UNIVERSITY OF NAMIBIA EXAMINATIONS



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FACULTY OF MEDICAL AND HEALTH SCIENCES DEPARTMENT:NURSING SCIENCE SUBJECT: HEALTH SERVICE MANAGEMENT SUBJECT CODE: NHM 3100 DATE: JULY 2003 TIME: 3 HOURS EXAMINATION QUESTION PAPER EXAMINER: MODERATOR: MRS L VAN DER WESTHUIZEN MRS. M KATJIRE This question paper consists of (2) pages. excluding this front page. INSTRUCTIONS: ANSWER FOUR (4) QUESTIONS. UNIVERSITY OF NAMIBIA EXAMINATIONS

QUESTION 1 1.1 The clinical nurse specialist is one of the solutions to the changing medical health scene. Discuss this statement. (10) 1.2 Describe the purpose and importance of keeping records. (10) 1.3 Describe the requirements for effective records, statistics and reports. (5) QUESTION 2 2.1 The health service authority has an obligation to facilitate effective unit management. Discuss this statement. (15) 2.2 Chapter 3 of the Constitution of Namibia deals with Fundamental Human Rights. Explain how the provisions in this chapter relate to the nursing practice. (10) QUESTION 3 3.1 Explain Supervision as a control mechanism. (10) 3.2 Differentiate amongst the various nursing care delivery systems that may be used in the organisation of personnel and patient care. (15) QUESTION 4 4.1 Why do people follow a certain person as leader? Describe the major sources of power and influence to this question. (10) 4.2 Discuss the benefits of planning in a health service. (15)

QUESTION 5 5.1 Differentiate between the principles for effective grievance management and the principles of discipline that you will apply in the retention of personnel in your unit. (15) 5.2 Explain which methods you will use in your unit to control financial costs. (10) QUESTION 6 6.1 An Infection Control Committee in a health service, is part of a quality control managing programme. Outline the activities of the infection control committee, essential in quality control. (15) 6.2 Describe principles that you will apply to establish a positive learning climate in the unit. (10)

MEMORANDUM: NHM 3100 JULY 2003 PRESCRIBED SOURCES BOOYENS, SW 1996 / 2000 INTRODUCTION TO HEALTH SERVICES MANAGEMENT. MULLER, M 1998 / 2000 NURSING DYNAMICS SEARLE, C & PERA, SA. 1995 / 2000 PROFESSIONAL PRACTICE: A SOUTHERN AFRICAN NURSING PERSPECTIVE STUDY GUIDES 1, 2, 3 FOR HEALTH SERVICE MANAGEMENT I.

QUESTION 1 1.1 Clinical nurse specialist: Study guide 1:Unit 2 (10) Objective: Discuss CNS as an answer for each medical specialist direction: - high turn over stability in nursing personnel essential; specialised work to general nurse - specialist nurse attached to each medical field; advisory role; availability; assist general nurse in technological sense; - general nurse mainly responsible for support of the patient complete sentences required. 1.2 Purpose and importance of record keeping: Booyens: Chapter 15 (10) Objective: Describe goals related to patient care and unit management 1.3 Requirements for effective record keeping: Booyens: Chapter 15 (5) Objective: Describe requirements referring to: - quality of writing; additions or corrections; recording; entries; patient details; terminology use. QUESTION 2 2.1 Obligation of the health authority: Searle & Pera: Chapter 19. (15) Objective:Discuss general aspects of administration: - unwritten contract to safeguard the patient, his name and his/ her property. - nurse / midwife has a duty to take care - authority provides: facilities; furniture; ancillary services; management policies complete sentences required. - authority divides the system into sub-systems for easy management and ensures: personnel understanding of policies; statutory requirements to work; safe physical environment; effective functioning of subsystems; adequate disaster and emergency facilities; job descriptions; correct workload; work teams; personnel

morale; training; communication systems; budgeting and planning provisions; orderly management complete sentences required. 2.2 Fundamental Human Rights in nursing practice: Study guide 1:Unit 2 (10) Objective: Explain the relation of the following provisions to nursing practice: Equality; life; human dignity; privacy; administrative justice; children; language and culture any other relevant provision identified. QUESTION 3 3.1 Supervision as control mechanism: Booyens: Chapter 13 (10) Objective: Discuss supervision as control mechanism reflecting on: - describing control process - control in nursing environment - steps according Mellish & Wannenburg - four steps of supervision - use of an instrument. 3.2 Nursing care delivery systems: Booyens: Chapter 10. (15) Objective: Discuss the following nursing care delivery systems by explaining their nature; advantages and disadvantages: - functional method; case assignment; team nursing; primary nursing; modular nursing. QUESTION 4 4.1 Sources of power and influence: Booyens: Chapter 7 (10) Objective: Describe the following sources of power and influence: Reward power; coercive power; legitimate power; referent power; expert power; informational power.

4.2 Benefits of planning: Booyens: Chapter 4 (15) Objective: Explain the following benefits: - direction in management; planning defines business; communication and team work improved; develops personnel; measure performance; improves profitability; manage change. QUESTION 5 5.1 Grievance principles versus principles of discipline: Muller: Chapter 20 (7½ 2 = 15) Objective: Differentiate between principles: - Grievance principles: familiar with; written; acceptable; communication channels; steps; right of representation; deadlines; common rights protected; solution in writing; record keeping. - Principles of discipline: familiar; written; acceptable; progressive phases; disciplinary hearing; authority to discipline; written reporting procedures; rights protected; prepared and objective manager. 5.2 Cost containment methods: Booyens: Chapter 8; Muller: Chapter 15 (10) Objective: Explain any method related to: Manpower, finances; equipment & stock; procedures and systems; patients.

QUESTION 6 6.1 Activities of the Infection Control Committee: Booyens: Chapter 14 (15) Objective: Describe the activities related to: Patient care; standards; evaluation; education; auditing; control manual; co-operation; follow-up; consultation; guidelines; policies. 6.2 Positive learning climate: Muller: Chapter 21 (10) Objective: Describe principles reflecting on: Learning atmosphere; planning; freedom of speech; team spirit; disturbances; interest and explanation; care and respect; assessment and feedback; aims; involvement; know learners.