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  1 ORGANIZING NURSING SERVICES AND PATIENT CARE INTRODUCTION Organization is the form of every human association for the attaintment of common purpose and the process of relating specific duties or function in a whole. WHO expert committee on nursing defines the nursing services as the part of the total health organization which aims to satisfy major objective of the nursing services is to provide prevention of disease and  promotion of health.Nursing has a large, important and unique role in the health care delivery system of a country. Nursing care is extremely important for good patient outcome. While the  physician plans the treatment and surgeon carries out the operation, it is the nurse who gives 24 hrs / round the clock nursing care and looks after the needs of the patient. The success of the patient care depends upon the competence of the nursing staff. Organizing the high level of nursing care is a big challenge for the nursing service administrator. Setting of standards and goals for providing care to patients depends upon the philosophy of nursing in order to organize the patient care. ORGANIZING NURSING SERVICES Meaning of nursing service and nursing service administration Nursing Service  Nursing service is the part of the total health organization which aims at satisfying the nursing needs of the patients/community. In nursing services, the nurse works with the members of allied disciples such as dietetics, medical social service, pharmacy etc. in supplying a comprehensive program of patient care in the hospital. Nursing service administration  Nursing service administration is a complex of elements in interaction and is organized to achieve the excellence in nursing care services. It results in output of clients whose health is unavoidably deteriorating, maintained or improved through input of  personnel and material resources used in a process of nursing services. DEFINITION OF NURSING SERVICE  2 WHO expert committee on nursing defines the nursing services as the part of the total health organization which aims to satisfy major objective of the nursing services is to  provide prevention of disease and promotion of health.  OBJECTIVES OF NURSING SERVICE The first component of nursing service administration is the planning and it should  be based on clearly defined objectives. The objectives of nursing service department are as follows: Objectives in relation to Patient care The primary emphasis is on total patient care that is:    To give highest possible quality care in terms of total patients need which include physical,  psychological, social, educational and spiritual needs by collaborating with other health tem members.    To assist the physician in providing medical care to the patients.    To provide preventive and rehabilitative services.    To provide round the clock nursing care to all the patients.    To render timely and appropriate nursing service to emergency patients.    To provide cost effective quality care as per the needs of patients.    Confidentiality and privacy of each patient should be maintained.    Constant monitoring and evaluating is of utmost importance to improve patient care continuously. Objectives in relation to Education    Planning of education and training programme for nurses are must for professional growth and development needs through in-service education and research support.      To provide regular staff development, in-service education and guidance services for all members of nursing staff.      To conduct regular orientation programme for new entrants and for those have been on the  job for a long time.      To conduct training for operating procedure of latest gadgets and on handling sophisticated  bio-medical equipment.  Objectives in relation to Administration and Organization    To make regular supervision through rounds.    3    To ensure that the essential equipment is provided in functional status for nursing care services.      To provide regular flow of essential supplies to render quality nursingcare.      To have a proper system of rotation of staff, provision for annual leave and days off for the nursing staff without hampering patient care.      Establish a communication system for nursing personnel, other health worker, patients, health authorities, government authorities and public.      Ensure that each nurse identifies her job responsibilities and accountability.      Counseling for health personnel, patients and the public.      The formulation of policies, standards, goals of nursing service, education and practice.      Maintaining proper documentation of the personnel employed in nursing service.  Objectives in relation to Research    Establish a system for collection of essential information, research and studies concerning all aspects of nursing.      To contribute in research programme conducted by hospitals and by other health personnel.      To encourage and support the nurse to conduct research projects/ activities.   FUNCTIONS OF NURSING SERVICE ◘   To assist the individual patient in performance of those activities contributing to his health or recovery that he would otherwise perform unaided has had the strength, will or knowledge. ◘   To help and encourage the patient to carry out the therapeutic plan initiated by the  physician. ◘   To assist other members of the team to plan and carry out the total programme of care. The organization of nur  sing care constitutes a subsystem for achieving the hospital’s overall objective. Nursing care of patients generally takes forms:    Technical    Educational    Trusting relationship  4 The director of nursing service is delegated the authority and responsibilities for organizing and administrating the nursing services in hospital. It is her duty to institute the essential characteristics of good nursing services in her institute such as: a.   Plan of organization  b.   Policy and administrative manuals c.    Nursing practice manual d.    Nursing service budget e.   Master staffing pattern f.    Nursing care appraisal plan g.    Nursing service administrative meetings h.   Adequate infrastructure facilities, supplies and equipment i.   Written job description & job specifications  j.   Personnel records k.   Personnel policies l.   Health services m.   In  –  service education n.   Co-ordination o.   Advisory committee a.Purposes and objectives of the nursing service: The purposes should be in accordance with the hospital philosophy regarding patient care and approved by administration. It must characterize the principles of excellence in service, in practice and leadership. Objectives are specific, practical, attainable, measurable and understandable to all the nursing staff. b.Plan of organization: Every hospital has the basic system of coordination of vast number of activities i.e. the Director of Nursing service, she is responsible for maintaining standards for patient care in terms of quality nursing service must be familiar with the formal organizational structure of the hospital and its relationship in various department and their functions. The plan of organization should indicate inter as well as intra-department relationship. The plan also
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