DEVELOPMENT AND MAINTENANCE OF STANDARDS AND ACCREDITATION IN NURSING EDUCATION PROGRAMS Role of INC, State Registration Nursing Council,

, Boards and University Role of Professional associations and unions INTRODUCTION Nursing education is the professional education for the preparation of Nurses to enable them to render professional nursing care to people of all ages, in all phases of health and illness in a variety of settings. Education should impart scientific and uptodate knowledge in the area of medical, social, behavioural and biological sciences. Nursing education should prepare nurses as good leaders to provide qualitative care. NURSING EDUCATION IN INDIA The Nursing Council Act came into existence in 1948 to constitute a council of nurses who would safeguard the quality of nursing education in the country. The mandate was to establish and maintain uniform standards of nursing education. Today, the Indian Nursing Council is a statutory body that regulates nursing education in the country through prescription, inspection, examination, certification and maintaining its stand for a uniform syllabus at each level of nursing education. They have also ensured easier measures for equivalence, exchange and practice for nurses in any part of the country. On the other hand, the strive for maintenance of a uniform standard and-pattern of nursing education has curbed creative development and experiments for expansion of nursing into newer horizons of caring and function.

Types of Nursing Programs ADMISSION TERMS & CONDITION FOR SCHOOL / COLLEGE OF NURSING

No.

Nursing Progra ms Auxiliary Nurse & Midwife

Eligibility Criteria

Training Examination Duration Nursing Examination Board

Registration

10 Pass

1 and 1/2 years

R.ANM

General Nursing & Midwifery

10+2 Class pass with aggregate of 40%

3 and 1/2 years

Nursing Examination Board

R.N & R.M

B. Sc (Basic)

10+2 Class Pass with 45% aggregate in PCBE

4 years

University

R.N & R.M

Regular B.Sc (Post Basic) 10+2 + GNM Distance 10+2 GNM + 2year Exp. B.Sc. Nursing / B.Sc. Hons. Nursing / Post Basic B.Sc. Nursing with minimum of 55% aggregate marks. one year of experience after Basic B.Sc. or Post Basic B.Sc. Nursing. 1 year (Full time) 2 years (part time) 3-5 years Additional Qualification Additional Qualification 3 years 2 years University Additional Qualification

M. Sc.

2 years

University

Additional Qualification

M. Phil

M. Sc.

University

Ph D Post Basic Specialty Diploma Courses

M. Sc./ M. Phil

University

R.N & R.M one year of clinical experience

One Year

Board or University

Additional Qualifications

M.Sc. Any organization under the Central Government, State Government, Local body or a Private or Public Trust, Mission, Voluntary registered under Society Registration Act or a Company registered under companys act wishes to open a M.Sc. Nursing programme, should obtain the No Objection/Essentiality certificate from the State Government. If the institution is recognized for B.Sc. (N) programme and if one batch has passed out after found suitable by INC, then the institution will be exempted from NOC/Essentiality certificate for M.Sc.(N) programe from the State Government. The Indian Nursing council on receipt of the proposal from the Institution to start nursing program, will undertake the first inspection to assess suitability with regard to physical infrastructure, clinical facility and teaching faculty in order to give permission to start the programme. After the receipt of the permission to start the nursing programme from Indian Nursing Council, the institution shall obtain the approval from the State Nursing Council and University. Institution will admit the students only after taking approval of State Nursing Council and University. The Indian Nursing Council will conduct inspection every year till the first batch completes the programme. Permission will be given year by year till the first batch completes. If the institution is recognized for B.Sc. (N) programme and if one batch has passed out after found suitable by INC, then the institution will be exempted from NOC/Essentiality certificate for M.Sc.(N) programe from the State Government.
Super Speciality Hospital* can start M.Sc.(N) programme,

however they have to get NOC/Essentiality certificate from respective State Government to start the M.Sc. (N) programme.
*Super Speciality Hospital are eligible to start M.Sc.(N) provided they have respective speciality beds

Upgradation from School to College

Any "School of Nursing" can upgrade to "College of Nursing"

provided one batch of students have passed out after found suitable by INC. Further on up-gradation institution has to stop GNM Programs.

 Documents to be submitted to INC for Upgradation:

o

Decision of the management committee to upgrade school of nursing to college of nursing. Consent letter of the university to which the college needs affiliation.

Regulation of M.Sc.

M.Sc. (N)

If parent hospital is super-specialty hospital like cardio-thoracic hospital/cancer with annual intake 10 M.Sc(N) in cardio thoracic/cancer
o o o

Professor cum coordinator 1 Reader / Associate Professor 1 Lecturer 2

The above faculty shall perform dual role.

M.Sc. (N) Annual intake of 60 students in B.Sc.(N) and 25 students for M.Sc. (N) programme.
o o o o o

Professor-cum-Principal Professor-cum-Vice Principal Reader / Associate Professor Lecturer Tutor / Clinical Instructor

-1 -1 -5 -8 - 19 --------------Total - 34

One in each specialty and all the M.Sc(N) qualified teaching faculty will participate in all collegiate programmes. Teacher Student Ratio = 1 : 10 for M.Sc.(N) programme. QUALIFICATIONS & EXPERIENCE OF TEACHERS OF COLLEGE OF NURSING

Sr. No. 1

Post

Qualification & Experience

Professor-cum- - Masters Degree in Nursing Principal - 14 years experience after M.Sc. (N) in College of Nursing . - 3 years experience in administration (Years of experience is relaxable if suitable candidate is not available) (If a candidate is not
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available, minimum 5 years of experience in college of nursing, with an aggregate of 14 years teaching experience) Desirable : Independent published work of high standard / doctorate degree / M.Phil. 2 Professor-cumVice Principal - Masters Degree in Nursing - 14 years experience after M.Sc. (N) in College of Nursing . - 3 years experience in administration (Years of experience is relaxable if suitable candidate is not available) (If a candidate is not available, minimum 5 years of experience in college of nursing, with an aggregate of 14 years teaching experience) Desirable : Independent published work of high standard / doctorate degree / M.Phil. 3 Reader / Associate - Master Degree in Nursing. Professor - 10 years experience after M.Sc.(N) in a College of Nursing. (If a candidate is not available, 5 years of experience in College of Nursing with an aggregates of 10 years teaching experience.

