MODULE

NCM 119 Nursing Leadership and Management

2

NURSING
LEADERSHIP
AND
MANAGEMENT

AUTHOR

Ma. Teresita F. Cerapion RN, MAN

2 | Page
 MODULE
NCM 119 Nursing Leadership and Management
2

MODULE 2
MANAGEMENT FUNCTIONS

NCM 119
www.urs.edu.ph

To the University of Rizal System Student:

Welcome to NCM 119 which has a course title of Nursing Leadership and Management. This
course deals with the concepts, principles, theories and methods of developing nursing leaders and
managers in the hospital and community-based settings. It also includes ethico-moral and legal aspects
of health care and nursing practice and nurses’ responsibilities for personal and professional growth.

I am Ma. Teresita F. Cerapion, RN, MAN, your Course Coordinator for NCM 119 Nursing
Leadership and Management. I am an Assistant Professor I in the College of Nursing, having a degree of
Bachelor of Science in Nursing from Chinese General Hospital College of Nursing, and Master of Nursing
Administration from Philippine College of Health Sciences, Inc. should you wish to get in touch with me,
please connect at materesitacerapion@urs.edu.ph

Should you wish to get in touch with me, please connect at materesitacerapion@urs.edu.ph

3 | Page
 MODULE
NCM 119 Nursing Leadership and Management
2

Course Code : NCM 119

Course Title : Nursing Leadership and Management
Credit Units : 7 units
Time Allotment : 4 hours lecture, 3 hours laboratory
Course Pre-requisites : NCM 100—NCM 117
Co-Requisites : NCM 118, NCM 120

Course Description:

This course deals with the concepts, principles, theories and methods of developing nursing leaders
and managers in the hospital and community-based settings. It also includes ethico-moral/legal
aspects of health care and nursing practice and nurses’ responsibilities for personal and professional
growth.

Course Structure:

The course NCM 119 consists of four instructional units divided into 9 modules, namely:

CONTENT WRITER
Unit 1 – Aspects of Management and Leadership
Ma. Teresita F. Cerapion
Module 1- Management
A. Definition/description
B. Universal principles of management
C. Theories of Management
D. Management Process
 Roles that managers fulfill in an organization
E. Strategic planning process
 Vision/Mission/Philosophy/Objectives/Core
Values
F. Standards of nursing practice

4 | Page
 MODULE
NCM 119 Nursing Leadership and Management
2

Module 2- Management Functions

A. Planning
B. Organizing
 Organizational structure
 Staffing (Selection, Orientation, Job Description)
 Patient classification system
 Scheduling
 Modalities of care:
a. Case method
b. Primary nursing
c. Team nursing
d. Modular nursing
e. Functional nursing
f. Modified nursing

Unit 2 – Leading and Budgeting

Module 3- Directing/Leading
A. Leadership theories
B. Leadership styles
C. Leadership skills
 Case analysis
 Decision-making
D. Bases for power
E. Principles of delegation
F. Communication
G. Motivation theories
H. Time Management
I. Conflict Management

Module 4- Controlling of Budgeting

A. Types of Budgeting
B. Costing of nursing services
C. Performance evaluation/ Appraisal
D. Staff development

5 | Page
 MODULE
NCM 119 Nursing Leadership and Management
2

E. Quality improvement / Quality management

 Nursing audits and rounds
 Variances reports
 Solutions to Identified problems

Unit 3- Nursing Aspects: Ethico-moral, Legal, and Others

Module 5- Professional and Personal Development

A. Ethico-moral aspects of nursing
 Code of Ethics for Nurses in the Philippines
 International Council of Nursing (ICN) Code of
the Ethics for Nurses
B. Legal aspects of Nursing
 RA 9173 or The Nursing Act of 2002
 Legal Responsibilities of Nurses

Module 6- Other Laws affecting Nursing Profession

A. Magna Carta for Public Health Workers
B. Labor Code
C. Rooming In and Breastfeeding Act
D. Milk Code
E. Senior Citizens Act
F. Sexual Harassment
G. Clean Air Act
H. Local Government Code
I. Dangerous Drug Act

