Relationship Between Performance Appraisal Systems And Nursing Staff Performance - Article Example

?Nursing Appraisal Nursing Appraisal Performance appraisal or review, also known as employee appraisal is a way in which the performance of an employee in his or her job is analyzed, usually in terms of quality, quantity, time and cost by an immediate supervisor. It is also an analysis the failures and successes, personal strengths and weaknesses, further training and worth of an employee. In nursing, it is a vital component of evaluating and controlling the function of its management. When implemented appropriately, it governs the behavior of the employee, which results in greater production of goods and services of a higher quality. In this context, it is essential for nurse managers to analyze the performance of their nurses, and manage them effectively and efficiently as a human resource. This is advantageous to the hospital, and the patients as well because, nurses will be motivated to put their best foot forward, so that during the evaluation, they score highly, which might earn them a promotion. For the patients, they will get the best care a treatment, which will ensure that there is more influx of patients to the hospital, resulting to economic benefits to the hospitals. This paper will focus on the process of carrying out the appraisal performance on nurses, and how it is beneficial to them. The key words used to search these articles were performance appraisal and nursing management. From the results, I determined whether the articles met the aims and objectives of the research, examined each one of them carefully by pulling and synthesizing the results. I also applied the qualitative results which examined the how and why questions, and the quantitative results which examined the cause and effect. Several literature reviews give their opinions on the same. There are many sources, but not all of them fit the research. The sources that I chose for this research were from their titles and abstracts of the articles, since they gave an overview of what was in the whole article. Those that were relevant were excluded, at this point. The next step was to gain access to the full texts of the chosen articles, and the same criteria of inclusion and exclusion applied again, and final number sources were left for use (Roussel & Swansburg, 2006). The Relationship between Performance Appraisal Systems and Nursing Staff Performance For over three decades, organizations have considered performance appraisal systems as key organizational processes for the management and development of personnel (Giangreco et al 2010; Levy & Williams 2004; Ferris et al 2008). The aim of performance appraisal systems is to offer a comparison between the level of performance expected by any one organization and the performance achieved by an individual or group of individuals. The basis for performance of evaluation is that it helps to improve performance by providing concise feedback on how the individual or department is doing in the place of work. The popularity of the use of appraisal systems is, however, surrounded by a forceful debate on their productivity and the related costs and benefits. It is widely believed that performance appraisals are prone to bias, that they do not demonstrate high levels of accuracy, and that they are not readily accepted by users (Coates, 2004). The argument against the use of performance appraisal systems is based on tension in the organizational climate, as well as resistance and opposition amongst employees who may find the use of performance appraisal systems derogatory or pejorative (Wright 2004). In some cases, a negative performance appraisal may even lead to a reduction in productivity (Banka & Roberson, 2002). Western business environments are different from those in the East and globalization has provided access to various business environments, which necessitates optimal expertise. Applying a performance appraisal system to a healthcare organization in which many of the employees may be unfamiliar with certain systems may again lead to a loss in productivity (Pritchard et al, 2008). The following review of the literature looks at how nurse performance can be optimized using appropriate performance appraisal tools, with a focus on the United Arab Emirates (UAE) and how applicable these systems are in an international context. The performance appraisal system should be clearly defined, and performance standards developed by the employer. The performance standards for nurses need to incorporate the professional standards of practice developed by the registering body and the expected performance standards expected by the employer (Yan et al, 2010). The application of performance standards should be objective, with both employer and employee measuring the employee’s performance against the standards. It could be helpful, as suggested by Yan et al (2010) to allow an employee to complete an internal review of their own performance before discussing it as part of a more formal appraisal procedure with a manager or supervisor. The procedure should include a system of planned interval feedback and subsequent improvements already agreed. The evaluation system should be in the form of a continuous cycle. ‘Job analysis and job description are essential instruments of behavior technology used in performance appraisal that provide objectivity and discriminate among jobs’ (Roussel & Swansburg 2006, p. 464). Incentive programs for employees are key I organizations, where payment for performance is used as a major tool in enhancing the appraisal process. Use of a payment means based on the output helps as an incentive when compared to payment based on time. It promotes productivity among the employees especially in organization operations such as quality, safety and attendance (Roussel & Swansburg, p.464). Despite incentives serving to improve performance among staff, there is a drop in performance after that period of appraisal passes. Such staff need extra motivation or should face action against them to ensure that they do not enhance productivity only for appraisal purposes. Merit or award pay stem works best in the nursing industry, compared to a system of the commission; this is in consideration that, in nursing, there are no items for sale. Performance based pay forms basis on expectancy, equity and effect theories (Roussel & Swansburg, 2006, p. 64). However, such appraisal systems face