Decision making & problem solving by: Hayaa Nafa Supervised by: Dr. Fatamah Baddar Ph.D.,M.Sc.N.,B.Sc.N Associate Prof. Nursing Adminstration &Education.

Decision making & problem solving

by: Hayaa NafaSupervised by: Dr. Fatamah BaddarPh.D.,M.Sc.N.,B.Sc.N Associate Prof. Nursing Adminstration &Education

Dept.

Outlines

- Introduction- What is decision making ?- Decision making situation.- Problem solving- Relationship between decision making and problem solving- Types of decisions- Level of decision - Factors affecting decision making- Decision making process- Decision making models- Decision making techniques- Problem solving methods- Problem solving steps- Critical elements in decision making and problem solving- Individual variations in decision making-Decision making in organizations-How to improve decision making- Summary

o To cope with the realities of today’s health care system, nurses must be prepared to be critical thinkers. They must also be ready to welcome change and thrive in rapidly changing environments.

o Decision making is often thought to be synonymousمرادف with management and is one

of the criteria on which management expertise is judged. Much of any manager’s time is spent critically examining issues, solving problems, and making decisions. It is the authors’ belief that problem solving, decision making, and critical thinking are learned skills that improve with practice. So that the processes can be consistently replicated, these learned skills rely heavily on established tools, techniques, and strategies.

Introduction

Decision making

Decision making is a complex, cognitive process often defined as choosing a particular course of action. Webster’s definition—to “judge or settle”—is another view of decision making.

OR

a systematic cognitive process in which there must be an identification of alternatives.

Decision making situation

Decision making situation: The situation in which decisions are made. It may be personal, clinical, or organizational.

Personal decision making: is a familiar part of everyday life.

Clinical decision making: relates to quality of care and competency issues.

Organizational decision making: is choosing options directed toward the resolution of organizational problems and the achievement of organizational goals.

What is the difference between decision making

and decision taking?

Decision taking

Decision taking Judgments selected from two or more alternatives, it is final step

of decision making.

Problem solving: - is part of decision making. A systematic process that focuses on analyzing a difficult situation, problem solving always includes a decision-making step

OR- is a process whereby a dilemma is identified and corrected.

Problem : - - A present unsatisfactory state that needs to be changed to a desired state as soon as possible

OR- Some deviation from the expected standard which prevent the achievement of objectives.

Many educators use the terms problem solving and decision making synonymously, but there is a small important difference between the two. Although decision making is the last step in the problem solving process, it is possible for decision making to occur without the full analysis required in problem solving. Because problem solving attempts to identify the root problem in situations, much time and energy are spent on identifying the real problem.

Decision making and problem solving used inconsistently or interchangeably.The two process appear similar and may in some instances depend on one another, they are not synonymous.The main distinctions between the two are that decision making may or may not involve a problem, but it involves selection of alternatives.Whereas problem solving involves diagnosis a problem and solving it, which may or may not entail deciding on one correct solution.Most of the time, decision making is a subset of problem solving.

Relationship between decision making and problem solving

There are THREE main types of decision that the nurse manager can experience in different situations, namely: routine, adaptive, and innovative decisions.

A- Routine decisions: is the decision made when problems are relatively

well defined and common and when established rules, policies, and procedures can be used to solve them. e.g. shortage of nursing staff

B- Adaptive decisions: is the decision made when problems and alternative

solutions are somewhat unusual and only partially understood. e.g. changing working time pattern or methods of assignment

C- Innovative decisions: is the decision made when problems are unusual and

unclear and creative solutions are necessary. e.g. increase infection rate to 50% among surgical patients

Types of decisions

Levels of decisions

Levels of decisions

Strategic Administrative Operational

Levels of decisions

1. Strategic decisions:- Decisions made by the top executives that a crucial to operations or long-range planning Are strategic because they define and focus on major, long-term goals.

2. Administrative decisions middle managers make most administrative decisions. They resolve unusual problems and develop techniques to improve functioning

3. Operational decisions: these are the routine decisions that relate to day-today events. Middle and first line managers make most of the operational decisions

Levels of decisions

1- experience and knowledge .

2- creating thinking.

3- self concept.

4- stress

5- interpersonal conflict

6- time available. , money, energy

Factors affecting decision making

The factors affecting decision making:

7-Routine versus non routine decision.

