2.

INFORMAL LEADERS – do not hold a position in the

Leadership & Management: organization, but they can motivates members to
perform (Senior Staff; Charge Nurse)

MANAGEMENT – an art of getting things done with Styles of leadership:

and through the people so that the GOALS of the
organization can be achieved. 1. AUTOCRATIC – leader-focused (best time to use
during EMERGENCY because members are not
Any questions about MANAGEMENT, the answer capable of decision making)
will always be GOALS!!!
2. DEMOCRATIC – members have a voice in decision
making and the leader acts as a facilitator (best
LEADERSHIP – is the use of one’s skill (can be time to use is when YOU NEED THE COMPLIANCE of
learned) to influence others to perform to the best the members)
of their ability
3. LAISSEZ FAIRE – member-focused ( with leader but
Uses different tactics [AIR CUBES] decoration lang – access in MONITOR) (best time to
use when the members are MATURED enough and
Assertiveness – sending direct messages, standing when the manager is NEW to the unit)
up for your own rights w/o stepping the rights of
others 4. BUREAUCRATIC - book - based leader, there’s a
Ingratiation – making others feel good or look good hierarchy to follow along with rules and regulations
before making a request
Rationality – relying on a detailed plan, reason or CONTINGENCY THEORY – a leadership style may or
logic (using of reasoning) may not be effective depending on the situation

Coalition – backing up a request together w/ your AUTHORITY – legitimate right to give command;
co-member officially sectionized responsibility
Upward appeal – using the name of a superior
formally or informally POWER – the ability to obtain, retain, and motivate
Blocking (blackmail) – threatening somebody to other people to perform
damage his opportunity for advancement or not
being friendly to another person until he grants the Sources of power: [LR CCRIES]
request o Legitimate power – people who hold a position in
Exchange – reminding somebody previous favors or the organization
return of favors (utang na loob) o Reward power – ability to give incentives and
Sanction – either giving or preventing incentives, benefits
benefits, or promotions o Coercive power – to give fear or punishment
o Connection power – are the people you know
o Referent power – pertains to charisma
Types of leaders:
o Information power – people who knows
(maraming alam)
1. FORMAL LEADERS – holds a position in the
organization. o Expert power – the people who have special skills
and abilities
Three (3) LEVELS o Self power – emanates from self due to maturity,
• TOP level leaders – focuses on the organization; experience, or gender (self-confidence/ esteem)
monitors entire organizations (PRESIDENT, VICE-
P, Board of Directors, Chairman, CEO, Chief MANAGEMENT
Nurse, etc)
Functions of management:
• MIDDLE level leaders – coordinates with the top
and the first level leaders (supervisors,
• PLANNING – MEETING; knowing where you are
coordinators, dep heads, etc) *all
and where you want to be
communications will go through the supervisor
• FIRST level leaders – focuses on the operations 2 types of planning:
(Head Nurse/ Union Managers)
1. Strategic – long term planning (usually • Levels of authority – there should be a BOSS
implemented in 3-5 yrs), benefits the organization • Lines of communication – solid line & broken/
<TOP level leaders do this> dotted line
2. Operational – short term planning (usually
changed annually/yearly, weekly, daily) benefits Principle of management: SOLID LINE
the operations <FIRST level leaders do this> • Direct relationship
SWOT analysis (Strength, weaknesses, opportunities, • Superior-subordinate relationship
threat) o UNITY OF COMMAND (there is only one person
Planning formula – what, where, when, who, how who could give orders: immediate superior)
(meeting) o SCALAR CHAIN (chain of command) – follow the
1. What action is necessary? hierarchical order (reporting relationship →
2. Where will it take place? immediate superior) if there’s a complain:
3. When will it take place? address the complaint to the immediate
4. Who will do it? superior of the person you are complaining
5. How will it be done?
Principle of management: BROKEN LINE
Tools in planning/ Hierarchy: • Indirect relationship
• Represent a coordinated relationship
1. Mission (reason for existence) and Vision (the
agency wants to achieve; futuristic) • Span of control – number of workers that directly
2. Philosophy – statements of beliefs, values, and report to a superior OR the number of workers
principles that the superiors handles
3. Goals – general statements of aims and
purposes MAJOR FORMS OF ORGANIZATION
1. Centralized model – there’s only one person
4. Objectives – specific statements of aims and (boss) who has the responsibility for decision making
purposes that are used to carry out the goals Advantages: Cost effective
5. Policies – are plans reduced to statements that Disadvantages: Cannot obtain quick decisions
help the organizations in decision making. <not
subject to regulations; general application 2. Decentralized model – the bigger organization is
(everybody is affected)> broken down into smaller units and the responsibility
6. Procedures – step by step instructions for decision making is delegated to the ones nearest
the majority of the workers.
7. Rules – guidelines for action and non-action.
Advantages: many ideas (greater imagination &
<subjected to regulations> employees are
better creativity); communication departmental
affected and interdepartmental
Disadvantages: More expensive and there’s danger
BUDGET – systematic way of meeting with the
of breakdown in communication and problem w/
expenses. FOCUS OF BUDGET: Revenues (income)
role communication
and expenses (costs)