problems especially on low preparation levels of both employee and employer, lack of set standards, errors accompanied by leniency or stringency, judgment, central tendency and first impression errors (Siegel et al, 2008). To counter all associated problems, a well-prepared appraisal format should be created, ensuring that both employees and employer fully understand. It should then be extensively used as a supervisory measure. Performance Appraisal Systems in Nursing It is necessary to embrace measures to ensure performance. Such measures may be attributed to other organizations that accredit the industry. This is a means of enhancing competence among the nursing fraternity (Kostpoulos 2011). There are several appraisal techniques as highlighted below: Interviews The most appropriate system involves an approach of solving problems. This promotes participation of all, as well as it aids to develop goals together with the employer. It is highly effective as it gives more focus to solutions rather than problems. It, however, works best in countries using a similar language since miscommunication would prevent proper analysis of an employee. Graphic Rating Scales This gives various levels ranging from most satisfactory to least satisfactory (Jones & Beck 2004). This gives visuals on the employee’s roles in the organization. It, however, has a disclaimer as to who will decide on levels of employees due to the likelihood of bias. Supervisor Ratings It involves an evaluator who analyses cluster of statements of an individual and organizes them into the least or highest fit (Jones &Beck 2004). It has to have set objectives, goals, and an appraisal form to determine performance to evaluate if they have been met. Peer Ratings Involves assessment administered by one or more persons in a peer group (Jones and Beck, 2004). It is purported that such appraisals developed by employees are more difficult since cover wider aspects of their jobs (Roussel & Swansburg 2006, p. 142). It is a better means of appraising nurses as it promotes a friendlier environment and since, nurses are more aware of daily happenings of their workplace. Self-Ratings and Goal Setting Involves self-evaluation on performance, where the nurses are expected to be objective in the rating (Jones & Beck 2004). It is an extremely rare system as much as it can it boost goals of the nurses. It is usually accompanied with group interviews (Harrion, 2000). Its success is enhanced by a work criterion for evaluation according to nursing standards. Team Evaluation Consensus It uses multiple rate factors to avoid bias and enhance accuracy. It incorporates peers, supervisors and managers for two to eight rate factors (Roussel & Swansburg, p. 453). Employees then are directly compared to other employees or against set rates. For it to work, the set standards are necessary. Behavior-Anchored Rating Scales (BARS) They involve rating scales specific on descriptors like good, average and poor performance, for various job aspects. Such scales need a lot of analysis hence take a lot of time to develop (Roussel & Swansburg 2006). After development, they only require revisions occasionally. Task- Oriented Performance Evaluation System (TOPES) It is more jobs oriented as compared to behaviors. However, it is based on behavior since it can measure task completion. It is able to relate directly with the job (Roussel & Swansburg 2006). It follows a total performance evaluation where employees can face comparison. Its advantage appears by the ability to measure performance quantitatively. Evaluations are rated as unacceptable, weak, average, good, and excellent and the score on each task is multiplied by its value, giving a composite score. Critical Incidents This technique is termed as anecdotal incidents, crucial to job performance (Jones & Becks 2004). The handling of critical incidents in healthcare impacts a lot on perception of a hospital. It is necessary to incorporate an appraisal format for such incidents. However, it may act negatively on staff, which seems under a spotlight when faced with such critical incidents. Rewarding of performance in such incidents would also motivate staff. Written Essay Technique In a written manner, one can note weaknesses and strengths of an employee, in the context of the job description (Jones & Becks 2006). However, the essays are mostly subjective and may cause workplace issues. It is difficult to analyze such qualitative data as the essays, since its less scientific (Yan et al 2010). Essays face likelihood of bias, dependent on individual relationships to each other (Schoessler et al 2008). Rankings This involves listing of employees from the most valuable to the least. Rankings depend on the evaluator, without a basis of facts. This can tarnish an employer’s reputation. Another ranking method is paired ranking that involves a selected criterion to evaluate employees against each other (Jones & Beck 2006). It is also subjective and may tend to divide employees, causing problems especially in the healthcare context (Murphey 2004). The Performance Appraisal Tool It is involved in measuring nurse’s performance in medical, surgical nursing. It is designed in a manner of use in the annual evaluation, and in assessing probationary surgical registered nurses. It puts emphasis on nurse activities that assist self-care wants of patients, which the patient cannot do without. It utilizes five aspects of the nursing; evaluation on nurse’s role in support and education; capacity to deal with patients; self-development responsibility of professional nurses and quality care responsibility inclusive of contribution to nursing practice (Kostopoulos 2001). This tool, in actual sense, involves 35 aspects, all rated by a Likert scale that ranges from 1, representing least standards to 5 for highest performance, with a supervisor who knows the nurse’s situation at work. A modified tool has 48 aspects rated from 0 to 4. This one is more specific and emphasizes more on excellence in service particularly in teamwork, accountability, communication, meeting the health needs and education needs of families and clients. The Negotiated Performance Appraisal (NPA) This system allows supervisor-subordinate dialogue enhancement (Billikopf 2010). It works well in promotion of communication between hierarchies in organizations. It is noted for its broad-spectrum use. It is usually better executed using external facilitators, to understand negotiations among