consent
client's name and the word client are omitted. • Treatment compliance/non-compliance
- For example, write "Perspiring profusely. (describe objectively)
Respirations shallow, 28/min." End each
• Boundary issues
thought or sentence with a period.
• Termination
• Completeness
What May Not Be Documented In Behavioral
- Not all data that a nurse obtains about a
Health:
client can be recorded. However, the
• Detailed account of sexuality
information that is recorded needs to be
- Interpersonal conflicts
complete and helpful to the client and health
care professionals. Nurses' notes need to
- Issues that may be embarrassing to the • A symbol identifying new/additional entries
patient if disclosed should be viewable
- Third party names • The original entry should still be viewable,
• But in Some Cases: "strike through" methods with author, date,
- Sexual behavior time, commentary, linked to the original entry
- Criminal behavior/history are often used
• Note the reason for the correction
When Documenting in an EMR System, It Is • If a hard copy is printed, the hard copy must
Important to Remember the Following also be corrected
Additional Principles:
• Use only approved abbreviations, acronyms Do’s and Don’ts for Written Documentation
and symbols • Do
• Exercise caution when moving from one - Write legibly in permanent ink
patient record to another - Put patient ID # on each page .
• Do not cut and paste information from one - Sign, initial and date (month, day, year, time),
EMR data field to another each entry
• Link each data field in the EMR to the patient - Make entries as soon as possible (do not
by name and health record number make entries in advance and identify late
• When referring to another patient, use that entries as such)
patient's health record number, not his/ her - Incorporate prior records into documentation
name Include test results/consultations in record as
• Each entry and signature must be associated well as notes that you reviewed.
with a date/time stamp - Document informed consent/refusal
• Avoid relying upon templates or diagnosis - Use specific, factual, objective language, and
aids not language that speculates, opines, or is
• Ensure patient data is encrypted and avoid subjective in nature
removing portable devices from the office if - Document all facts relevant to an event,
they contain patient data course of treatment, patient condition, and
• Make sure your system indicates when response to treatment
modifications are made to patient record - Document rationale for deviating from
• Preserve all electronic data, emails, phone standard treatment, when applicable
messages and computer records • Don't
• Do not delete information - Don't leave blank areas on a page
• Do not give out your "login password" - Don't squeeze in late entries
- Don't use personal/non-standard
Correcting Medical Record Information: abbreviations when documenting
• Draw a single line through entry errors (make - Don't include names of informal consults, nor
sure original entry is still legible). Write should informal consults document in the
"mistaken entry" medical record
• Use first initial and last name - Avoid using words like error, mistake,
accident, inadvertent, and malpractice
• Write the correct entry as close as possible,
- Don't erase/ block out entered information
but not over it.
• Sign and date the entry (including time)
Documenting Nursing Activities
• Document the correct entry
• The client record should describe the client's
• DO NOT alter the original entry, or "black it
ongoing status and reflect the full range of
out"
the nursing process. Regardless of the records
When correcting an error in an EMR, keep in
system used in an agency, nurses document
mind the following:
evidence of the nursing process on a variety
• Every entry should be date, time, author
of forms throughout the clinical record.
stamped
Types of Documentation A The patient's status is improving, and he is
1. Soapie and Soapier less short of breath than in previous days.
• Subjective He continues with edema. Currently, the
- Background or historical information that may patient is at risk for falls due to confusion
be relevant to understanding the patient's and will need fall precautions enforced.
current or future clinical state such as P Initiate fall precautions with a bed
description of events leading from the last alarm/body alarm. Continue with Lasix for
encounter to the current visit, pertinent past diuresis. Awaiting cardiology consult
and family histories, social habits placing the tomorrow. Pt had an echocardiogram
patient at risk for disease, current today, and the results are pending.
medications used to manage existing I Assessed patient and reconciled
conditions and known allergies. medications. Spoke with daughter, pt's
• Objective power of attorney, to provide update and
- Observable, measurable or quantifiable data education on patient's condition.
obtained from past records, physical Laboratory obtained morning labs without
examinations, tests, procedures, screenings a problem, and vascular therapy placed a
and other diagnostic techniques. new 18g peripheral IV as the previous one
• Assessment was due for a change. Pt took all morning
- Possible diagnosis including reported meds without a problem. Reoriented
differentials and impressions by the dictating patient and provided opportunities for
physician or clinical staff treating the patient. toileting and for making needs known
• Plan every 1-2 hours today to lessen the risk of
- Completed or follow-up care plans, treatment fall."
actions, education.
• Not Applicable Narrative SOAPIE and SOAPIER
- Irreconcilable statements that don't apply to - The acronyms SOAPIE and SOAPIER refer to
the previous classes formats that add interventions, evaluation,
and revision:
Example of a SOAPI note: I Interventions refer to the specific
S "Mr. Smith is an 88-year-old male with a interventions that have actually been
diagnosis of congestive heart failure. The performed by the caregiver.
patient is alert and oriented x 1 but E Evaluation includes client responses to
pleasantly confused. He complained of nursing interventions and medical
shortness of breath on this shift and stated treatments.
the 2 liters of oxygen made him feel better. This is primarily reassessment data.
He verbally denied pain and his nonverbal R Revision reflects care plan modifications
pain score was 0. His daughter visited suggested by the evaluation. Changes may
today and advised that he was trying to be made in desired outcomes,
climb out of bed to go to the bathroom interventions, or target dates. Newer
because of his confusion. She stated he versions of this format eliminate the
"forgot he was in the hospital." subjective and objective data and start
O Today, the patient's vital signs were as with assessment, which combines the
follows: BP 162/82, Pulse 64 and regular, subjective and objective.
Respirations 20 per minute, and pulse ox
98% on 2L Oxygen via nasal cannula. His 2. Focus charting
lungs are diminished with scattered - Focus Charting of F-DAR is intended to make
crackles. Bowel sounds are active, and the the client and client concerns and strengths
patient had a bowel movement x 2 today, the focus of care. It is a method of organizing
both soft. Incontinent of urine and wearing health information in an individual's record.
a diaper. Skin intact at this time. Skin color Focus Charting is a systematic approach to
is pale. 2+ non-pitting edema noted in documentation.
bilateral calves and ankles.
Focus Charting Parts
Three columns are usually used in Focus Charting
for documentation:
➢ Date and Hour
➢ Focus
➢ Progress Notes

• The progress notes are organized into (D)

data, (A) action, and (R) response, referred to
as DAR (third column)
3. SBAR
Date/Hour Focus Progress
- SBAR stands for Situation, Background,
Notes
Assessment and Recommendation. According
11/17/2021 Focus of care, this Data to Safer Healthcare, SBAR was originally
8:00pm may be: a nursing Action developed by the U.S. Navy as a way to
diagnosis Response communicate information on nuclear
a sign or a submarines. However, the healthcare system
symptom adopted it in the 1990s, and now it's used
an acute change worldwide.
in the condition - According to the Institute for Healthcare
behavior Improvement, "SBAR is an easy-to-remember,
concrete mechanism useful for framing any
conversation, especially critical ones,
Progress Notes
requiring a clinician's immediate attention
Data The data category is like the
and action." It gives clinicians a specific,
assessment phase of the nursing
unambiguous way to communicate critical
process. It is in this category that
information to one another, leaving little
you would be writing your
room for error and minimizing the chance
assessment cues like: vital signs,
that a miscommunication will cause patient
behaviors, and other observations
deterioration.
noticed from the patient. Both
subjective and objective data are
The components of SBAR are as follows:
recorded in the data category.
• Situation
Action The action category reflects the
- Clearly and briefly describe the current
planning and implementation
situation.
phase of the nursing process and
• Background
includes immediate and future
- Provide clear, relevant background
nursing actions. It may also include
information on the patient.
any changes to the plan of care.
Response The response category reflects the • Assessment
evaluation phase of the nursing - State your professional conclusion, based on
process and describes the client’s the situation and background.
response to any nursing and • Recommendation
medical care. - Tell the person with whom you're
communicating what you need from him or
her, in a clear and relevant way.