Desirable : Independent published work of high standard /doctorate degree / M.Phil. 4 Lecturer - Master Degree in Nursing. - 3 years teaching experience after M.Sc. (N)

Note: Qualifications & Experience of Nursing Teaching faculty relaxed till 2012 & placed under Annexure I
External /Guest faculty may be arranged for the selected units in different subjects as required

NOTE:

No part time nursing faculty will be counted for calculating total no. of faculty required for a college.

Irrespective of number of admissions, all faculty positions (Professor to Lecturer) must be filled. For M.Sc.(N) programme appropriate number of M.Sc. faculty in each speciality be appointed subject to the condition that total number of teaching faculty ceiling is maintained. All nursing teachers must possess a basic university or equivalent qualification as laid down in the schedules of the Indian Nursing Council Act, 1947. They shall be registered under the State Nursing Registration Act. Nursing faculty in nursing college except tutor/clinical instructors must possess the requisite recognized postgraduate qualification in nursing subjects. Holders of equivalent postgraduate qualifications, which may be approved by the Indian Nursing Council from time to time, may be considered to have the requisite recognized postgraduate qualification in the subject concerned. All teachers of nursing other than Principal and Vice-Principal should spend at least 4 hours in the clinical area for clinical teaching and/or supervision of care every day.

ACCREDITATION IN NURSING Accreditation is a certification of the academic quality of an institution of higher learning. Some countries have independent/private organizations that oversee the educational accreditation process, while other countries accredit through a government agency. Some countries require accreditation and others consider it voluntary. In either case accreditation denotes academic quality and schools that lack recognized accreditation often claim accreditation from unrecognized sources. Unrecognized accreditations are meaningless to the academic community. What is the objective of accreditation?
Accreditation is a voluntary, privately managed process of peer

evaluation programs.

of

post-secondary

education

institutions

and

Being accredited imparts to the public, potential students,

educational institutions, government agencies, lenders, and others that the institution or program meets an established standard of quality.
In order for students, programs, or institutions to be eligible for

federal support under the Higher Education Act of 1965 or the

6

Nurse Education Act (Title VIII of the Public Health Service Act), a program or institution must be accredited by an agency recognized by the U.S. Department of Education (DOE) and be recognized in the published list of accrediting agencies. Thus, accrediting agencies play a critically important role as gatekeepers for access to federal funds.
There are two types of accreditation: institutional (as performed

by various regional agencies, and by the National League for Nursing (NLN) for schools, such as hospital. diploma programs, not within a higher education institution), and specialized or programmatic (such as performed by NLN and specialty nursing organizations for nursing schools within higher education institutions). All regional accrediting bodies have had, for a number of years, recognition status from the DOE. Baccalaureate and graduatedegree nursing programs already meet DOE criteria due to their position within regionally accredited institutions. How is nursing education currently accredited? A variety of organizations currently conduct specialized accreditation of nursing education, including the National League for Nursing (for all levels of nursing education, including practical, hospital diploma, as well as associate-, baccalaureate-, and masters-degree programs), the American Association of Nurse Anesthetists (for nurse anesthesia education), the American College of Nurse-Midwives (for preaccreditation and accreditation of nurse-midwifery programs), and the American Nurses Association (for continuing education). In addition, programs in institutions of higher education are reviewed by regional accrediting agencies, as well as by state agencies such as boards of education or state boards of nursing charged with approval of nursing education programs. Moreover, a variety of other nursing organizations have expressed interest in creating additional accreditation review processes for oversight of graduate-level nursing education, such as nurse practitioner programs. India Accreditation for universities in India are required by law unless it was created through an act of Parliament. Without accreditation It is emphasized that these fake institutions have no legal entity to call themselves as University/Vishwvidyalaya and to award degree which are not treated as valid for academic/employment purposes.

Accreditation for higher learning is overseen by autonomous institutions established by the University Grants Commission: All India Council for Technical Education (AICTE) including the National Board of Accreditation (NBA) Distance Education Council (DEC) Indian Council for Agriculture Research (ICAR) Bar Council of India (BCI) National Council for Teacher Education (NCTE) Rehabilitation Council of India (RCI) Medical Council of India (MCI) Pharmacy Council of India (PCI) Indian Nursing Council (INC) Dentist Council of India (DCI) Central Council of Homeopathy (CCH) Central Council of Indian Medicine (CCIM) Board of Theological Education of the Senate of Serampore College (BTESSC) Government Approvable Of Nursing Programs
In most states, the approval accrediting activities for nursing

programs are carried out through the state board of nursing.

