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SEMINAR
ON
NURSING REGULATORY MECHANISMS:
ACCREDITATION LICENSURE AND
RENEWEL
POONAM DHIMAN
The standard of nursing care delivery is set by certain
regulations of nursing practice called ― nurse practice acts‘.
Nurse practice acts are legally defined and describe
regulations of nursing actions by an administrative board such
as a state board of nurse examiners. These boards generally
have the authority to regulate nursing practice and education
within the states.
NURSING REGULATORY MECHANISMS
The main functions of these regulations include:
 To protect patient or society
 To define the scope of nursing practice
 To identify the minimum level of nursing care that must be
provided to clients
The regulatory bodies that define the laws and regulations in
nursing practice are:
• International council of nurses
• Indian nursing council
• State nursing council
ACCREDITATION
• The concept of accreditation of educational programs in
nursing is very important. Accreditation is an internationally
recognised evaluation process used in many countries to
assess the quality of care and services provided.
• It focus on continuous quality improvement strategies.
DEFINITION
• Accreditation refers to voluntary review process of education
program by a professional organization. The organization is
called an accreditating agency which compares the educational
quality of the program with established standard and criteria
• “Accreditation is a process whereby an organizations or
agency recognizes a college or university or a program of
study as having met certain predetermined qualifications and
standards.”
NURSING ACCREDITATION
• Accreditation is a form of independent, professional
certification that focuses on schools and programs in a
particular field. Accreditation of nursing schools and programs
therefore assures that the institutions and school adheres to
high quality standards.
Objectives:
• To improve the quality of nursing education in country.
• To agree upon the guidelines on quality assurance and
accreditation of institutions.
• To provide recommendations on the roles and functions of
nursing educational institutions, nursing councils or regulatory
bodies and national authority on the quality of education.
Purposes:
Maintenance of adequate admission requirements.
Maintenance of minimum academic standards.
Stimulation of institutional self improvements.
Protection of institutions of higher education against
educationally and socially harmful
Elements of accreditation
Self-assessment by the home against the Accreditation
Standards
Submission of an application for re-accreditation (with or
without the self-assessment)
Assessment by a team of registered aged care quality assessors
at a site audit
A decision about the home’s accreditation by a decision-maker
Issue of an accreditation certificate
Publication of the decision on this website
Unannounced visits to monitor homes’ on-going performance
Accrediting organizations: -
In higher education are generally classed into three
types:
• National accreditating agency
• National professional accreditating agency
• State accreditating bodies
National agency
India has following all India Educational councils:
 Central advisory board of education
 All India council for elementary education
 All India council for secondary education
 University grant commission
 All India council for technical education
 National assessment and accreditation council
National professional accreditating agency
 Medical council of India
 Indian nursing council
 Dental council of India
 Pharmacy council of India
 Central council of Indian system of medicine
 But now....National council for human resources in health
NCHRH....this one will cover the above all
National professional accreditating agency:-National professional accreditating agency:-
Areas generally scrutinized in accreditation
review are:
• Administration and governance
• Finances and budget
• Faculty and students
• Curriculum and resources
• Criteria and standards are established in each area,
programs under review prepare reports, than show how school
and college meet each criterion.
• Once accredited and in good standing, continuing
accreditation review take place every 8 years or 5 years.
• Programs that do not meet standards may be placed on
warning and given a specific time period to correct the
deficiencies.
• Accreditation can be withdrawn if deficiencies are not
corrected with in specific time.
Criteria for appraisal of nursing programs:
1) Philosophy, purposes and objectives:-
• The philosophy and purposes of the colleges of nursing are developed and
clearly stated by the faculty.
• The philosophy and purposes of the colleges of nursing are consistent with
the published statements of characteristics of educational programs in
nursing accepted by the membership of the statuary bodies like INC or any
other agency.
• The objective of each program interprets the purposes in definite terms.
2) Organization and administration:-
• Adequate and stable financial support for the college is assured.
• The policy in effect for faculty members of the college is those in
effect for faculty members throughout the institutions, with
adjustments for differences that may be required in education for a
profession.
• The organization of the college’s faculty is appropriate to its size,
and its effective functioning is promoted.
• The faculty conducts planned periodic evaluations of the
organization and administration.
3) Types of Nursing Program
Nursing programs Training &
duration
Examination Registration
ANM 2 yrs Nursing
examination board
R. ANM
GNM 31/2 yrs Nursing
examination board
R.N & R.M
B.Sc 4 yrs University R.N & R.M
B.Sc (Post Basic) Regular: 2yrs
Distance: 3 yrs
University Additional
qualification
M.Sc. 2 yrs University Additional
qualification
M. Phil Regular: 1yrs
Distance: 2 yrs
University Additional
qualification
Ph D 3-5 yrs University Additional
qualification
4) Students:-
• The policies pertaining to admission, progression, and
graduation are consistent with those of the parent institutions.