8-Risk associated with the decision.

9-Critical nature of work.

10-Written guidelines.

11-Organization attitude toward decision making.

12-Amount and kind of information available.

The factors affecting decision making:

13-Degree of acceptance and support.

14-Manegers personal ability.

Characteristics of effective decision making process:

• Conducted in a systematic, comprehensive way of thinking.

• The consequences of the implemented decision are determined.

• Results in positive outcomes and fewer negative consequences.

• Based on a "Goal-oriented" analysis of the situation, its problems, and their alternative solutions.

Decision making process


1) Defining the problem:

You may need to state the problem in broad terms since the exact problem may not be obvious.( Increase Medication errors)

you may lack information to define it

you can confuse symptoms with underlying causes Prepare a statement of the problem and find someone you

trust to review it and to talk it over. If the problem is a job situation, review it with your supervisor or the appropriate committee or resource.


2- Gather Information: from where!!!

Stakeholders:”Individuals, groups, organizations that are affected by the problem or its solution”.

Facts & data - Research. - Results from experimentation and studies. - Interviews of "experts" and trusted sources. - Observed events, past or present, either personally observed .

Boundaries The boundaries or constraints of the situation are difficult

to change.

Opinions and AssumptionsOpinions of decision makers, committees or groups, or other powerful groups will be important to the success of your decision. It is important to recognize truth, bias, or prejudice in the opinion.

3) Develop Alternatives

Look at the problems in different ways; find a new perspective that hasn’t thought of before. Once you have listed or mapped alternatives, be open to their possibilities. Make notes on those that:

Need more information. Are new solutions. Can be combined or eliminated. Will meet opposition. Seem promising or exciting.

4) Weigh Alternatives After listing possible alternatives, evaluate them without prejudice, no matter how appealing or distasteful Consider all criteria while a suitable solution may solve the problem, it may not work if resources aren't available, if people won't accept it, or if it causes new problems

5. Select the best alternative Don't consider any alternative as "perfect solution." If there were, there probably wouldn't be a problem in the first place

Consider your intuition, or inner feelings in deciding on a course of action

Return to a trusted outsider: Is there something you missed?Does he/she see a problem with your solution?

Compromise when you have a full grasp of the problem, and your alternatives

Techniques in weighing alternatives:

1-Thomas Saaty's Analytical Hierarchy Matrix:

List alternatives in columns and rows as depicted in the

matrix above. Starting with Alternative A, go across

columns in the matrix and rate each alternative against

all the others.

When the alternative under consideration has more value

than the others.

Then give the more valuable alternative a score of 1

When the alternative has less value than the others.

Then give the less valuable alternative a score of 0

1-Thomas Saaty's Analytical Hierarchy Matrix:

Add the scores for each row/alternative;

highest score is the highest rated

alternative according to the criteria you

used. In the matrix above, Alternative C

scores highest, so it's the highest rated

alternative.

2- SFF Matrix: Suitability, Feasibility & Flexibility:

Suitability Feasibility Flexibility Total

Alternative A

Alternative B

Alternative C

Alternative D

A-Suitability: refers to

the alternative itself, whether it is ethical or practical. Is it

appropriate in scale or importance? An adequate

response? Too extreme?

B-Feasibility: refers to

how many resources will be needed to solve the problem

(i.e. Is it affordable?)

How likely will it solve the problem?

C-Flexibility: refers to

your ability to respond to unintended consequences, or

openness to new possibilities? The alternative itself

and whether you can control outcomes once you begin.

Total a score for each alternative, compare, prioritize your

alternatives...

6) Implement the solutionuntil the solution is acted on, a decision is only a good intention.

Develop a plan for implementation. Its elements include:

Step-by-step process or actions for solving the problem.

Communications strategy for notifying stakeholders.

Where important or necessary, inform those who care for you and/or will be affected by the change. Prepare them as necessary about your decision.

Resource identification/allocation. Timeline for implementation

7) Monitor progress if results are not what you expect, review your options and alternatives

Whether or not you achieved your goals, it is important to consider what you have learned from your experience: about yourself, about what you consider important.

Lastly, if you have done your best, you have this as one measure of success.

1- interpret data in more than one way.

2- set criteria of success beforehand .