After registration laws were passed. State boards of nursing

began to emerge for the purpose of licensing nurses and protecting the public. Inspectors from the boards began making program visits for approval. Through the ANA, the Council of State Boards of Nursing was created to have a common forum for those who had the responsibility to regulate the practice of nursing in each state. In 1978, the National Council of State Boards of Nursing, Inc. (NCSBN) was formed to replace the ANA Council. NCSBN provided greater independence of the regulatory authorities from the professional organization.
When a new nursing program is to be initiated, it must provide

preliminary information to the appropriate state government department while in the planning phase, often in the form of a feasibility study or a self study or both. The nursing program must be approved prior to admitting students to assure prospective students that the program will provide the
8

preparation they seek. Each state also has a designated time frame to renew its approval of existing nursing programs. This often involves a comprehensive evaluation study, done by the program/school, that is submitted to the stat.
Representatives of the state approval authority then visit the

program. In some jurisdictions, a school that has received national accreditation from the National League for Nursing Accreditation Commission (NLNAC) or the Commission on Collegiate Nursing Education (CCNE) is not required to be further reviewed for state approval). RULES AND REGULATIONS FOR ACCREDITATION A. CONFIDENTIALITY OF ACCREDITATION INFORMATION All data, observations, conversations, conclusions, reports, and minutes relating to accrediting activities are CONFIDENTIAL. Acceptance of an invitation to be a visitor constitutes a contractual agreement to safeguard the confidentiality of accrediting data. B. TYPES OF ACCREDITATION The Board shall grant to a state nursing degree program one of the following types of accreditation: 1. Initial Accreditation a. Granted when the program is in compliance with all standards for a new program. Permission is granted to admit students and the next review is in the final semester of the first class in conjunction with the initial national review. b. Denied when the program does not meet all standards for a new program. The program may reapply at any time. 2. Continuing Accreditation a. Full Accreditation. All standards are met. The next review is in conjunction with the next national visit.
b. Full Accreditation with Recommendations. The program meets all

but one or two standards. A performance improvement plan must be submitted within three months. The program must be in compliance within one year. c. Accreditation with a statement of warning. The program does not meet three or more standards OR the performance improvement plan has not resulted in compliance with standards. A follow up focused visit is scheduled within two years.

3. Withdrawal of Accreditation. If the program is not in compliance within the time frame allowed in the Statement of Warning, accreditation will be withdrawn. STANDARDS FOR ACCREDITATION All state standards must be met by all programs of nursing in Mississippi in order to be fully accredited. a. Administrative Organization An organizational chart depicts the relationship of the nursing unit to the parent institution, Minimum requirements for administrators are:
o Associate degree - Masters in nursing from a regionally

accredited institution and a minimum of one year of clinical experience.

o Baccalaureate and higher degree - Doctorate with one

graduate degree in nursing from a regionally acrcdite4 institution and a minimum of one year of clinical experience. It is preferred that second level administrators (i.e. Associate/Assistant Dean/Director) hold a Doctorate with one graduate degree in nursing.
o All - unencumbered current license to practice in Mississippi

OR a valid license from another Compact state AND satisfactory criminal history background check. The administrator, with faculty involvement, has authority and responsibility for the following:
o Preparation and administration of the budget; o Screening

and recommending candidates for faculty appointments, retention, and promotion and tenure; and

o All administrative and leadership activities of the position. Nursing personnel policies are not illegally discriminatory, are written, accessible, and the same as for other faculty and staff. Position descriptions delineate qualifications and responsibilities of nursing administration, faculty and staff. b. Educational Programs

10

 All programs must maintain national accreditation by an approved accrediting agency. All programs must have:
o A written statement of philosophy that reflects the beliefs of

the faculty, is reviewed and revised as needed, and reflects the mission of the parent institution. o Anticipated outcomes that are consistent with the mission of the parent institution. o A program of learning that reflects the philosophy and outcomes, is developed by the faculty and program administrator, is organized so that knowledge and skills are progressively developed, and meets the requirements of the parent institution for graduation. o Provision to grant credit for prior learning, consistent with the parent institutions mission and the philosophy of the unit in nursing. o A general education component that contributes to the achievement of program outcomes.
o Written agreements with all health care facilities that must:

ensure faculty responsibility for students and the selection of their learning experiences contain termination clauses, and be periodically reviewed and revised as necessary. Each course must have: o Written measurable objectives. o Learning experiences and instructional methods that fulfill the objectives.
o Evolution methods and tools that measure achievement of

classroom and clinical objectives. Undergraduate student-to-faculty ratios must be: o No more than 15 to I for total enrollment. o No more than 10 to 1 for clinical laboratory courses. o No more than 15 to I for final semester clinical capstone courses where students work one on one with a qualified preceptor.
11

Associate Degree The relationship between nursing and liberal arts/general education courses is consistent with that of the parent institution with a balanced distribution of no more than 60 percent of the total number of credit hours allocated to nursing courses. Baccalaureate The relationship between nursing and liberal arts/general education courses is consistent with that of the parent institution. The majority of the course work in nursing is at the upper (junior/senior) level. Graduate The graduate curriculum builds on the knowledge and competencies of baccalaureate education in nursing and provides for attainment of advanced knowledge of nursing and related theories and application to advanced nursing practice. C. FACULTY AND/OR STAFF Faculty All faculty in nursing programs must have a masters or higher degree with a major in nursing, and a minimum of one year of clinical experience as a registered nurse. Exceptions may be granted by the Boards Director of Nursing education within the following parameters:
Exception faculty must be continuously enrolled in a graduate

degree nursing program. The maximum time allowed to complete the graduate program is three years. The maximum time allowed to complete the graduate program is three years. The majority of faculty in graduate nursing programs must have earned doctorates in nursing or a related field from regionally accredited institutions. Faculty without a masters in nursing may teach non-nursing courses (i.e., computer, statistics) in nursing programs where these courses are not otherwise offered at the institution. Exceptions made prior to the effective date of these standards will continue employment as exceptions.

