PROJECT DEVELOPMENT IN ADVANCED NURSING

Project definition

It is a set of interrelated activities designed to achieve specific objectives with in a

specified period of time using a specific budget/plan/strategies.

Projects respond to conceived identified needs/ problems or issues. In advanced nursing,

the nurse identifies a gap in the nursing care practice and initiates a project to meet the
gap for example, if it is perceived that there is increasing sepsis in maternity ward, a
nurse may verify the problem on the ground by performing an initial assessment and
quantify the sepsis level like 50% sepsis, will then look at the possible causes of sepsis.
Inadequate administration of prescribed antibiotics, peer environment hygiene, lack of
exercises, inadequate sterility during procedures. Then would work out strategies to
reduce the sepsis to a set quantifiable level eg reduce sepsis to 10%. in a given period.
For example of the project in place, SSP surgical safety program with WHO.

Categories of projects

According to types

-Incoming generating projects/businesses Projects

-Social projects /public services

Research projects

According to size

Small or micro project- Have few objects and small budget and in a short time.

-Medium scale projects

-Macro (large) -big or extensive

Planning
Is thinking through something intended to be done, so as to lay strategies for achieving
the objectives.

To plan is just to look a head and prepare what has to be accomplished in future.

It involves thinking, deciding and acting.

Planning gives a purpose and direction to the project in the prevailing environment
(considering available resources including human resource) therefore project
development means planning and management.

Management

It is a science of mobilizing various resources both human and non human for the
purpose of accomplishing the desired results to achieve in the changing environment. for
example in the given example of reducing sepsis, the leading nurse in the project may
need to provide a CUE on control / prevention of sepsis and bring the staff together so
that a team combines efforts for a common goal.

Project cycle /sequence

The project cycle are activities involved in the arrangement for achieving the set goals of
the project from its conception to its completion.

Six stages /phases have been identified in the evolution of projects

i) Project identification

Project identification is the conceptualization of the project ideas. Ideas may be triggered
by some need /problem that become obvious to the individual or institution. It covers
preliminary screening /scanning in the needs /problems. Some times this is termed as
feasibility study. It involves selecting of the project out of many alternatives ie priority
setting.

ii) Project design

This involves translation of ideas into specific activities, identification of the most
important needs/aspects of the project. eg the technical- does the project need a more
qualified staff or specialist, size- is it going to involve the whole hospital or just one
department, cost- does it need extra resources or are they available in hospital or need a
special order and finally working plans.

iii) Project appraisal

The appraisal of the project is a systematic review of all aspects of the projects with the
aim of providing reliable information to proceed or not to proceed with the project. It
involves checking the estimates and projections of the cost of resources and the expected
flow of benefits from the project along with possible financiers and beneficiaries. The
appraisal can be internal or by use of independent experts. The report of the appraisal or
project proposal can be used for selecting funds for the project if presented to
management or even donors.

Project appraisal may examine the technical, financial, economic, social, institutional
environment and sustainability aspects of the project. Political and legal aspects are
considered during the appraisal process.

iv) Project implementation

This stage involves carrying out most of the activities of the project. Service delivery is
undertaken. The human resources are in place and other resources are distributed
accordingly. Human resources share activities according to specialties so that the prior
agreed course of action is in place.

v) Project monitoring

This is a continuous overseeing /regular observation and follow up of project

implementation to find out if project is on track with respect to objectives, availability of
resources, timeliness, benefit and other aspects are examined to suggest any necessary
adjustments. for example in decrease of sepsis- what is being done? Are the patients
receiving medications as prescribed? ie right drug, dose, time if not, why not? What can
be done?

vi) Project evaluation

Evaluation involves a systematic assessment of the performance of the project with

respect to prior set goals.

Evaluation takes place every phase of the project.

Practical consideration in project implementation

Registration of the project implementation agency; it is important for the implementing

agency /individual to be registered with government so that its activities are backed by
law. In the advanced nursing small projects, the health facility may only be registered or
formally reported to then management locally. Before any project organization is
registered, the following should be in place;

a) Formation of the foundation body

b)Formation of articles and memorandum of association (articles that rule and regulate
the association)

Getting the approval of the general assembly of the project members

2. Project implementation planning

The project cant be viable with out proper implementation plan. A work plan of the
project is the schedule of activities and how they follow one another.

It is at the stage when job descriptions and elaboration of departmental functions,

monitoring plans of the project should be designed and project evaluation guidelines are
also designed.
3. Institutional establishment for project implementation

For every project implementing agency requires a well established system to constitute its
institutional frame work for the controlled implementation of its project.

4. Launching and introducing the project operation (official opening of the project)

This involves setting a project into the operational process. It is the actual stage of the
project. The competent workers are selected and introduced in the project. There is
mobilization and sensitization of the target group in order to solicit their acceptability,
support and willingness to participate in all major activities of the project.

5. Mainatinance and enhancement of the day to day administration of the project

This involves management of the project as an operational process, it includes;

Supervision, monitoring, controlling, evaluation.

It is important to remember that the more survival of the project is not a guarantee of
achieving project objectives to an acceptable level. A project may be running but
underachieving or under performing, necessitating to be put on the right course and
enhance efficiency and effectiveness.

Strategies for improving (enhancing project viability)

- Through SWOT analysis- strength, weaknesses, opportunities and threats

-Through maintaining interest of the stake holders

-Through improved operational plans and procedures

Indicators for project strength

Includes; have staff who are committed, honesty, responsible, transparent, accountable,
self motivated and clear headed.
Too adequate resource allocation and other factors of production including a clear
leadership with clear goals and mission constitutes strength of the project.

Indicators of the project weaknesses

This is reflected in the project workers /staff lacking self confidence or being ignorant of
the goals of the project / not knowing what the project is about and what it stands for. The
staff may also be too ambitious, arrogant and critical of one another, lack of recognition
of each others inputs.

Other indicators include poor communication, poor chain of command and lack of
regular appraisal and reporting.
Indications of the project opportunities
Project opportunities can be reflected by chances of staff development programmes to
equip workers with better knowledge and skills. Opportunities also include increased new
contact with more influential persons and organizations including good will from policy
makers, funding bodies and other agencies.

Project indicators of threats

Threats of a project may be shown by existence of rival organizations (competitors o lack

or resources, lack of motivation, funds, poor beliefs)

1. Through maintaining interests of the project stake holders

This is done by considering then following;

All those who have interest in the project, customers/ patients, service providers and
other beneficiaries.

By keeping them informed on what is going on

Recognizing their inputs

Inviting them for meetings and special occasions

Involving them in identifying strategies for new plans

Through improved operational plans and procedures

It is done by considering the following;

- Trying to follow the project work plan because its guide in project implementation

- By allocating resources effectively, such resources include finances, man power

- By developing an efficient system of scheduling and delegation of functions

- Establish an efficient management of