Four (4) common types of budgets: Job description = WORK

1. Capital expense budget – usually expensive; it is • termed as performance responsibility; spells
for long term use out the precise job content
2. Operational – the day-to-day expense
3. Personnel budget – salary of full time employees/ Purpose of job description:
full time equivalent; prepared ahead of time • prevents malpractice
4. Cash budget – available all the time for • used for delegation
emergency purpose <EMERGENCY FUND; CASH ON • used for evaluation
HAND> • used for staffing (assigning of competent
people to fill the roles of the organization)
• ORGANIZING – establish a formal structure of the Malpractice - used for professionals who failed to
organization and create the job qualification execute their duty/oath
and job description Negligence - used for unprofessional/ unlicensed
who are careless in duty
Purpose of the organizational structure: WORK
DISTRIBUTION Staffing process
Four (4) Methods of staffing
Elements of organizational structure:
 1. Conventional – oldest method (either • to promote the quality of life
centralized or decentralized); no system • to decrease fragmentation →
followed, based on the manager’s decision decrease isolation
2. Cyclic – the schedule repeats itself (manager • to contain costs
creates a base schedule) § Nursing homes <ex. Music therapy;
3. 40 hours – 8hrs a day, 5 days a week, with 2 occupational therapy>
days off; mandated in the PH and is supported § Focuses on long term treatment
in PD442 (labor code)
1. Employee can work for 6 days but it’s • DIRECTING – issuance of orders assignments and
considered as overtime <BEFORE instructions
PANDEMIC>
2. Code is not applicable <DURING Two (2) aspects
PANDEMIC> 1. Technical aspect
4. 7 days – min. of 10 hrs a day for 7 days a week, • Includes tasks, procedures, materials, and
followed by 7 days off <DURING PANDEMIC> equipment
• If incompetent: show them the procedures,
teach, demonstrate, supervise,
do/performing with a nurse
NURSING CARE SYSTEMS (AKA: modalities of nursing 2. Interpersonal aspect
care; patterns of nursing care) - system that is used • Includes attitudes, behaviors, and styles of
to deliver nsg. care direction giving
• If attitude and behavior is the
1. Case method/ Total care nursing problem: verbalization of feelings
o Oldest method • Styles of direction giving = Assertiveness
o Responsible for the total patient care (therapeutic)
o Nurse to patient ratio is 1:1
o Can be used in private nursing Four (4) pointers in delegation “WHAT & WHO” in
o Ideal to be used in ICU delegation
2. Functional nursing 1. Position of the staff – know if licensed or unlicensed
§ Tasks are delegated among the staffs (BP 2. Ward – know where did they come from and
monitoring, medication, hygiene) where they’ll be assigned to
3. Team nursing 3. Capabilities of the staff – will depend on the
§ Group of nurses assigned to a group of position and the ward
patients wherein there is a team leader 4. Condition of the patient
§ Ideal for pediatric ward
4. Primary nursing Communication – sending of messages from sender
§ 24 hour continuous coordinated to receiver and vice versa, hoping what is being
comprehensive nursing service of 5-6 sent is understood
patients from admission to discharge.
§ Nurse to patient ratio is 1:5 or 1:6 Five (5) elements of communications:
§ Ideal to be used in the ward 1. Message
§ Primary nurse 2. Encoding - Typing
• Responsible for Nursing Care Plan 3.Transmitting - via the channels of
§ Associate primary nurse communication/ mode of transmission
• Responsible for the patient after the 4. Decoding
primary nurse’s shift 5. Feedback/ action - will vary depending on the
• Cannot change NPC except if there receiver
are changes in the patient's condition.
Must report it to the primary nurse first. Barriers in communication – common hindrances
5. Modular nursing are the following:
§ Combination of team and primary nursing 1. Physical barrier: environmental (i.e. noise,
§ there is geographical assignment of distance)
patients with same disease condition 2. Socio Psychological barrier – relationship with
§ best to use during calamities, pandemic, other people but also includes the mind (i.e. lack of
endemic TRUST, echolalia)
6. Case management/ nursing case 3. Semantic barrier – common, misinterpretation of
management signs and symbols
§ Utilizing the health care delivery system
wherein the goals are:
• to deliver quality care
Grapevine communication/ Chismis BON RESOLUTION 220, SERIES OF 2004 = CODE OF
• 75% accurate ETHICS
• Beneficial because it gives manager an
opportunity to solve the problem 3. Implement the plan one step at a time (gradually)
immediately – to prevent RESISTANCE