When calling the physician, follow the SBAR

process:
Situation What is the situation you
are calling about? Identify
self, unit, patient, room
number. Briefly state the
 problem, what is it, when Diagnosis Provides direction to what
it happened or started, interventions should be used
and how severe. for the client. This part
Background Pertinent background of the charting is usually stated
information related to the in a two-part format accepted
situation could include the by the North American Nursing
following: The admitting
diagnosis and date of Diagnosis Association (NANDA)
admission. List of current - the diagnostic statement
medications, allergies, IV follow the problem, etiology
fluids, and labs Most and
recent vital signs. Lab symptom (PES)
results: provide the date Planning Include specific orders
and time test was done designed to manage the
and results of previous problem of the client, collect
tests for comparison. additional data about the
Other clinical information. problem and the goals of care.
Code status Interventions These refers to the actions
Assessment What is the nurse’s taken by the nurse relevant to
assessment of the the presented problem. It
situation? includes independent,
Recommendation What is the nurse’s dependent and collaborative
recommendation or what nursing actions
does he/she want? Evaluation Evaluates the response of the
client to the interventions
Examples: performed.
Notification that patient has been admitted
Patient needs to be seen now Order change. Computerized Documentation Electronic health
Document the change in the patient’s condition records (EHRs)
and physician notification - are used to manage the huge volume of
information required in contemporary health
Example; SBAR Report to Physician about a care. That is, the EHR can integrate all
Critical Situation pertinent client information into one record.
S Dr. King, this is Shen Co calling from the ER Nurses use computers to store the client's
complex. I have Mr. Red in Room 311, a database, add new data, create and revise
53- year-old man who looks pale and care plans, and document client progress.
sweaty, feels confused and weak, and is
complaining of chest pain rated as 7/10. Kardex
B • He has a history of HTN. - A Kardex is a desktop file system that gives a
• He was admitted for a GI bleed brief overview of each patient and is updated
• His vital signs are BP 100/60, pulse 120, every shift. It is like having a cheat sheet for
RR 21 nurses to reference that is separate from the
A I think he’s got an active bleed and we patient chart. It is usually kept in a central
can’t rule out an MI, but we don’t have a location, such as the nursing station, for quick
troponin or a recent lab results access.
R I’d like to get an EKG and labs, and I need
for you to evaluate him right away Principles in Nursing Documentation
Accordingly, the American Nurses Association
4. ADPIE Method (ANA) presents these principles:
Assessment Includes the subjective and • Principle 1. Documentation
objective data supporting the Characteristics High quality documentation is:
identified problem. ➢ Accessible
 ➢ Accurate, relevant, and consistent ➢ Confidentiality of clinical professionals'
➢ Auditable information
➢ Clear, concise, and complete ➢ Confidentiality of organizational
➢ Legible/readable (particularly in terms of information
the resolution and related qualities of EHR
content as it is displayed on the screens of • Principle 5. Documentation Entries
various devices) Entries into organization documents or the health
➢ Thoughtful record (including but not limited to provider
➢ Timely, contemporaneous, and sequential orders) must be:
Reflective of the nursing process ➢ Accurate, valid, and complete;
➢ Authenticated; that is, the information is
• Principle 2. Education and Training truthful, the author is identified, and
Nurses, in all settings and at all levels of service, nothing has been added or inserted;
must be provided comprehensive education and ➢ Dated and time-stamped by the persons
training in the technical elements of who created the entry;
documentation and the organization's policies ➢ Legible/readable; and
and procedures that are related to ➢ Made using standardized terminology,
documentation. This education and training including acronyms and symbols.
should include staffing issues that take into
account the time needed for documentation • Principle 6. Standardized Terminologies
work to ensure that each nurse is capable of the Because standardized terminologies permit data
following: . to be aggregated and analyzed, these
➢ Functional and skillful use of the global terminologies should include the terms that are
documentation system used to describe the planning, delivery, and
➢ Competence in the use of the computer evaluation of the nursing care of the patient or
and its supporting hardware client in diverse settings
➢ Proficiency in the use of the software
systems in which documentation or other Responsibilities of the Nurse in Documentation
relevant patient, nursing and health care 1. The nurse understands his/her accountability
reports, documents,and data are captured for documenting on the clinical record the
care he/she personally provides to the clients.
• Principle 3. Policies and Procedures 2. The nurse documents the care process
The nurse must be familiar with all organizational including information or concerns
policies and procedures related to communicated to another health care
documentation and apply these as part of nursing provider.
practice. Of particular importance are those 3. The nurse documents all relevant information
policies or procedures on maintaining efficiency about clients in chronological order with date
in the use of the "downtime" system for and time.
documentation when the available electronic 4. The nurse carries out comprehensive, in-
systems do not function. depth and frequent documentation when
clients are acutely ill, high risk or have
• Principle 4. Protection Systems complex health problems.
Protection systems must be designed and built 5. The nurse documents timely the care he/she
into documentation systems, paper-based or provides.
electronic, in order to provide the following as 6. The nurse corrects any documentation error
prescribed by industry standards, governmental in a timely and forthright manner.
mandates, accrediting agencies, and 7. The nurse remarks any late entry, if indicated,
organizational policies and procedures: with both date and time of the late entry and
➢ Security of data of the actual event.
➢ Protection of patient identification, 8. The nurse indicates his/her accountability by
➢ Confidentiality of patient information adding his/her signature and title as approved
by his/her organization to each entry and
 correction he/she makes on the clinical requirements for Medicare and other third-
record. party disbursements.
9. The nurse safeguards the privacy, security  Legal guidelines for the process of recording
and confidentiality of clinical record by in a client record include documenting date
appropriate storage and custody. and time, legible entries, using dark ink, using
10. The nurse updates himself/herself with accepted terminology and spelling, accuracy,
contemporary documentation knowledge. sequence, appropriateness, completeness,
conciseness, and including an appropriate
Highlights: signature.
 Client records are legal documents that
provide evidence of a client’s care.
 The nurse has a legal and ethical duty to
maintain confidentiality of the client’s record;
this includes special
measures to protect client information stored
in computers.
 Client records are kept for a number of
purposes, including communication, planning
client care, auditing health agencies, research,
education, reimbursement, legal
documentation, and health care analysis.
 Examples of documentation systems include
source oriented, problem oriented, PIE, focus
charting, charting by , computerized
documentation, and case management.
 In source-oriented clinical records, each
health care professional group provides its
own record. Recording is oriented around the
source of the information.
 In problem-oriented clinical records,
recording is organized around client
problems.
 Computers make care planning and
documentation relatively easy. The use of
computer terminals at the bedside allows
immediate documentation of nursing actions.
 The case management model emphasizes
quality, cost-effective care delivered within an
established length of stay.
 The Kardex is used to organize client data,
making information quick to access for health
professionals.
 Nursing progress notes provide information
about the progress the client is making
toward desired outcomes. The format for the
progress note depends on the documentation
system at the facility.
 Long-term documentation varies depending
on the level of care provided and
requirements set by Medicare and Medicaid.
 Home health agencies must standardize their
documentation methods to meet
 WEEK 14 ➢ Prepares / compounds, packages,
INTERDISCIPLINARY HEALTH TEAM labels and dispenses medications
COLLABORATION ➢ Gives pharmacological information to
health care professionals, and
Interdisciplinary Mental Health Team monitors patient drug therapies.
- comprises professionals from various
disciplines who work in collaboration to 4. Psychiatric Nurse:
address a patient with mental health needs. - The nurse has a solid foundation in health
They complement one another's expertise promotion, illness prevention, and
and actively coordinate to work toward rehabilitation in all areas, allowing him/her to
shared treatment goals. view the client holistically. The nurse is also
- Regardless of the treatment setting, an essential team member in evaluating the
rehabilitation program, or population, an effectiveness of nursing care and medical
interdisciplinary team approach is most useful treatment, particularly medications.
in dealing with the multifaceted problems of
clients with mental illness. 5. Psychiatric Nursing Aide
- Psychiatric aides help with personal hygiene,
Members of the Interdisciplinary Mental Health meals, recreation, transportation, and
Team socialization. They als assist in medical care
1. Psychiatrist: under the supervision of nurses or psychiatric
- The psychiatrist is a physician certified in technicians.
psychiatry by the Philippine Board of
Psychiatry, and Neurology, which requires 6. Psychiatric Social Worker:
residency training program in their field of - Psychiatric social workers are a bachelor's
specialization after passing the licensure degree or/and master's social work, and
exam. They will undergo a 3-year residency, require years of clinical experience as a
2-year of clinical practice, and completion of prerequisite to receive a license or
an examination. certification.
- The primary function of the psychiatrist is to - Social workers may practice therapy and
diagnose, treat and rehabilitate mentally ill often have the primary responsibility for
patients. working with families, community support,
and referral.
2. Psychologist: - Responsible for patients' anamnesis
- The clinical psychologist has a bachelor's
degree and/or a master's degree plus a 7. Occupational Therapist:
doctorate degree to become a clinical - Occupational therapists may have an
psychologist or a researcher. To be Psyc.D one associate degree (certified" Occupational
must pass practical work and examinations therapy assistant), or a baccalaureate degree
rather than a dissertation (certified occupational therapist).
- Clinical psychologists identify emotional, - Occupational therapist assists patient's ability
mental, and behavioral problems. Through to perform useful tasks that may contribute
observation, interviews, and tests, the to patients socializations and recovery
psychologist will diagnose any existing or - Focus on the client's functional abilities and
potential disorders. ways to improve functioning