• Participation in program development and evaluation by the
students is encouraged.
• Criteria for determining student progress at periodic intervals
in the program have been developed and are utilized and
evaluated.
Eligibility Criteria Nursing Programs
A. N. M.
• minimum age 17 years on or before 31st December of the year in
which admission is sought.
• maximum age 35 years.
• The minimum educational requirements shall be 10 + 2 in Arts
(Mathematics, Physics, Chemistry, Biology, Biotechnology,
Economics, Political Science, History, Geography, Business Studies,
Accountancy, Home Science, Sociology, Psychology, and
Philosophy) and English Core/English Elective or Science or Health
care Science - Vocational stream ONLY passing out from
recognized Board.
• Student shall be medically fit.
• Student shall be admitted once in a year.
G. N. M.
• Minimum and Maximum age for admission will be 17 and 35 years.
• Minimum education:
▫ 10+2 class passed preferably Science (PCB) & English with aggregate of
40% marks.
▫ 10+2 in Arts (Mathematics, Biotechnology, Economics, Political Science,
History, Geography, Business Studies, Accountancy, Home Science,
Sociology, Psychology, Philosophy) and English Core/English Elective or
Health care Science - Vocational stream ONLY, passing out from recognized
Board under AISSCE/CBSE/ICSE/SSCE/HSCE or other equivalent Board
with 40% marks.
▫ 10+2 vocational ANM under CBSE Board or other equivalent board from
the school and recognized by Indian Nursing Council with 40% marks.
▫ Registered as ANM with State Nursing Registration Council.
• Student shall be medically fit.
• Student shall be admitted once in a year.
B. Sc. (N)
• minimum age 17 years on 31st December of the year in which
admission is sought.
• Minimum education:
▫ 10+2 class passed with Science (PCB) & English
Core/English Elective with aggregate of 45% marks from
recognized board under CBSE/ICSE/SSCE/HSCE or other
equivalent Board.
• Student shall be medically fit.
• Students appearing in 10+2 examination in Science conducted
by National Institute of Open School with 45% marks.
• Student shall be admitted once in a year.
Post Basic B. Sc. (N)
• Passed the Higher Secondary or Senior Secondary or Intermediate
or 10+2 or an equivalent examination recognized by the university
for this purpose.
• Obtained a certificate in General Nursing and Midwifery and
registered as R.N.R.M. with the State Nurses Registration Council.
▫ O.T. Techniques
▫ Ophthalmic Nursing
▫ Leprosy Nursing
▫ TB Nursing
▫ Psychiatric Nursing
▫ Neurological and Neuro surgical Nursing
▫ Community Health Nursing
▫ Cancer Nursing
• Candidates shall be medically fit.
M. Sc. (N)
• The candidate should be a Registered Nurse and Registered midwife of
equivalent with any State Nursing Registration Council.
• The Minimum education requirements shall be the passing of: B.Sc.
Nursing/B.Sc. Hons. Nursing/Post Basic B.Sc. Nursing with minimum of 55%
aggregate marks.
• The candidate should have undergone in B.Sc. Nursing / B.Sc. Hons. Nursing
/ Post Basic B.Sc. Nursing in an institution which is recognized by Indian
Nursing Council.
• Minimum one year of work experience after Basic B.Sc. Nursing.
• Minimum one year of work experience prior or after Post Basic B.Sc.
Nursing.
5) Resources, facilities and services:-
• Resources, facilities and services of the institutes are availed
to and used by the college of nursing.
• Resources, facilities and services are adequate to the needs of
the faculty and the students and to the number and the type of
programs in nursing offered.
• The physical facility of the college of nursing is adequate to
the needs of the instructional programs and to size of the
faculty and the student body.
GUIDELINES AND MINIMUM REQUIREMENTS TO ESTABLISH
B.Sc. (N) COLLEGE OF NURSING
1. Any organization under: (i) Central Government/State Government/Local
body
(ii) Registered Private or Public Trust
(iii) Missionary or any other organization registered under Society
Registration Act
2. Any organization having 100 bedded Parent (Own) hospital is eligible to
establish B.Sc. (N) Course.
3. Above organization shall obtain the Essentiality Certificate/No Objection
Certificate for the B.Sc. (N) programme from the respective State
Government. The institution name along with Trust Deed/Society address
shall be mentioned in No Objection Certificate/Essentiality Certificate.
Contd..
4. An application form to establish Nursing programme is available on the
website viz., www.indiannursingcouncil.org, which shall be downloaded.
Duly filled in application form with the requisite documents mentioned in
the form shall be submitted before the last date as per the calendar of
events of that year.
5. The Indian Nursing Council on receipt of the proposal from the Institution
to start nursing programme, 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.
Contd..
6. 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.
7. Institution will admit the students only after taking approval of State
Nursing Council and University.