3- ask other people

4- lest your failure

5- improve feedback by avoid missing and confuse

6- scrutinize the decision making process

7- Change your way of deciding and reevaluate your

time, and learning from experience

8- have group do decisions audits too.

9- be rational.

How to improve decision making

How to improve decision making?

10 Educate people so they know how to make appropriate decision.11.Seeking support of top management for decision making at the lowest

possible level, (e.g decentralization)12.Successful manager stay informed about decision being made at

different levels of the organization after appropriately delegating these responsibilities.

13.The managers should deal only with these decisions requiring their level of expertise (non routine decisions), support implementation of decisions, and credit the decision maker.

14.Delegation of decision making (routine decision making) to subordinates to gain their trust, loyalty and to raise their self-esteem.

15.Successful manager who is skilled in both decision making and problem solving serves as a motivator and role model for others

Traditional Problem-Solving Process

The traditional problem-solving model is widely used and is perhaps the most well known of the various models. The seven steps follow. (Decision-making occurs at step 5.)

1. Identify the problem.2. Gather data to analyze the causes and consequences of the problem.3. Explore alternative solutions.4. Evaluate the alternatives.5. Select the appropriate solution.6. Implement the solution.7. Evaluate the results.

Traditional Problem-Solving Process

Although the traditional problem-solving process is an effective model, its weakness lies in :

1. the amount of time needed for proper implementation. This process, therefore, is less effective when time constraints are a consideration.

2. lack of an initial objective-setting step. Setting a decision goalhelps to prevent the decision maker from becoming sidetracked.

The Managerial Decision-Making Process

The managerial decision-making model, a modified traditional model, eliminates the weakness of the traditional model by adding a goal-setting step. Harrison (1981) has delineated the following steps in the managerial decision-making process:

1. Set objectives.2. Search for alternatives.3. Evaluate alternatives.4. Choose.5. Implement.6. Follow up and control.

user

there is another steps for decision making beside the previous mentioned , called MORAL,please search about it and do itas a thired example

The Managerial Decision-Making Process

The managerial decision-making process flows in much the same manner as the nursing process.

Decision-Making Process

Nursing process

Identify the decision assess

Collect data

Identify criteria for decision

plan

Identify alternatives

Choose alternative implement

Implement alternative

Evaluate steps in decision

evaluate

The nursing process

As a decision-making model, the nursing process has a strength that the previous two models lack, namely its feedback mechanism. It shows constant input into the process. When the decision point has been identified, initial decision-making occurs and continues throughout the process by using a feedback mechanism. Although the process was designed for nursing practice with regard to patient care and nursing accountability, it can easily be adapted as a theoretical model for solving leadership and management problems.

The nursing process

The weakness of the nursing process, like the traditional problem-solving model, is in not requiring clearly stated objectives. Goals should be clearly stated in the planning phase of the process, but this step is frequently omitted or obscured.However, because nurses are familiar with this process and its proven effectiveness, it continues to be recommended as an adapted theoretical process for leadership and managerial decision making.

Intuitive Decision-Making Model

• Romiszowski (1981) built on the nursing process in creating the intuitive decision making Model, In this model, the decision maker consciously incorporates recall or cumulative knowledge that comes from education, both formal and informal, as well as experience, in planning the decision. Inexperienced or novice decision makers spend more time in the assessment, recall, and planning phases, whereasexperienced decision makers gather information, recall, and often leap directly to Implementation.• “leap” from information gathering to implementation may be the greatest weakness of this model. In discussing intuitive decision making.

user

incomplete sentences

• Add MORAL & Morphy Models of decision making

Decision making techniques

Decision making techniques vary according to the nature of the problem or topic, decision maker, situation, and decision making method or process. Nurses are using tools such as cause- and- effect diagrams, flow charts, Pareto charts, run charts, histograms, control charts, and scatter diagrams to help understand facts and relationships in processes they are examining.


1. Group decision making: A number of studies have shown that professional people do not function well under micromanagement.

Group problem solving casts the manager in the role of facilitators and consultant.

Compare to individual decision making , group can provide more input and better decision.


2. Nominal group technique (NGT)

-It is eliciting written questions, ideas, and reactions from group members. Consists of :-Silently generating ideas in written.-Round-robin presentation by group members of their ideas on a flip chart.-Discussing each recorded idea and evaluate.-Voting individually on priority ideas, with group solution being derived mathematically through rank ordering.


