Antonio C. Badiola, RN
Antonio C. Badiola, RN
Antonio C. Badiola, RN
BADIOLA, RN
Refers
to the manner of delegating assignments, orders and instructions to the nursing personnel where the latter is made aware of the work expected of him/her. The nursing personnel should be properly guided so they can contribute effectively and efficiently to the attainment of the nursing service goals. It includes collaboration, delegation, supervision, coordination, communication and staff development.
Human nature is much more complex than what we perceive though understanding of this nature is essential.
Involves
providing guidance and direction to the work in order to achieve a certain purpose; In the Nursing Service, the main goal of supervision is to attain quality care for each patient and to develop the potentials of workers for an effective and efficient performance.
good understanding of administration, clinical competence, and democratic management are essentials in supervision. Instead of giving commands, the supervisor should persuade the workers. Orders and commands should be given only in very rare cases.
* Supervision ensures that the major goal in patient care is achieved. Todays Nursing Supervision is centered on clinical service rather than the traditional managerial service.
Good
supervision is focused on improving the staffs work rather than on upgrading himself/herself. Good supervision is based on predetermined individual needs. It requires self-study by staff members as a starting point in their growth and development. It means that the staff, with the help of the senior nurse, would make an assessment of his/her own ability in giving patient care and set goals based on his/her need for further development. Only when both share in the assessment can they coordinate their efforts.
Good
supervision is planned cooperatively. Good supervision employs democratic methods. Good supervision stimulates the staff to continuous self-improvement. Good supervision respects the individuality of the staff member. Good supervision helps create a social, psychological and physical atmospheres where the individual is free to function at her own level.
Nursing
Orientation Efficient assignment, rotation, and follow up Evaluation, guidance counseling, and promotion Health service, recreation and safety Staff and in-service education
Communication is a process by which you convey your message to someone or a group of people. And if the message is conveyed clearly and unambiguously, then it is known as effective communication. In effective communication, the message you had send would reach the receiver with very little distortion. However, a communication becomes successful only if the receiver understands what the sender is trying to convey.
Noise
interference with effective transmission and reception of a message. physical noise or external noise which are environmental distractions such as poorly heated rooms, startling sounds, appearances of things, music playing some where else, and someone talking really loudly near you. physiological noise are biological influences that distract you from communicating competently such as sweaty palms, pounding heart, butterfly in the stomach, induced by speech anxiety, or feeling sick, exhausted at work, the ringing noise in your ear, being really hungry, and if you have a runny noise or a cough. psychological noise are the preconception bias and assumptions such as thinking someone who speaks like a valley girl is dumb, or someone from a foreign country cant speak English well so you speak loudly and slowly to them. semantic noise are word choices that are confusing and distracting such as using the word tri-syllabic instead of three syllables.
Sender
Receiver
Decode
translates the senders spoken idea/message into something the receiver understands by using their knowledge of language from personal experience.
puts the idea into spoken language while putting their own meaning into the word/message. the medium through which the message travels such as through oral communication (radio, television, phone, in person) or written communication (letters, email, text messages) the receivers verbal and nonverbal responses to a message such as a nod for understanding (nonverbal), a raised eyebrow for being confused (nonverbal), or asking a question to clarify the message (verbal). the verbal and nonverbal components of language that is sent to the receiver by the sender which conveys an idea.
Encode
Channel
Feedback
Message
Shannon's model, as shown in Figure, breaks the process of communication down into eight discrete components:
An information source. Presumably a person who creates a message. The message, which is both sent by the information source and received by the destination. A transmitter. For Shannon's immediate purpose a telephone instrument that captures an audio signal, converts it into an electronic signal, and amplifies it for transmission through the telephone network. Transmission is readily generalized within Shannon's information theory to encompass a wide range of transmitters. The simplest transmission system, that associated with face-to-face communication, has at least two layers of transmission. The first, the mouth (sound) and body (gesture), create and modulate a signal. The second layer, which might also be described as a channel, is built of the air (sound) and light (gesture) that enable the transmission of those signals from one person to another. A television broadcast would obviously include many more layers, with the addition of cameras and microphones, editing and filtering systems, a national signal distribution network (often satellite), and a local radio wave broadcast antenna.