8. Upgradation is not a additional B.Sc. (N) programme, but is the convert
from School of Nursing into College of Nursing.
Minimum Requirement to establish B.Sc. (N)
Programme
Building:
• The College of Nursing should have a separate building.
• The college of Nursing should be near to its parent hospital having space
for expansion in an institutional area.
• For a College with an annual admission capacity of 40-60 students, the
constructed area of the college should be 23720 square feet.
• Adequate hostel/residential accommodation for students and staff should
be available in addition to the above mentioned built up area of the Nursing
College respectively.
PHYSICAL FACILITIES
1. Nursing Educational institution should be in Institutional
area only and not in residential area.
2. If the institute has non-nursing programme in the same
building, Nursing programme should have separate teaching
block.
3. Shift-wise management with other educational institutions
will not be accepted.
4. Separate teaching block shall be available if it is in hospital
premises.
5. Proportionately the size of the built-up area will increase
according to the number of students admitted.
6. School and College of nursing can share laboratories, if they
are same campus under same name and under same trust, that
is the institution is one but offering different nursing
programmes.
The class rooms should be available as per the requirement
stipulated by Indian Nursing Council of each programme.
1. Class rooms
• There should be at least four classrooms with the capacity of
accommodating the number of students admitted in each class.
• The rooms should be well ventilated with proper lighting
system.
• There should be built in Black/Green/White Boards. Also
there should be a desk/ dais/a big table and a chair for the
teacher and racks/cupboards for keeping teaching aids or any
other equipment needed for the conduct of classes also should
be there.
Departments: College should have following
departments:
1. Fundamentals of Nursing including Nutrition
2. Medical Surgical Nursing
3. Community Health Nursing
4. Obstetric and Gynaecological Nursing
5. Child Health Nursing
6. Psychiatry and Mental Health Nursing
2. Laboratories
There should be at least Seven laboratories as listed below:
• Nursing Foundations and Medical Surgical
• Community Health Nursing
• OBG and Paediatrics
• Nutrition
• Computer with 10 computers
• Pre Clinical Science Lab. (Biochemistry,
• Microbiology, Biophysics, Anatomy & Physiology)
3. Auditorium
• Auditorium should be spacious enough to accommodate at
least double the sanctioned/actual strength of students, so that
it can be utilised for hosting functions of the college,
educational conferences/ workshops, examinations etc.
• It should have proper stage with green room facilities. It
should be well – ventilated and have proper lighting system.
• There should be arrangements for the use of all kinds of basic
and advanced audio-visual aids.
4. Multipurpose Hall
• College of Nursing should have multipurpose hall, if there is
no auditorium
5. Library
• There should be a separate library for the college. The size of
the Library should be of minimum 2400 sqr. ft. It should be
easily accessible to the teaching faculty and the students.
• Library should have seating arrangements for at least 60
students for reading and having good lighting and ventilation
and space for stocking and displaying of books and journals.
• The library should have at least 3000 books. In a new College
of Nursing the total number of books should be
proportionately divided on yearly basis in four years.
• .
• Atleast 10 sets of books in each subject to facilitate
for the students to refer the books. The number of
journals should 15 out of which one- third shall be
foreign journals and subscribed on continuous basis.
• There should be sufficient number of cupboards,
book shelves and racks with glass doors for proper
and safe storage of books, magazines, journals,
newspapers and other literature
In the library there should be provision for:
- Staff reading room for 10 persons.
- Rooms for librarian and other staff with intercom
phone facility
- Video and cassette / CD room (desirable)
- Internet facility.
6. Offices Requirements
(a) Principal’s Office
• There should be a separate office for the Principal with attached
toilet and provision for visitor’s room.
• Independent telephone facility is a must for the Principal’s office
with intercom facility connected/linked to the hospital and hostel
and a computer with internet facility.
• The size of the office should be 300 sqr. ft.
(b) Office for Vice-Principal
• There should be a separate office for the Vice-Principal with
attached toilet and provision for visitor’s room.
• Independent telephone facility is a must for Vice principal’s office
with intercom facility connected/linked to the hospital and hostel
and a computer with internet facility. The size of the office should
be 200 sqr. ft.
(c) Office for Faculty Members
• There should be adequate number of office rooms in proportion to the
number of teaching faculty. One office room should accommodate 2
teachers only. Separate toilet facility should be provided for the teaching
faculty with hand washing facility. There should be a separate toilet for
male teachers. The size of the room should be 200 sqr. ft. Separate
chambers for heads of the department should be there.
7. Common Rooms
• A minimum of 3 common rooms should be provided. One for the teaching
faculty, one for the student and one for the office staff.
• Sufficient space with adequate seating arrangements, cupboards, lockers,
cabinets, built-in-shelves and racks should be provided in all the common
rooms. Toilet and hand washing facilities should be made available in each
room.
