Defnition of Nursing

DEFNITION OF NURSING
According to international council of nursing,

nursing encompasses autonomous and
collaborations care of individuals of all ages, families,
groups and communities, sick or well in all settings.
Nursing includes promotion of health ,prevention of
illness and care of ill , disabled and dying people.
Advocacy, promotion of a safe environment,
research , participation in shaping health policy and
in patent and health systems management and
education are also key nursing roles.
HISTORY OF NURSING
Nurse evolved from latin word “nutritious”
which means nourishing.
In 100 BC – Hippocrates – father of scientific

medicine, established ethical code of
conduct for all who practiced medicine.
In 12 & 13 century – nursing became
differentiated from medicine and surgery.
 1854- Crimean war – service to wounded
soldiers- title- lady with the lamp.
HISTORY OF NURSING
1860- first school of nursing by Nightingale.
1865-Suggestions for system of nursing for hospitals in
India1949 by Florence Nightingale.
1890-1900-National nursing association.
 1949- Indian nursing council was established.
1949- Council was constituted.
- ICN, Nurses auxillary of CMA of India, Indian nursing
council & state level registration council- connected with
promotion and upliftment of nusing profession.
FUNCTIONS OF NURSING
ADMINSTRATION UNIT
Establishing objectives
Formulating nursing service policies and
procedures.
Executing these policies.
Maintaining stable staffing pattern.
Selecting and assigning nursing personnel.
Planning and directing orientation & in service
training programmes.
Constantly evaluaating.
FUNCTIONS OF NURSING
ADMINSTRATION UNIT
Maintaining proper nursing records .
Assisting in preparation of and administering
the budget for the dept.
Coordination of activities of various nursing
units.
Maintaining interpersonal relationships.
Participating in community and health
education programmes.
LOCATON
It generally generates moderate to heavy
traffic.
In administrative block generally it is
centrally located.
To decentralize nursing adminstration many
hospitals place supervisory nursing staff in
patient care areas.

Organization
DESIGN
General nursing unit
Pediatric nursing unit
Obstetrical nursing unit
Psychiatric nursing unit
Isolation rooms
Intensive and coronary care units.