12

 Faculty must implement an annual professional development plan that

includes a combination of course work, continuing education presentations, or attendance at continuing education programs. The plan must have been approved by the administrative head of the program AND must total a minimum of ten contact hours per year. All nursing faculty (full-time, part-time, and adjunct) must hold an unencumbered license from Mississippi OR a valid license from another Compact state AND satisfy a criminal history background check. Nursing faculty are responsible for: o Development, implementation and evaluation of the program of learning; o Development of standards for the admission, progression and graduation of students; o Participation in academic advisement; o Participation in the activities of the total. faculty of the parent institution; o Participation in professional and community activities. Preceptors shall be academically/experientially prepared at or beyond the level for which the preceptor service is rendered and shall have a minimum of one year of experience. D. STUDENTS Minimal admission criteria for associate degree nursing programs are as follows: o An ACT composite score of 18 and a 2.0 grade point average.
o Students with less than the required ACT composite score must

have completed a minimum of 12 semester hours, including Anatomy and Physiology, with a 2.5 grade point average before being admitted. They must have made at least a grade of C in Anatomy and Physiology courses.
o Students who have previously earned a baccalaureate or higher

degree may enter without an ACT by completing all the course prerequisites to the nursing major with a grade of C or better and having an overall grade point average of 2.5. Minimal admission criteria for state-supported bachelor of science nursing programs are as follows:

13

o An ACT composite score of 21. Students with the required ACT composite score must also have at least a grade of C in each prerequisite course and a 2.0 grade point average.
o Students with less than the required ACT composite score must

complete all the course prerequisites to the nursing major with at least a grade of C and have an overall grade point average of 3.0. o RN students and students enrolling for a second baccalaureate degree may enter without an ACT by completing all the course prerequisites to the nursing major with at least a grade of C and having an overall grade point average of 2.5.
o Baccalaureate nursing programs in independent institutions may

establish admission criteria which support the goals and aims of individual independent institutions.
Each school is permitted an allowance of 10 percent of the previous

falls nursing program admissions for high risk students who do not meet the criteria. Policies in effect for students in nursing are nondiscriminatory and are consistent with those in effect for all students enrolled in the parent institution; policies that differ are justified by program outcomes. E. RESOURCES, FACILITIES, AND SERVICES Financial support is adequate to achieve the stated outcomes for the program. Salaries are sufficient to recruit and retain qualified nursing faculty. Physical facilities are adequate for the need of the program. Secretarial and other support services are sufficient for the needs of the program. Learning resources and facilities are comprehensive, current and accessible to students and faculty. F. INTEGRITY Information about the program to the general public, students, employees, and others is clear, current, and accurate. Legal limitations for licensure are printed in a current catalog.
Complaints about the program are addressed and records are

maintained and available for review. G. EVALUATION

14

 Findings from a systematic evaluation of the unit in nursing, the

program of learning, graduates, and faculty are used for the programs development, maintenance, and revision.
The pass rate for all first writes on the registered nurse licensure

examination (NCLEX RN), regardless of where the exam was written, shall meet the following requirements.
o First write results for each calendar year shall be no less than 95%

of that years national average. Any program that has less than 95% of that years national average for first writes must submit a written plan for improvement that notes changes made and/or planned by July 1 of the following year. o The pass rate for first and second writes combined shall be no less than 95% pass for each calendar year. Each year will be calculated no later than 3 years from December31 of that year and any graduate who has never taken NCLEX shall not be included in the calculation. The pass rate for the nurse practitioner certification exam shall be 100% of those who have taken the exam during the first year after graduation. Graduation rates shall be: o 60% in 150% of the prescribed time for the program of study for undergraduate programs. o 80% of the prescribed program of study for graduate programs. H. CHANGES IN EXISTING NURSING PROGRAMS/REPORTS 34. Educational programs must submit the following reports: Action Annual Report Change in ownership Change in directors/deans Markedly curriculum altering Requirement Complete annual report form Notification letter Notification letter the Detailed description with review by Accreditation Committee Detailed description of educational, financial, operational, management, and physical resources to offer program with-

Adding a new teaching site

15

review by Accreditation Committee National accreditation status Copy of notification

Decision made to discontinue The Board shall be notified in writing of the program the intention of the controlling institution. If the remaining students continue in the program, adequate faculty and educational standards shall be maintained until the last student has completed the program. This date shall be the official closing date of the nursing program. Disposition of all students permanent transcripts and final records shall be made in accordance with institutional policy. A representative of the Board shall visit the nursing program and assist in making arrangements for proper closure and, if necessary, for the transfer of students. An institution desiring to reopen .an educational unit in nursing or a nursing program shall reapply for approval of a newly planned program.

The Director of Nursing Education will submit a report to the Board annually that will include: a. Admission numbers . b. Enrollment and graduation numbers c. NCLEX pass rates d. Certification exam pass rates e. Graduation rates f. Student to faculty ratio g. Faculty vacancy numbers h. Graduate enrollment by clinical major and practice role. i. LPN to RN enrollment j. RN to BSN enrollment

ROLE OF THE INDIAN NURSING COUNCIL The Indian Nursing Council is an autonomous body under the Government of India, Ministry of Health and Family Welfare. Indian Nursing Council Act, 1947 enacted by, giving statutory powers to
16

maintain uniform standards and regulation of nursing education all over the Country.