8. Record Room
• There should be a separate record room with steel racks, built-
in shelves and racks, cupboards and filing cabinets for proper
storage of records and other important papers/ documents
belonging to the college.
9. Store room
10. Room for Audio-Visual Aids
• This room should be provided for the proper and safe storage
of size 600 sq. ft. for all the Audio- Visual Aids.
11. Other Facilities
• Indoor games hall of size 4000 ft. Safe drinking water and adequate
sanitary/toilet facilities should be available for both men and women
separately in the college in each floor common toilets for teachers
(separate for male and female) i.e 4 toilets with Wash basins.
• Common toilets for students (separate for male and female) 12 with
Wash Basins for 60 students.
12. Fire Extinguisher
• Adequate provision for extinguishing fire should be available as per
the local bye-laws.
13. Playground
• Playground should be spacious for outdoor sports like Volleyball,
football, badminton and for Athletics.
Hostel Block (60 Students):
1. Single Room, Double Room
2. Sanitary One latrine & One Bath room (for 5 students)
3. Visitor Room
4. Reading Room
5. Store
6. Recreation Room
7. Dining Hall
8. Kitchen & Store
9. Pantry
10. Sick room
11. Guest room
12. Warden’s room
13.Canteen
14. Transport
Residential Accommodation:
• Crèche
There should be a crèche in the college campus.
• Staff for the Hostel:
1. Warden (Female) -3: Qualification- B.Sc. Home Science or Diploma in
Housekeeping/ Catering. Minimum three wardens must be there in every
hostel for morning, evening and night shifts. If number of students s
more than 150, one more warden/ Asst. Warden/ House keeper for every
additional 50 students.
2. Cook-1: For every 20 students for each shift.
3. Kitchen & Dining Room helper- 1: For every 20 students for each shift.
4. Sweeper-3
5. Gardener-2
6. Security Guard/ Chowkidar-3
QUALIFICATIONS & EXPERIENCE OF
TEACHERS OF COLLEGE OF NURSING
• Post Qualification & Experience
1 Principal –cum-Professor - M.Sc. (N) with 15 years
experience after M.Sc.(N) out of which 12 years should
be teaching experience with minimum of 5 years in
collegiate programme. Ph.D. (N) is desirable
2 Vice Principal -cum-Professor- M.Sc. (N) with 12 years
experience after M.Sc.(N) out of which 10 years should
teaching experience with minimum of 5 years in
collegiate programme. Ph.D. (N) is desirable
3 Professor- M.Sc. (N) with 10 years experience after
M.Sc.(N) out of which 7 years should be teaching
experience. Ph.D. (N) is desirable
4 Associate Professor- M.Sc. (N) with 08 years experience
after M.Sc.(N) including 5 years teaching experience.
Ph.D. (N) desirable
5Assistant Professor- M.Sc. (N) with 3 years experience
after M.Sc.(N)
6 Tutor- M.Sc.(N) Or B.Sc.(N)/P.B.B.Sc.(N) with 1 year
experience
S.N
o.
Designation GNM
20-60
B.Sc.(N)
40-60
PB.B.Sc
(N)
20-60
M.Sc.(N)
10-25
1. Professor cum
PRINCIPAL
1 1
2. Professor cum
VICE-
PRINCIPAL
1 1
3. Professor 0 1
4. Associate
Professor
2 1
5. Assistant
Professor
3 2 3
6. Tutor 6-18 10-18 2-10
Other Staff (Minimum requirements)
(To be reviewed and revised and rationalized keeping in mind the
mechanization and contract service)
• Ministerial
a) Administrative Officer 1
b) Office Superintendent 1
c) PA to Principal 1
d) Accountant/Cashier 1
• Upper Division Clerk 2
• Lower Division Clerk 2
• Store Keeper 1
a) Maintenance of stores 1
b) Classroom attendants 2
c) Sanitary staff As per the physical space
d) Security Staff As per the requirement
• Peons/Office attendants 4
• Library
a) Librarian 2
b) Library Attendants as per the requirement
• Hostel
a) Wardens 2
b) Cooks, As per the requirement
c) Sanitary Staff, Ayas/Peons As per the requirement
d) Security Staff As per the requirement
e) Gardeners & Dhobi Depends on structural facilities (desirable)
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.
Cont….
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.
 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.
College Management Committee
Following members should constitute the Board of
Management of the College.