persons and in completing the required lists. It enhances communication between subordinates and their supervisors after the facilitator departs and significantly settles disputes between them (Billikopf 2010). Such a system is useful in evaluation of nurse’s performance by their managers due to better communication and information gathering. Peri-Operative Nurse Performance Review Here, monitoring of activities and appraisals are necessary. Quality control and supervision is necessary to monitor performances. Performance appraisal involves periodic assessment and evaluation of nursing care using pre-established standards with corrective counseling as needed’ (Fairchild 2006). Three aspects to note are quality review, quality evaluation and quality approval. This is done throe audits, measurements of performance and through retrospective survey of personnel performance and system from others like patients, personnel and outside agencies. Public Health Nursing Performance Appraisal This tool evaluates performance in 5 nursing activity classifications. These are nurse practitioner, clinical specialist, staff registered nurse, nursing supervisor and public health nurse. They practice in several areas such as policymaking, evaluation, assessment, cultural competency, partnerships, disease mitigation and leadership thinking (Kalb, Cherry, Kauzloric et al 2006). Such systems allow analysing the different forms of appraising in an organization. Performance Assessment on Internship Program for Novice Nurses A nurse’s role in the rapid transition to the Intensive Care Unit has been enhanced by a nursing education agency that designed an internship program for novice nurses dubbed Joan Stout, RN, Shadow-A-Nurse ICU Program in the United States. It is applicable to the United Arab Emirates due to the generalizability of implementing a shadowing program that includes novice nurses, with an education and necessary skills, shadowing with experienced ICU nurses. Study shows that such an approach increases critical knowledge in care as well as gain experience in ICU situations (Messmer et al 2004). Both qualitative and quantitative approaches are used to evaluate the program, where quantitative tools such as Watson glaser thinking appraisal (WGCTA) and Toth’s basic knowledge assessment tool (BKAT) for shadowers in the adult ICU, Neonatal ICU (NICU) Nursing Assessment Competency Exam and the WGCTA for those assigned to the NICU. Shadowers are expected to document, in a six-week journal to reflect on the effects of the experience gained in that shadow period (Messmer et al 2004). Such documentation is adopted as evidence of viability of such projects. UAE adopted this system to all its new nurses, and they achieved the same results in their hospitals. It helped develop, the new beginner practitioners program in the UAE. WGCTA and BKAT are used to evaluate critical thinking abilities of the nurses. WGCTA score ranges are 0 to 80, while BKAT is a 100-item paper and pencil test. Study is necessary to aid understanding how critical thinking helps ability to practice nursing safely and effectively (Messmer et al 2004). Whether Performance Appraisal Systems should be Abolished Performance appraisals may be destructive, rather than beneficial. They interfere with total quality management since they may result in work conflicts, at the same time utilizing resources that could have been channeled into quality improvement (Swansburg & Swansburg 2006). Winning and losing in appraisals affect initially healthy relationships (Swansburg & Swansburg 2006). Appraisals that overpass their intended purpose develop negative effects such as ineffectiveness in dialogue with an employee who understands that a salary increment is depended on evaluation, blaming shortcomings on other factors. In some professions, such as nursing, it is impossible to provide production records, making appraisals lack valid need, and usually dwell more on results rather than the process. Appraisals maintain the status quo and limit creativity and innovation (Swansburg & Swansburg 2001). Some persons term the whole system as unfair, particularly the unsuccessful ones. Appraisals in such a case may seem inhuman and aggressive acts that aim at destroying persons. Assessment of the Validity and Reliability of Appraisal Systems Appraisals should evaluate nurses and equip them with rates that they can work towards (Riley 2000). It should also seemingly develop their careers through learning and growth. Appraisals are conducted by management, leaving the supervisor out, who is closer and understands the nurse better. Management closest to the nurse is best suited to evaluate performance of the management, since they have a closer interaction. They lose meaning if a standardized system is utilized to all employees. It should be let based on the nurse’s job description (Riley 2000). Appraisal should have more focus on behaviors at work rather than on personal traits. Such should be measurable and observable behaviors on a nurse. In appraisals that lack regular feedback on performance, the systems should be altered in a manner to include enough interaction through its processes. It should also be conducted in the correct period. There should be ongoing training, in counseling and coaching, deriving recommendation that promote enhancement. Frequent appraisals increase the chance of identifying and evaluating the exercise as a means of offering guidance. This would make the processes less formal (Yan et al, 2010). Conclusion This paper has highlighted performance appraisal in nursing, for improving the effectiveness of the nursing processes, quality improvement of patient care, and staff motivation. Various types of evaluation techniques were outlined. The Task-Oriented Performance Appraisal system appears to be a comprehensive, objective, as well as an efficient tool, though other methods such as the interview and graphic rating scales are valuable in some aspects. The relationship between performance appraisal systems and nursing staff performance has been examined. The evidence indicates that performance appraisal serves as a key control system in nursing. It effectively provides a combined measure of staff performance for the nurse executive while at the same time providing guidance to individual nurses for career progress. On the other hand, various forceful arguments opposing performance appraisal were identified. 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