M.

SC DEGREE COURSE IN NURSING

(I – YEAR)
ADVANCED NUSING PRACTICE

UNIT – 1
NURSING AS A PROFESSION

MRS.P.VALLIMEENA,M.SC(NURSING),
PROFESSOR
 OBJECTIVES

Students are able to:

• List down the International Agencies and its functions

• Enumerate the Indian regulatory bodies and its functions.

 Introduction

• Regulatory agencies are usually a part of the executive branch

of the government or they have statutory authority to perform
their functions with oversight from the legislative branch . Their
actions are generally open to legal review . Regulatory
authorities are commonly setup to enforce standards and
safety.
 REGULATORY BODIES

• A regulatory body is a public authority or government agency

responsible for exercising autonomous authority over some
area of human activity in a regulatory or supervisory capacity.
 INTERNATIONAL AGENCIES

• International Council of Nurses (ICN)

• American Nurses Association(ANA)

• Canadian Nurses Association(CNA)

• Australian Nurses And Midwives Association

• British Nurses Association

 INDIAN REGULATORY AGENCIES

• Indian Nursing Council

• Trained Nurses Association of India(TNAI)

• State Nursing Council

• State Medical Health Universities

 INTERNATIONAL COUNCIL OF NURSES

• It was found in 1899 , head quarters in Geneva , Switzerland.

• It is the world’s first largest International organization for health.

• Represent 16 million International Nurses .

• 130 National Nurses Organization.

 ICN GOALS

• To influence nursing, health and social policies, professional and

socioeconomic standards worldwide.

• To assist national nurses associations (NNAs) to improve the standard of

nursing and the competence of nurses.

• To promote the development of strong national nurses associations.

• To represent nurses and nursing internationally.

• To establish , receive and manage funds and trust which contribute to the
advancement of nursing and of ICN.
 PROFESSIONAL NURSING PRACTICE

• Advanced nursing practice

• HIV/AIDS ,TB &malaria

• Women’s health

• Primary health care

• Family health

• Safe water
 NURSING REGULATIONS

• Code of ethics ,standards and competencies

• CNE

SOCIO ECONOMIC WELFARE OF NURSES:

• Occupational health and safety

• Human resources planning and policies

• Career development

• International trade in professional services.

 GOVERNANCE OF ICN MEETINGS

• ICN meets every 4 years .The quadrennial meetings are called

as “congresses” and when they are in sessions , the
organization is called as the International Congress of Nurses.
 FUNCTIONS

• To provide policy directions to fulfill the objectives of ICN

• To establish the categories of membership and determine their

rights and obligations.

• To act upon the recommendations of the board of directors relating

to admissions and read missions of the members associations in to
ICN

• To receive and consider information from the borad regarding ICN

activities.
 FUNCTIONS

• To receive nominees for the board and to elect the board

• To act upon the proposed amendments to ICN constitutions

• To act upon the recommendation of the board of directors for

the amount of NNA’s dues

• To act through mail or any written communication on ICN

business that requires immediate attention.
 BOARD OF DIRECTORS

• ICN governed by 16 member board of directors.

• Board meet every year.

PUBLICATIONS:

• International Nursing Review

• Health and Well Being of women

• Incentive for Health Professionals.

 AMERICAN NURSES ASSOCIATION

• It was found in 1896 , based in Silver Spring , Maryland , USA.

• Represents RNs of USA .

ACTIVITIES
• Establish standards for nursing care

• Develop educational standards

• Promote nursing research

 AMERICAN NURSES ASSOCIATION

• Establish a professional code of ethics

• Oversee a credentialing system

• Influence registration affecting health care

• Protect the economic and general welfare of registered nurses

• Assist with professional development of nurses by providing

continuing education programmed.
 MEMBERSHIP

FEDEDERATION OF STATE NURSES ASSOCIATION.

Individual registered nurses can participate in ANA by

joining their respective state nurses associations

PUBLICATIONS
• American general of Nursing

• American nurses
 INDIAN NURSING COUNCIL-INC

The Indian Nursing Council statutory constituted under

the Indian Nursing Council act,1947 .It was established in 1949 .
The council is responsible for regulation and maintenance of a
uniform standard of training for nurses , midwives, auxiliary
nurses midwives and health visitors .
 AIMS OF INDIAN NURSING COUNCIL

• To establish a uniform standard for nurses midwives and

health visitors.

• INC is a regulatory body for nurses and nursing education in

India.