Aims and Objectives of Indian Nursing Council: To regulate the training policies and programmes in the field of Nursing. To bring about standardization of training courses. To prescribe minimum standards of education and training of various Nursing programmes. To regulate these standards in all training institutions uniformly throughout the country.
To recognise institutions / Organisations / Universities imparting

Masters Degree/ Bachelors Degree / P.G. Diploma / Diploma / Certificate Courses in the field of Nursing.
To Recognize Degree/Diploma/Certificate awarded by Foreign

Universities/Institutions on reciprocal basis. To promote research in Nursing. To maintain Indian Nurses Register for registration of Nursing Personnel. Training Programmes. Indian Nursing Council is responsible for the corporate governance of Nurses and the Nursing profession. This includes the issue of discipline, the promotion of health and health care, proposing and commenting on planned legislation, as well as proactively advising, alerting and offering comment to the Govt. on matters affecting the Nursing profession. Indian Nursing Council prime responsibility is to set the norms and standards for education, training, research and practice with in the ambit of the relevant legislative framework. In this regard, the following issues are considered critical. An ongoing review of curriculum in response to national priorities. An ongoing review of the education system with a focus on community based education.

17

 Integrated education with a focus on problem - based learning to

promote critical thinking. Competency based education. An ongoing review of the performance of work of Nursing professionals with in the ambit of the service delivery principles. Protection of the rights and dignity of people. ROLE OF INC FOR NURSES
Additional responsibilities were given to the INC when the initial

Indian Nursing Council Act of 1947 was amended in 1957. The INC was then asked to provide for Registration of Foreign Nurses and for the maintenance of the Indian Nurses Registers. This Register contains the names of all Nurses, Midwives, auxillary nurse midwives and para-nursing workers who are enrolled on all state registers. The INC authorized State Nurses Registration Councils and Examining Boards to issue qualifying certificates. This recognition is given, however, only after those bodies have been recognized by their State Governments. The Indian Nursing Council has been given heavy responsibilities for Nursing Practice and Nursing education, but it has not been able to exert enough power to support high standards in nursing. Private diploma and degree programmes which have no approval of the Indian Nursing Council (or) state councils are growing in Number. At the same time, many untrained and unlicensed Nursing personnel are used to staff there institutions. There is a desperate need for Nursing practice Act which would control Nursing Practice and education and provide soft and skilled Nursing care to the public. You may not necessarily participate in the activities of the INC but you should know the function and authority of this body because of it unique role in the Nursing profession in India. INDIAN NURSING COUNCIL ACT - 1947 Act Objective: An Act to constitute an Indian Nursing Council. Where As it is expedient to constitute an Indian Nursing Council in order to establish a uniform standard of training for nurses, midwives and health visitors; ACT YEAR: 1947-48.
18

STATE REGISTRATION COUNCILS Registration councils have now been established in all states. Nursing schools in the union Territories are affiliated to Nursing Councils in adjacent to state.

Functions 1. Inspect and accredit schools of Nursing in their state 2. Conduct the examination 3. Prescribe rules of conduct 4. Maintain register of Nurses, midwives, ANM and Health visitors in the state. 5. The state registration councils are autonomous except they do not have power to prescribe the syllabus for courses. The procedure of registration is usually initiated by the nursing administration of y our institution you are qualified to register when you have completed the recognized programme of nursing education and passed the qualifying examination. The examining authority will issue a diploma to you which must then be sent with copies and a property filled out application from to the register for the stat e nurses registration council in you state. This is usually done by your nursing administration who also you for the required fees. Registration is necessary for active nursing practice either here or aboard. This is done through your state Nurses Registration council. It provides you with legal protection and protect the patient from poor nursing care. It is very important for you to be able to complete an application form for registration accurately and without omissions. It is wise to get assistance from a senior colleague it you need it. REGISTRATION OF NURSES AND MIDWIFE (LICENSING) A license is a legal document that permits a person to offer her or his skills and knowledge to the public in a particular jurisdiction, where such practice could be unlawful without a license. The purpose of Nursing license is to protect society from unskilled and in competent person who would be practice Nursing.

19

Respective State Nursing Council has the responsibility to issue license and to ensure maintenance of standards as laid down by Indian Nursing Council. INSTITUTIONAL POLICIES AND REGULATION Policy is defined as the principles and values that govern actions directed towards given ends, policy statement set forth a plan direction, or goal for action, policies may be laws, regulations or guidelines that govern behaviour in Government or Agency. The rules and regulations pertaining to the rights and duties of personnel are for different positions. The rules and regulations of an office/institution ensures accountability. ROLE OF INTERNATIONAL COUNCIL FOR NURSES The International Council of Nurses The International Council of Nurses, founded in 1899 by Mrs. Bedford Fenwick. It is a federation of Non Political and self Governing National Nurses Association. The head quarters are in Geneva, Switzerland. Purposes To provide a means through which the National Associations can share their interests in the promotion of health and care of the sick. Great emphasis has been placed upon non discrimination Objectives To promote the development of strong National Nurses Association To assist National Nurses associations to improve the standards of Nursing and the competence of Nurse. To assist National Nurses Association to improve the states of Nurses within their countries. To serve as the authoritive voice for nurses and nursing internationally Role of International Council of Nurses ICN is the global voice of Nursing. Among its many activities and accomplishments are the publication of the code for Nurses, the world wide accepted definition of a Nurse and the Nurses Dilemma, a book of Ethics

20

 It also makes policy statements on health and social issues and offers a great variety of seminar and the statements aimed at maintaining and improving the status of the Nurse and the standard of Nursing around the world.
The Guidelines for National Nurses Associations in the Indian

Nursing year book, 1988 89 is one example of how the council works to improve Nursing education and practice. ICN (Council of National) Representation which is made up of the ICN Honorary officers and President, of the National member Association Council meets atleast every other year and once every face year at the time of ICN congress Work at the headquarters is carried on by a staff or clerical and expert nursing advisor personnel Publications The ICN publishes the International Nursing Review on a quarterly basis. The News letter, which is published ten times a year, give new of the ICN and the National member Associations. Membership Membership in the ICN though the TNAI offices various benefit to you as an individual Nurse. A limited Number of Nursing students may have their expenses paid in order to attend the congresses as observes. Benefit Among benefits to the graduate Nurse are attendance of international congresses (or) conferences. The ICN exchange of privilege programme, professional advice (or) assistance through ICN Headquarters and use of the ICN information centre. Nurses may receive publications about development in Nursing and Nursing education around the world.