Conflict – misunderstanding or disagreement 4. Evaluate the overall results – determine if

between two or more persons, agencies, or effective. Two (2) aspects: Technical and
organizations. interpersonal

Conflict resolutions strategies

1. Avoidance – “let us not talk about it” • CONTROLLING /evaluating/ reviewing/
2. Dominance & suppression – “I am the manager checking/ determining/ comparing – seeing to it
here; you have no choice” that what is planned is done.
3. Restriction/ power – “I am the manager here; I will Controlling = Standard
do what is best for everybody”
4. Majority rule – “let us divide the house” – voting
Four (4) BASIC STEPS
5. Smoothing – the unacceptable appears to be
acceptable
6. Compromise – meeting halfway
7. Collaboration – working hand-in-hand in solving 1. Develop standards and criteria – standard is the
the problem. Brainstorming. All are giving predetermined level of care. Criteria are the
suggestions; all ideas are welcome! characteristics used to meet the level of care.

Basis for evaluation: standards & criteria

Reporting is automatically wrong when the
question is about problem-solving (Manager has Standard – always the best answer; standard of
no participation) evaluation!

Three (3) types of standards: [SPO]

Four (4) approaches in problem solving: 1. Structure – includes facilities, equipment,
(Manager – Members) materials, and management system (manager)
1. Win-lose approach – able to solve the problem at 2. Process – includes plans and procedures (nurse)
the expense of others (dominance & suppression) 3. Outcome – pertains to results
2. Lose-win approach – able to solve problem at
your own expense, restriction/ power (Smoothing) 2. Determine compliance to standards and criteria –
3. Lose-lose approach – both parties sacrifice in the evaluation
solution of the problem (Compromise)
4. Win-win approach – both parties benefit from the Two (2) types of evaluation:
solution of the problem (Collaboration, majority rule)
1. Nursing audit (patient-focused)
Change management – any alteration in the status Two (2) types of nursing audit:
quo a. Concurrent – (current) evaluate as the
Status quo – present situation (nakasanayan) care is given
b. Retrospective – (past) source of
evaluation is the patient chart
CHANGE PROCESS