3. Pharmacist: 8. Recreational Therapist:

- The pharmacist is a bachelor's degree - Recreational therapists complete a bachelor's
graduate or/and a master in social work that degree in recreational therapy or a related
requires years of clinical experience as a field. Some may take associate's degree in
prerequisite to receive a license or therapeutic recreation or another subject
certification related to health care.
- The registered pharmacist:
- The recreation therapist helps the client to • Collaboration also implies helping to facilitate
achieve a balance of work and play in his/her the mental health of the patient, family or
life and provides activities that promote community within the context of the
constructive use of leisure or unstructured treatment team.
time. • Nurses bring their own specialized knowledge
and skills to the treatment process.
9. Vocational Rehabilitation Specialist:
- Vocational rehabilitation specialists should Seven characteristics of effective collaboration
have bachelor's degrees in vocational includes:
rehabilitation, counseling, or a related field. 1. Trust
Typically, they may hold a master's degree in 2. Respect
vocational or rehabilitation counseling, 3. Commitment
psychology, or, sometimes, social work. 4. Cooperation
- Vocational rehabilitation specialist work may 5. Coordination
includes determining clients' interests and 6. Communication
abilities and matching them with vocational 7. Flexibility.
choices. Clients are also assisted in job-
seeking and job-retention skills as well as in PMHN Core Skill Areas: KSA
pursuit of further education, if that is needed • Knowledgeable
and desired. - Concepts, theories, principles, standard
practices in the care of patients with mental I
10. Expressive Art Therapist disorders.
- Expressive art therapist is normally a • Skillful
bachelor's degree. They usually study - Communication skills
rehabilitation science, psychology or fine arts. - Interpersonal skills
They may also have masters or doctors - Decision making skills
degree in a clinical mental health-related field - Technical psychiatric nursing skills
(e.g., counseling, marriage & family therapy, - Risk assessment and risk management skill
social work, psychology • Attitude
- Assists patients in exploring underlying - Acceptance
feelings and emotional conflicts that impair - Empathy
their physical, cognitive, and emotional - Genuineness
wellbeing by using music, art, and movements - Nonjudgmental attitude
- Patient/Tolerant
11. Dietitian - Consistent
- Dietitians are a bachelor's degree in dietetics, - Assertiveness
foods, nutrition, food service systems
management, or a related area. The SOLER position (Egan, 2010)
- Responsible for the nutritional needs of the S: Squarely face the patient
client 0: Open posture
L: Lean forward
12. Chaplain E: Eye contact
- Responsible for the spiritual needs of the R: Relaxed attending attitude
client.
- They are trained to assess the patient's Team Approach in Nursing Care
spiritual and religious needs • Team nursing approach is a care model that
uses a group of people led by a
Psychiatric nurse as collaborative members of knowledgeable nurse.
the interdisciplinary team: • It is a delivery approach that provides care to
• Collaboration implies a commitment to a group of clients by coordinating a team of
common goals, with shared responsibility for Registered Nurses (RNs), Licensed Practical
the outcome of care. Nurses (LPNs), and psychiatric nursing aides
 under the supervision of a TEAM LEADER Advantages
(HEAD NURSE) - Care is provided economically and efficiently
- Minimum number of RNs required
- Tasks are completed quickly
Disadvantages
- Care may be fragmented
- Patient may be confused with many care
providers
- Caregivers feel unchallenged
Functional Nursing
- Staff members assigned to complete specific
tasks for a group of patients
- Evolved during World War II as a result of a
Nursing Care Delivery System nursing shortage \Unskilled workers trained
• Choosing the most appropriate organizational to perform routine, simple tasks
model to deliver patient care for each unit or - Common use area – operating room
organization depends on the ff:
➢ skills and expertise of the staff Team Nursing
➢ the availability of registered professional • Team nursing is where groups of professional
nurses and non-professional personnel work
➢ the economic resources of the together to identify, plan, implement and
organization evaluate comprehensive client-centered care.
➢ the acuity of the patients,
• The key concept is a group that works
➢ the complexity of the tasks to be
together toward a common goal, providing
completed. qualitative, comprehensive nursing care
• Four classic nursing care delivery models (Wikipedia).
(1) Functional nursing
• The nurses are divided into a number of
(2) Team nursing teams. Each team has to provide care for a
(3) Primary nursing fixed group of patients. Therefore, nurses
(4) Total patient care
have a close relation with the patients they
have to take care. Team leader is responsible
Functional Nursing
for the performance for each team members.
• Functional Nursing is a kind of nursing
modality, which is task-oriented where a
particular nursing function is assigned to each
nursing staff.
• The nurse identifies the tasks to be done for a
shift and the tasks will be divided among the
nursing staff members who should focus on
completing the assigned task.
• Functional nursing has the advantage of being
efficient in handing a large number of clients.
• The idea behind functional nursing is that Advantages
there is a specialist for each task. - High-quality, comprehensive care with a high
proportion of ancillary staff
- Team members participate in decision making
and contribute their own expertise
Disadvantages
- Continuity suffers if daily team assignments
vary
- Team leader must have good leadership skills Primary Nursing
Insufficient time for planning and • Primary nursing is a system of nursing care
communication delivery which emphasizes continuity of care
Team Nursing and responsibility acceptance by having one
- RN as team leader coordinates care for a registered nurse (RN).
group of patients • Primary nursing focuses on the therapeutic
- Evolved in the 1950s to improve patient relationship between a patient and a nurse
satisfaction who assumes responsibility for a patient's
- Goal was to reduce fragmented care plan of care for their length of stay in a
- Common use areas-most inpatient and particular institution. The patient is aware of
outpatient areas who their nurse is and can communicate to
the entire hospital staff through the primary
Total Patient Care nurse.
• Also called Total Patient Care. Commonly
used in intensive care unit (ICU) and post-
anesthetic care unit (PACU).
• The nurse is fully responsible for organizing,
planning, and performing all aspects of
nursing care.
• Total Patient Care provides a high degree of
autonomy, clear lines of responsibility and
accountability, holistic patient care and
unfragmented care
Advantages
- High-quality, holistic patient care
- Establish rapport with patient
- RN feels challenged and rewarded
Disadvantages
- Primary nurse must be able to practice with a
- high degree of responsibility and autonomy
- RN must accept 24-hour responsibility
- More RNs needed; not cost-effective
Advantages History
- High degree of autonomy - "RN "primary nurse" assumes 24-hour
- Lines of responsibility and accountability are responsibility for planning, directing, and
clear evaluating care
- Patient receives holistic, unfragmented care - Evolved in the 1970s to improve RN
Disadvantages autonomy
- Each RN may have a different approach to - Common use areas-hospice, home health,
care and long-term care settings
- Not cost-effective
- Lack of RN availability Partnership Model (Co-Primary Nursing)
Total Patient Care • RN is partnered with an licensed practical
- Nurse is responsible for planning, organizing, nurse licensed vocational nurse (LPN/LVN) or
and performing all care nursing assistant to work together
- Oldest method of organizing patient care consistently
- Typically performed by nursing students • Modification of primary nursing to make
- Common use areas-intensive care unit (ICU) more efficient use of the RN
and postanesthetic care unit (PACU) Advantages
- More cost-effective than primary nursing
- RN can encourage training and growth of
partner
Disadvantages
- RN may have difficulty delegating to partner
- Consistent partnerships difficult to maintain
due to varied

Modular Nursing
• Modular nursing is an ideal model of care to
improve the quality of care and nurses'
Advantages
satisfaction, far from being optimal with
- Patient comes into contact with fewer
Functional Nursing (FN).
workers
• Patients are assigned to one unit, thus the
- Workers are unit based and spend more time
staff members know what is their maximum
in direct-care activities
workload, the number of beds on that unit,
- Team is supervised by an RN
etc. And the staff quickly get to know all the
- RN is accountable for a wide range of services
staff in that unit and develop excellent
and functions at a higher level
working relationships.
- Cost-effective
Advantages
Disadvantages
- Continuity of care is improved
- Major change in organizational structure is
- RN more involved in planning and
required
coordinating care
- Departments other than nursing must be
- Geographic closeness and efficient
willing to accept nursing leadership
communication
- Nurse manager supervises many types of
Disadvantages
workers
- Increased costs to stock each module
- Long corridors not conducive to modular
Functions of the PMHN in Collaboration
nursing
Functions of the PMHN collaboration with
Modular Nursing
1. Inter-professionals
- Modification of team nursing
- This refers to the working relationships
- Patient unit is divided into modules or units
between different groups of professionals
with an RN as team leader
such as psychiatrist, psychiatric nurse,
- The same team of caregivers is assigned
psychologist and other mental' health team
consistently to the same geographic area
members
- "Concept evolved to increase RN involvement
- Each professional group should bring their
in care
own perspective to the collaborative process
to improve the standard of service and the
Patient-Centered Care (Patient-Focused Care)
experiences of patients needing mental
• Cross-functional teams of professionals and
health services and their carers.
assistive personnel work together as a unit
based team
2. Inter-agency
• Recent development in nursing care delivery - Intra-agency collaboration are agreements
models occurring between or involving different
• More patient oriented than department organizations working together for the
oriented betterment of the provision of care.
• Models vary considerably among facilities - Ex: Department of Health & Human Services,
Mental Health Organizations. Mental /
Psychiatric Institutions

3. Intra-agency
- Interagency collaboration in systems of care is 3. decrease cooperation and participation to
"the process of agencies and families joining meet the organization vision and mission
together for the purpose of interdependent 4. decrease productivity.
problem solving that focuses on improving
services to children and families" (Hodges, Conflict Resolution
Nesman, & Hernandez, 1999, p.8). - Conflict resolution is a process where a given
- The psychiatric nurse collaborate within the disagreement between parties is mediated to
organizations rather than only professionals reach a proper solution.
within them for successful provision of care. - It is a way to work out certain differences that
arise between parties.
4. Multidisciplinary
- Multidisciplinary care team model brings Example of Conflict in Workplace
together different providers such as 1. Leadership Conflict
physicians, nurses, social workers, and other - Sometimes conflict is caused by leadership
specialists to reduce potential for errors and weakness, poor communication style,
improve health care outcomes. favoritism.
- Service users, such as clients of mental health Solution:
services, have specific needs which require a - Clearly communicate goals, the corporate
multidisciplinary team approach to care vision, mission and other directives.
planning and delivery (Couchman 1995). - Provide opportunity for employees to
- Example, within mental health care, contribute to corporate goals and objectives.
specialties such as community care, elderly - Listen attentively to subordinates' grievances
care, child, adolescent and family services, - Help employees to address their conflict
parent and baby services, substance abuse, efficiently and effectively between
rehabilitation etc., require a range of themselves, with their oversight.
specialist services with dedicated resources.
2. Employee Diversity
• Current best practice in nursing is based on - This can lead to miscommunication and
the principles of patient centered care, shared differences in the way employees relate to
decision making and multidisciplinary one another
teamwork. Solution:
• When applying these principles to practice, - Holds diversity trainings
psychiatric nurses engage in intensive - Corporate morale boosting events like picnics
collaboration with colleagues, patients and or brown bag lunches, and other programs to
relatives. help employees interact with one another
• Collaboration is crucial in everyday practice and share similarities in a positive setting will
and should be considered a core value of help resolve conflict.
nursing. - Focus on the goal and mission of the company
to help find commonalities rather than focus
Conflicts and Conflict Resolution for Better on differences.
Working Relationships
• Conflict is simply defined as a disagreement 3. Growth & Development
or opposition of interests or ideas. - Conflict maybe the result of employees
• There are broadly two kinds of workplace thinking that they are not recognized or
conflict: employees being bored with the company.
➢ when people's ideas, decisions or actions Solution:
relating directly to the job are in - Motivates employees by rewards and or
opposition recognition/ appreciations
➢ when two people just don't get along - Provide trainings for their growth &
• Workplace conflict may tend to: development
1. lower the team morale, - Engage employees in team building events
2. increase absenteeism
4. Individualism 6. Identify A Common Goal
- Conflict may be the result of "dog eat dog" - In this step, both parties agree on the desired
mindset that puts personal growth and outcome for the conflict
success above co-workers and at times, even - Both parties may realize they have the same
the company. goal, they just have different opinions on how
Solution: to reach that goal
- Managers should offer trainings that show - Once the common goal is identified, you can
how harmony and collaboration in the office start working towards a resolution.
actually helps everyone reach their individual
goals. When employees see the connection 7. Use A Third-Party Mediator
between their own success and their co- - In some cases, it may be useful to use a
workers' and company's success, collectivism neutral third party whom everyone trusts to
will occur naturally. be fair.
- This can help ensure both parties understand
Nine Steps in Resolving a Conflict in the one another fully and, if necessary,
Workplace (Indeed Editorial Team, 2021) continually remind everyone of the ultimate
1. Understand The Conflict goal so that the conversation and
- Fully understand your position in the conflict brainstorming session remains productive
and the position of the other party.
- Clarify your own interests and those of the 8. Brainstorm Solutions
other person. - Look for win-win solutions or compromises
- Think through what agreements you might be that all parties can agree upon.
able to reach. - If the conflict is between you and someone
who works under you, use their ideas first to
2. Explore Alternatives increase the personal commitment on their
- In some cases, the parties are not able to part and make them feel heard.
reach an agreeable solution in a conflict.
- Brainstorm possible resolutions to the conflict 9. Agree on A Plan Of Action
- Compare each of those solutions that you - Identify different solutions that both you and
have already decided upon and determine if the other party can accept and see where
the new solution is better. there is common ground.
- Ideally, you would identify a solution that's a
3. Find A Private, Neutral Place win-win for everyone involved. However, if
- It's important to find a quiet and neutral this isn't possible, look for an idea that
location where you can discuss the conflict in everyone can agree with and be committed
private. on it.