The signal, which flows through a channel. There may be multiple parallel signals, as is the case in face-toface interaction where sound and gesture involve different signal systems that depend on different channels and modes of transmission. There may be multiple serial signals, with sound and/or gesture turned into electronic signals, radio waves, or words and pictures in a book. A carrier or channel, which is represented by the small unlabeled box in the middle of the model. The most commonly used channels include air, light, electricity, radio waves, paper, and postal systems. Note that there may be multiple channels associated with the multiple layers of transmission, as described above.
Noise, in the form of secondary signals that obscure or confuse the signal carried. Given Shannon's focus on telephone transmission, carriers, and reception, it should not be surprising that noise is restricted to noise that obscures or obliterates some portion of the signal within the channel. This is a fairly restrictive notion of noise, by current standards, and a somewhat misleading one. Today we have at least some media which are so noise free that compressed signals are constructed with an absolutely minimal amount information and little likelihood of signal loss. In the process, Shannon's solution to noise, redundancy, has been largely replaced by a minimally redundant solution: error detection and correction. Today we use noise more as a metaphor for problems associated with effective listening. A receiver. In Shannon's conception, the receiving telephone instrument. In face to face communication a set of ears (sound) and eyes (gesture). In television, several layers of receiver, including an antenna and a television set. A destination. Presumably a person who consumes and processes the message.
It is two linear models stacked on top of each other. The sender channels a message to the receiver and the receiver then becomes the sender and channels a message to the original sender. This model has added feedback, indicates that communication is not a one way but a two way process. It also has field of experience which includes our cultural background, ethnicity geographic location, extend of travel, and general personal experiences accumulated over the course of your lifetime. Draw backs there is feedback but it is not simultaneous.
It is a one way model to communicate with others. It consists of the sender encoding a message and channeling it to the receiver in the presence of noise. Draw backs the linear model assumes that there is a clear cut beginning and end to communication. It also displays no feedback from the receiver.
It assumes that people are connected through communication; they engage in transaction. Firstly, it recognizes that each of us is a sender-receiver, not merely a sender or a receiver. Secondly, it recognizes that communication affects all parties involved. So communication is fluid/simultaneous. This is how most conversation are like. The transactional model also contains ellipses that symbolize the communication environment (how you interpret the data that you are given). Where the ellipses meet is the most effect communication area because both communicators share the same meaning of the message.
For example talking/listening to friends. While your friend is talking you are constantly giving them feedback on what you think through your facial expression verbal feedback without necessarily stopping your friend from talking.
A number of relationships are described in this model: Messages are created and consumed using language Language occurs within the context of media Messages are constructed and consumed within the context of media The roles of consumer and creator are reflexive. People become creators when they reply or supply feedback to other people. Creators become consumers when they make use of feedback to adapt their messages to message consumers. People learn how to create messages through the act of consuming other peoples messages. The roles of consumer and creator are introspective. Creators of messages create messages within the context of their perspectives of and relationships with anticipated consumers of messages. Creators optimize their messages to their target audiences. Consumers of messages interpret those messages within the context of their perspectives of, and relationships with, creators of messages. Consumers make attributions of meaning based on their opinion of the message creator. People form these perspectives and relationships as a function of their communication.
The messages creators of messages construct are necessarily imperfect representations of the meaning they imagine. Messages are created within the expressive limitations of the medium selected and the meaning representation space provided by the language used. The message created is almost always a partial and imperfect representation of what the creator would like to say. A consumers interpretation of a messages necessarily attributes meaning imperfectly. Consumers interpret messages within the limits of the languages used and the media those languages are used in. A consumers interpretation of a message may be very different than what the creator of a message imagined. People learn language by through the experience of encountering language being used within media. The languages they learn will almost always be the languages when communicating with people who already know and use those languages. That communication always occurs within a medium that enables those languages.
People learn media by using media. The media they learn will necessarily be the media used by the people they communicate with. People invent and evolve languages. While some behavior expressions (a baby's cry) occur naturally and some aspects of language structure may mirror the ways in which the brain structures ideas, language does not occur naturally. People invent new language when there is no language that they can be socialized into. People evolve language when they need to communicate ideas that existing language is not sufficient to. People invent and evolve media While some of the modalities and channels associated with communication are naturally occurring, the media we use to communicate are not.