• It is an autonomous body under the government of India ,

Ministry of health and family Affair.
 AMENDMENTS IN INC ACT1947

The act was amended in November 1957 to provide for the

following things:
FOREIGN QUALIFICATION:

A) A citizen of India holding a qualification which entitles him or

her to be registered with any registering body may , by the
approval of the Council , be enrolled in any state register.
 AMENDMENTS IN INC ACT1947

1. FOREIGN QUALIFICATION:

B) A person not a citizen of India , who is employed as a

nurse , midwives , ANM, teacher or administrator in any
hospital or institution in any state , by the approval of
President of Council is enrolled temporarily for a period of 5
years .
 AMENDMENTS IN INC ACT 1947

• If one continues to practice in India , an extension of recognition

should be sort from INC .
 AMENDMENTS IN INC ACT 1947

2.INDIAN NURSES REGISTER:

• A) The council shall cause to be maintained in the prescribed
manner a register of nurses , midwives, ANM and health visitors
to be known as the Indian nurses register which shall contain the
names of all persons who are for the time being enrolled on any
state register.

• B) Such register shall be deemed to be a public document within

the meaning of the Indian Evidence act 1872.
 COMMITTEES

1.EXECUTIVE COMMITTEE:

Of the council to deliberate on the issues related to maintenance

of standards of nursing programs.

2.THE NURSING EDUCATION COMMITTEE:

It is constituted to deliberate on the issues concerned mainly with

the nursing education and policy matters concerning the nursing
education.
 COMMITTEES

3.EQUIVALENCE COMMITTEE:

To deliberate on the issues of recognition of Foreign

qualification. This is essential for the purpose of registration of the
Indian Nursing Council act , 1947 as amended
 COMMITTEES

4. FINANCE COMMITTEE:

Which decide upon the matters pertaining to finance of

the council in terms of budget, expenditure, implementation of
Government orders with respect to service conditions etc.
 FUNCTION

• To recognize the qualification for the purpose of registration and

employment in India and abroad.

• To give approval for registration of Indian and foreign nurses

possessing foreign qualification.

• To prescribe the syllabus and regulation for nursing

programmed.
 FUNCTION

• Power to withdraw the recognition of qualification standards, that

an institution recognized by a state council for the training of
nurses, midwives, auxiliary nurses and midwives or health
visitors does not satisfy the requirement of council.

• To advice the state nursing councils , examinations board , state

government and central government in various important items
regarding nursing education in country.
GUIDELINES FOR THE ESTABLISHMENT OF NEW
NURSING SCHOOL/COLLEGE IN INDIA
APPROVED BY INC

• Any organization under the central government , state

government , local body or private or public trust , mission ,
voluntarily registered under society registration act wishes to
open a school of nursing should obtain the no objections
/essentiality certificate from the state government .
 GUIDELINES FOR THE ESTABLISHMENT OF NEW
NURSING SCHOOL/COLLEGE IN INDIA APPROVED
BY INC

• 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 infra
structure , clinical facility and teaching faculty is in order to give
permission to start the programmers .
 GUIDELINES FOR THE ESTABLISHMENT OF NEW
NURSING SCHOOL/COLLEGE IN INDIA APPROVED
BY INC

• After the receipt of the permission to start the nursing

programmers from INC the institution shall obtain that approval
from the state nursing council and examination board.

• Institution will admit the students only after taking approval of

state nursing council and examination board.
 GUIDELINES FOR THE ESTABLISHMENT OF NEW
NURSING SCHOOL/COLLEGE IN INDIA APPROVED
BY INC

• The INC will conduct inspection every year till the first batch
completes the programmers. Permission will be given year by
year till the first batch complete
 TYPE OF INSPECTION

• FIRST INSPECTION:

The first inspection is conducted on receipt of the

proposal received from the institute to start any nursing

programme prescribed by INC.

 TYPE OF INSPECTION
RE - INSPECTION:

Re - inspection are conducted for those institutions ,which

are found unsuitable by INC . The institution and Government are
informed about the deficiencies and advised to improve upon
them. Once the institution takes necessary steps to rectify the
deficiencies institution should submit the compliance report with
documentary proof of deficiency pointed out and re – inspection
fees . On the receipt of the compliance report and the fees from
the institution ,it will be considered for re - inspection
 TYPES OF INSPECTION
PERIODIC INSPECTION:

INC conducts periodical ( after 3 years) inspection of the

institution once the institution is found suitable by INC to monitor the
nursing education standards and adherence of norm prescribed by
INC. institutions are required to pay annual affliation fee every year.
However if the institution does not comply to the norms prescribed by
the INC for teaching for the clinical and physical facility , the institution
will be declared unsuitable .
 PROGRAMES UNDER INC

• ANM

• GNM

• POST BASIC B.SC NURSING

• B.SC NURSING

• M.SC NURSING

• M.PHIL

• DOCTRATE IN NURSING
 RESOLUTIONS

• Maximum period for the students to complete revised ANM and

GNM courses two years and three years respectively.

• INC resolved that maximum age for teaching faculty is seventy

years subject to the conditions that he / she should be
physically and mentally fit .
 RESOLUTIONS

• Admission to the married candidate for the entire nursing

program allowed subject to the conditions that they should
produce medical fitness certificate .