4. Communicate Both Sides

- Be an active listener.
- Let everyone participate
- Avoid forming assumptions
- Remain calm

5. Be Aware Of Body Language

- Maintaining eye contact
- Being conscious of your expression
- Relaxing your neck and shoulders
- Using a neutral tone with a moderate speed
and volume
- Avoiding the use of words that imply an
absolute such as "always" or "never"
 WEEK 15 - A clinical psychologist is a psychologist who is
LEADERSHIP AND MANAGEMENT ROLES OF A an expert in mental health. They have
PSYCHIATRIC-MENTAL HEALTH NURSE (PMHN) undertaken highly specialized accredited
training in the assessment, diagnosis,
Terminologies formulation, and psychological treatment of
• Psychiatric and mental health nursing mental health, behavioral, and emotional
- PMH nurses promote well-being through disorders across the lifespan.
prevention and education, in addition to the
assessment, diagnosis, care, and treatment of 4. Psychiatrists
mental health and substance use disorders, - A psychiatrist is a physician who specializes in
medications, etc. psychiatry, the branch of medicine devoted to
• Psychiatric Home care the diagnosis, prevention, study, and
- A care provided by psychiatric nurses in the treatment of mental disorders.
client's home. Psychiatric home care nurses - Psychiatrists are medical doctors and evaluate
must patients to determine whether their
- have physical and psychosocial nursing skills symptoms are the result of a physical illness,
to the demands of the client population they a combination of physical and mental
serve. ailments or strictly mental issues.
• Management
- the process of getting work done through 5. Mental Health Technicians (aka Psychiatric
others. Aides or Mental Health Assistants)
• Manager - are medical professionals who provide care
- one who carries out predetermined policies, for mentally ill or emotionally disturbed
rules and regulations with official sanction or patients.
act. - They typically work under the supervision of a
• Effectiveness mental health professional, like a psychiatrist,
- extent wo which desired outcomes are doctor or nurse, and often work in hospitals
attained through use of intervention. or institutions.
• Efficiency
- the relationship between monetary value of 6. Clinical Social Workers
resources expanded and monetary value of - are highly trained professionals working to
results achieved. Achieving the best results improve the quality of life and well being of
with least cost. others through direct practice, crisis
intervention, research, community organizing,
Interdisciplinary Team policy change, advocacy, and educational
1. Mental Health Nurse programs.
- An expert in assessing, diagnosing and
treating various psychiatric disorders. These 7. Occupational Therapists (OTs)
nursing professionals work as members of a - are health care professionals specializing in
dedicated health care team that provides occupational therapy and occupational
complete health care for the mental and science.
physical aspects of people. - OTs and occupational therapy assistants
(OTAs) use scientific bases and a holistic
2. Psychiatric Nurse perspective to promote a person's ability to
- Earn a master's in nursing or a doctor of fulfill their daily routines and roles.
nursing practice (DNP), they can become - OTs have immense training in the physical,
APRNs who can assess, diagnose, and treat psychological, and social aspects of human
the mental health needs of a patient, which functioning deriving from an education
can include prescribing medication and grounded in anatomical and physiological
providing psychotherapy. concepts, and psychological perspectives.

3. Clinical Psychologist 8. Music Therapists

- is part of an employment subgroup of Management
creative arts therapists who use the arts to - is an old French term it means "the directing".
treat mental illness, provide support for There are many definition of management is.
individuals with disabilities, and to promote It is a universal process. It is the process of
wellness and personal growth and creativity. coordinating and supervising personnel and
resources to accomplish organizational goals.
9. Art Therapists Also it is to design and maintain an internal
- have studied and mastered both psychology environment in which people working
and human development, and are trained in together in groups that can perform
both therapy and art. They can help effectively and efficiently towards the
individuals, couples, families, or groups of attainment of group goals.
people regardless of sex, age, or ethnicity. - It is a universal process.
- Use in business, practice of one's profession
10. Psychodrama Director or Psychodramatist and even day to day personal affairs.
- Directs an action method, often used as a - The process of coordinating and supervising
psychotherapy, in which clients use personnel and resources to accomplish
spontaneous dramatization, role playing, and organizational goals.
dramatic self-presentation to investigate and
gain insight into their lives. Three-Fold Concept to Emphasize The Broader
Scope of Management (HARBIZON AND MYERS)
11. Dietitian 1. Economic source
- help people to understand the relationship - is one of the factors of production together
between food and health. They also help with land, and capital.
people change their diet so that they can - Industrialization increases, management is
become healthier, and stay healthy. substituted by labor and capital.
- Management of a firm determines to a large
12. Chaplain extent, its productivity and profitability.
- They bring expertise that is essential to
patient and family care, including: assessing, 2. System of authority
responding, documenting and communicating - management first develops with top
issues of spiritual distress and interventions individuals determining the course of action
to other members of the team; acting as for the rank and file.
cultural brokers, ensuring beliefs and - The constitutional management emphasizes
practices are identified and integrated into definite and consistent concern for policies
care; participating in invaluable conversations and procedures in dealing with the working
when ethical issues arise and consultations group.
are needed; and educating physicians and - A line toward a democratic and participative
other clinical staff on spiritual, religious, approach follows as employee receive higher
existential or cultural components that education.
influence beliefs and values, as well as how
they can respond as "spiritual care 3. Class and status system
generalists." - this is from sociologist's point of view that
managers have become an elite group of
Nursing Management brains and education.
- is a guide for nurses who wants to learn the - This class is based on education and
concepts behind Nursing Management. knowledge.
This will also guide nurses to; - Managers continue to expand their horizons
➢ organizing in an effort to attain the ultimate
➢ staffing
➢ scheduling Role of Manager
➢ directing 1. Interpersonal
➢ controlling - Symbol
- Leader ➢ Span of Control-refers to the number of
- Liaison employees that should be placed under
2. Informational the direction of one leader-manager
- Monitors
- Disseminates 2. Staff Authority
- As spokes person - authority that is based on the expertise and
3. Decisional which usually involves advising the line
- Entrepreneur or Innovator managers.
- Trouble shooter
3. Team Authority
Four Principles of Scientific Management - is granted to committees or work teams
1. Traditional "Rule of Thumb" means organizing involved in an organization's daily operations
work must be replaced with scientific Work teams are group of operating
methods. Give allotted time to workers in employees who shared a common vision,
accomplishing their task. goals and objectives.
2. Workers can be hired, trained and promoted
based on their competence and abilities. C. Staffing functions consist of recruiting
3. Employees are entitled of receiving financial interviewing, hiring and orienting staff.
rewards, and incentives for worked • Process of assigning competent people to
accomplished because he viewed humans as fulfill the roles designated for the
"economic animals' motivated solely by organizational structure through recruitment,
money. selection and development, induction and
4. Maintain good interpersonal relationship orientation of the new staff of the goals,
between the workers and managers they vision, mission, philosophy etc.
should be cooperative and interdependent
and the work should be shared equally. Staffing Process
1. Preparing to Recruit - types and number of
Management Process personnel
A. Planning it is determining philosophy, goals 2. Attracting a Staff - formal advertisement
and objective, policies, procedures and rules.
3. Recruiting and Selecting a Staff - interview,
B. Organizing it includes establishing the induction, orientation job, order pre-
organizational structure to carry out plans. employment testing, signing of contract
Organizing Process Includes
• Identifying and defining basic tasks. Staffing Pattern
• Delegation of authority and assigning - plan that articulates how many and what kind
responsibility of staff are needed/shift or per day in unit or
• Establishing relationships in department.