Principal Chairperson
Vice-Principal Member
Professor/Reader/Senior Lecturer Member
Chief Nursing Officer/ Nursing Superintendent Member
Representative of Medical Superintendent Member
• Admission /Selection Committee
Principal Chairperson
Vice-Principal
Professor
Chief Nursing Officer or Nursing superintendent
CLINICAL FACILITIES
• College of nursing should have a 100 bedded Parent Hospital.
i. Distribution of beds in different areas/ for 40 annual intake is
• Medical 30
• Surgical 30
• Obst. & Gynaecology 30
• Paediatrics 20
• Ortho 10
ii. Bed Occupancy of the Hospital should be minimum 75%.
iii. The size of the Hospital/Nursing Home for affiliation should not be less
than 100 beds.
vi. Other Specialities/Facilities for clinical experience required are as follows:
• Major OT
• Minor OT
• Dental
• Eye/ENT
• Burns and Plastic
• Neonatology with Nursery
• Communicable disease
• Community Health Nursing
• Cardiology
• Oncology
• Neurology/Neuro-surgery
• Nephrology etc.
• ICU/ICCU
v. Affiliation of psychiatric hospital should be of minimum 50 beds.
vi. The Nursing Staffing norms in the affiliated Hospital should be as per the
INC norms.
vii. The affiliated Hospital should give student status to the candidates of the
nursing programme.
viii. Affiliated hospitals should be in the radius of 15-30 kms.
ix. 1:3 student patient ratio to be maintained.
• If the institution is having both GNM and B.Sc (N) programme, it would
require 240 bedded parent/affiliated hospital for 40 annual intakes in each
programme to maintain 1:3 student patient ratio.
*Parent Hospital: The same trust which has established nursing institutions
and has also established the hospital, then only it will be considered as
“Parent Hospital” of that institute.
6) Evaluation of the program
• The statement in each of the proceeding sections is
evaluation criteria in themselves. In addition, the self
evaluation report submitted by a faculty to the board of
reviews should include the following:
▫ A description of the methods and the procedures uses by the
faculty in the appraised of its program, including evidence of
participation by students and graduates.
ACCREDITATION BODIES FOR HOSPITAL
• National Accreditation Board for Hospitals:
NABH is an acronym for National Accreditation Board for
Hospitals & Healthcare Providers is a constituent board of
Quality Council of India, set up to establish and operate
accreditation programme for healthcare organizations. NABH
was established in year 2006.
• Joint commission organization:
LICENSURE
• A nursing license is a credential granted by an individual
state. Most states require that healthcare practitioners with
direct patient contact be licensed.
• Each individual state has the sole authority to license health
care practitioners in their jurisdiction.
• A license confers a legal property right to the
holder. Consequently, the license cannot be taken away from
the practitioner without due process. Legally speaking due
process includes the right to a hearing and access to the courts
in a proceeding to remove a legal right.
A license differs from certification or registration.
• Registration requires a practitioner only register their intent to
practice within a jurisdiction.
• Certification is a credential provided by an organization rather
than the state and is usually granted after an applicant has
completed an approved course of study and passed and
examination.
Nursing licensure: - A nursing license is a credential
granted by an individual state. Most states require
that health care practitioners with direct patient
contact be licensed.
Components of nursing practice
• Each state develops rules and regulations to govern the
practice of nursing within that state.
• These rules are in the state’s nursing practice act or its
accompanying rules and regulations to administer the act
• Many nursing practice acts are patterned after the ANA or the
National Council of state Boards of Nursing model practice
acts, and all contain comparable information.
Purposes of act: - 2 essential purposes
• First each includes statements that refer to protecting the
health and safety of the citizens of the jurisdiction.
• The act describes the qualifications and responsibilities of
those individuals covered by the regulations.
• The second purpose is to protect the title of RN. The legal title
RN is reserved for those who have met the requirements to
practice nursing and who have attained licensure.
• Thus unlicensed personnel are prevented from using the title
of registered nurse.
Licensure Requirements
• An initial requirement in all jurisdictions is graduation from high
school and an accredited nursing program.
• Candidate for licensure must submit evidence of graduation as
defined by the state.
• Additional requirements for licensure may include the mental and
physical health status of the applicant.
• A temporary permit is still available for nurses moving from state to
another.
• To obtain a license to practice in another state, the nurse applies for
licensure by endorsement
Licensure by endorsement
• The process of obtaining a nursing license in a new state
(when already licensed in another state) is called licensure by
endorsement.
• In licensure by endorsement, each case is considered
independently, based on rules and regulation of the state.
• The same licensure examination and same passing standards
are used nationwide, no state requires the examination be
retaken.
• Basic educational and legal requirements of the individual
state where a license is sought must be met.
Types
• Mandatory: Anyone who practice nursing must be
licensed
• Permissive: The title RN is reserved for licensed but
the practice of nursing is not prohibited to others who
are not licensed or registered.
Permissive Nursing Licensure
• Permissive licensure allowed nurses who met certain standards to use the
title, registered nurse. Requirements included graduating from a nursing
school that met predetermined standards and passing a comprehensive
examination.
• Permissive licensure allowed nurses to choose whether or not to obtain the
additional registered nurse credential. Permissive licensure provided the
public with protection by establishing a way for the public to identify a
qualified practitioner. Permissive licensure did not protect the title
“nurse”. Anyone could call themselves a nurse, however in order to be
called a “registered nurse” the practitioner had to complete the
requirements determined by the state.