21

This helps the Nurse become aware of being professionally related to international organizations such as the united Nations and World Health Organisation. ICNS ROLE IN REGULATION INCLUDES: 1. Convening regular international meetings of National Nurses Association leaders, government Chief Nurses, and national nursing regulatory authorities to address key issues in regulation. 2. Monitoring and analysing nursing regulation and regulatory forces and trends worldwide. 3. Providing regular opportunities for interaction among individuals, groups and organisations who have an interest in or are responsible for regulating nursing. (e.g. conferences, network and web based activities) 4. Providing national nurses associations and others with the tools (e.g. information, guidelines, international standards, competencies and frameworks) to enable them to remain up-to-date on regulatory matters 5. Providing nursing and other key stakeholders with advice and consultation to undertake reforms and to respond to changes having an impact on professional regulation. 6. Liaising with international institutions addressing issues of regulation. 7. Influencing/negotiating regulatory reform in the best interest of the public and the profession. 8. Establishing accreditation, certification and endorsement services in selected areas. 9. Collaborating with other groups and interested parties on regulatory activities and issues of common interest. 10.Setting directions for the ongoing development of nursing regulation worldwide. 11.Promoting data collection in order to provide an evidence base for regulatory policies and practices. NURSING EDUCATION BOARDS Graduate nurses may also go aboard for higher education. Developed countries such as the United Kingdom, the United States, Canada and Australia, provide opportunities for nurses from foreign
22

countries to continue their nursing education. Post certificate and post graduate courses are available as well as advanced courses in specific clinical areas such as orthopaedic or psychiatric nursing. Nursing research is studied more intensively on the level of the Masters or Doctorates Degrees. It is necessary to make detailed arrangements if you wish to study aboard. You should be sure, first of all that your enquiries and application are sent only to approved colleges or and intuitions in the foreign country. A full transcript of you general and professional education will be needed. Even with this you may be asked to take certain courses of study in the foreign country to make up for any deficiencies in you education from their stand point. Personal references will be necessary. Both your sponsoring organization and the university or school to which you are going will ask for evidence of good health and your ability to study. The higher degree in nursing from abroad can be very useful to the nursing profession here. It brings in new ideas based upon broad experience and education as well as highly developed research. Study abroad is very expensive. If is wise to check the Rupee money exchange of the country to which you wish to go. Travel, tuition and living expenses require large amounts of money which usually must be readily available as cash rather than credit payments. ROLE OF PROFESSIONAL ASSOCIATIONS AND UNIONS THE TRAINED NURSES' ASSOCIATION OF INDIA (TNAI) It is a national professional association of nurses. The present name and organization were established in 1922 but its history of developments goes back to 1905. The TNAI had its beginning in the Association of Nursing superintendents which was founded at Lucknow in 1905. Purposes Upholding the dignity and honour of the Nursing Profession Promoting a sense of esprit de corps among all Nurses Enabling members to take counsel together on matters relating to their profession.

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Other nurses gradually became members of the Association of Nursing Superintendents until a decision was made to establish a Trained Nurses Association in 1908. The Association was inaugurated in 1909. There was organizations operated under the same leadership until 1910 when the Trained Nurses Association elected its own officers. In 1922, the two organizations were brought together as the trained Nurses Association of India. The organization of the TNAI makes it possible for all Nurses to participate at some level. Beginning with the local unit, which is usually made up of personnel in a specific institutions. The level of organization moves to the district. o District level o State level o National level Members of the TNAI are usually most active on the level of the local unit. Activities and conferences, however, are planned regularly by the state branches and provide opportunities for valuable professional participation and development of the individuals member. Some state branches of the TNAI have full time secretaries. Active members have an opportunity to participate on the state level also through service on the executive committee of the state branch. The interest group is one way in which the individual nurse can participate. It centers its activities on a specific area of practice in Nursing. This is done on a state level with groups for such areas as nursing education, Nursing administration, Public health and Psychiatric Nursing. The Governing body of the TNAI is the council which is assisted by standing committees for economic welfare, Nursing Research and finance.

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A full time salaried secretary was first appointed in 1935. A salaried assistant secretary, who also serves as the advisor to the Student Nurses Association, was appointed in 1983. Aims The aims of the TNAI center upon needs of the individual members and problems in the Nursing Profession as a whole. It include upgrading, development and standardization of Nursing education. It aims to improve the living and working condition for nurses in India, and registration for qualified nurses Activities It was active helping to set up basic Nursing curricula when it first organized It has promoted the development of courses in higher education for nurses. This includes all of the colleges of Nursing active today The TNAI gives scholarships for Nurses who wish to go on for advanced study either here (or) aboard. It has also stimulated action to organize the State Nurses and midwives Registration councils. It helped to remove discrimination against male nurses and initiated much needed study and improvement of economic conditions for Nurses. The TNAI opposes strikes unless all other means of negotiating have failed to bring about satisfactory working condition. EMBLEM OF TNAI

