Time Management and Prioritization of Nursing Care

Influences on perception
Individual personality, environment, culture
Component of time management
Goal setting, priority determination, daily planning, delegation, limiting losers, evaluation, analysis
Short term vs long term: how to determine goals
Professional shift by shift, make lists, tickler file, schedule blocks
Make a list
Priority, importance, time needed, your availability
Tickler file
Keep track of approaching deadlines, due dates
Schedule blocks
Tasks, flow sheets, group tasks together
Setting limits
Say no, don’t do unnecessary work
Unnecessary work
Beds, some baths,duplicate charting, too much socialization, gather all equiptment, one trip, use intercom, encourage patient care independence
Priority determination
Use maslows hierarchy of needs
Maslows hierarchy of needs
Physiological drives, safety and security needs, belonging needs, esteem and ego needs, self actual inaction needs
Prioritization
Based on application of maslows theory, urgent or not, recognizing the essential activities, safety and well being, discretionary needs
Safety and well being needs are
Meds on time, treatments, dressing changes, comfort needs are met, prevention from actual injury
Discretionary needs are
Baths, personal care, linen changes, documentation, charting, extra patient grooming needs, cleaning up the rooms
Urgent needs are
Physiological needs, safety and security needs
No urgent needs are
Belonging, esteem and self actualization
1st order do prioritization by EF Wywialowski
Threats of patients immediate survival/safety
2nd order do prioritization by EF Wywialowski
Actual or potential problems pt or family has asked for immediate help, relief of pain, nausea, bladder and bowel needs
3rd order do prioritization by EF Wywialowski
Actual or potential problems pt or family does not recognize (cognitive dysfunction from sedation)
4th order do prioritization by EF Wywialowski
Actual or potential problems pt or family may need help in the future
The extras to prioritize as well
Time to spend: talking with the family and patient, teaching and listening, learn a new skill, decrease anxiety of family/pt, what you find most professionally and personally satisfying
Daily planning
The to do list, streamlining, look further into patients that don’t “look good”
Six aims of crossing the chasm: STEEP
safe, timely, efficient, equitable, effective, patient
Safe
Facilitates care safe as at home
Timely
No waits or delays, to get pt out of hospital
Efficient
Cost effective, no waste, equiptment, supplies, ideas or energy
Equitable
Evidence based as standard
Effective
Unequal treatment in the past for everyone
Patient
Centered, revolve around the patient, preferences, patient in control
Delegation
Efficient time management tool, assign tasks, determine expected results, grant authority to individual to accomplish tasks, very difficult leadership skill for nurses to aquire
Limiting losers
Time is a valuable resource, recognize the time wasters to guard against them, time losers, time wasters
Time losers and wasters
Doing too much, just say no, procrastination, complaining, perfectionism, interruptions, disorganization, information overload
Doing too much
3-4 projects at the same time, thinking about future events that do not apply to the current task, if you think you have too much to do you probably do, should have fewer projects going at once, concentrate on one at a time, complete one then move on after full attention
Just say no
Overload from not being able to say no, when someone asks you to do something you need to stop and consider the request, do not accept a request that you can never accomplish,say no, delegate, or negotiate tasks
Procrastination
Put off tasks that are not enjoyable, find excuses for not starting or completing a task, doing one thing when you should be doing something else, not wanting to begin or knowing where to begin, or how to begin
How to deal with procrastination
Identify the reason and make it your highest priority for the next day, give yourself a reward for a completion, break it down into manageable pieces, select least attractive part to do first
Complaining
Can take up the time needed to solve the problem, better to ask what is the solution and do it, better to talk directly to the person and suggest a solution
Perfectionism
Tendency to never finish because it’s never perfect, give permission to do slightly less than perfect, still your best
Interruptions
Strategy to prevent and control these, resume doing it now, maintain attitudes that these are part of your duties
Tips
Chart in place less accessible, be comfortable saying no, plan to accomplish highest prioroty time consuming tasks early, develop plan for the day and stick to it, recognize crisis and interruptions as part of your day and plug them, be aware of your own time wasters
Disorganization
Organization is a process not a product, not the goal, but a means to achieve it, simple guidelines
Simple guidelines for organization
Eliminate clutter, keep everything in place, do similar tasks together
Information overload
Too much,too fast, too often
scientific, research evidence, significance, predication that helps with information overload
by learning what information is important, you can learn to use it to your advantage
Evaluation analysis and time analysis
Time log, entry every 15-30min activity once you see how large amounts of time are spent, you will be better able to eliminate or reduce lost time
Crisis is an opportunity in disguise
Don’t worry about things you can’t control more energy to maintain positive. Perspective and move projects forward
Pagana’s student list
Ommission by decision- deciding what not to do, learn to say no, refusal bc of time restraints and prioritization, blocking interruptions, visitors and phone, program blocks of time for large projects, organize work space, med carts and charting
relevance/ accuracy that helps with info overload
develop data receiving skills, inf. is simply a tool to use to plan action on making decisions
Gaps that affect info overload
not the skills to interpret into useful information