2. Performance appraisal (staff-focused)

1. Perceive the need to change – need to identify/ Two (2) types of performance appraisal:
determine the problem a. Informal – the incidental performance
appraisal
2. Initiate a group interaction – bring the group b. formal – systematically done and usually
together, meeting with the group (key to problem ends in a review session.
solving)
Information = patient owned
If the problem concerns the group: confront the Document = hospital owned
group! If one single employee: confront the
employee. 3. Identify strengths and weakness
4. Act to reinforce the strength and take corrective a. Operational definition – define the variables
action for the weaknesses. on how they were used in the study
How to correct a weakness? Two (2) aspects: b. Conceptual definition - found in research
technical or interpersonal material
Framework - graphical representation of concepts
and relationship of concepts.
Research Two (2) types of framework:
a. Conceptual framework – relates topic to
Scientific method – informal way to discover new concept
things b. Theoretical framework – relates topic to
Research – more formal, intensive, and theory
comprehensive method for the discovery of new 5. Formulating the hypothesis
knowledge
Phase II: DESIGN AND PLANNING PHASE - Spend
Types of research most of the time in research
6. Selecting the research design
1. Nursing research – deals with clinical problems 7. Developing the protocols for the intervention
encountered in clinical duty (optional) – usually used in experimental research
2. Research in nursing – “more” broader study of (since it is the only one with manipulation &
nursing and the profession (historical, social, intervention)
professional issue, etc) = focuses more on issues 8. Identifying the population to be studied (can be
3. Evidence-based practice – use of the current skipped)
(latest) best evidence (findings) 9. Designing the sampling plan
10. Specifying the method on how to measure
Importance of research: research variables
11. Developing a method (tools/ instruments for
1. Professionalism: enhance the profession data collection) on how to safeguard human/
2. Accountability: increase accountability animal rights (rights of the research subject)
3. Social relevance of nursing: contribute something 12. Reviewing & finalizing the plan
to the country
4. Mainly for research and decision making: make Phase III: EMPIRICAL PHASE - longest phase in
new discoveries to come up with good decision
research
13. Collecting the data
14. Preparing the data for analysis
Ultimate (highest) goal of research:
- Improve the practice of the profession/ client Phase IV: ANALYTIC PHASE - analyze data and
care/ patient care/ health care/ nursing care interpret
15. Analyzing the data
16. Interpreting the results

Sources of knowledge: (TALES) Phase V: DISSEMINATING PHASE - communicate the

Tradition – stories that has been passed one finding
generation to another 17. Communicating the findings
Authority – people who are considered experts 18. Utilizing the findings into practice
Logical reasoning - use of logic reasoning
Experience/ trial & error - learn from mistakes RESEARCH PROBLEM
Scientific method - experiment Sources of research problem [NITESS]
NURSING LITERATURE – magazine, website,
5 MAJOR STEPS OF THE RESEARCH PROCESS newspaper
IDEAS FROM EXTERNAL SOURCES – suggestion or idea
Phase I: CONCEPTUAL PHASE - Look for appropriate
from other people
topic
THEORY – could be an existing theory/ your own
1. Formulating and delimiting the problem theory
2. Reviewing related literature - know your variable; EXPERIENCE & CLINICAL FRAMEWORK – richest in
computer search. FOCUS: to get an idea or information (could be from your experience)
background about the study SOCIAL ISSUES – issues in the society
3. Undertaking the clinical fieldwork - Same purpose SCIENTIFIC RESEARCH – previous researches
as RRL (innovation and modification) used least – DON’T
4. Defining the framework & conceptual definitions
USE THIS AS AN ANSWER
CRITERIA OF A GOOD RESEARCH PROBLEM [SALTLIN] INTEREST OF RESEARCHERS
SIGNIFICANCE OF THE STUDY: address it to the NOVELTY: newness/ freshness of the idea
people, to society, to profession
AVAILABILITY OF THE SUBJECTS BEST STATEMENT OF THE PROBLEM
LIMITATIONS OF THE SUBJECTS: (i.e. no read no write)
TIME ALLOTMENT & RESEARCH ABILITY 1. Brief: SHORT
LIMITATIONS OF TOOLS 2.Concise: INDEPENDENT & DEPENDENT VARIABLE
3. Specific: INDICATE WHAT YOU’RE TRYING TO
Major Forms of data collection PROVE (i.e. Relationship, Effect, Difference)