Three Forms of Authority Scheduling

1. Line authority - Timetable showing planned work days and
- is a direct supervisory authority from shifts for nursing personnel.
supervisor to subordinates. • Issues to consider in scheduling staff:
➢ Chain of Command- unbroken line of 1. Patient type and acuity
reporting relationships that extends 2. Number of patients
through the entire organization. The line 3. Experience of Staff
defines the chain of command and the 4. Support available to the staff
formal decision making structure.
➢ Unity of Command-within the chin states • Shifting Variations
that, each person in the organization 1. Traditional Shifting Patterns
should take orders and reports only to ➢ 3 shift (8 hr shift)
one person ➢ 12 hr shift
 ➢ 10 hr shift • Much of the work of manager is accomplished
2. Weekend option by transferring the responsibilities to
3. Rotating work shift subordinates
4. Self-scheduling - staff makes their own
schedule • Permanent work shift Good Reasons for Delegation
5. Floaters-"on-call" • Manager delegate routine task so that they
are free to handle problems that are more
D. Directing it includes several staffing functions complex or require higher level of expertise
such as motivating, managing conflict. • Delegate routine task if someone else is
Delegating, communicating, facilitating better prepared or has greater expertise or
collaboration. knowledge in solving the problems
• Act of issuing of orders, assignments,
instructions, to accomplish organizational Common Errors in Delegation
goals and objectives. • Underdelegating
• Delegation - entails responsibility - systems from the manager's false
• Assignments- no responsibility assumptions that delegation maybe
interpreted as a lack of ability on his part to
Elements of Directing do the job correctly and competently.
1. Communication Reasons are:
2. Delegation ➢ Managers believe that they can do the
3. Motivation work faster and better
4. Coordination ➢ Managers believe that the responsibility
5. Evaluation may be rejected if delegated
• Overdelegating
E. Controlling functions include performance - subordinates become overburdened which
appraisals. Fiscal accountability, quality may lead to dissatisfaction and low
control, legal and ethical control. productivity. Reasons are:
➢ Managers who are lazy
The Manager is Motivating: ➢ Manager who are overburdened and
• When the subordinate says we, not you or I, exhausted
in discussing business matters; • Improper Delegation
• When the subordinate is in complete - delegating at the wrong person, time, tasks
agreement on objectives and works towards and beyond the capability of the
achieving them in the knowledge that these subordinates.
are attainable;
• When the subordinate brings his problems to Steps in Effective Delegating
the manager without fear of criticism and 1. Plan ahead
knows that the manager will listen to him; 2. Identify necessary skills and levels
• When the subordinate knows that the 3. Select most capable personnel
manager will attempt to correct his faulty 4. Communicate goal clearly
behavior and his personality. 5. Empower the delegate
6. Set deadlines and monitor progress
Delegation 7. Model the role and provide guidance
• Act of assigning to someone else a portion of 8. Evaluate performance
the work to be done with corresponding
authority, responsibility and accountability “Leaders can be Mangers, but Not All are
(ARA). Leaders”
• According to ANA, it is the transfer of
responsibilities for the performance of the Leadership
task from one person to another - is the act of influencing group to follow a
certain course of action.
- A process of influence in which the leader - Emphasize - Organization
influences others toward goal achievement. interpersonal - Have a greater
- Is about creating change. It involves relationship format
establishing a direction, aligning people - Direct willing responsibility and
through empowerment, motivating and followers accountability for
inspiring them toward producing useful - Have goals that rationality and
change and achieving the mission. may or may not control than
reflect those of leaders
Nursing Leadership the organization - Direct willing and
- process where by nurse influences one or unwilling
more person to achieve a specific goal in the subordinates
provision of quality nursing care.
Great Man theory: (1900-1940)
COMPARISON BETWEEN LEADERSHIP AND - Leaders are born.
MANAGEMENT - Leaders display both instrumental (technical)
LEADERS MANAGERS and supportive (socially oriented) leadership
Leaders need to do Managers do things behavior
the right things. are right are challenged - Great leaders arise when situation demands
challenged by change, by continuity and it.
focus on purposes and focus on structures
have a future time and procedures in a Trait Theory
frame. present time frame. - Traits are inherent (before). Traits can be
They ask who, what, learned (now)
when, where and how - Identified traits: energy, affection,
as they use schedules enthusiasm, ambition, aggressiveness,
to get to the decisiveness, self assurance, self confidence,
destinations and friendliness, affection, honesty, fairness,
evaluate human loyalty, dependability, technical mastery,
performance. teaching skill.
LEADER MANAGER
- Often do not have - Are assigned a Charismatic Theory
delegated position by the - Leaders possess charisma (an inspirational
authority but organization quality that some leaders possess that makes
obtain power - Have a legitimate others feel better in their presence.
through other source of power
means, such as due to delegated Situational Theory
influence authority that - Traits required of a leader differ according to
- Have a wider accompanies their varying situations (variables)
variety of roles position Variables:
than managers - Have a specific ➢ personality of the leader
- Focus on group duties and ➢ performance requirements of both the
process, responsibilities leader and followers
information they are expected ➢ attitudes, expectations and needs of the
gathering, to carry out leader and followers
feedback, and - Manipulate
empowering people, the Leadership Styles
others environment, 1. Authoritarian
- May or may not be money, time, and - rigid leader and uses leadership role as an
part of the formal other resources to instrument of power.
hierarchy of the achieve the goals - Makes all decision
organization of the - Strong control is maintained over the work
group
- Others are motivated by coercion
- Others are directed with command

2. Democratic
- fair and logical uses the leadership role to
stimulate others to achieve collective goal
- less control is maintained
- economic and ego awards are used to
motivate
- others are directed through suggestion and
guidance

3. Laissez-Fair
- passive and unproductive, usually assumes
the role of participant
- observer and exerts a little control or
guidance.
 WEEK 16 6. Tissue and sample Collection and
PSYCHIATRIC NURSING ROLE AS MEMBER OF Processing
THE RESEARCH TEAM
Action Research
Research - In the health Care settings, the leadership,
- helps determine effective best practices and interpersonal, and management skills needed
improve patient care. to manage such change effectively within
- helps nursing respond to changes and multi-professional in a variety of health care
challenges in the healthcare environment, settings. It provides unique use of action
individual, family, patient and group research as a model for planning and
populations and government regulations. implementing change at the patient-service
interface.
Nursing research is:
- Systematic inquiry designed to develop Example of Action Research that can be applied
knowledge about issues of importance to with Nursing Leadership and Management.
nurses, including nursing practice, nursing Work-based learning: a leadership
education, and nursing administration. Polit development example from an action
and Beck (2006) research study of shared governance
implementation
Patient Satisfaction - Tracey Williamsonl
- Is an important and commonly used indicator - Affiliations expand,
for measuring the quality in health care. PMID:16238690DOI:10.1111/j.1365-
- affects clinical outcomes, patient retention, 2934.2005.00576.x
and medical malpractice claims.
- It affects the timely, efficient, and patient- Abstract
centered delivery of quality health care. Aim: An empowering action research study was
undertaken to evaluate and strengthen the
ROLES of Nurses in Research implementation of shared governance. One
Related activities: aim was to identify actors that acted as aids or
- Participate in journal club in a practice setting barriers to effective decision-making by clinical
to discuss & critique research articles leaders. As a work-based learning approach,
- Attend research presentations at professional action research was expected to lead to
conferences integration of learning in to practice by
- Evaluate completed research for its possible researcher and participants alike
use in practice
- Help to develop an idea for a clinical study Background:
- Review a proposed research plan and other Shared governance replaces traditional
clinical expertise to improve the plan hierarchies and requires and develops clinical
- Assist researchers in collecting information leaders. Strategies are needed to maximize
for study learning from introduction of such initiatives at
- Provide information and advise to clients who the individual, group and organizational level.
are participating in studies
- Discuss the implications and relevance of Methods:
research findings with clients Participant observations and interviews were
undertaken with shared governance council
Steps of Research Project (Nurses Role in members from one model in north-west
CLINICAL RESEARCH) England.
1. Protocol Development
2. Informed Consent Results:
3. Ethics approval Leadership skills and knowledge and shared
4. Patient Recruitment governance practices were significantly
5. Data Collection enhanced Preparation for council roles was
 considered inadequate Increased structured to carry out a study, or other processes to
time for reflection and action planning was be undertaken in an anticipated future
indicated trial (excluding the specific intervention
and exact protocol) with a small sample,
Conclusions: conduct a feasibility study that is not a
Implementation of shared governance has pilot study
succeeded in developing leadership capacity 6. Design the study
Evaluation findings have led to improvements a. Choose a research design (cross sectional,
in the overall shared governance model Action cohort, or correlation, for example)
research has been found to have great utility at b. Determine setting, sample size,
optimizing work based learning Nurse recruitment strategy, randomization (if
Managers need to develop their coaching and appropriate), instruments, data analysis,
facilitating skills and recognize there is no and procedures
"quick fix" for developing clinical leaders c. Ensure protection of human subjects
Implications include the need to support (submit plan for institutional review board
learners in identifying and implementing approval)
changes arising from work based learning 7. Collaborate with stakeholders at the setting
activities, the significant resource implications to minimize disruptions and obtain support
and the need to optimize the organizational 8. Carry out the study
climate if work based learning approaches to 9. Analyze the results
leadership and management development are 10. Relate the findings to plans for a future study
to succeed a. Do results suggest it is worthwhile to
pursue the study as planned?
Feasibility b. Do results provide data suggesting it
- can provide such data and this can validate would be important to modify aspects of
study procedures or identify procedures in this study to improve the anticipated
need of revision. larger study?
c. Do results provide the data needed to
Step-by-Step Guide to Feasibility Research propose a larger study as planned?
1. Identify a problem and/or a question. 11. Disseminate findings
2. Review the literature.
3. Identify gaps in our knowledge. Journal Sharing and Reaction on Shared
4. Refine the general question, formulating a Governance
specific research question(s). Reflective journaling
5. Consider reasons for conducting preliminary - is a term that refers to documenting ideas,
research and determine the form it should personal thoughts and experience through
take. writing
a. If a nurse researcher want to evaluate the - a valued tool for teaching nursing students
feasibility of carrying out the planned and for documentation, support, and
protocols and interventions of an generation of nursing knowledge among
anticipated larger study with experienced nurses
randomization of participants, conduct a - a comfortable medium for nurses to be more
randomized pilot study open about their journey and experience
b. If a nurse researcher want to evaluate the - can also be a great way to map a nurse's
feasibility of using all or part of an progress and achievements in his or her
intervention and, possibly, other nursing/clinical education as well as in their
processes in a proposed larger study, but career
without randomizing participants, conduct
a nonrandomized pilot study Shared Responsibility for Implementing
c. If a nurse researcher want to evaluate Evidence Based Practice
aspects of data collection, data - Evidence based practice (EBP) is the process
management, the adequacy of resources of collecting, processing, and implementing
 research findings to improve clinical practice, - Who needs to be trained and what training is
the work environment, or patient outcomes needed
- According to the American Nurses Association
(ANA) nursing interventions should be
practical, methodical decisions based on EBP
research studies utilizing the EBP approach to
nursing practice helps us provide the highest
quality and most cost efficient patient care
possible

