Chapter five of Yoder-Wise’s book Leading and Managing in Nursing concentrates and explores the legal and ethical issues pertaining to the practice of nursing. Legal issues include negligence, liability, malpractice, consent, employment laws, federal laws, and other related issues in the nurse practice acts. Ethical issues include ethical principles and regulations and the code of ethics. The nurse practice act is the law, and the state board of nursing cannot tamper with any of its provisions. It sets educational requirements, licensing requirements, and roles of each type of nursing and provides for the establishment of a state board of nursing. The state boards of nursing help to enforce the provisions of the act. Negligence and malpractice are major causes of action brought against nurses. Liability is of three types: personal, corporate, and vicarious. Informed consent is the patient’s or patient’s representative authorized to act on the patient. Employment laws involve equal employment opportunity, such as the Civil Rights Act of 1964.
Technology should be embraced by all, and nurses are no exception. Chapter eleven discusses the relationship between nurses, science, and the patient. Biomedical, knowledge, and information technology is a current trend that enables nurses to perform their duties efficiently and effectively. It includes patient care quality, safety, evidence-based practice, information systems hardware, and informatics. It describes the roles of new inventions in patient care, elements of informatics, types of healthcare information technology, and the use of the internet for healthcare purposes. For good decision-making, nurses require accurate and reliable data and information. This is facilitated by technology. Biomedical technology is useful in physiologic monitoring, diagnostic testing, therapeutic treatments, and intravenous fluid and medication dispensing and administration. Information technology is essential in acquiring, managing, analyzing, and disseminating information. Evidence-based practice encompasses the use of evidence in healthcare practice. Nurses should remain involved in the development and implementation of the three types of technology to improve the healthcare system.
Chapter twelve explores the ways of financing managing costs and budgets in a healthcare setting. It discusses the determinants of healthcare costs, sources of funds, methods of repayment, and the management of costs. Nursing should be a cost-conscious practice that requires financial skills. Only services that add value to patients should be provided. The healthcare system should understand what constitutes operating costs and benefits, capital and profit, and their interrelationship. Factors affecting costs comprise the price and utilization of services. Nursing practices should be cost-conscious; nurses should evaluate the cost-effectiveness of the use of technology, they should utilize time effectively, undertake research activities and use it appropriately for prediction purposes and discussing the costs of patient care with the patients. Budget control can be achieved by analyzing the supplies, analyzing changes in staffing, and evaluating the patients’ needs. The nursing staff has an impact on the profitability of the organization.
Chapter fourteen focuses on the relationship between the personnel budget and the staffing plan. It discusses the staffing and scheduling function of nurse managers. The nurse manager should measure nurses and patients on a scale and address their factors and characteristics. Staffing policies should be introduced and maintained, structural and support services should be provided. Evaluation of a unit’s productivity should be conducted. In doing so, the following should be considered, labor cost per unit of service, staff input, and periodic reports for each unit. Nurse leaders should establish nurse-sensitive indicators to get the required information and use such information to communicate with the nursing staff about staffing to effectively manage the services provided by the staff. To ensure this, state laws and standards of staffing should be understood, undertake research on the factors of patient outcomes and identify the demands for staff and anticipate changes. Data collection regarding the patients’ factors, nursing characteristics, nurse staffing, and other factors that have an impact on nurse and patient outcomes is the core to strategic staffing.
Chapter sixteen focuses on the strategic planning process, the setting and the management of goals, and strategic marketing. This is provided for by the organization’s mission and vision statement. The statement should be reviewed regularly and ensure it meets the consumer’s needs and the roles of each part of the system are clear to the staff. The efficiency of healthcare operations hugely relies on its strategic planning. This can be achieved by product line development and defining its goals, and working towards the objectives. The strategic planning process involves establishing appraisal techniques, assessing the immediate environment, identifying strengths and weaknesses, managing and evaluating strategies. Competition in the healthcare field continues to increase; this necessitates the implementation of marketing strategies. Steps involved in the marketing process include a market assessment, planning, implementation, and evaluation. Strategic planning results in the achievement of goals and objectives and provides a sense of direction and meaning to the system’s operations.
Chapter twenty explores risk and quality management. It focuses on improving patient care by applying quality management principles in the healthcare system. In every system, better efficiency and improved quality are the main goals. This is achieved by considering the expectations of customers, strategic planning, evaluation of outcomes, and adaptation. Planning ensures the prevention of errors, the needs of the customer are evaluated, the collection of data is done effectively, and quality indicators are established. Some of the steps in quality management and improvement include: identifying factors most important to consumers, reviewing such factors, measuring the current outcomes, identifying expected outcomes, and undertaking measures to meet the expected outcomes. Therefore data collection is the stem to the risk and quality management. Risk and quality management objective is to improve patient safety and management of costs by making important decisions based on facts. For this to work, the nursing staff, together with their leaders, should be committed to quality management and improvement processes.
Reference List
Yoder-Wise, P. (2010). Leading and Managing in Nursing (5th ed.). Mosby.