2. Nursing Direction

1. Professional Nursing Organization – The Professional Nursing Organization of the University of Arkansas for Medical Sciences Medical Center and Clinical Programs operates within a decentralized organizational framework under the leadership of the Chief Nursing Officer. Within the Professional Nursing Organization, nursing colleagues from all areas across the continuum of care come together to develop, monitor, and evaluate nursing practice. While nursing services are provided in areas in which the Chief Nursing Officer does not have direct line accountability, it is through this organization that formal collaborative relationships exist which assure consistent, high quality standards of nursing care for our patients and consistent personnel credentialing/performance appraisal practices for our staff.

The bylaws of the Professional Organization may be found in Addendum E.1.

The credentialing process for nurses not employed by the University of Arkansas for Medical Sciences Medical Center and Clinical Programs is found in Addendum E.1.A.

b. Inpatient Nursing Operations:

1. The Chief Nursing Officer is assisted in the execution of her duties by the Directors. The Directors function in the role of the middle managers, each being responsible for the provision of leadership and management for their respective divisions.  Included in these responsibilities are planning, ongoing evaluation of their individual program areas and the maintenance of continuity within a decentralized PNO.  The Directors function in liaison roles with the medical staff and various colleges on campus.  In addition, they assume accountability for the PNO in the absence of the Chief Nursing Officer.
2. The Assistant Directors of Nursing (ADONs) report directly to the Associate Director of Patient Care Services and have a functional relationship with the Nursing Directors and Clinical Services Managers.  The Assistant Directors of Nursing assume responsibility for the operations of the nursing units on evenings, nights, and weekends, and are accountable for assuring continued implementation of hospital, departmental, division and unit-specific policies.  They are authorized to act in the absence of the Chief Nursing Officer, Directors, and Clinical Services managers, and have final authority for allocation of resources to meet immediate needs on the patient care units.  The ADONs serve as a representative and liaison of hospital administration on evenings, nights and weekends.
3. Each nursing unit is managed by a Clinical Services Manager who maintains twenty four-hour accountability for patient care delivery on his/her unit. This RN reports to the Director. The Clinical Services Manager may be assisted in the execution of his/her duties by an RN IVs and Care Delivery Facilitators.
4. Delivery of quality patient care is the ultimate responsibility of the registered nurse. Each unit has a variety of non-licensed support personnel who assist in provision of nursing care.  The accountability for assessment, patient care planning and evaluation of the effectiveness of care rests with the registered nurse.  The accountability for safe execution of the plan of care is that of all members of the nursing team.  Care is facilitated by an RN IV or Care Delivery Facilitator who is a senior level clinician whose scope is that of the Clinical Services Manager to whom they report. 
5. The Clinical Programs Education Department, Infection Control Practitioners, and an Enterostomal Therapists, all of whom report to an Associate Hospital Director, provide support to patients and staff of University of Arkansas for Medical Sciences Medical Center Clinical Programs. The Nursing Quality Improvement Department under the direction of an Associate Director of Patient Care Services reports directly to the Chief Nursing Officer.
6. Additional support personnel include a Business Manager, an assistant to the Chief Nursing Officer, and a Nurse Recruiter. The Business Manager has responsibility for financial matters, paycheck distribution, and functioning of the Business Office. The Business Office coordinates payroll/paycheck distribution (Addendum E.2). The Nurse Recruiter coordinates recruitment and retention activities in the Professional Nursing Organization.

3. Outpatient Nursing Operations

1. The outpatient nursing directors work under the supervision of the Outpatient Administration, the Medical Directors and in collaboration with the Chief Nursing Officer. The outpatient directors coordinate the basic operation of the outpatient clinics, establish and enforce systems to ensure the quality of care, maintain ongoing financial viability within the designated budget, adapt the organization to economic, technologic and regulatory regulations and respond to physician, employee, patient and community needs.
2. Clinic Manager – Directly accountable for the operations of their designated clinics and reports directly to the medical director and clinical nursing director.
3. Charge Nurse – RN IIIs who are responsible for direct patient care of the professional nursing team. The charge nurse assigns nurses to assist physician specialists with the coordination of care based on their expertise and level of skill. The clinic manager oversees the delivery of care provided by LPN's and non-professional support personnel.