2 types:
External Communication (communicate with other organization) Internal Communication (within the organization) Formal communication
Staff Meetings, Union Management Meeting, Branch Managers Conferences Periodical Sales Review Meetings and Customer
Informal communication
Formal
communication
Upward Communication
Any communication that moves from Employees to Supervisors, Supervisors to Managers, Managers to Executives, Regional Manager to General Manager and so on is known as the upward communication. It moves from bottom to top levels in the hierarchy. Employee suggestions, market reports, performance reports, feedback on new products and requests for facilities or instructions are all examples of upward communication. Channels of upward communications are; Superiors keep an open door complaints-and suggestions boxes, social gatherings, direct correspondence, reports and counseling.
Downward Communication
moves from top to the bottom, i.e., from a superior to a subordinate .The Managing Director communicating with the departmental Heads, a Manager giving a directive to an Assistant Manager or a Superior, a Foreman instructing a worker etc are engaged in the process of downward communication. Orders, Individual Instructions, Policy Statements, Job-Sheets, Circulars, etc fall under downward communication.
Vertical/Horizontal Communication
Communication between departments or people on the same level in the managerial hierarchy of an organization may be termed as Horizontal or Lateral Communication. It is both upward now downward but proceeds in a horizontal manner and takes place among equals and at peer level. It is carried on through face-to-face discussion, telephonic talk, periodical meetings and memos.
Informal Communication
Grapevine Communication
It doesnt follow any set lines or nay definite rules. It spreads like the grapevine, in any direction anywhere, and spreads fast. It spreads by way of gossip and rumors. Primarily grapevine is a channel of horizontal communication but it can flow even vertically and diagonally. Specialists in this field have identified four types of grapevine chains. (1) Single Strand Chain: It flows like a chain, i.e., A tells something to B who tells it to C and so on. (2) Gossip Chain: One person tells everybody else. This chain passes a message regarding a not-on-job nature. (3) Probability Chain: here information may move from anybody to anybody. This chain is found when the information is somewhat interesting but not really significant. (4) Cluster Chain: This move through selected groups. A tells something to a few selected individuals and then some of these individuals inform a few other selected individuals. Cluster chain is the dominant grapevine pattern in an organization. Most informal communication flows through this chain.
When your message is not clearly understood you should understand that you are facing a barrier to communication. Barriers to effective communication could cause roadblocks in your professional and personal life and it could be one of the major hurdles in achieving your professional goals.
An effective communication barrier is one of the problems faced by many organizations. Many social psychologists opine that there is 50% to 70% loss of meaning while conveying the messages from a sender to a receiver. They estimate there are four basic places where communication could be interpreted wrongly.
Physical Barriers - One of the major barriers of communication in a workplace is the physical barrier. Physical barriers in an organization includes large working areas that are physically separated from others. Other distractions that could cause a physical barrier in an organization are environmental factors such as background noise. Language - Inability to converse in a language that is known by both the sender and receiver is the greatest barrier to effective communication. When a person uses inappropriate words while conversing or writing, it could lead to misunderstanding between the sender and a receiver.
Emotions - Your emotions could be a barrier to communication if you are engrossed in your emotions for some reason. In such cases, you tend to have trouble listening to others or understanding the message conveyed to you. A few of the emotional interferences include hostility, anger, resentfulness and fear. Lack of Subject Knowledge - If a person who sends a message lacks subject knowledge then he may not be able to convey his message clearly. The receiver could misunderstand his message and this could lead to a barrier to effective communication. Stress - One of the major communication barriers faced by employees in most organizations is stress. When a person is under immense stress, he may find it difficult to understand the message, leading to communication distortion. At the time of stress, our psychological frame of mind depends on our beliefs, experiences, goals and values. Thus, we fail to realize the essence of communication.
Communication is regarded as basic to the functioning of the organization, in its absence, the organization would cease to exist. It is the process through which two or more persons come to exchange ideas and understanding among themselves.
What is information?
Information may be considered as data that has been organized & processed. Information consists of usable sates of data. Information increases understanding & help people in taking intelligent decision. The result of any data process that we get by output device is called information.