Unit 4- Programs and Seminars in Nursing and Health-Related

Fields

Module 7- Government and Non-Government Programs

A. Community-organization-definition, principles and
mechanics
B. Leadership training principles and process
C. Specific programs and projects of DOH
D. Evaluation of programs and services

6 | Page
 MODULE
NCM 119 Nursing Leadership and Management
2

Module 8- Recording and Reporting System

A. Vital statistics
B. Notifiable disease
C. Services provided to a family and community

Module 9- Seminar on Issues and Trends in Nursing And

Health-Related Fields
A. Planning
 Identify issues and trends
 Map out priority/relevant issues and trends
 Assign specific topics to perspective groups
 Prepare schedule for the seminars
 Formulate objectives for seminars
B. Organizing/Leading
 Identify working committees for the seminar
 Define functions of each committee
 Assign committee member
 Delegate functions and responsibilities to the
committee member
 Prepare schedule for activities
C. Controlling
 Prepare budget for the seminar
 Develop and evaluation tool
 Monitor Implementation of the
 Scheduled activity
 Post-seminar evaluation

Course Outcomes:

At the end of the course, the student shall be able to:

1. Discuss principles of leadership and management.

2. Apply the principles learned in organizing and conducting a seminar.

7 | Page
 MODULE
NCM 119 Nursing Leadership and Management
2

Course Schedule:

8 | Page
 MODULE
NCM 119 Nursing Leadership and Management
2

MANAGEMENT PROCESS: PLANNING

Planning is critically important to and precedes all other management functions. Without
adequate planning, the management process fails and organizational needs and objectives cannot
be met. Planning may be defined as deciding in advance what to do; who is to do it; and how, when,
and where it is to be done. Therefore, all planning involves choosing among alternatives.

In effective planning, the manager must identify short- and long-term goals and changes
needed to ensure that the unit will continue to meet its goals. Identifying such short- and long-term
goals requires leadership skills such as vision and creativity because it is impossible to plan what
cannot be dreamed or envisioned.

Management Functions Associated with Organizational Planning:

1. Is knowledgeable regarding legal, political, economic, and social factors affecting

health-care planning
2. Demonstrates knowledge of and uses appropriate techniques in both personal
and organizational planning
3. Provides opportunities for subordinates, peers, competitors, regulatory agencies,
and the general public to participate in organizational planning
4. Coordinates unit-level planning to be congruent with organizational goals
5. Periodically assesses unit constraints and assets to determine available resources
for planning
6. Develops and articulates a unit philosophy that is congruent with the
organization’s philosophy
7. Develops and articulates unit goals and objectives that reflect unit philosophy
8. Develops and articulates unit policies, procedures, and rules that put unit
objectives into operation
9. Periodically reviews unit philosophy, goals, policies, procedures, and rules and
revises them to meet the unit’s changing needs
10. Actively participates in organizational planning, defining, and operationalizing
plans at the unit level

9 | Page
 MODULE
NCM 119 Nursing Leadership and Management
2

Four Planning Modes

1. Reactive planning occurs

after a problem exists.
Because there is
dissatisfaction with the
current situation, planning
efforts are directed at returning the organization to a previous, more
comfortable state. Frequently, in reactive planning, problems are dealt with
separately without integration with the whole organization. In addition,
because it is done in response to a crisis, this type of planning can lead to hasty
decisions and mistakes.
2. Inactive planning is where inactivists seek the status quo, and they spend their
energy preventing change and maintaining conformity. When changes do
occur, they occur slowly and incrementally.
3. Preactive planning involves preactive planners who utilize technology to
accelerate change and are future oriented. Unsatisfied with the past or
present, preactivists do not value experience and believe that the future is
always preferable to the present.
4. Interactive or proactive planning is where planners who fall into this category
consider the past, present, and future and attempt to plan the future of their
organization rather than react to it. Because the organizational setting changes
often, adaptability is a key requirement for proactive planning. Proactive
planning occurs, then, in anticipation of changing needs or to promote growth
within an organization and is required of all leader-managers so that personal
as well as organizational needs and objectives are met.

