Nursing Chapter 11 Homework Selecting Date Time And Appropriate Place Meet

Chapter 11: Monitoring and Improving Performance

Learning Outcome 1

Describe the performance-appraisal system.

Concepts for Lecture

1. Performance appraisal is one element in a broader organizational system of quality

assurance, and is an effective way to measure obligations of the employment agreement

2. Performance appraisal is a multifaceted managerial tool designed to evaluate

performance, identify staff development and training needs, identify unrecognized ability,

3. Many health care organizations use a matrix structure, and the performance-appraisal

system must allow for a design that permits each different department to work together

PowerPoint Slides

1. Performance appraisal

• One element in a broader organizational system of quality assurance

• Effective way to measure obligations of the employment agreement

• Developing an effective system requires:

o Money;

• In nursing departments, designed to protect clients by ensuring competent

practitioners who meet:

o Professional standards;

2. Performance appraisal as a managerial tool

• Multifaceted tool designed to:

o Evaluate performance;

3. Performance appraisal design with a matrix structure

• Design should permit each department to produce information that identifies its

primary contribution to the overall mission.

Suggestions for Classroom Activities

• Students are well prepared to participate actively in the process because of their

experience in being evaluated in each of their clinical courses. They should, therefore,

Reference

• Queen, V.A. (1995, September). Performance evaluation. Nursing Management, 26(9),

52–55.

Learning Outcome 2

Identify criteria used to evaluate staff.

Concepts for Lecture

1. Professional standards of nursing practice constitute the basic framework and serve as

2. Expectations and criteria for nurses’ performance can be found in position descriptions,

defined by the organization. The nursing service department is responsible to formulate

PowerPoint Slides

1. Criteria to evaluate staff: professional standards of nursing practice

• Constitute basic framework.

2. Criteria to evaluate staff: position descriptions

• Defined by the organization, the nursing service department

Suggestions for Classroom Activities

• Have a student-led discussion about the criteria used to evaluate staff. Are the criteria

used fair and unbiased? What is the reasoning behind the criteria used?

Reference

• Gropper, E.I., and Skarzynski, J.J. (1995, March). Integrating quality assessment and

Learning Outcome 3

Describe the process of an objective evaluation.

Concepts for Lecture

1. An objective evaluation is a form of one-way evaluation resulting from supervisors, staff,

or both either lacking knowledge or skills needed to use the performance appraisal

PowerPoint Slides

1. Objective evaluation

• A form of one-way evaluation resulting from supervisors, staff, or both:

o Lacking knowledge or skills needed to use the process; or

Case Study: The First Evaluation For a New Employee

Suggestions for Classroom Activities

• Have an in-class discussion about the effectiveness/ineffectiveness of objective

evaluation. Highlight the elements of the performance-appraisal process that are most

important to employees. Appraisals should be ongoing throughout the year, should

Learning Outcome 4

Concepts for Lecture

2. Documents and activities of an effective performance-appraisal system in any

organization will:

PowerPoint Slides

1. Elements of the performance-appraisal system

2. Documents and activities of an effective performance appraisal system

• Reflect its philosophy, mission, and objectives.

Table 11-1: In column 1, the supervisor’s responsibilities to the staff relative to the

organization’s performance appraisal program are listed. In column 2, the corresponding

staff nurse areas of accountability are listed. The information in this figure should be

reviewed periodically at staff meetings to encourage skillful implementation of the

program.

Figure 11-1: The performance appraisal process is continuous and interactive.

Suggestions for Classroom Activities

• Have an in-class discussion outlining the importance of each element in the

performance-appraisal system. Does each element have some importance? Why is it

important to reflect on the organization’s philosophy, mission, and objectives? Students

Reference

• Queen, V.A. (1995, September). Performance evaluation. Nursing Management, 26(9),

52–55.

• Ingersoll, G.I., Witzel, P.A., and Smith, T.C. (2005, February). Using organizational

Learning Outcome 5

Explain the phases in the performance-appraisal process.

Concepts for Lecture

1. Success of the performance-appraisal process can be determined by indicators of

performance in employees’ files and quality care indices in unit records. The three main

2. Planning for the interview is important, and reflecting on past performance will help the

nurse identify her strengths and weaknesses. Supervisors also need to prepare for

3. Interviewing allows the supervisor to evaluate an individual staff member, and it is never

appropriate to discuss anyone else or allow the staff member to become the evaluator. A

4. Utilization of outcomes from the interview is an ongoing phase of the performance-

appraisal process, and careful attention must be given to how the results will be used if

PowerPoint Slides

1. Performance-appraisal process

• Success is determined by indicators in employees’ files and quality care indices.

• Process begins with a formal meeting with the immediate supervisor and staff

nurse.

• Reviews past performance and plans for the future.

• The three main phases

2. Performance-appraisal process: planning

• Staff nurse should reflect on past performance to identify strengths and

weaknesses.

• Supervisors should prepare by:

o Observing the nurse’s performance over time;

3. Performance-appraisal process: interviewing

• Allows supervisor to evaluate an individual staff member.