3. Delphi technique

It is judgments on a particular topic are systematically gathered from participants who do not meet face to face.

Useful when expert opinions are needed .


4. Statistical aggregation:

Individuals are polled(قرعة (regarding a specific problem and their responses are tallied . like Delphi technique , does not require a group meeting. no opportunity for group members to strength their interpersonal tie or interaction.


5. Brainstorming

The idea generating technique wherein a Group members meet

and generate diverse ideas about the nature, cause , definition,

or solution to a problem without regard to questions of

feasibility or practicality. Through this technique, individuals

are encouraged to identify a wide range of ideas. Usually, one

individual is assigned to record the ideas on a chalkboard.

Brainstorming may be used at any stage of the decision-

making process, but it is most effective at the beginning, once

a problem has been stated.


Brainstorming is most effective for simple, well-defined problems. It encourages enthusiasm and competitiveness among group members in generating ideas. It also prevents group members from feeling hopeless about the range of possibilities in a given situation. Two methods are more frequently used.First: is the structured method (known as the round-robin) where each, member is asked to put forward an idea.


The other technique: is unstructured and is known as free-wheeling, in which ideas are produced and expressed by anyone at any time.

It is enjoyable but are often unsuccessful because members being to critique ideas.


6. fishbone diagram (causes and effect) Is drawn after a brainstorming session, the central problem is visualized as the head of the fish, with the skeleton divided into branches showing contributing causes of different parts of the problem.

Work system

ED Overcrowding

Resources and facilities

lack of availability of ground ambulance transportation

limited resources of ED in the form of medical Lack of supplies and

medications Unavailability of operating room time

shortage of physical plant space

Ancillary services not same hours as ED

Lack of availability of 24-hour laboratory tests Increased medical records documentation

requirements Increase length of stay due to waiting for test

Delay in the services provided by radiology, lab. and ancillary services

Fishbone diagram (Cause and effect)

Delay in treatment and prolonged patient stay in ED

No system available for supervising &evaluating work

Decision making techniques vary according to the nature of the problem or topic, decision maker, situation, and decision making method or process.

7. Thomas Saaty's Analytical Hierarchy Matrix

Thomas Saaty's Analytical Hierarchy Matrix

List alternatives in columns and rows as depicted in the matrix above. Starting with Alternative A, go across columns in the matrix and rate each alternative against all the others.When the alternative under consideration has more value than the others,Then give the more valuable alternative a score of When the alternative has less value than the others.Then give the less valuable alternative a score of Add the scores for each row/alternative; highest score is the highest rated alternative according to the criteria you used. In the matrix above, Alternative C scores highest, so it's the highest rated alternative.


8. Pareto Analysis

Selecting the Most Important Changes To Make. It uses the Pareto principle - the idea that by doing

20% of work you can generate 80% of the advantage of doing the entire job

is a formal technique for finding the changes that will give the biggest benefits.

How to use tool:

1. write out a list of the changes you could make 2. Then score the items or groups. 3. The first change to tackle is the one that has the

highest score


9. Paired Comparison Analysis Working Out the Relative Importance of Different Options. helps you to work out the importance of a number of options relative to each other. It is particularly useful where you do not have objective data to base this on.easy to choose the most important problem to solve, or select the solution that will give you the greatest advantage .

How to use tool: list your options. Then draw up a grid with each option as both a row and a column header.use this grid to compare each option with each other optiondecide which of the two options is most important


10. PMI ('Plus/Minus/Implications' )Weighing the Pros and Cons of a Decision.

How to use :focused on selecting a course of action from a range of options. check that it is going to improve the situation draw up a table headed up with: 'Plus', 'Minus', In the column underneath 'Plus', write down all the positive results of taking the action. Underneath 'Minus' write down all the negative effects. In the 'Implications' column write down the implications and possible outcomes of taking the action, whether positive or negative.


11. Six thinking hats Looking at a Decision from All Points of View It is used to look at decisions from a number of important perspectives. This forces you to move outside your habitual thinking style, and helps you to get a more rounded view of a situation.

'6 Thinking Hats‘ How to the Tool:Each 'Thinking Hat' is a different style of thinking.


White Hat:With this thinking hat you focus on the data available. Look at the information you have, and see what you can learn from it. Red Hat: you look at problems using intuition, gut reaction, and emotion . Try to understand the responses of people who do not fully know your reasoning.Black Hat:look at all the bad points of the decision .