1. Use of existing data (Use of something already HYPOTHESIS

available data): Any forms of records reports and • scientific guess
document • tentative prediction of the relationship
between variables
2. Self-Reports (interviews & questionnaires): usually
used to gather data (either oral or writing) Four (4) parts of hypothesis:
• can gather data that cannot be gathered
by other methods 1. Independent variable (cause) = FIXED
• usually gathers opinions 2. Dependent variable (effect) = CAN VARY
• can jump one question to another (flexible & 3. Relationship
versatile) 4. Population to which it applies
• Most crucial disadvantage: validity &
accuracy Cause and effect:
3. Observation – can either be a participant or non- 1) POPULATION – include all their characteristics [Put
participant a box]
• Best to elicit emotions 2) SET – 2 or more sets of population = concentrate
• Participant Observer: they give intervention on the characteristics that differentiate the
and observe the participant population [FOCUS ON THE BOX!]
• Non-participant observer: not going to give CHARACTERISTICS – difference = INDEPENDENT
intervention, JUST A PLAIN OBSERVER VARIABLE
3) DEPENDENT VARIABLE → varies on the population
Phenomena – circumstances where observation is 4) IF THERE’S ONLY ONE SET!! – eliminate
used in data gathering characteristics
Go back to the hypothesis/ study & ask: “what is
Phenomena amenable to observation being studied”
1. Characteristics and the condition of the subjects 5) EXPERIMENTAL – manipulation (anything that is
2. Activities and behavior of the subjects (highly given)
observable) ALL MANIPULATION IS INDEPENDENT VARIABLE
3. Skill attainment and performance
4. Environmental characteristics – ex. newscasters TYPES OF RESEARCH:
5. Verbal communication I. According to motive – purpose why you are doing
6. Non-verbal communication research
1. Pure/ Basic Research – increase knowledge
4. Biophysical Measurements – use of elements and 2. Applied Research – to use the knowledge
gadgets; physiological measurement. into practice
A. In-vivo – measurement is performed directly
in the subject II. According to the level of investigation
B. In-vitro – movement perform outside Level 1: Exploratory – wanted to identify the
(laboratory) variables
CRITERIA TO KNOW THE EFFECTIVITY OF THE TOOL: • LOOKING FOR OPINION – “quality” or if the
a. Validity – able to measure what is supposed to be research wanted to get “census”
measured
b. Reliability – consistency or the repeatability of the Level 2. Descriptive – to know whether the
tool variables are associated or related
c. Sensitivity – able to detect small variations or fine “DESCRIBE, RELATIONSHIP, SIMILARITIES/
differences DIFFERENCE, FACTS, & ISSUES, STUDY, ANALYSIS”
a. Descriptive – describe variables as it is; plain
Combination of tools if not all criteria are met descriptive research
 b. Descriptive-correlational – wanted to b. quasi-experiment – “quasi”, just-like true
describe the relationship of the variables to experimental:
each other 1. There’s control over the variables
c. Descriptive comparative – compare the 2. Lacks randomization
variables to each other
QUASI IS ALWAYS AN OPTION BUT IS RARELY THE
Level 3. Experimental – to find out the cause and ANSWER
effect of the variables to each other
“EFFECT, MANIPULATION”
IV. According to time frame
FIND THIS IN THE QUESTION
Types of research according to time frame:
A. Cross Sectional – one time study
1. If the study is looking for OPINION = exploratory B. Longitudinal – repetitive studies
(survey) C. Retrospective studies – study of the past to
2. If there is MANIPULATION = experimental explain the present
3. If no manipulation, DESCRIPTIVE (Historical, D. Prospective – study of the present to predict the
Case study, Methodological, Analytical) future