• When evaluating EBP nursing research

studies, focus on these four criteria:
- Validity
- Reliability Continuing Professional Development Program
- Relevance Philippine Qualifications Framework
- Outcome - describes the levels of educational
• Facilitating EBP is a shared responsibility of qualifications and sets the standards for
the professional nurse, the organization, qualification outcomes. It is a quality assured
leader managers and the education or staff national system for the development,
development department recognition and award of qualifications based
on standards of knowledge, skills and values
Training Needs Analysis acquired in different ways and methods by
- is a process in which the company identifies learners and workers of the country.
training and development needs of its - It is a collaborative program by the
employees so that they can do their job Department of Education (DepEd), Technical
effectively It involves a complete analysis of Education and Skills Development Authority
training needs required of various levels of (TESDA), Commission on Higher Education
the Organization. (CHED), Professional Regulation Commission
- It is a process which helps the organization (PRC) and Department of Labor and
review the state of their training Its Employment (DOLE).
importance is to helps them to determine all
the training needs to be completed in a
certain period to allow their team to
complete their job as effectively as possible.
- The purpose of training needs analysis is to
identify performance requirements and the
knowledge, skills, and abilities needed by an
agency's workforce to achieve the
requirements An effective training needs
assessment will help direct resources to areas
of greatest demand.

Three Levels of Training Needs Analysis FACTS OF PQF

1. Organizational Analysis • WHAT... It is a reference-system of national
- TNA at the organizational level. Ex: SWOT standards of qualifications earned by
Analysis individuals educated and trained in the
2. Task Analysis Philippines
- Tasks to be performed on the job are • WHO...It is governed by the PQF National
analyzed: Knowledge, Skills, and Abilities Coordinating Council (PQF NCC) composed of
needed to do those tasks are also analyzed the Department of education (DepED),
3. Individual Analysis Commission on Higher Education (CHED),
Technical Education and skills Development
 Authority (TESDA), Professional Regulations • Staff development
Commission (PRC) and Department of Labor - is cost-effective method of increasing
and Employment (DOLE). productivity.
• FOR...It is for employers, workers, teachers • Training
and learners, parents and government who - organized method of ensuring that people
wish to understand Philippine qualifications have knowledge and skills for specific
and compare them with others. purpose. The manager must first determine
• WHO...Its objective is to establish national the employees needs by asking their
standards and levels of qualifications to assist knowledge deficits or giving employees skills
and support academic and worker mobility checklists or tests. By identifying their
and to address job skills mismatch. handicaps, planning their programs and
• HOW...It outlines what an individual has development to correct this deficiency early.
learned and can do based on qualification • Education
type, levels and agrees of competency. - more formal and broader scope than training.
Training is for immediate use, Education is
• The Philippine Report referenced against the designed to develop individuals in a broader
ASEAN Qualifications Reference Framework sense by re-organizing educational needs,
(AQRF) has been accepted as aligned to the encouraging educational pursuits and
AQRF Referencing Criteria and has been specialty programs
endorsed by the AQRF Committee to the • Competence
ASEAN Ministers of Economy, Education and - having the abilities to meet requirements for
Labor. particular role. Health care organizations use
• The Philippine education and training system many resources to determine competency.
and responsibilities and legal bases of all These include licensure exams, national
relevant national bodies involved in the certification and performance review
referencing process. It also presented the
procedures for the inclusion of qualifications A. Orientation
in the PQF and in the Philippine Qualifications - Refers to planned and guided activities of an
Register (PhQuaR). It ascertains the employee in the organization, the work
demonstrable link between the qualification environment, and his/her job.
levels in the PQF and the AQRF and the basis - Purpose: seeks to establish favorable
in agreed standards of the qualifications attitudes towards the organization, unit and
system.. department, provide information and
education for success on the job, instill
Continuing Professional Development feelings of belongingness and acceptance
- One aspect of Human Resource Management. - An effective orientation program results in
- The Major Task of Staff Development in higher productivity and fewer infractions of
nursing is to provide structure and assistance rules, regulations or policies.
for employees to learn in greater depth and Induction
translate these knowledge, skills, abilities and - Takes place before the employee performs
principles learned in nursing practice within his/her job wherein the Personnel Section
the institution. Manager provides information on the
- Better Trained and more competent staff can mission, vision, philosophy goals and
save the organization money by increasing objectives of the organization/institution,
productivity and positive outcomes. organizational structure, policies on hiring,
salaries, benefits, rules of conduct and safety
Purpose of Staff Development Activities or fire programs
- To establish competence - These information are usually found in the
- To meet new learning needs employee's handbook wherein he is required
- To satisfy interests the staff may have in to sign this handbook as evidence that he has
learning specific areas received it.
Orientation In The Nursing Service present job or to achieve promotion to a
➢ Usually done in the conference room or position with higher responsibilities. It
training room of the nursing service where provides experience of new concepts,
the members of the training staff conduct this innovations, product application or
conference. acquisition of increase expertise.
➢ In the absence of training division, Clinical - Examples include team building, values re-
managers or Chief nurses conducts the orientation, infection control, documentation,
orientation of new nursing personnel. The medication updates, case presentation,
training staff, clinical manager, head nurse journal meeting, ECG monitoring
acts as a mentor to the new employee and - Management Training or Supervisory
instill values and attitudes that each position Development Training Programs are designed
requires. They are leading by Example. to train employees who have potential for
➢ Starts with the vision, mission, philosophy and leadership in supervisory or managerial
objectives of the nursing service, hospital positions.
policies on selection, hiring, promotion, - Nurses are also given opportunities to attend
transfer, dismissal, review of job descriptions seminars or programs conducted by other
and updating license are explained agencies or associations or even conferences
➢ Induction to unit personnel, unit policies, of other departments within the same
nursing standards of practice and nursing institution.
procedures.
➢ Tour of the new employee around the C. Continuing Education
hospital and unit where she will be assigned - Continuing education programs are usually
will be done. accredited by the Professional Regulation
➢ A preceptor together with the new employee Commission (PRC) with corresponding contact
observes nursing activities, joins hours/units that are used when renewing
medical/nursing rounds and observes turn of licensure card.
shift endorsements. They are also given - Professional Regulations Commission (PRC)
opportunities to observe experience nurses started to require CPD units for renewal after
by "shadowing" or being the "big sister" or Republic Act 10912 or the Continuing
"buddy" to the next employee. Professional Development Act of 2016 was
➢ This can establish camaraderie and feelings of enacted into law. PRC then issued Resolution
belongingness and acceptance and helps new No. 1032 or Implementing Rules and
employees develop confidence in their duties Regulations (IRR) for CPD Law.
and responsibilities in the shortest time - Initially, nurses were required 45 CPD units
possible. for the 3-year renewal cycle or 15 units per
➢ On the second week, depending on his year. But due to public backlash, stakeholders
evaluation, new employee assumes greater had to reconsider the guidelines and come up
responsibilities and may be given 75-80% of with some amendments.
staff nurse functions by Clinical
Manager/Head Nurse. • On February 27, 2019 PRC and CPD Councils
came up with IRR Amendments through
B. In-Service Education Resolution No. 2019-1146 which take effect
- Includes all job instructions that are given to March 1. Here are the salient points in the
enhance the employee's recent job amendments:
performance. • PRC provides a "transition period" for
- It is a planned educational experience professional to comply the unit requirements.
provided by the employer/agency with the During this transition period the following
purpose of assisting the employee to perform shall be observed:
more effectively both as a persona and as a a) Professionals working overseas (OFWs)
worker. will not be covered by the CPD
- Purpose: enable employees to move from requirement
satisfactory to excellent performance in the
 b) Newly licensed professionals shall not be ➢ renal nursing at the National Kidney and
covered by CPD requirement for the first Transplant Institute (NKTI);
renewal cycle after obtaining their license. ➢ pediatric nursing at the Philippine
c) The various CPD Councils shall reduce the Children's Medical Center, National
required CPD credit units to a minimum, Children's Hospital;
which shall not be more than 15, as ➢ pulmonary nursing at the Lung Center of
provided for under applicable laws. the Philippines;
➢ mental health nursing at the National
• Professionals who lacked CPD units but were Center for Mental Health.
able to renew through an Affidavit of
Undertaking shall only comply with the D. Formal Education
required number of units as amended • Career development in nursing consists of
pursuant to this Resolution equivalent to not formal academic instruction in a defined
more than 15 credit units. program of higher education, licensure,
• Nurses need to attend programs accredited professional continuing education,
by CPD Council to earn units. These may certification, and advanced practice academic
include: Formal learning, Nonformal learning, degrees at the master's and doctoral levels.
Informal learning, Self-directed learning, • As required by PNA Act of 2002, RA 9173,
Online leaming activities, Professional work specifies that nursing administrators and
experience. those engaged in nursing education and
• These CPD programs are usually offered by training programs should have Master's
nursing organizations such as Philippine Degree in Nursing (MAN).
Nurses Association (PNA), Association of • Nurses are encouraged to attend formal
Nursing Service Administrators of the schooling in Graduate Schools, not just for
Philippines (ANSAP), Critical Care Nurses promotion but also for career development.
Association of the Philippines, Inc. (CCNAPI), • Specialization in nursing occurs at the
Ang Nars and other accredited providers. master's level. Master's programs prepare
They need to be accredited by PRC for formal leaders for advanced practice nursing as
number of units/hours for CPD. clinical nurse specialists (CNS), nurse
practitioners (NP), certified nurse-midwives
Staff Development Programme in Nursing (CNM), certified registered nurse anesthetists
Specialty Courses (CRNA), administrators, teachers, and
• The Program is a system of developing and consultants. Courses in nursing and other
certifying nurses based on a set of standard science disciplines provide advanced
competencies in both basic and specialty theoretical knowledge, assessment skills, role
areas. and leadership development, advanced
• The components of the certification include clinical practice in a selected specialization,
competency assessments of self and and the opportunity to critique and apply
workplace, competency-based learning nursing theory and research as a scientific
interventions and accreditation of providers. base for nursing practice.
• The Department of Health (DOH) today
launched its certification program for nurses Professional Advocacy
in eleven specialty areas such as • The American Nurses Association (ANA)
cardiovascular, renal, pulmonary, mental believes that advocacy is a pillar of nursing.
health, maternal and child, infectious Nurses instinctively advocate for their
diseases, orthopaedic rehabilitation, trauma patients, in their workplaces, and in their
and emergency, operating room, and communities; but legislative and political
anesthesia care. advocacy is no less important to advancing
• Courses at selected DOH Specialty hospitals: the profession and patient care.
➢ cardiovascular nursing at the Philippine • Nurses need essential skills in order to be
Heart Center (PHC); successful in patient advocacy Nurse
advocates need leadership, negotiating, and
 decision-making skills to work with medical Four criterial in evaluation of staff development.
teams, legal entities, and families in a. Learner's Reaction how did the learner
championing the patient. They need to know perceive the orientation?
the laws and regulations impacting health b. Behavior Change what behavior change
care and patient treatment options. They also occurred as a result of the learning?
need strong communication skills and c. Organizational impact - examples - assessing
empathy when working with patients and quality of care, medication errors, accidents,
understanding their unique situations. quality of clinical judgment, turnover and
• According to a 2017 paper in Nursing productivity
Management, key characteristics of ethical d. cost-effectiveness - most neglected aspect of
leaders include courage, compassion, and accountability. All staff development activities
trust in their intuition. should be evaluated for quality control,
• ANA offers the information, tools, and impact on the institution and cost
resources that nurses need to become effectiveness.
effective advocates. Through championing
the nursing profession, nurses give a voice to Socialization and Resocialization
the essential role that they play in advancing • Socialization
access to high-quality, affordable care. With - learning of behaviors that accompany each
energetic participation in advocacy, every role by instruction, observation and trial and
nurse can help the profession to improve and error.
move to higher levels. - First socialization to nursing role occurs
during nursing school and continuous after
Social Learning Theory graduation.
- Suggests an individual learns from social • Reality Shock
interactions in a social context. - occurs when the gaps in academic and
- Teamwork and mental model development in practice expectations provide fertile ground
Los for the new graduate to feel overwhelmed,
- Albert Bandura believed that direct conflicted and frustrated.
reinforcement could not account for all types • Anticipatory Socialization
of learning and that most people learn their - helps ease transition of roles of new
behavior by direct experience and graduates to professional roles by building
observation. (Observational Learning or opportunities for sharing and clarifying values
Modeling) and attitudes about nursing role into
orientation programs.
Four Process involved in social learning:
1. People learn as a result of direct experience
of the effects of their actions
2. Knowledge is frequently obtained through
vicarious experiences like observation of
someone's actions.
3. People learn by judgments voiced by others
especially when vicarious experience is
limited
4. People evaluate the soundness of the new
information by reasoning through inductive
and deductive logic.