Yellow Hat:The yellow hat helps you to think positively. It is the optimistic viewpoint that helps you to see all the benefits of the decision and the value in it Green Hat:The Green Hat stands for creativity. This is where you can develop creative solutions to a problem Blue Hat:The Blue Hat stands for process control. This is the hat worn by people chairing meetings. When running into difficulties because ideas are running dry, they may direct activity into Green Hat thinking. When contingency plans are needed, they will ask for Black Hat thinking,


12. Decision grid:A decision making process grid is a matrix for comparing multiple options when there are also several criteria to consider.

It has many names, including Pugh matrix, solution matrix, decision making matrix, decision grid, problem selection grid. It is a rational model and is also classed as a visual decision tool.

When the complexity of the decision increases these decision making tools and techniques can prove useful. Especially as the number of options and criteria increase.

Example

Problem solving

Problem solving methods:

Trial-and-error method :one solution after another is tried until the problem is solved or appears to be improving.

Experimentation: a theory is tested to enhance knowledge, understanding , or prediction.

Affinity map : a tool used to identify problems.

Steps in problem solving

1- define the problem2- gather information3- analyze the information4- develop solutions5- Make a decision6- implement the decision7- evaluate the solution

CRITICAL ELEMENTS IN PROBLEM SOLVING ANDDECISION MAKING

1. Define Objectives Clearly :• If a decision lacks a clear objective or if an objective is

not consistent with the individual’s or organization’s stated philosophy, a poor-quality decision is likely. Sometimes the problem has been identified

but the wrong objectives are set. Problems can be extremely complex and may need multiple objectives (Clancy, 2003).


2. Gather Data Carefully:Because decisions are based on knowledge and information available to the problem solver at the time the decision must be made, one must learn how to process and obtain accurate information. The acquisition of information begins with identifyingthe problem or the occasion for the decision and continues throughout the problem-solving process.


Questions that should be examined in data gathering are:1. What is the setting?2. What is the problem?3. Where is it a problem?4. When is it a problem?5. Who is affected by the problem?6. Is this your problem or someone else’s problem?7. What is happening?8. Why is it happening? What are the causes of the problem? Can the causes be prioritized?9. What are the basic underlying issues? What are the areas of conflict?10. What are the consequences of the problem? Which is the most serious?


3. Generate Many Alternatives :- When seeking alternatives, individuals need to expand their horizons; the most common trap managers fall into is limiting the borders of their decision frames. - Because everyone thinks uniquely, increasing the number of people working on a problem increases the number of alternatives that can be generated.

- Brainstorming is another frequently used technique. The goal in brainstormingis to think of all possible alternatives


4. Think Logically : People think illogically primarily in three ways.1. Overgeneralizing. This type of “crooked” thinking occurs when one believes that because A has a particular characteristic, every other A also has the same characteristic. An example of this thinking is when stereotypical statements are used to justify arguments and decisions.2. Affirming the consequences. In this type of illogical thinking, one decides that if B is good but he or she is doing A, then A must not be good. For example, if a new method is heralded as the best way to perform a nursing procedure and the nurses on your unit are not using that technique, it is illogical to assume that the technique currently used in your unit is wrong or bad.


3. Arguing from analogy. This thinking applies a component that is present in two separate concepts and then states that because A is present in B, then A and B are alike in all respects. An example of this would be to argue that because intuition plays a part in clinical and managerial nursing, then any characteristic present in a good clinical nurse also should be present in a good nurse–manager. However, this is not necessarily true; a good nurse– manager does not necessarily possess all the same skills as a good nurse– clinician.


5. Choose and Act Decisively :Individuals may become vulnerable at this last point in theproblem-solving process and choose to delay acting because they lack the courage to face the consequences of their choices. For example, if managers granted all employees’ requests for days off, they would have to accept the consequences of their decision by dealing with short staffing.

INDIVIDUAL VARIATIONS IN DECISION MAKING

Because everyone has different values and life experiences,and each person perceives and thinks differently, different decisions may be made given the same set of circumstances. No discussion of decision making would, therefore, be complete without a careful examination of the role of the individual in decision making


• Values• Life experience

• Individual preference• Individual ways of thinking and decision making


1. values:

Individual decisions are based on each person’s value system.No matter how objective the criteria, value judgments will always play a part in a person’s decision making, either consciously or subconsciously. The alternatives generated and the final choice selected are limited by each person’s value system.

