Administration
What this domain tests
Management functions, leadership, staffing and budgeting, quality improvement, legal records, delegation and ethical issues in nursing administration.
Core rules
- Management process: planning, organising, staffing, directing, coordinating, reporting, budgeting (POSDCORB).
- Leadership styles: autocratic (quick, low participation), democratic (shared decisions), laissez-faire (minimal direction), transformational (vision and motivation). Match style to situation.
- Staffing: calculate patient care hours or nurse-patient ratios, then apply a relief factor for leave and absence.
- Budgets: line-item (incremental), zero-based (justify every item), programme and performance; capital versus operating budget.
- Quality: PDSA cycle, clinical audit, incident reporting, NABH or JCI accreditation. Incident reports are not placed in the patient's progress notes.
- Delegation: right task, circumstance, person, direction or communication, supervision and evaluation.
- Legal: informed consent, confidentiality, documentation, negligence and vicarious liability.
Worked example
A 30-bed ward requires a 1:6 nurse-patient ratio per shift. Nurses per shift = 30 ÷ 6 = 5. For three 8-hour shifts, daily requirement = 15. With a 1.3 relief factor for leave and sickness, budgeted posts = 15 × 1.3 = 19.5, rounded to 20. The ratio is a planning standard, not a guarantee for every moment.
Traps
Using the relief factor backwards; confusing zero-based budgeting with line-item; choosing autocratic leadership for a highly motivated team; and filing an incident report in the patient's chart.