Mandatory nursing licensure
• Permissive licensure allows for those meeting certain standards voluntarily
to be licensed, whereas mandatory licensure requires that all individuals
who wish to practice in the field be licensed to practice.
• Mandatory nursing licensure requires that all the persons who wish to
practice nursing meet established standards for education, pass
standardized examinations, and secure a license to practice in the state,
province or territory in which they wish to work.
• The first mandatory licensure law took effect in NEW York in 1947
• Today mandatory licensure is the standard in the United States and Canada
and in most other countries
Types of Inspection for Licensing for Various
Nursing Programs
First Inspection
• First Inspection is conducted on receipt of the proposal
received from the institute to start any nursing program
prescribed by Indian Nursing Council. The proposal should
have the following requisite documents:
• Application
The requisite annexure for School of Nursing:
▫ Permission letter by State Government/Essentiality certificate of
the respective State Government, duly attested by notary.
▫ Duly attested Registration Certificate of Society or Trust Deed
▫ A bank draft for Rs. 50,000/- towards first inspection fee for
School of Nursing in favour of Secretary, Indian Nursing
Council, New Delhi (ANM, GNM, Post Basic Diploma Course).
▫ Proposal for starting School of Nursing, which includes in detail
teaching, clinical & physical facility including budget.
• The requisite annexure for College of Nursing:
▫ Permission letter by State Government/Essentiality certificate of the
respective State Government.
▫ Consent letter from the University.
▫ Duly attested Registration Certificate of Society or Trust Deed
▫ A bank draft for Rs. 1,00,000/- towards first inspection fee for College
of Nursing in favour of Secretary, Indian Nursing Council, New Delhi
{P.B.B.Sc.(N), B.Sc.(N), M.Sc.(N), M. Phil(N), Ph.D(N)}
▫ Proposal for starting College of Nursing, which includes in detail
teaching, clinical & physical facility including budget.
Re Inspection
• Re-inspections are conducted for those institutions, which are found
unsuitable by Indian Nursing Council.
• The institutions and the 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
the deficiencies pointed out and re-inspection fees.
• On receipt of the Compliance report & fees from the institution application
will be considered for re-inspection.
Periodic Inspection
• Indian Nursing Council conducts periodical (after 1 year of 3
years) inspection of the institution once the institution is found
suitable by Indian Nursing Council to monitor the standard of
nursing education and the adherence of the norms prescribed
by INC.
• Institution are required to pay annual affiliation fees every
year. However, if the institution does not comply to the norms
prescribed by Indian Nursing Council for teaching, clinical &
physical facilities, the institution will be declared unsuitable.
Enhancement of Seats
• Indian Nursing Council will conduct inspection after one year
from the last inspection conducted subject to the condition that
the students are admitted.
• Proposal of enhancement of seats will be considered only from
those institutions that are found suitable by Indian Nursing
Council.
• Indian Nursing Council will conduct inspection on above
guidelines and on receipt of the fees and the proposal for
Enhancement of seats.
Renewal of licensure
• In addition to outlining requirements for initial licensure, each
nursing practice act includes the requirements and information
necessary to renew ones nursing license.
• These regulations define the length of time license is valid.
Generally from 2-3 year
• All nurses are expected to remain competent to practice
through various means of continuing education.
Bibliography:
• B T Basavanthappa. Nursing administration. 1st ed. New
Delhi: Jaypee Brothers Medical Publishers; 2002. 474 – 510.
• Accreditation. Available at
http://aam.govst.edu/projects/scomer/student_page1.html.
Accessed on 20 March 2012.
• Accreditation. Available at
http://www.accreditation.org.au/accreditation/accreditationove
rview/. Accessed on 5th March 2012.
• Licensure. Available at
http://whoindia.org/LinkFiles/Workshop_Health_Services_02-
Nandraj-Anagha.pdf. Accessed on 5th March 2012.
• ncdrc.nic.in/1_1.html
• www.indiannursingcouncil.org
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Accrediation, lisence,renwl

  • 1. SEMINAR ON NURSING REGULATORY MECHANISMS: ACCREDITATION LICENSURE AND RENEWEL POONAM DHIMAN
  • 2. The standard of nursing care delivery is set by certain regulations of nursing practice called ― nurse practice acts‘. Nurse practice acts are legally defined and describe regulations of nursing actions by an administrative board such as a state board of nurse examiners. These boards generally have the authority to regulate nursing practice and education within the states.
  • 3. NURSING REGULATORY MECHANISMS The main functions of these regulations include:  To protect patient or society  To define the scope of nursing practice  To identify the minimum level of nursing care that must be provided to clients
  • 4. The regulatory bodies that define the laws and regulations in nursing practice are: • International council of nurses • Indian nursing council • State nursing council
  • 5. ACCREDITATION • The concept of accreditation of educational programs in nursing is very important. Accreditation is an internationally recognised evaluation process used in many countries to assess the quality of care and services provided. • It focus on continuous quality improvement strategies.