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Membership Membership in the TNAI is obtained by application and submission of a copy of your State Registration certificate. You may transfer membership from the Student Nurses Association by having a certificate e sent from the Institution in which you have studied within six months after completing the course. Membership fees are required A reduced fees is offered to those who transfer memberships directly from the SNA. A part of these fees is used to pay affiliation fees to the international council of Nurses. It is possible to apply for a life membership. Many nursing authorities required membership in the TNAI as a condition for employment. a) The official organ of the TNAI is The Nursing Journal of India which is published monthly. The cost of this is included in the annual subscription for membership in the Association. Another impressive publication is the Indian Nursing Year Book, which has been published five times since 1982. This contains important reports, discussion of trends and statistics which are available for the Nursing profession in India. Its list of whos who has continued to grow with each publication. The TNAI has initially planned to make this an annual publication but found it necessary to publish it less frequently. Your members hip in the TNAI means your personal support in the aims and objectives of this organization. You support these through your financial contributions and your participation in the activities sponsored by the organization. You are encouraged to become a member of the TNAI. If it has a large enough membership it can yield t he power it needs to bring about action which will improve the lives and careers of all professional nurses as well as healthcare to the general public. It continues to give for a majority membership of Registered Professional Nurses. You are professional nurse, will also benefit from membership in the TNAI. It gives you a feeling of belonging and security because of the Number of Nurses who are United through the organization.

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Professional activities give you ample opportunity to develop leadership ability and professional poise, keep abreast of changes and share and solve professional problems. The Journal helps you to be informed of current events in Nursing and offers opportunities to publish articles and voice you opinions. The TNAI can help you to apply for a career position if desired. It is also of help economically by providing scholarship for advanced study, railway concessions for Nursing students and staff Nurses and a Limited income for welfare aid when necessary. THE STUDENT NURSES ASSOCIATION The student Nurses Association, organized in 1920. Role of Student Nurses Association It is associated with and under the Jurisdiction of the TNAI. In addition to providing a means of personal and professional development for the Nursing Student. It sense as a source of membership for the parent organization. The Assistant secretary of the TNAI serve as advisor for the Student Nurses Association. Purposes and functions of the Student Nurses Association: To help student Nurses learn how the professional organization serves to uphold the dignity and ideas of the Nursing Profession To promote a close rapport with other student nurses To furnish student Nurses advice in their course in study leading upto professional qualifications. To encourage leadership ability and help students to gain a wide knowledge of the nursing profession in all of its different branches and aspects. To increase the student nurses social contact and general knowledge in order to help them with their total personal and professional development. To encourage both professional and recreational meetings games and sports To provide a special section in The Nursing Journal of India for the benefit of the students.

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 To encourage students to complete for prizes in the Student Nurses Exhibition and to attend national and regional conferences.
To help student Nurses develop a co-operative sprit with other

student nurses which will help them in future professional relationships. To provide a means of having a voice in what the Association stands for and does. Activities Student Nurses Association to that of the TNAI, the beginning level of organization in the local unit established in a teaching institution. It then more on the state and national levels as in the TNAI. Membership Members of the local unit are led by a unit executive committee which is made up of the president, Student Nurses Association advisor and the remaining officers who are students. The President is a professional nurse members of the TNAI and some only as an advisor. The Vice President, who President at all meetings and the secretary of the unit must be students. State level advisors are active members of the TNAI elected by the state branches. There is a full time secretary on the national level at the National Head Quarters located in New Delhi. This person is also member of the TNAI appointed by the TNAI council and part of the National level Student Nurses Association General Committee. Membership fees in the Student Nurses Association are minimal and easily met by the Nursing Student. The arrangement for transfer of membership to the TNAI has made it convenient for the new professional nurse to establish a life membership in the parent organization at a lower cost. This special offer for life membership is good for six months after graduation. Role of Student Nurses Association includes i) Activities of the Student Nurses Association include the Student Nurses Association exhibit which has developed a high standards: fund raising for the TNAI, fine arts and sports competition and conferences Special prizes are given for out standing achievement in specific areas of nursing education

ii)

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iii)

Nursing students are given opportunity to contribute article to the Nursing Journal of India through a regular section reserved for the Student Nurses Association. Each unit received this Journal at a reduced cost with an allowance of one Journal for every twelve members and maximum of six copies. Unit activities include maintaining the dairy of unit activities, giving quarterly reports preparing articles for publication and distributing application forms for membership in the TNAI The Unit also celebrates national and international holidays and plans other activities which promote the objectives of the Student Nurses Association. Nursing students who participate in the student Nurses Association have a valuable opportunity to begin to develop leadership abilities, social poise, competitive skills and an interest in the profession as a whole. The association and its relationship with the TNAI is also helpful to the Nursing students in many ways. Problems in Nursing Education (is) Problems related to living and study conditions can be shared and solved through the united efforts of this organization and the TNAI.

iv)

v)

vi)

vii)

COMMON WEALTH NURSES FEDERATION The TNAI is also affiliated with the common wealth nurses federation which is a Nurses Association begun by the common wealth foundations. It is made up of Nurses associations from common wealth countries. The headquarters of the federation cue is London. Aims i) To promoter sharing, better communications and close relationship between its member association. ii) It also provide expert professional advice scholarships for advanced study, financial assistance for professional meetings and seminars and an office through which funds can be received and disbursed for the benefit of Nursing in the countries which are represented. The common wealth Nurses federation was formally organized in 1973 and operators in six regions of the world which are East, Central and Southern Africa, Africa west, Atlantic, Australia, for east and pacific. South Asia and Europe. Beginning with 25 member countries it is now represented in 62 independent nations. THE CHRISTIAN MEDICAL ASSOCIATION OF INDIA
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CMAI began in 1905 as a fellowship of Christian Missionary doctors to provide spiritual and professional sharing and support. It gradually developed into a large organization which include other Christian health. Professionals and health institutions. Its present name was assumed in 1926. Headquarters Headquarters for the CMAI are in New Delhi with a South office in Bangalore. Functions i) To provide spiritual support and a better understanding of the healing ministry with a focus upon the Bible. It does this through retreats and conferences. ii) To provide professional training through formal and informal education, publication of text books and other materials and scholarships this text book is an example iii) To encourage community health work through training, advisory services and technical support. iv) To assist and support churches and health institution with study and training v) To work with other agencies in an exchange of information and development and programmes it is the official agency of the National Council of Churches in India. vi) To disperse health related information which will help with health education and lead towards a more healthy and just society. Membership Membership in the CMAI is open to Doctors registered Nurses and ANM / Health workers ; all health professionals, hospital administrators and chaplains. Students in health professional courses may also become members but may not vote (V) hold office. THE NURSES LEAGUE OF THE CHRISTIAN MEDICAL ASSOCIATION The Nurses league of the CMAI was founded in 1930 as the Nurses. Auxiliary of the CMAI. The name was changed from Nurses Auxiliary and Nurses League in 1965. it became affiliated to the TNAI in 1936 and promotes membership in this organization.