10 | Page
 MODULE
NCM 119 Nursing Leadership and Management
2

Strategic Planning Tools

1. SWOT Analysis
 One of the most commonly used in health-care organizations is SWOT analysis
(identification of strengths, weaknesses, opportunities, and threats).
 SWOT analysis, also known as TOWS analysis, was developed by Albert Humphrey at
Stanford University in the 1960s and 1970s.

Strengths are those internal attributes that help an organization to achieve

its objectives.

Weaknesses are those internal attributes that challenge an organization in

achieving its objectives.

Opportunities are external conditions that promote achievement of

organizational objectives.

Threats are external conditions that challenge or threaten the achievement

of organizational objectives.

2. Balanced Scorecard
 Balanced scorecard, developed by Robert Kaplan and David Norton in the early 1990s,
is another tool that is highly assistive in strategic planning.
 Strategic planners using a balanced scorecard develop metrics (performance
measurement indicators), collect data, and analyze that data from four organizational
perspectives: financial, customers, internal business processes (or simply processes),
and learning and growth.

11 | Page
 MODULE
NCM 119 Nursing Leadership and Management
2

Although SWOT and balanced scorecard are different, they are also similar in that they can help
organizations assess what they do well and what they need to do to continue to be effective and

1. Clearly define the purpose of the organization.

2. Establish realistic goals and objectives consistent with the mission of the organization.

3. Identify the organization’s external constituencies or stakeholders and then determine their
assessment of the organization’s purposes and operations.

4. Clearly communicate the goals and objectives to the organization’s constituents.

5. Develop a sense of ownership of the plan.

6. Develop strategies to achieve the goals.

7. Ensure that the most effective use is made of the organization’s resources.

8. Provide a base from which progress can be measured.

9. Provide a mechanism for informed change as needed.

10. Build a consensus about where the organization is going.

financially sound. Regardless of the tool(s) used, strategic planning as a management process
generally includes the following steps:

MANAGEMENT PROCESS: ORGANIZING

In the organizing phase, relationships are defined, procedures are outlined, equipment is readied,
and tasks are assigned. Organizing also involves establishing a formal structure that provides the
best possible coordination or use of resources to accomplish unit objectives.

12 | Page
 MODULE
NCM 119 Nursing Leadership and Management
2

Formal and Informal Organizational Structure

1. Formal Structure- through departmentalization and

Organizational structure- the way
work division, provides a framework for defining in which a group is formed, its
managerial authority, responsibility, and lines of communication, and its
means for channeling authority
accountability. In a well-defined formal structure, and making decisions.
roles and functions are defined and systematically
arranged, different people have differing roles, and rank and hierarchy are evident.
2. Informal Structure- is generally a naturally forming social network of employees. It has its
very own form of communication called the grapevine which defined as conversations that
occur in the break room, down the halls, during the carpool, and in between work that
allows the relationships of informal groups to develop. More so, social media sites
(Facebook, Instagram, Snapchat, Twitter, etc.) and electronic communication such as e-mail
and text messages are also used to facilitate communication among informal group
members.

Management Functions Associated with Organizational Structure:

1. Is knowledgeable about the organization’s internal structure, including personal

and department authority and responsibilities within that structure
2. Facilitates constructive formal group structure
3. Provides the staff with an accurate unit organization chart and assists with
interpretation
9. 4.Uses the informal
When possible,organization to meet
maintains unity organizational goals
of command
10. 5.Uses committee
Clarifies unitystructure
of commandto increase the quality
when there and quantity of work accomplished
is confusion
11. 6.Works, as appropriate,
Follows appropriateto achieve a level
subordinate of operational
complaints upward excellence
through the befitting
chain ofan
organization
commandthat would be eligible for Magnet status or some other recognition of
7.excellence
Establishes an appropriate span of control
12. 8.Continually
Strives toidentifies, analyzes, andorganizational
create a constructive promotes stakeholder interests
culture and positivein the
organization
organizational climate

13 | Page
 MODULE
NCM 119 Nursing Leadership and Management
2

Components of Organizational Structure

 Max Weber was credited for the development of the organization chart to depict an
organization’s structure.
 An organization chart can help identify roles and their expectations and define formal
relationships within the institution.