What is system? The word system means an organized relationship among functioning units or components. A system exists because it is designed to achieve one or more objectives. Therefore, a system is an orderly grouping of interdependent components linked together according to a plan to achieve a specific objective.
a) A system must be designed to achieve a predetermined objective. b) Interrelationship & interdependence must exist among the components. c) The objectives of the organization as a whole have a higher priority than the objectives of its system.
system refers to information technology that is used by people to accomplish a specific organizational or individual objective. It is consisted of the procedures & rules established to deliver information to the people in an organization. an organized combination of people, hardware, software, communication network & data resources, that collects, transform & disseminates information through different level in an organization.
1)Human resources: - the main element or resource of information system is human resources. It is the combination of data, collection, storage, verification, operation system design and coordination between software and hardware.
Human resources are divided into two types. These are: User: user refers such person who uses information system. The main task of users is to collect different data and use it for achieving predetermined goal. Expert: expert refers those people who develop and implement the design of information system for general users.
2) Hardware resources: - all types of devices of computer is called hardware. Hardware components are monitor, motherboard, cpu, ram, memory, expansion card, power supply, cd rom drive, keyboard, mouse etc. the hardware components are not only machine but also included media.
Machine: machine includes computer system & other peripheral instruments like barcode reader, ocr, omr, scanner, printer etc. which are use in information system. Media: all types of storages media such as floppy disk, optical disk, magneto optical disk etc where data or information can be collected, stored or carried.
3) Software: - computer program and associated documentation is called software. Ms Office, visual basic, windows XP, adobe photo shop etc are the example of software. Without software hardware is meaningless. The software resource of information system is including in program.
4) Procedure: - procedure is such process of information system which should be a specific procedure for performing the activities of any operation in the information system. For example data entry procedures, data correction procedure etc. 5) Data resources: - data is raw material of information system. Data resources stores data about product, customers, inventory and so on.
Data resources includes Description of product. Customer record. Inventory data based.
6) Network resources: - network resource is very essential in implementing modern information system. A network resource mainly consists of communication media and network support.
Communication media: in order to reach data from sources to the final destination there needs a reliable link between the two sides. A verity of media is used implement this link. For example cable or wire, general telephone connection, radio etc. Network support: different types of hardware, software, data wave technology are needed to operate and use communication network.
A hospital information systems (HIS) is a computer system that is designed to manage all the hospitals medical and administrative information in order to enable health professional perform their jobs effectively and efficiently.
Hospital information systems now focus on the integration of all clinical, financial and administrative applications and thus could also be called an integrated hospital information processing systems (IHIPS).
A Clinical Information System (CIS) is a computer based system that is designed for collecting, storing, manipulating and making available clinical information important to the healthcare delivery process. Clinical Information Systems may be limited in extent to a single area (e.g. laboratory systems, ECG management systems) or they may be more widespread and include virtually all aspects of clinical information (e.g. electronic medical records). Clinical Information Systems provide a clinical data repository that stores clinical data such as the patients history of illness and the interactions with care providers. The repository encodes information capable of helping physicians decide about the patients condition, treatment options, and wellness activities as well as the status of decisions, actions undertaken and other relevant information that could help in performing those actions.
Easy Access to Patient Data: Clinical Information Systems can provide convenient access to medical records at all points of care. This is especially beneficial at ambulatory points, hence enhancing continuity of care. Internet-based access improves the ability to remotely access such data. Structured Information: The clinical information captured in Clinical Information Systems is well organized, thus making I easier to maintain and quicker to search through for relevant information. The information is also legible, making it less likely that mistakes would be made due to illegible writing. Improved Drug Prescription and Patient Safety: Clinical Information Systems improve drug dosing and this leads to the reduction of adverse drug interactions while promoting more appropriate pharmaceutical utilization.
Despite the benefits being offered by Clinical Information Systems, they are not without the barriers that prevent them from being rolled out in every hospital. These include some of the following:
Initial cost of acquisition: the high cost of basic infrastructure of clinical information technology can be a stumbling block to many healthcare organizations. Privacy and Security: There are still huge concerns in the healthcare industry about the privacy of patient data on computer systems and how to keep such information secure. The HIPAA and Data Protection Act passed by respective governments in the US and the UK were introduced to address some of these concerns. Clinician Resistance: Clinicians usually have 10-20 minutes to see their patients and if their interactions with a CIS during these sessions proves to be counterintuitive by taking up more time than is necessary, there is bound to resistance to it use. Integration of Legacy Systems: This poses a stiff challenge to many organizations.