GENERAL NURSING UNIT
Functions- handling materials , maintain
communication and medical records social and
physical needs of patients and specific needs of staff.
Location- close relationship with operating rooms,
pharmacy, central stores, laboratory and the dietary.
Design- the possible configuration may be round,
square, straight, triangular, oval , y- shaped, H-
shaped, T-shaped, and circular.
They can be single corridor or double corridor.
General Nursing Unit Plan
PRIVATE ROOMS
Size of one bed patient room- not less than 11.61 sq.
mtrs & width at least 3.81 mtrs.
Two bed rooms should be minimum of 14.86 sq, mtrs.
Four bed rooms – minimum floor are- 29.722 sq.mtrs.
0.37 sq.mtrs (4 feet) space between the beds.
Windows should be parallel to windows, there should be
well build in wardrobe, nursing call signal card, movable
furniture, telephone, TV, bedside locker,
Doors should open outward with outside lock.
Toilet should be provided with grab bar, emergency call
button, flush valve for bedpan cleaning, and night
lighting should be provided.
OBSTETRICAL NURSING UNIT
LOCATION- close to labor suite room and nursing
room
Space requirements-
A conference room
Near to ultrasound screening room.
Private rooms- preferably double rooms.
Obstetric Nursing Unit
Plan
PSYCHIATRIC NURSING UNIT
Location- floor with separate entrance
Design- open type
Light, paint, décor should provide therapeutic effect.
Single exit, tamper- proof fittings, precautions
against suicide and escape, and 24-hour security.
3 types of patients-
Acutely disturbed patients- isolation rooms must be
provided.
Chronic , deteriorated a- motivated patients
Patients who come for diagnosis and not pose
management problems.
PSYCHIATRIC UNITS
4 sub units-
 Tretment consultation area
 Conference therapy area
 Inpatient area
 Area for therapeutic activities.
Psychitric nursing units should have 20 to 30 beds.
2 seclusion rooms.
Continuous observation by staff.
Toilets- central in location
Patient laundry facilities.
ICU’S AND CCU’S
 LOCATION – close to operating rooms
 Electronic instruments for observation, signalling, recording,
measuring physiological functions
 Nurse :patient= 3:1
 No. of beds= 10% of total beds.(not more than 12-16 beds)
 Non cubicled curtained area
 Medical gas outlets
 Entrancee door-1.11mtrs &1.21 mtrs wide
 Nurses call button
 Room should be sound proof &air conditioned.
 Respiratory therapist
 Code blue- emergency for cardiac arrest.
Nursing station
Medical area, linen stores, clean supply, equipment, etc
should be located close to control station.
Facilities needed are-
Desk
Nurses call system panel
Wall clock & bulletin board
Hand washing facilities
Storage facilities
Refrigerator
Chart desk
Nursing adminstrtion unit
Space requirements-
Nursing director’s office
Asst. and supervisor’s office
Receiption control area
Secretarial and clerical area
Conference room
Toilet facilities
Storage for files, office supplies
PAEDIATRIC NURSING UNIT
12 to 15 % of total beds.
Location- away from main stream of hospital
traffic,adjacent to play area.
Design- floor room of one bed room- 100sq. Feet
 - 2 bed room – 14.86 sq. feet
Nursing station – centrally located
25% beds – sigle rooms for critically ill patients.
Recreation room, play room.
STAFFING PATTERN
ICU’s – Nurse : Bed = 1 : 1
General Ward – Nurse : Bed = 1 : 3
OT’s – Nurse : Table = 3 : 1
3 Categories of patients
1st Category : Severely ill
2nd Category : Moderately ill
3rd Category : Need less nursing
care/ambulatory patient
Nursing and budget
Budget committee-
Director of nursing
Director of HR
Director of SCM
Director of engineering &plant operations
Chief of medical staff
Chief executive officer, chief operating officer,
chief financial officer.
FACTORS IN BUDGET PLANNING
The type of patient, length of stay, acuteness of illness.
Size &facility and its bed occupancy.
Physical layout of facility, the size & plan of ward- open,
small, private etc.
personal policies – salaries, vacation, educational
programs.
Grouping of patients-ICU,CCU
Standards of nursing care.
Methods of nursing procedures-records, charts etc.
Amount of supervision
Addition of non nursing services.
BUDGET APPROACHES
Zero base budgeting
Fixed budgets
Flexible budgets
Rolling or moving budgets
Variable budgets
Program budget
KEY BUDGETARY INDICATORS
Patient volume
Occupancy rate
Patient acquits
Direct hours/ patient day
Paid hours/ patient day
Salary cost / patient day
Non-salary cost / patient day
KEY BUDGETARY INDICATORS
Patient volume
Occupancy rate
Patient acquits
Direct hours/ patient day
Paid hours/ patient day
Salary cost / patient day
Non-salary cost / patient day
COMPLEXITIES
Interruptions in nursing service delivery.
Wasted transportation.
Increased wastage of time in paper
documentation or chart work.
Irrational documentation of usage of drugs to
procurement.
Iv solutions and drugs unused are thrown away.
COMPLEXITIES
Interruptions in nursing service delivery.
Wasted transportation.
Increased wastage of time in paper
documentation or chart work.
Irrational documentation of usage of drugs to
procurement.
Iv solutions and drugs unused are thrown away.
Role of middle level
managers
They have low decision making authority for
attacking and solving problems .
Functions-
Meet with unit staff to identify symptoms and
causes of productivity and quality of care problems.
Determine cause and magnitude of problem.

Evaluate recommendations by top management.
Implement solutions.
Publicize results to entire hospitals.
RECOMMENDATIONS
Audit committee – consists of 6 nurses and
pharmacists .
Combined and coordinated work by nurses and
fiscal services.
Usage of technology
Facility layout structures.
Return of all unused medicines.

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DEFNITION OF NURSING

According to international council of nursing,

In 100 BC – Hippocrates – father of scientific

Determine cause and magnitude of problem.

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