Example of hospital organization chart from: https://www.phc.gov.ph

Elements of an Organization Chart:

 Solid horizontal lines represent communication between people with similar spheres of
responsibility and power but different functions.
 Solid vertical lines between positions denote the official chain of command, the formal paths
of communication and authority.
 Dotted or broken lines on the organization chart represent staff positions.

14 | Page
 MODULE
NCM 119 Nursing Leadership and Management
2

o Chain of command refers to a formal line of authority from the top to the
bottom of the organization. Each unit is connected to another, and reporting
relationships are hierarchical.
o Unity of command suggests that each individual employee is accountable to
only one manager, with expectations clearly defined and well understood.
o Span of control defines a manager’s scope of responsibility and reflects the
number of employees who report to a given manager.

Centralized and Decentralized Organization Structure

 A centralized structure, often

referred to as tall (or
hierarchical), is one in which
the authority for decision
making is held by a few
individuals at the top level of
management.

15 | Page
 MODULE
NCM 119 Nursing Leadership and Management
2

 In a decentralized structure, often

referred to as flat, authority and
power for decision making are
shared by a number of individuals
across the organization.

Staffing (Selection, Orientation, Job Description)

Selection is the process of choosing from among applicants the best qualified individual or
individuals for a particular job or position.

 This process involves:

a. verifying the applicant’s qualifications
b. checking his or her work history
c. deciding if a good match exists between the applicant’s qualifications

Orientation activities focus for the job position which help the employees by providing hem with
information that will smooth their transition into the work setting.
 This process may include:
a. a tour of the hospital and all of the induction items
b. presentation of aspects of concern of employees such as fire safety, accident
prevention, and health promotion
c. an individual orientation for each health department

Job description or placement requires a proper work for it helps an employee to be assigned a
position within his or her sphere of authority and achieve success.

 Proper placement may be beneficial in many ways including:

16 | Page
 MODULE
NCM 119 Nursing Leadership and Management
2

a. fostering personal growth

b. providing a motivating climate for the employee
c. maximizing productivity
d. increasing the probability that organizational goals will be met

Patient Classification System

 A patient classification system (PCS) predicts patient Patient acuity represents how
needs and requirements for nursing care. patients are categorized
 Patient classification systems are tools used to according to an assessment of
determine staffing based on patient acuity. Typically, their nursing care needs
patients with more acute conditions or sicker (Harper & McCully, 2007).
patients receive higher classification scores to
indicate that they need more direct nursing care.
 A PCS groups patients according to acuity of illness and complexity of nursing activities
necessary to care for the patients. Typically, patient acuity data are collected every shift by
nursing staff and are analyzed to project nursing staff needs for the next shift.

PCS’ Advantage PCS’ Disadvantages

a. provides an objective approach to a. lack of standardization

determining staffing based on b. lack of credibility among nurse leaders
patient care needs and managers
c. no consideration of patient flow

 Although there are commercial PCSs for purchase, many health-care organizations design
their own. Regardless of the type of PCS used, it must be reliable and valid.

Scheduling

- Nurse leaders and managers must ensure that appropriate staff members are scheduled
during each shift each day to provide safe and quality nursing care.