Because values also influence perceptions, they invariably influence information gathering, information processing, and final outcome


2. Life Experience:Each person brings to the decision-making task past experiences that include education and decision-making experience. The more mature the person and the broader his or her background, the more alternatives he or she can identify.3. Individual Preference:With all the alternatives a person considers in decision making, one alternative may be preferred over another. The decision maker, for example, may see certain choices as involving greater personal risk than others and therefore may choose the safer alternative. Physical, economic, and emotional risks, and time and energy expenditures, are types of personal risk and costs involved in decision making.


4. Individual Ways of Thinking and Decision Making :Our way of evaluating information and alternatives on which we base our final decision constitutes a thinking skill. Individuals think differently. Some think systematically—and are often called analytical thinkers—whereas others think intuitively. It is believed that most people have either right- or left-brain hemisphere dominance.

Some feel that there is a gender difference in how we think and behave. Rudan’s research (2003) looked at how male and female leaders behaved differently and noted that males and females socialized and communicated differently; males paid much less attention to relationships and resisted being influenced. These differences have the potential to effect decision making.

OVERCOMING INDIVIDUAL VULNERABILITY INDECISION MAKING

1. Values :Overcoming a lack of self-awareness through valuesclarification decreases confusion. People who understand their personalbeliefs and feelings will have a conscious awareness of the values on which their decisions are based.2. Life experience: a person can do some things to decrease this area of vulnerability:-use available resources, including current research and literature, to gain a fuller understanding of the issues involved. -involve other people, such as experienced colleagues, trustedfriends, or superiors, to act as sounding boards and advisors. - analyze decisions later to assess their success.

OVERCOMING INDIVIDUAL VULNERABILITY INDECISION MAKING

3. Individual Preference :Overcoming this area of vulnerability involves self-awareness, honesty, and risk taking. 4. Individual Ways of Thinking :People who make decisions alone are frequently handicapped because they are not able to understand problems fully or make decisions from both an analytical and intuitive perspective. However, in most organizations, both types of thinkers may be found. Using group process, talking management problems over with others, and developing whole-brain thinking also are methods for ensuring that both intuitive and analytical approaches will be used in solving problems and making decisions. Use of heterogeneous rather than homogeneous groups will usually result in better-quality decision making

DECISION MAKING IN ORGANIZATIONS

Since organizations are made up of people with differing values and preferences, there is often conflict in organizational decision dynamics.

1. Effect of Organizational Power on Decision MakingPowerful people in organizations are more apt to have decisions made (by themselves or their subordinates) that are congruent with their own preferences and values. On the other hand, people wielding little power in organizations must always consider the preference of the powerful when they make management decisions. Power is frequently part of the decision factor (Good, 2003). In organizations choice is constructed and constrained by many factors, and therefore choice is not equally available to all people.

DECISION MAKING IN ORGANIZATIONS

2. Rational and Administrative Decision Makingmost managerial decisions were based on a careful, scientific, and objective thought process and managers made decisions in a rational manner. In the late 1940s, Herbert A. Simon’s classic work revealed that most managers made many decisions that did not fit the objective rationality theory. Simon (1965) delineated two types of management decision makers: the economic man and the administrative man.

Comparing the Economic Man with theAdministrative Man

Economic Administrative

Makes decisions in a very rational manner

Makes decisions that are good enough.

Has complete knowledge of the problem or decision situation.

Because complete knowledge is not possible, knowledge is always fragmented.

Has a complete list of possible alternatives.

Because consequences of alternatives occur in the future, they are impossible to predict accurately.

Has a rational system of ordering preference of alternatives.

Usually chooses from among a few alternatives, not all possible ones.

Selects the decision that willmaximize utility function.

The final choice is “satisficing” rather than maximizing.

Summary

The decision making process may employ several models: rational or normative, descriptive or bounded rationality, satisfying, and political.

Decision making techniques vary according to the problem and the degree of risk and uncertainty in the situation.

Decision making & problem solving by: Hayaa Nafa Supervised by: Dr. Fatamah Baddar Ph.D.,M.Sc.N.,B.Sc.N Associate Prof. Nursing Adminstration &Education.

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