Financial Information Systems (FIS) are computer systems that manage the business aspect of a hospital. While healthcare organizations' primary priority is to save lives and not making profits, they do acquire running costs from day to day operations; including purchases and staff payroll.
Payroll: Handles all the recurring and non-recurring payments and deductions for employees. All recurring transactions can be automatically generated each payroll period with non-recurring transactions such as overtime added to the payroll upon approval. It is also possible to maintain employee pay rates, entitlements, full salary movements and payroll histories. Patient Accounting: This concentrates on financial transactions generated during a patients visit to the hospital. These include inpatient and outpatient charges, doctors fees generated across the hospital, the cost of procedures, operations and medications. Accounts Payable: Handles the processing of invoices and payments within the hospital.
Accounts Receivable: This provides support for and the maintenance of the records of all clients, invoices and payments. General Ledger: This handles the collection, processing and reporting of financial data generated by all transactions, enabling a current, accurate and instant view of the financial status of the hospital at any point in time. Fixed Asset Management: This deals with asset data retention and depreciation forecasting. The transfer of fixed assets between locations, cost centers or departments; reclassification of assets and reassessments of asset values can functions that can be done by the Financial Information System. Claims Management: Manages all claims that are made to insurance companies Contract Management: Keeps track of all ongoing contracts.
Nursing information systems (NIS) are computer systems that manage clinical data from a variety of healthcare environments, and made available in a timely and orderly fashion to aid nurses in improving patient care. To achieve this, most Nursing Information Systems are designed using a database and at least one nursing classification language such as North American Nursing Diagnosis (NANDA), Nursing Intervention Classification (NIC) and Nursing Diagnosis Extension and Classification (NDEC).
Some of the features that are provided by Nursing Information Systems include:
Patient Charting: A patients vital signs, admission and nursing assessments, care plan and nursing notes can be entered into the system either as structured or free text. These are the stored in a central repository and retrieved when needed. Staff Schedules: Nurse can self schedule their shifts using scheduling rules provided in shift modules. The shifts can later be confirmed or changed by a scheduling coordinator or manager. Shift modules are designed to handle absences, overtime, staffing levels and costeffective staffing. Clinical Data Integration: Here clinical information from all the disciplines can be retrieved, viewed and analysed by nursing staff and then integrated into a patients care plan. Decision Support: Decision support module can be added to Nursing Information Systems, and they provide prompts and reminders, along with guides to disease linkages between signs/symptoms, etiologies/related factors and patient populations. Online access to medical resources can also be made available.
There are benefits to be enjoyed by implementing Nursing Information Systems and they include:
Improved workload functionality: Staffing levels and appropriate skill mix per shift can be more easily determined by the shift modules. This leads to less time spent in designing and amending rosters. Better care planning: Time spent on care planning is reduced, while the quality of what is recorded is improved. This makes for more complete care plans and more complete assessments and evaluations. Better drug administration: Electronically prescribed drugs are more legible, thus making it less likely that drugs would be wrongly administered to patients.
Despite the benefits Nursing Information Systems have to offer, they are not widely used in healthcare and where they have been installed, they have not been readily accepted. This could probably due to lack of adequate training and failure of educate the end-user what the reasons are for its introduction. Moreover, very little research has been done to determine the cost benefits or cost effectives of such information systems.
Pharmacy information systems (PIS) are complex computer systems that have been designed to meet the needs of a pharmacy department. Through the use of such systems, pharmacists can supervise and have inputs on how medication is used in a hospital. Some of the activities which Pharmacy Information Systems have been employed in pharmacy departments include:
Clinical Screening: The Pharmacy Information System can assist in patient care by the monitoring of drug interactions, drug allergies and other possible medication-related complications. When a prescription order is entered, the system can check to see if there are any interactions between two or more drugs taken by the patient simultaneously or with any typical food, any known allergies to the drug, and if the appropriate dosage has been given based on the patients age, weight and other physiologic factors. Alerts and flags come up when the system picks up any of these.