17 | Page
 MODULE
NCM 119 Nursing Leadership and Management
2

- A staffing plan describes the number and type of nursing staff needed from shift to shift and
from day to day.
- Nurse leaders and managers are responsible for creating and sustaining a healthy work
environment that promotes healthy work schedules.
- The American Nurses Association (2014) offers the following evidence-based strategies that
nurse leaders and managers can use to prevent nurse fatigue:
● Limiting shifts nurses work to no more than 12 hours in 24 hours and no more than 40
hours per week
● Conducting regular audits to ensure that safe schedule policies are followed
● Ensuring that nurses are able to take scheduled meal and rest breaks
● Establishing policies to allow nurses to take naps during long shifts
● Supporting nurses’ decisions to decline working extra shifts or overtime without penalizing
them

Patient Modalities of Care

- Care delivery models are used to organize and deliver nursing care and focus on structure,
process, and outcomes.
- They serve to drive assessments, decisions, planning, organization, and evaluation of
structures, processes, and outcomes.

1. Case Method
- Case method, also known as Total patient care, is the oldest model of care delivery. At the
turn of the 20th century, nursing care took place in the patient’s home. The nurse was
responsible for complete nursing care of the patient as well as other duties, such as cooking
and cleaning.
- In the total patient care method, often used in settings such as critical care and hospice care,
the nurse provides holistic care.

2. Primary Nursing
- Developed in 1968, primary nursing brought the RN back to the bedside. Initially, this model
was developed for inpatient units on which an RN managed care for a group of patients for
24 hours a day, 7 days a week throughout their hospital stay (Manthey, 2009).

18 | Page
 MODULE
NCM 119 Nursing Leadership and Management
2

- It fosters a strong relationship between the nurse and the patient and his or her family
because much of the decision making occurs at the bedside.

3. Team Nursing
- In team nursing, licensed and unlicensed personnel collaborate to deliver total care for a
group of patients under the direction of a team leader.
- In this model, the team leader must have effective communication skills and the necessary
experience to provide strong leadership for his or her team (Tiedeman & Lookinland, 2004).

4. Modular Nursing
- One of the modifications of team nursing arrived to a new model called modular nursing.
- Modular nursing uses a mini-team (two or three members with at least one member being
an RN), with members of the modular nursing team sometimes being called care pairs. In
modular nursing, patient care units are typically divided into modules or districts, and
assignments are based on the geographical location of patients.

5. Functional Nursing
- Functional nursing was implemented as a means to accomplish patient care with the
assistance of ancillary personnel.
- In this model, staff members work side by side and are assigned to complete specific tasks,
such as passing medications, taking vital signs, and providing hygiene, for all or many
patients on a unit (Tiedeman & Lookinland, 2004).

REFERENCES:
1. Leadership Roles and Management Functions in Nursing, Fourth Edition by Bessie L. Marquis
and Carol J. Huston
2. Leadership Roles and Management Functions in Nursing Theory and Application, Ninth
Edition by Carol J. Huston
3. Nursing Leadership and Management for Patient Safety and Quality Care by Elizabeth Murra

19 | Page
 MODULE
NCM 119 Nursing Leadership and Management
2

SELF-ASSESSMENT TASK
Direction: identify the word/s being described by choosing in the word pool.

Chain of Command
Reactive Planning Organizing SWOT analysis Span of Control
Organizational Structure Patient Acuity Case method
Modular Nursing Planning

1. It can be defined as deciding in advance what to do; who is to do it; and how, when,
and where it is to be done.
2. This mode of planning occurs after a problem exists. Thus, it is past-oriented.
3. It is a strategic planning tools developed by Albert Humphrey that was most
commonly used in health-care organizations.
4. In this management process, relationships are defined, procedures are outlined,
equipment is readied, and tasks are assigned.
5. It is the way in which a group is formed, its lines of communication, and its means
for channeling authority and making decisions.
6. It refers to a formal line of authority from the top to the bottom of the organization.
7. This defines a manager’s scope of responsibility and reflects the number of
employees who report to a given manager.
8. It represents how patients are categorized according to an assessment of their
nursing care needs.
9. This modality of care is also known as Total patient care.
10. This modality of care uses a mini-team (two or three members with at least one
member being an RN), with members of the modular nursing team sometimes being
called care pairs.

20 | Page