• Relaxation of norms to establish M.SC nursing program: as per

INC norm only those institution can start M.SC program where
at least one batch of students has qualified B.SC nursing
program.
 RESOLUTIONS

• INC resolved apart from these institutions the super specialty

hospital can also open the M.SC nursing programed even
though the institutions are not having the B.SC nursing
programs.

• Relaxation of the students patient ratio for clinical practice : 1:3

student patient ratio instead of 1:5 student patient ratio.
 RESOLUTIONS

Relaxation of teaching faculty qualification to start a

B.SC nursing programs at least two M.SC nursing qualified
teaching faculty to be available to start B.SC nursing programed
for the next four years in order to compact acute shortage of
nursing and teachers till the position of M.SC nursing qualified
teaching faculty improve.
 RESOLUTIONS

• To maintain the quality of post graduate in nursing . INC resolved

not to have M.SC nursing programme through distance education .

• Institution should have its own building with two years

establishments.

• Maximum number of sixty seats can be sanctioned to those

institutions which are having less than 500 bedded hospitals and
100 seats can be sanctioned to those having 500 bedded
hospitals.
 REGISTRATION OF ADDITIONAL QUALIFICATION
INITIATIVES BY INC
TEACHING MATERIALS FOR QUALITY ASSURANCE MODEL
QAM :

It is a set of elements that are related to each other and compromise

of planning for quality , development of objectives , setting and actively
communicating standards , developing indicators , setting thresholds ,
collecting data to monitor compliance with set standards for nursing
practice and applying solutions to improve care.
 REGISTRATION OF ADDITIONAL QUALIFICATION
INITIATIVES BY INC

PRINCES SRI NAGARINDRA AWARD :

It is to recognize the exemplary contribution towards progress

and advancement in the field of nursing and social services .
 REGISTRATION OF ADDITIONAL QUALIFICATION
INITIATIVES BY INC

DEVELOPMENT OF CURRICULUM FOR HIV /

AIDS AND TRAINIG FOR NURSES :
INC collaboration with NACO and Clinton foundation is
developing a curriculum for training of nurses in HIV / AIDS areas
.It will be a six days training programmed .
 REGISTRATION OF ADDITIONAL QUALIFICATION
INITIATIVES BY INC

NATIONAL CONSORTIUM FOR P.HD IN NURSING

CONSTITUTED SIX STUDY CENTRES RECOGNIZED
UNDER NATIONAL CONSORTIUM FOR P.HD NURSING:

INC collaborated with WHO and RGUHS under the faculty of

nursing to promote doctoral education in various fields of nursing.
 REGISTRATION OF ADDITIONAL QUALIFICATION
INITIATIVES BY INC

MOU(MEMORANDUM OF UNDERSTANDNG):

It is entered at New Delhi on11 th April 2006 between

INC Sir Edward Dunlop hospitals (I) limited. For developing the
strategic framework for advance standard and investment plan
for advancing standards nursing education and practice in India .
 REGISTRATION OF ADDITIONAL QUALIFICATION
INITIATIVES BY INC

STEPS TAKENUP TO ENTER INTO MRA UNDER

COMPRHENSIVE ECONOMIC COPERATION AGREEMENT
(CECA) BETWEEN INDIA AND SINGAPORE:

India and Singapore would enter into mutual recognition

agreement in medical , dental and nursing services in the health
care sector.
 REGISTRATION OF ADDITIONAL QUALIFICATION
INITIATIVES BY INC

ALL STATE REGISTRARS WERE INVITED TO ATTEND

THE TWO DAYS MEETING:

To ensure the uniformity and to maintain the quality of

nursing education in the country and also solve the issues of
each state Nursing Council .
 STATE NURSING COUNCIL

Registration in State Nursing Council is very necessary

for every nurses . It is necessary to be registered in order to
function officially as a professional nurse .

• It is an independent body though it has two obtain approval

from State government for all the By-Laws passed by it.

• It is headed by the registrar .

 STATE NURSING COUNCIL

FUNCTIONS OF STATE NURSES REGISTRATION COUNCIL :

1) Recognize officially an inspect schools of nursing in their state .

2) Conduct examination

3) Prescribe rules and take disciplinary actions etc.

4) Maintain registers of graduate nurses , nurses holding degree's in

nursing , midwives prevised auxiliary nurse midwives or multi purpose
workers and health visitors .
 TRAINED NURSES ASSOCIATION OF INDIA

• The association had its beginning in the association of nursing

superintendents which was found in 1905 at Lucknow.

OBJECTIVES:

A) Uphold the dignity and honor of nursing profession .

B) Promote a sense of sprit de-corps among all the nurses.

C) Enabling members to take Council together on matters

relating to the professions.
 BENEFITS FROM TNAI MEMBERSHIP
1) Various professional issues like representation to central pay commission .

