Types of institutional budget depending

on management philosophy

 Open ended budget

 Fixed ceiling budget
 Flexible budget-
 Performance budget
 Program budget
 Zero based budget
 Sunset budget
Benefits derived from the budgetary
process

– Planning

– coordination

– comprehensive control
Planning

 Budgeting stimulates thinking in advance

 It leads to specific planning
 Budget preparation stimulates action and
interaction
Coordination

 The budgetary process has a balancing

effect the total organization, that is ,the
quantity and quality of service to be given a
patient should closely equal the expected
volume
 Budgeting encourages exchange of
information
 The budget process stimulates team play
or team approach
comprehensive control

 the budgeting process gives the administration an

opportunity to evaluate the thinking of the budget
contributor
 Once the budget standards are set, comparisons
between actual expenditures and budgeted
standards can be made with little or no effort.
 Though budgeting process is flexible ,it tends to
define fixed and agreed upon goals
 Cost consciousness is enhanced throughout the
institution
Factors in budgeting
 The type of patient
 the size of hospital and its bed capacity
 the physical layout of the hospital
 personnel policies
 the grouping of patients
 standards of nursing care
 the method of performing nursing care
 the method of documentation
 the proportion of nursing care by professional nurses and those given by non-
professionals
 the amount and quality of supervision available and provided
 the efficiency of job description job classification
 the method of patient assignment
 the amount and kind of labor-saving devices and equipment
 the amount of centralized service provided
 the nursing service requirements of ancillary departments
 reports required by administration affiliation
ESTABLISHING NURSING
STANDARDS, POLICIES
AND PROCEDURES
Nursing Standards
-these established standards in an evaluation process provide
professionally desirable norms against which the department can be measured.

STANDARDS (structure ,criteria ,and standards )

 Structure: organization of nursing service
-There is an organized nursing service/department which is directed by a qualified nurse administrator
 Criterion: philosophy and goals
-the nursing services has a written set of philosophy and goals that reflects the standards prescribed by the
nursing profession and provides direction towards the development of programs to improve the delivery of
nursing care.
 Standards
Philosophy and Objectives –the philosophy shall be based on the belief that the client is an
integral whole and that he is a unique individual with needs that can met through nursing interventions
Philosophy shall reflects collective views of the nursing personnel and the clientele e served
The goals and objectives shall reflects the philosophy of the nursing service
The primary goal shall be provision of the prescribed quality and quantity of nursing care.
Statements formulated shall be widely disseminated and interpreted to the extent possible
Statements formulated shall be reviewed and revised as necessary
Guidelines
The Nursing Service Administrator:
 Identifies /utilizes the following in the formulation of its philosophy
 Considers the philosophy of nursing service in the formulation of goals
and objectives
 Together with nursing staff , formulates goals and objectives which
are stated in behavioral terms, defines the terminal behavior and
specify the time constraints
 Discusses the implementation of the philosophy with emphasis on the
care of the clientele
 Disseminates and interprets the philosophy , goals and objectives
 Reviews, updates and /or revises the philosophy , goals and
objectives if nursing service together with nursing staff
POLICIES

-are broad guidelines for the managerial decisions that are

necessary in organization and departmental planning
-they serve as basis for future actions and decisions, help
coordinates plans, control performance, and increase
consistency of action
-they govern the action of workers and supervisors at all levels
and are intended to achieve pre-determine goals
 Three general areas in nursing that require policy formulation:
[Link] in which confusion about the locus responsibility might
result in neglect or malperformance of an act necessary to
patients welfare
[Link] pertaining to the protection of patients and families rights
[Link] involving personnel management and welfare
Characteristic of good Policies

 policies should be written and understandable and

known by those who will be affected by them
 policies should be comprehensive un scope ,
stable and flexible
 policies should be consistent
 policies should allow for discretion and
interpretation
 policies should be realistic and should prescribe
limits
The nursing services policy manual
-Departmental policies must reflect the policies of the hospital; hence it
should be carefully made to define the scope of departmental responsibility within
the hospital
-a periodic review of policies is necessary to evaluate their effectiveness
and workability

Examples of nursing service policies:

 accidents
 admissions
 autopsies
 breakage
 bulletin Boards
 committees
 complaints
 consent
 death
 discharge
 doctors orders
 equipment and supplies
 fire regulations
 nursing care(administration and preparation , charting ,daily assignment , emergency drug supply, Kardex
,medications property of patients, private duty nurse ,reasonable and due care referrals safety devices
 reports
 reporting On or Off –duty
 Meetings
Interdepartmental Policies
-are developed in keeping with overall hospital policies, thus ensuring

unity and harmonious relationship among departments

 Examples of Interdepartmental policies:

 Admissions
 transfer
 discharge
 blood bank
 cashier
 laboratory
 dietary
 personnel department
 pharmacy
 social service
 x-ray
2 areas:
those that are related to job situations such as reporting complaints or disciplinary
instances
those involving patient care procedures
General format of procedure:
-its definition, purpose, materials needed, proper requisitioning of supplies
proper disposal of used equipment, legal implications, proper and proper

documentation

 Examples of contents in a Procedure Manual:

 admission of patients
 A.M. care
 bath
 Bed making
 bladder catheterization
 blood administration
 cleansing enema
 dressing ,
 emergency cart
 feeding patients
 heat and cold application
 hygiene
 I&O