Prescription Management: The Pharmacy Information System can also be use to manage prescription for inpatients and/or outpatients. When prescription orders are received, the orders are matched to available pharmaceutical products and then dispensed accordingly depending on whether the patient is an inpatient or outpatient. It is possible to track all prescriptions passed through the system from who prescribed the drug, when it was prescribed to when it was dispensed. It is also possible to print out prescription labels and instructions on how medication should be taken based on the prescription. Inventory Management: Pharmacies require a continuous inventory culture in order to ensure that drugs do not go out of stock. This is made even more difficult when there are multiple dispensing points. When don manually it is very difficult to maintain an accurate inventory.
Pharmacy Information Systems aid inventory management by maintaining an internal inventory of all pharmaceutical products, providing alerts when the quantity of an item is below a set quantity and providing an electronic ordering system that recommends the ordering of the affected item and with the appropriate quantity from approved suppliers. Patient Drug Profiles: These are patient profiles managed by the Pharmacy Information System and contain details of their current and past medications, known allergies and physiological parameters. These profiles are used for used for clinical screening anytime a prescription is ordered for the patient. Report Generation: Most Pharmacy Information Systems can generate reports which range from determining medication usage patterns in the hospital to the cost of drugs purchased and /or dispensed. Interactivity with other systems: It is important that Pharmacy Information Systems should be able to interact with other available systems such as the clinical information systems to receive prescription orders and financial information system for billing and charging.
Picture Archiving Communication System (PACS) is a loose term to describe a set of systems that facilitate the archiving, processing and viewing of digital radiological images and their related information. The images are acquired, archived and retrieved over a network for diagnosis and review by physicians. These images can be interpreted and viewed at workstations, which can also double as archive stations for image storage.
The introduction of client/server computing, improved digital imaging and computer network technologies, along with the advancement of the DICOM and HL7 standards have put PACS along side radiology information systems (RIS) as an ideal solution for managing radiological images. Some of these images include:
X-ray photos Cycloplegia Retinoscopy Computed Tomography Magnetic Resonance Imaging Radio Isotope Ultrasound
PACS first emerged in the 1980s, although initially trumpeted as a solution to lost films, healthcare organizations, especially the larger ones, have found that digital images can easily be lost as well. One of the main benefits that PACS provides is the ability to provide a timely delivered and efficient access to images, interpretations and related data throughout the organization. This helps to ease consultations between physicians who can now simultaneously access the same images over networks, leading to a better diagnosis process. It is also beneficial to physicians in emergency situations, as they need not wait for long periods in order to view a patients radiological images as these are instantly available on the network when ready. Another feature of PACS is the ability to digitally enhance the images, providing more detailed and sharper images. This improves diagnostic capabilities at radiological examinations.
Advantages of PACS
Rapid access to critical information to decrease exam-todiagnosis time. This is especially useful in emergency and operating rooms. Elimination of film, handling and storage costs Images can be easily shared between reading radiologists, other physicians and medical records. Images can be archived at secure locations using database servers manages the transfer, retrieval and storage of images and relevant information; the archive provides permanent image storage. Radiologists can access soft-copy images instantly after acquisition to expedite diagnosis and reporting at the almost any available workstation. Web servers can be used to most cost-effectively share images with other departments, even referring physicians across town. They can access the images using the Internet or the local intranet.
Hardcopy films or paper printouts can be made when needed for traditional archiving or the provision of images to other departments.
A radiology information system (RIS) is a computer system that assists radiology services in the storing, manipulation and retrieving of information. RIS were first used in the 1970s and their primary aim was to manage and store radiology information.
Some of the areas that can be addressed by radiology information systems are:
Patient Management: radiology information systems can be used to manage a patients entire workflow within the radiology department, images and reports can be added to and retrieved from electronic medical records (EMRs) and viewed by the authorized radiology staff. Scheduling: Patient appointments for inpatients and outpatients can be scheduled when an order is received. Functions for scheduling the various available radiology staff with the allocated time slots can also be handled by the radiology information system. Patient Tracking: The patient can be tracked from admission to discharge, with all the radiology procedures carried out recorded. This would include the patients past, present and future appointments. Results Reporting: Reports concerning the results of an individual patient, a group of patients or a particular procedure can be generated using a radiology information system. Film Tracking: Individual films can be tracked.
*No hospital information system can be regarded as a success unless it has the full participation of its users. Thus human and social factors would have to be considered in its design, more often than not, they can be easily addressed by providing adequate training and education about the system.
GRACIAS!