  • 6. DEFINITION • Accreditation refers to voluntary review process of education program by a professional organization. The organization is called an accreditating agency which compares the educational quality of the program with established standard and criteria • “Accreditation is a process whereby an organizations or agency recognizes a college or university or a program of study as having met certain predetermined qualifications and standards.”
  • 7. NURSING ACCREDITATION • Accreditation is a form of independent, professional certification that focuses on schools and programs in a particular field. Accreditation of nursing schools and programs therefore assures that the institutions and school adheres to high quality standards.
  • 8. Objectives: • To improve the quality of nursing education in country. • To agree upon the guidelines on quality assurance and accreditation of institutions. • To provide recommendations on the roles and functions of nursing educational institutions, nursing councils or regulatory bodies and national authority on the quality of education.
  • 9. Purposes: Maintenance of adequate admission requirements. Maintenance of minimum academic standards. Stimulation of institutional self improvements. Protection of institutions of higher education against educationally and socially harmful
  • 10. Elements of accreditation Self-assessment by the home against the Accreditation Standards Submission of an application for re-accreditation (with or without the self-assessment) Assessment by a team of registered aged care quality assessors at a site audit A decision about the home’s accreditation by a decision-maker Issue of an accreditation certificate Publication of the decision on this website Unannounced visits to monitor homes’ on-going performance
  • 11. Accrediting organizations: - In higher education are generally classed into three types: • National accreditating agency • National professional accreditating agency • State accreditating bodies
  • 12. National agency India has following all India Educational councils:  Central advisory board of education  All India council for elementary education  All India council for secondary education  University grant commission  All India council for technical education  National assessment and accreditation council
  • 13. National professional accreditating agency  Medical council of India  Indian nursing council  Dental council of India  Pharmacy council of India  Central council of Indian system of medicine  But now....National council for human resources in health NCHRH....this one will cover the above all National professional accreditating agency:-National professional accreditating agency:-
  • 14. Areas generally scrutinized in accreditation review are: • Administration and governance • Finances and budget • Faculty and students • Curriculum and resources
  • 15. • Criteria and standards are established in each area, programs under review prepare reports, than show how school and college meet each criterion. • Once accredited and in good standing, continuing accreditation review take place every 8 years or 5 years. • Programs that do not meet standards may be placed on warning and given a specific time period to correct the deficiencies. • Accreditation can be withdrawn if deficiencies are not corrected with in specific time.
  • 16. Criteria for appraisal of nursing programs: 1) Philosophy, purposes and objectives:- • The philosophy and purposes of the colleges of nursing are developed and clearly stated by the faculty. • The philosophy and purposes of the colleges of nursing are consistent with the published statements of characteristics of educational programs in nursing accepted by the membership of the statuary bodies like INC or any other agency. • The objective of each program interprets the purposes in definite terms.
  • 17. 2) Organization and administration:- • Adequate and stable financial support for the college is assured. • The policy in effect for faculty members of the college is those in effect for faculty members throughout the institutions, with adjustments for differences that may be required in education for a profession. • The organization of the college’s faculty is appropriate to its size, and its effective functioning is promoted. • The faculty conducts planned periodic evaluations of the organization and administration.
  • 18. 3) Types of Nursing Program Nursing programs Training & duration Examination Registration ANM 2 yrs Nursing examination board R. ANM GNM 31/2 yrs Nursing examination board R.N & R.M B.Sc 4 yrs University R.N & R.M B.Sc (Post Basic) Regular: 2yrs Distance: 3 yrs University Additional qualification M.Sc. 2 yrs University Additional qualification M. Phil Regular: 1yrs Distance: 2 yrs University Additional qualification Ph D 3-5 yrs University Additional qualification
  • 19. 4) Students:- • The policies pertaining to admission, progression, and graduation are consistent with those of the parent institutions. • Participation in program development and evaluation by the students is encouraged. • Criteria for determining student progress at periodic intervals in the program have been developed and are utilized and evaluated.
  • 20. Eligibility Criteria Nursing Programs A. N. M. • minimum age 17 years on or before 31st December of the year in which admission is sought. • maximum age 35 years. • The minimum educational requirements shall be 10 + 2 in Arts (Mathematics, Physics, Chemistry, Biology, Biotechnology, Economics, Political Science, History, Geography, Business Studies, Accountancy, Home Science, Sociology, Psychology, and Philosophy) and English Core/English Elective or Science or Health care Science - Vocational stream ONLY passing out from recognized Board. • Student shall be medically fit. • Student shall be admitted once in a year.