III. According to DESIGN POPULATION - Entire aggregate of cases that the

researcher would like to study
Two (2) types of research:
1. Non-experimental research a. Eligibility criteria: exact criteria to narrow down
the population
a. Historical – study of the past issue b. Accessible population - within the reach of the
b. Survey – use of interviews and questionnaires researcher
to gather public opinion c. Target population/ universe - entire aggregate
c. Case study – in depth/ detailed study of of cases that researcher will like
persons or entities generalization
d. Methodological – study of methods, tests, d. Sampling - process used to get representative of
and procedures population; Sample = Representative
e. Analytical – further analysis of issues and
events in the present Characteristics of sample
Representativeness/ representation
2. Experimental research – with manipulation
Sampling plan
a. true experiment – there’s strict control over
Non - probability Probability sampling
the variables sampling (non- (random; more
random) accurate)
Elements of experimental research
(ALL should be present) a. Convenienc a. Simple random
A. Randomization e / accidental sampling - everybody
B. Manipulation sampling - has a chance to
C. Controlled sample are sample <i.e. draw lots>
readily
EXPERIMENTAL CONTROL GROUP available
GROUP
b. Stratified sampling -
b. Quota sampling
create a strata of
- get proportion
population and
EXPERIMENTAL PLACEBO (without therapeutic of population
then divide the
MANIPULATION effect) = give if there is no population into
comparison <i.e. PNSS, Sugar, c. Purposive /
homogeneous
Sterile water> judgmental
(same)
sampling -
OTHERS INTERVENTIONS = give sample are
if there is comparison <i.e. hand picked of
Music Therapy, Cherifer, the researcher c. Cluster sampling -
Vitamins> (big group)
d. Snowball successive random
Double blind = both researchers and participants sampling - sampling of the unit
are unaware which intervention is given until the networking/ (no characteristics)
clinical trial is over. referral system
 • Assignment of number according to rules
d. Systematic
sampling
- get kth of list 1. Nominal data (categorical): name
K = N (population category <i.e. GENDER>
size)/n (sample size) 2. Ordinal data (categorical): ranking of the
events <i.e. 1st, 2nd…, Good, better, best>
3. Interval data (numerical): show ranking of
Slovin’s formula
the events with equal intervals and zero is not
[n = N/ 1 + Ne ]
2

e → margin of error
absolute (zero is possible). <i.e. temperature>
Ne → SOLVE FIRST
2
4. Ratio data (numerical): show equal ranking
of events with equal intervals and zero is absolute
(no zero but negative is possible). <i.e. weight ,
Four (4) basic rights of research subjects
Height>
1. Right not to be harmed
1. Beneficence (To do)
ANALYTIC
2. Non- maleficence (To prevent/
Two (2) types:
protect)
1. Descriptive analysis: Summarize data; does not
prove your hypothesis
2. Right to FULL disclosure
1. Frequency of distribution - use of
a. Veracity (Truthfulness/ Honesty)
table and graphs
3. Right to self determination Table and graphs - the one who communicates to
a. Autonomy (Self governance): Patient right; the leaders
accept refusal b. Measure of central tendency - includes mean
Priority: DOCUMENT! → Then report to MD (average), median (middle: add the highest
and lowest), mode (high frequency)
4. Right to anonymity/ confidentiality and c. Measure variability - simple rank, range,
privacy variants of standard deviation
a. Anonymity (Anonymous) - cannot disclose
the name of subject to protect identity 2. Inferential Statistics
b. Confidentiality - cannot disclose any a. ANOVA (Analysis of Variance) - 3 or more set
information/ case subject; those who are population to compare 1 variable
professionally and directly involve are only allowed b. Chi-square - 1 set of population vs 2 or more
by the law variable is focused on frequency
c. T-Test
Court orders i.Student: 2 set of population = 1 variable
Subpoena duces tecum ii.Paired: 1 set of population = dependent group/
• Court order to asking the person appear to result, twins/triplets
bring the records, documents, reports within iii.
his control TO UNDERSTAND
Subpoena ad testificandum Population → focus on the set
• Court order asking to appear in court to
testify d. Pearson R - Like chi-square
1 set = 2 or more variable; focused on interval and
Two (2) types of witness ratio data
1. Ordinary - testify the court or formal
knowledge (subject in senses)
2. Expert witness - who are going to testify
under their profession

PRIVACY
• Private movements, parts, property

Private moments: Give moment to themselves

Private property
• Nurse-patient relationship
• Picture of patient

LEVELS OF MEASUREMENT