Evaluation of Staff Development Activities

Staff development activities involved
participation from many departments and are
needed to be evaluated for its effectivity.
 WEEK 17 4. Utang Na Loob.
FILIPINO CULTURE, VALUES AND PRACTICES IN - Refer to as a "debt of gratitude."
RELATION TO MENTAL HEALTH - The essence of ’utang na loob’ is an obligation
to appropriately repay a person who has done
PART 1: Filipino Culture, Values and Practices one a favor.
related to Mental Health - ‘Utang na loob’ upholds group harmony and
• Filipino Culture relationships that demand the balancing of
- The summation of indigenous forces and obligations and debts. This involves the
foreign influences that had come to bear concept ‘reciprocity’ or returning the received
upon the people in varying degrees that are favor.
passed down from generation to generation
• Filipino Values 5. Pakikisama.
- Refers to the set of standards of behavior that - A typical trait of a Filipino which means
define which is socially considered to be “getting along with others” to avoid clash
desirable. with other people or a certain group
• Filipino Practices. ➢ Pakikisama entails a genuine intrinsic
- Also referred to FILIPINO CUSTOMS or appreciation of togetherness where group
TRADITIONS, which is a common way of doing harmony and unity is valued
things that are handed down from the past to ➢ People want to get along rather than
future generation. stand out. If progress is achieved, it is for
the entire group and no one should be left
Filipino Culture, Values and Practices behind (“Walang iwanan”)
1. Hiya
- This is a Filipino value that gives them a sense 6. Paggalang (Respect To Elders)
of social decency, and politeness to win - Filipinos, are not only respectful to elders, but
respect from the community. also have unique ways of expressing this
- Filipinos believe they must live up to the respect to elders. These include the use of
accepted standards of behavior. ‘po’ and ‘opo’ when talking to elders and
- Too much “hiya” may lead to having ‘pagmamano’ or the putting of the elder’s
inferiority complex and low self-confidence. hand to one’s forehead.
- When excessive respect to elders makes one
2. Amor Propio dependent or irrationally obedient to parents
- Amor propio’ has been “characterized as the or elders thus prevent ones autonomy.
high degree of sensitivity that makes a person
intolerant to criticism and causes him to have 7. Pakikipagkapwa
an easily wounded pride” - Refers to the Filipinos’ nature of easily getting
- ‘Amor propio’ comes from the person’s along with other people. The "
tendency to protect his/her dignity and pakikipagkapwa tao'' is synonymous with the
honor. Filipinos being friendly, compassionate,
respectful, and happy people.
3. Bahala Na - It's the virtue of the Filipinos that allows them
- Bahala originated from the Tagalog word to mingle, cooperate, empathize, and help
“Bathala”. Therefore, bahala na means “leave others whether to their fellow Filipinos or
it to God” or “God willing”. foreign nationals.
- The use of “Bahala na” displays the tendency - Filipinos would treat their visitors with utmost
of Filipinos to submit everything to God respect and warmth regardless of one's race,
especially during tough times. It highlights gender or religion
their devotion and trust to God on any - This trait, however, makes Filipinos prone to
difficult situations. being abused or maltreated.
- It is considered the Filipino art of happiness
and being resilient. Filipino Values
• Matatag
• Magalang 1.5. Healthy lifestyle interventions
• Masigasig - Are effective component of management for
• Mapagpasalamat patients with mental illness to improve their
• Mapagmalasakit mental health, physical health and quality of
• Mapagmahal life.
1.6. Counselling and addressing caregiver
burden
- Caregiver burden is a term used to describe
the physical, mental, social, and financial
impact of caring for someone who is ill or who
has functional impairments.
1.7. Psychoeducation
- Helps people better understand and become
accustomed to living with mental health
conditions.
1.8. Financial incentives
- Financial incentives are increasingly seen as
PART 2: Assessment and Provision of Care of an important vehicle by which to bring about
Clients with Mental Health Problems changes in behavior that can lead to healthier
• Provision of Mental Health Care at Primary lifestyles.
Health Care (PHC) Setting
- There are different strategies that strengthen 2. Integration of care or collaborative
the provision of mental health care at primary interventions
health care (PHC) setting and the impact - Interventions the nurse carries out in
these strategies have on patient, hospital and collaboration with other health care team
societal level indicators. professionals assuring that the client receives
the treatment and management.
The top three strategies that were reported the
most, included: 3. E-health interventions. (Mapanga, Casteleijn,
1. Strategies to empower families, carers and Ramiah, Odendaal, Metu, Robertson,
patients Goudge, 2019)
- Some of the strategies that empower families, - Any health services and information being
carers and patients includes: delivered or enhanced through the internet
and related technologies to relieve the
1.1. Community residential or day centers, workload of PHC staff
- Referred to as "assisted living"
1.2. Self help interventions, 4. Specialized Community Based Services
- involve individuals working through a set of - These services manage mental illness (chronic
therapeutic materials either on their own illness) through formalized links between
('unguided' self-help) or with minimal primary and specialized care. These
guidance from a therapist ('therapist-guided' interventions are run by specialists but
or 'minimal contact' self-help). located in the community or PHC setting
1.3. Support group
- A group of people with common experiences 5. Task Shifting/ Sharing Approaches
and concerns who provide emotional and - Less skilled or less trained workers take on
moral support for one another under the tasks normally carried out by more highly
guidance of a licensed mental health care trained staff.
provider. - This approach involves the rational
1.4. Vocational interventions redistribution of specific, where appropriate,
- Vocational rehabilitation services help people from highly qualified mental health workers
with mental and physical disabilities find work to health workers with shorter training and
for them to become independent. fewer qualifications in order to make more
 efficient use of the available human resources
for health care. • Organizational Core Values
- The core values of an organization underlie all
6. Group Therapy VS. Individual Therapy activity, including the strategies used to fulfill
- In group therapy, one health care worker their vision and mission, and how the
supports several patients at once and this members of the organization interact with
could potentially relieve the workload of PHC one another.
staff - They are the core elements of how people
approach their work.
7. Psychotherapy and Psychosocial
Interventions VS. In Combination with ➢ OLFU Core Values and Graduates Attributes
Pharmacotherapy - Through innovative learning strategies
- A combination of psychotherapy with focused on strong and updated academic
pharmacotherapy can be effective and allows foundation with enhanced industry skills and
a multidisciplinary approach to managing experience, a graduate of OLFU is expected to
mentally ill patients. be an ACHIEVER. In the community and in the
- Specialist mental health professional or non- workplace, an OLFU graduate will be known
health sector, community based organizations as a person who: ACHIEVER
can deliver these interventions. A Aspires to do his best
C Is credible and compassionate
8. Early Detection and Preventive Strategies H Is hardworking and honorable
- Early detection, prevention and screening I Is an inspiration to others
strategies all have implications for patient E Is efficient, effective and ethical
outcomes as well as cost implications. V Is A visionary
- This include when PHC workers screening E Is entrepreneurial, employable and
patients for mental illness and refer them to fsfsdfsfexcellent work habits
appropriate service immediately R Is responsible