• Not appropriate to discuss anyone else or allow staff member to become

evaluator.

• First topic should be review of successes, to set a positive climate.

4. Performance-appraisal process: utilization of outcomes

• An ongoing phase

• A structured plan using the evaluation outcomes should be implemented.

Table 11-2: Column 1 is a list of recommended supervisor behaviors preparatory to the

evaluation interview. Column 2 lists recommended staff nurse behaviors preparatory to the

evaluation interview. The behaviors are designed to facilitate a productive interview.

Table 11-3: Column 1 is a list of supervisor responsibilities for conducting the evaluation

interview. Column 2 is a list of staff nurse responsibilities for active participation in the

evaluation interview. All activities listed in both columns are essential if the interview is to

benefit the nurse and the organization.

Suggestions for Classroom Activities

• From review of the chapter, students will know instructor responsibilities and their own

responsibilities relative to performance evaluation. Some issues of importance include:

o Skill of the evaluator;

o Evaluation distortions;

Reference

• Spitzer, R. (1986). Nursing productivity—The hospital’s key to survival and profit.

Chicago: S-N Publication, p. 101.

• Makinson, G. (2002, July). Appraisal and performance management. Nursing &

Residential Care, 6(7), 345–347, 352–353.

Learning Outcome 6

Evaluate the use of rewards to improve performance.

Concepts for Lecture

1. Variable scheduling—replacing the traditional five-days-a-week, 8-hour shifts—was an

attempt of nurse managers to satisfy the different needs of individuals. Several alternative

have emerged that provide attractive incentives for some nurses:

2. The “menu” of schedules has had varied responses. Its advantage is the reduction of

dissatisfaction of nurses in client care settings and improvement of satisfaction because it

fits into nurses’ lifestyles. For example, it can be ideal for students who need free time

3. Clinical and career ladders offer another strategy for improving rewards for nurses.

Clinical ladders permit horizontal advancement through a determined number of levels

within a position category based on predetermined criteria. At each level there are

4. A menu of benefits is another attempt to satisfy individuals’ different interests and needs.

Employees select from a list up to a specified monetary allowance that is the same for all.

PowerPoint Slides

1. Variable scheduling

• Replaces the traditional five-days-a-week, 8-hour shifts.

• Attempt to satisfy the different needs of individuals

• Alternative hours that provide attractive incentives for some nurses

2. Advantages and disadvantages of variable scheduling

• Advantages

o Reduction of dissatisfaction in client care settings

o Difficulty coordinating the schedule for nurses who work different time

patterns

3. Clinical ladders

• Permit horizontal advancement.

• At each level, there are additional advantages.

4. Menu of benefits

• Employees select from a list of benefits up to a specified monetary allowance.

Figure 11-2: A diagram of levels within the staff nurse category allowing for progression

without having to leave the patient-care role. The levels with benefits and responsibilities

depicted are examples. The assistant nurse manager position at Level Four is considered to

be serving in a clinical role rather than a formal management role.

Figure 11-3: The path from basic clinical practice to advanced career levels in nursing. The

academic preparation represents recent changes in recommended preparation for

professional nurse roles.

Figure 11-4: An example of what a menu of employment benefits might look like. The point

system shown is a rough estimate of value of each benefit, and has no basis in fact. A

reduced benefit package can be developed for permanent part-time employees.

Case Study: Employee Goals and the Performance Appraisal

Suggestions for Classroom Activities

• Have an in-class discussion about the various rewards/use of benefits given to improve

performance. Discuss the advantages and disadvantages of each reward type. Highlight

Learning Outcome 7

Analyze the obstacles to performance improvement.

Concepts for Lecture

1. Obvious obstacles to performance improvement are a program that does not address

performance requirements, vagueness of purpose, unqualified raters, a tool that does not

2. Rater biases and errors have been listed as commonly occurring distortions in

performance appraisal by Stevens.

a. The halo effect: Occurs when the rater assumes the individual who performs well in

some areas must also perform well in other areas that have not been observed.

b. The recency effect: The rater weighs recent events more heavily than other events that

occurred throughout the evaluation period.

PowerPoint Slides

1. Obstacles to performance improvement

• A program that does not address performance requirements

• Vagueness of purpose

• Unqualified raters

2. Rater biases and errors, by Stevens

• The halo effect: assumption that an individual good in one area is good in another

• The recency effect: recent events weighted more heavily than others

• Problem distortion: Poor observed performance weighs more than others.

Case Study: Evaluation and Morale

Suggestions for Classroom Activities

• Split the class up into seven groups, and assign each group a corresponding obstacle to

performance improvement from the rater biases and errors list by Stevens. Have each

Reference

• Queen, V.A. (1995, September). Performance evaluation. Nursing Management, 26(9),

52–55.

GENERAL CHAPTER CONSIDERATIONS

1. Have students study and learn key terms listed at the beginning of the chapter.

2. Have students complete end-of-chapter exercises either in their book or on the MyNursingKit

Web site.

MYNURSINGKIT

(www.mynursingkit.com)