2)Holding National Level conference scientific and business sessions .

3) Low cost publications for members and students .

4) CNE for updating knowledge on various topics at regular interval .

5) Socio economic welfare program for destitute members.

6)Research studies conducted regularly for the benefit of the members.

7)at home with patron of TNAI member at rashstarlpati Bhawan every year on
nurses day celebration.
 BENEFITS FROM TNAI MEMBERSHIP

6) Research studies conducted regularly for the benefit of the members.

7) At home with patron of TNAI member at rashstarlpati Bhawan every

year on nurses day celebration.

8) Scholarship for TNAI member and students nurses.

9) Annual grant to state branches to hold activities.

10) One fourth railway concession for TNAI members.

11) The guest room facilities at the Head Quarters and also in some
states.
 BENEFITS FROM TNAI MEMBERSHIP

PUBLICATIONS:
• Hand book of T.N.A.I ,published in 1913.

• Nursing Journal of India published monthly.

• WHO day ,international Nursing Day and International women’s

day and other related activities are celebrated with the initiative
of T.N.A.I in all the states of country.
 MEMBERSHIP

• The membership consists of:

• Full members-fully qualified registered nurses

• Associate members-health visitors, midwives, and ANM

• Affiliate members-students nurses and members of the affiliated

organizations eg.chritian nurse's ,leagues

• Membership of TNAI is obtained by application of submission of copy of

once state registration certificate.one can apply for a life membership.
 STUDENTS NURSES ASSOCIATION OF INDIA

• It was established in 1929 .There is a full time secretary for SNA at

National Level .
 STUDENTS NURSES ASSOCIATION OF INDIA

OBJECTIVES OF SNA:
• To help student to uphold the dignity and ideas of the profession
for which they are qualifying.

• To promote a cooperate sprit among student for the common

good.

• To furnish nurse in training with advise in their case of study

leading to professional qualifications.
 STUDENTS NURSES ASSOCIATION OF INDIA

• To encourage leadership ability and help students to gain a wide

knowledge of the nursing profession in all its different branches and
aspects.

• To help the students to increase their social contact .

• To increase professional social and recreational development.

• To encourage student to compete for prices in the student nursing

exhibition and to attend National and Regional conference.
 MEMBERSHIP

• The student nurses can obtain membership of student nurses

association during their training period and SNA membership
can be transferred to TNAI membership .
 ACTIVITIES OF SNA

ORGANIZATION OF MEETING AND CONFERENCE

Three to four days conference held for SNA members

biennially. At the units usually meeting is held monthly or by monthly.
MAINTENECE OF DIARY

The dairy are assets annually by the state , best two dairies are
sent by state to National SNA advisor for awards. The dairies are
assess for professional extra curricular , social , cultural and
recreational aspects.
 ACTIVITIES OF SNA

EXHIBITION:

Students can prepare models, charts & posters on the

subjects taught in their course of studies .Now their activity is
competed at the state level and one best entry under each
category and section is entertained at national level.
 ACTIVITIES OF SNA

PUBLIC SPEAKING AND WRITING

Students are encouraged to increase self confidence and help

them to gain skill in communication through debates , panel
discussions , seminar on the theme of confidence .
PROJECT UNDERTAKING:

Students are given a project work given on health related

topics on International day nurses day celebration.
 ACTIVITIES OF SNA

FUND RISING:

To meet the expenses at headquarters and SNA state level

unit it is necessary to rise the fund through voluntary donation.

SOCIO CULTURAL AND RECREATIONAL ACTIVITY:

Students are encouraged to participate in drama , dance ,

music , painting , poetry writing and article writing.
 CONCLUSION

It is to conclude that the knowledge of all above discussed

organization is must for every nursing personnel . By utilizing this
knowledge we can update advance nursing practices into the
highest standards.
 POST EVALUATION

I . WRITE AN ESSAY ON : 1 x 10 = 10marks

1.How will you get affiliation from Indian Nursing Council ?

II . WRITE SHORT NOTES ON : 3 x 5 = 15 marks

1. SNA

2. TNAI

3. ANA
 BIBLIOGRAPHY

• Mrs.Swinder Kaur’s, ”Professional Adjustment, ward

management and trends in nursing", Edition 1st ,published by
lotus Publications ,PP 37-52

• Ann J.Zwemenr’s “Professional adjustment and ethics for

nurses in India”,Edition 6th published by B.I publications.PP232-
249
 BIBLIOGRAPHY

• Mr.Kamal.S. Joglekar’s , “Hospital ward management, professional

adjustments and trends in nursing”, Edition 12 th ,published by vora
medical publications.PP132-153.

• Sue C.Delaune and Patricia K Ladner’s “Fundamentals of Nursing

standards and practice”, Edition 7th ,published by Delmar Publishers
,PP 216-217.

• www.google.com