9. Systemic Strategies that may Change ➢ Psychiatric – Mental Health Nurses

Provider Behavior and Strengthen the Association of the Philippines, Inc.
Quality of Care (PMHNAP)
- This include any strategies that may - Psychiatric-Mental Health Nurses Association
strengthen adherence to clinical guidelines or of the Philippines, Inc. (PMHNAP) is a duly
improve data collection of mental illness. recognized nursing specialty organization of
- These include continuous professional nurses working in the area of psychiatry and
development, capacity building courses and mental health.
training of PHC workers on mental health - The organization was established in 2010
through the leadership of Prof. Nenita Y.
PART 3: Attributes and Core Values of a Nurse Davadilla.
and Nursing Organizations in Psychiatric Mental - Located at #11, gen. Capinpin St. Brgy. San
Health Practice Antonio, Pasig (2021).
• Core Values - The association's vision: UNIFIED,
- Core values are the basis upon which the EMPOWERED and RECOGNIZED
members of a company make decisions, plan PROFESSIONALS responsive to the mental
strategies, and interact with each other and health needs of the Filipino people.
their stakeholders.
- Core values drive behavior and form ones ➢ Ang Nars Partylist
beliefs. - ANG NARS stands as one solid voice for
- Clarifying your personal values is the best gift nurses and health workers to be heard and
you can give yourself -the gift of inner peace, empower them to protect their rights and
a more meaningful life and understanding dignity to deliver safe and quality health care
your purpose. for Filipinos
- Core Values • American psychiatric nurses association
L Love (APNA) is a professional association organized
I Integrity exclusively for charitable, educational, and
F Fortitude scientific purposes.
E Excellence • It provides leadership to promote psychiatric-
- Headed by Congresswoman Leah S. Paquiz mental health nurses, improve mental health
care for culturally diverse individuals, families,
➢ National League of Nursing groups, and communities, and shape health
- The National League of Nursing promotes policy for the delivery of mental health
excellence in nursing education to build a services.
strong and diverse nursing workforce to
advance the health of our nation and the American Psychiatric Nursing Association Core
global community. Values
- Common core values of a Nurse according to 1. Empowerment
National League of Nursing - Empowerment is a state of mind that
 Caring influences our behavior. It gives the direction
 Professionalism of our destination and our purpose in life
 Respect - Core values that help build empowerment
 Integrity include - insight, focus, innovation, openness,
 Diversity tolerance, authenticity and knowledge.
 Excellence. 2. Inclusivity
- creating a culture of safety and acceptance -
• Nurses’ Core Values By this, employees will be more satisfied, do
1. Caring and enjoy their job efficiently and get results
- Promoting health, healing, and hope in for the organization.
response to the human condition 3. Integrity
2. Professionalism - The core values to integrity are honesty and
- Characterized by ones attire, behavior, trust.
attitude, and communication. It also includes - Integrity can be defined as the quality of
ones. timeliness, organization, and possessing and adhering to high moral
dedication. principles or professional standards.
3. Respect 4. Collegiality
- Treating all people with dignity and value the - Collegiality embodies all those behaviors that
collective power of teamwork. Demonstrating people outside the nursing profession
high regard for clients, for one another, espouse nurses for - kindness, compassion,
partners and regulatory obligations respect, teamwork and service to others
4. Integrity - Collegiality among nurses is an equal and
- Respecting the dignity and moral wholeness reciprocal relationship between members of
of every person without conditions or the profession.
limitation; - It supports our professional work, and aims to
5. Diversity: achieve a common objective - the best
- Affirming the uniqueness of and differences patient care possible.
among persons, ideas, values, and ethnicities. 5. Innovation
6. Excellence - Innovation in nursing fuels growth and
- Striving to do more and be great even if that progression within the profession and leads
means failures along the way. When we to new or improved resources that drive costs
deliver excellence, we give ourselves in a way down and advance nursing care and optimal
that exceeds our expectations and achieve patient outcomes.
the level of distinction. 6. Transparency
- Transparency is HONESTY, and it's a value
American Psychiatric Nurses Association (APNA) that every organization should have.
➢ Communication
➢ Sharing information homemaker services, in-home care, and
➢ Rationale companionship services.
➢ Embed the culture
7. Stewardship 2. Wellness Program
- Stewardship refers to every decision that a - Wellness program is a comprehensive health
person makes, how he/she chooses to use initiative designed to maintain or improve
his/her time, talents, and energies. It's where well-being through proper diet, exercise,
one draws the boundaries on his/her stress management, and physical-mental
commitments. illness prevention.
- Good stewardship allows any organization to
continually develop and adjust to an ever- Best Nursing Business Ideas for Nurse
changing world. Entrepreneurs (Samantha Acuna, 2019)
1. Nurse Health Coach
PART 4: Entrepreneurial Opportunities in - Nurse health coaches help clients live a
Psychiatric Mental Health Nursing Practice healthy, balanced lifestyle by teaching them
• Entrepreneurial Nursing in the Philippines how to take the best care of themselves. This
- Project initiated by the department of labor can involve a holistic approach that examines
and employment (DOLE) in collaboration with all aspects of their lives including medical,
DOH, OHNAP, BON-PRC, PNA and other mental, diet, work and environmental
government and non government entities to considerations.
promote nurse entrepreneurship by - The experience from being a registered nurse
introducing a home health care industry in is very useful for health and wellness
the Philippines. coaching."
The project aims to:
1. Engage unemployed nurses on cooperatives 2. Concierge Nursing Services
and entrepreneurial management of nurses' - Concierge nurses provide in-home care and
clinics customized nursing services for wealthy
- This offers reduced cost of primary and home patients who pay out of pocket for the
health care services to indigent or poor mural services.
communities. - These clients are often going through some
2. Encourage nurses to offer telehealth services medical/mental issue or treatment process
in their community and can afford to pay for the specialized
- This will help seniors, rural patients, and service they want.
those with different disabilities safely access - Concierge Nursing Services includes
the care they need. The care model allows ➢ Consultations
clients to register sessions on their own ➢ Home health services after surgery
schedule and providers to sign up for the ➢ Post op-travel services (flight nurse)
hours they want. ➢ Wellness support
3. Offer health care professional to offer ➢ Patient advocacy
collaborative rounding ➢ Respite care
- This allows patients continuity of care
between patient and therapy groups such as 3. Fitness Nurse
psychologists, social workers, and psychiatric - Fitness nursing is a relatively new area that
nurse practitioners. integrates physical exercise, wellness and
physical-mental disease prevention.
Entrepreneurial Opportunities in Psychiatric - A fitness nurse works with patients to develop
Mental Health Nursing Practice a customized nutrition plan and exercise
1. Home Health Care regimen to optimize clients' health and
- It is a care given to patients at home by recovery from injury or illness.
medically trained and licensed professionals.
- In-home care allows individuals to age in 4. Legal Nurse Consultant
place at home by offering custodial care,
- Legal nurse consultant (LNC) is a registered
nurse that analyzes medical cases, testimony,
and healthcare facts for legal cases. They help
lawyers evaluate evidence, prepare for
litigation and prove their cases.
- LNCS perform varied tasks including:
evaluating the strengths and weaknesses of a
case, preparing analysis and documents,
testifying as an expert witness and educating
legal staff.

5. Nurse Continuing Education Classes

- Nurses are required to regularly take
continuing education courses to stay current
on new nursing knowledge.
- Nurse educators can teach general courses or
specialize in specific areas such as psychiatric
nursing.

6. Nurse Blogging or Freelance Writing

- There are many areas to write about, such as
wellness, healthy living, nurse mom life and
nursing specialties. Developing a blog
readership can be challenging and generally
takes longer than one may think.
- As a nurse freelance writer, you would write
content for other websites, healthcare
organizations, publications and healthcare
businesses for a fee.

7. Specialized Care Provider

- The healthcare industry is massive with a vast
array of business opportunities for nurses.
Depending on their experience and interests.
➢ Telehealth nursing
➢ Mental Health Consulting Service
➢ In-home senior care
➢ Home care for mentally patients
Mindfulness and stress consulting
➢ Complementary and alternative care
services
➢ Holistic and alternative service