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The Nurses league of the CMAI was originally organized to meet the needs felt by Christian Nurses to share common problems related to training and registration of Nurses. Objectives Promote co-operation and encouragement among Christian Nurses Promote efficiency in Nursing education and service Encourage the highest quality of candidate to choose Nursing as a vocation Secure the highest standard possible in Christian Nursing education through the Christian Schools of Nursing And consider the special work and problems of Christian Nurses wherever employed especially in isolated areas The Nurses League has a full time secretary, until 1986 it published the Christian Nurse bi monthly but now limits regular publications to a column in the CMAI newsletter. Membership fees are required and a life membership is available. Nursing students may become associate member of the league membership in the Nurses League may be requirement for certain Nursing positions under control of Christian employing authorities. Activities It include National and area conference and retreats for its members, Development of Leadership abilities is encouraged by participation in these meetings where professional papers and exhibits of high quality are given. Each meeting also allows for sharing of problems common to the Christian Nurse. The Nurses league has two examining boards which are recognized by the Indian Nursing council. One is the Mid-India Board of examiners and the other is the Board of Nursing Education in South India. These bodies direct examinations in general nursing and midwifery and diplomas granted by them are accepted for Registration with the states in those areas. Another major contribution of there boards has been continues to be the overseeing of the preparation of text books and manuals for Nursing education in India.

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 They have published at least nine text books, written in both the English and Hindi languages for Nursing Education. THE INTERNATIONAL RED CROSS The Indian Red Cross society, discussed on pages 128 129, is related to other Red Cross organizations around the world through international organizations. The first to be established was the International Committee of the Red Cross also called the ICRC. It follows the directions of the Geneva conventions in an effort to protect victims of armed conflict. Its head quarters are in Geneva, Switzerland. ROLE OF INTERNATIONAL RED CROSS ICRC delegates visit and inspect prisons of war camps They arrange for delivery of mail and food package to the prisoners They also offer emergency relief by providing food and medical supplies A very valuable service is that of a central tracing agency which helps to locate prisons of war and missing persons long after a conflict is over.
Some countries prefer to call this same national organization the

Red Crescent. The international league of Red Cross and Red Crescent Societies was formed in 1919 after World War I. It works closely with national society during times of natural disasters It provides experts and seminars to help these societies improve their administration and services. The only national society which is not affiliated with the league is that is Israel the Magen David Adam.
A super global body made up of the above league and national

societies is the international conference of the Red Cross which is also based in Geneva.
This body meets only once in four years, it supports unity in the

work of all these organizations and promotes government support of the Red Cross activities. UNITED NATIONAL INTERNATIONAL CHILDREN EMERGENCY FUND

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UNICEF is an agency of the United Nations. It was founded in 1946 for the purpose of helping mothers and children in countries affected by World War II. It now offers services in all undeveloped countries. It is financial by voluntary contributions only either from individuals (or) Government. ROLE OF UNICEF Contributions of UNICEF in India have provided teaching equipment for Nursing education, textbooks and visual aids for schools of nursing, and training for personnel to help with the health of mothers and children. THE WORLD HEALTH ORGANIZATION The world health organization, commonly called the WHO, is also a specialized agency of the United Nations. It was organized in 1948. Purpose Helping to achieve the highest possible level of health of all people more than one hundred countries are members of WHO and help to finance its broad health activities around the world. ROLE OF WHO The WHO has been active in Nursing education and practice in a number of ways here in India. It has offered guidance in setting up programmes of Nursing education and has promoted training for auxiliary nursing personal. The WHO promotes public health in many ways around the world. It is currently well known for its declaration of making towards. Health for all by 2000 A.P.. This declaration has given a tremendous push to developing primary health care and recognizing the very essential role of Nursing in the health care system. CONCLUSION So far we have discussed about the development and maintenance of a standard and accreditation in nursing education programs, role of INC, State Registration Nursing Councils, Boards and University, Role of Professional Associations and Unions participation of professional organization is of profit to you and to profession. The profession provides a means through which united efforts can be made to elevate standards of Nursing education and practice. BIBLIOGRAPHY

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1. B. Sankaranarayanan B. Sindu, 2008, Learning and teaching

nursing 2nd Edition, Brainfil Publishing Company P.No.52. 2. Teaching material for Quality Assurance model Nursing I Edition 2006. Published by Indian Nursing Council P.No.88. 3. Curriculum Developed in Nursing Education I Edition 2005 Jones and Barlett Publishers P.No.53. 4. K.P.Neeraja, Text Book of Nursing Education, I Edition 2006. Jaypee Brothers Company P.No.48 74.
5. Professional Adjustment and Ethics for Nurses in India Ann. J.

Zwener, B.A., R.N., M.Sc 6th Edition 1995. B.I. Publications Pvt. Ltd., 234 255.
6. Net Source.

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