  • 21. G. N. M. • Minimum and Maximum age for admission will be 17 and 35 years. • Minimum education: ▫ 10+2 class passed preferably Science (PCB) & English with aggregate of 40% marks. ▫ 10+2 in Arts (Mathematics, Biotechnology, Economics, Political Science, History, Geography, Business Studies, Accountancy, Home Science, Sociology, Psychology, Philosophy) and English Core/English Elective or Health care Science - Vocational stream ONLY, passing out from recognized Board under AISSCE/CBSE/ICSE/SSCE/HSCE or other equivalent Board with 40% marks. ▫ 10+2 vocational ANM under CBSE Board or other equivalent board from the school and recognized by Indian Nursing Council with 40% marks. ▫ Registered as ANM with State Nursing Registration Council. • Student shall be medically fit. • Student shall be admitted once in a year.
  • 22. B. Sc. (N) • minimum age 17 years on 31st December of the year in which admission is sought. • Minimum education: ▫ 10+2 class passed with Science (PCB) & English Core/English Elective with aggregate of 45% marks from recognized board under CBSE/ICSE/SSCE/HSCE or other equivalent Board. • Student shall be medically fit. • Students appearing in 10+2 examination in Science conducted by National Institute of Open School with 45% marks. • Student shall be admitted once in a year.
  • 23. Post Basic B. Sc. (N) • Passed the Higher Secondary or Senior Secondary or Intermediate or 10+2 or an equivalent examination recognized by the university for this purpose. • Obtained a certificate in General Nursing and Midwifery and registered as R.N.R.M. with the State Nurses Registration Council. ▫ O.T. Techniques ▫ Ophthalmic Nursing ▫ Leprosy Nursing ▫ TB Nursing ▫ Psychiatric Nursing ▫ Neurological and Neuro surgical Nursing ▫ Community Health Nursing ▫ Cancer Nursing • Candidates shall be medically fit.
  • 24. M. Sc. (N) • The candidate should be a Registered Nurse and Registered midwife of equivalent with any State Nursing Registration Council. • The Minimum education requirements shall be the passing of: B.Sc. Nursing/B.Sc. Hons. Nursing/Post Basic B.Sc. Nursing with minimum of 55% aggregate marks. • The candidate should have undergone in B.Sc. Nursing / B.Sc. Hons. Nursing / Post Basic B.Sc. Nursing in an institution which is recognized by Indian Nursing Council. • Minimum one year of work experience after Basic B.Sc. Nursing. • Minimum one year of work experience prior or after Post Basic B.Sc. Nursing.
  • 25. 5) Resources, facilities and services:- • Resources, facilities and services of the institutes are availed to and used by the college of nursing. • Resources, facilities and services are adequate to the needs of the faculty and the students and to the number and the type of programs in nursing offered. • The physical facility of the college of nursing is adequate to the needs of the instructional programs and to size of the faculty and the student body.
  • 26. GUIDELINES AND MINIMUM REQUIREMENTS TO ESTABLISH B.Sc. (N) COLLEGE OF NURSING 1. Any organization under: (i) Central Government/State Government/Local body (ii) Registered Private or Public Trust (iii) Missionary or any other organization registered under Society Registration Act 2. Any organization having 100 bedded Parent (Own) hospital is eligible to establish B.Sc. (N) Course. 3. Above organization shall obtain the Essentiality Certificate/No Objection Certificate for the B.Sc. (N) programme from the respective State Government. The institution name along with Trust Deed/Society address shall be mentioned in No Objection Certificate/Essentiality Certificate.
  • 27. Contd.. 4. An application form to establish Nursing programme is available on the website viz., www.indiannursingcouncil.org, which shall be downloaded. Duly filled in application form with the requisite documents mentioned in the form shall be submitted before the last date as per the calendar of events of that year. 5. The Indian Nursing Council on receipt of the proposal from the Institution to start nursing programme, 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.
  • 28. Contd.. 6. 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. 7. Institution will admit the students only after taking approval of State Nursing Council and University. 8. Upgradation is not a additional B.Sc. (N) programme, but is the convert from School of Nursing into College of Nursing.
  • 29. Minimum Requirement to establish B.Sc. (N) Programme Building: • The College of Nursing should have a separate building. • The college of Nursing should be near to its parent hospital having space for expansion in an institutional area. • For a College with an annual admission capacity of 40-60 students, the constructed area of the college should be 23720 square feet. • Adequate hostel/residential accommodation for students and staff should be available in addition to the above mentioned built up area of the Nursing College respectively.
  • 30. PHYSICAL FACILITIES 1. Nursing Educational institution should be in Institutional area only and not in residential area. 2. If the institute has non-nursing programme in the same building, Nursing programme should have separate teaching block. 3. Shift-wise management with other educational institutions will not be accepted.
  • 31. 4. Separate teaching block shall be available if it is in hospital premises. 5. Proportionately the size of the built-up area will increase according to the number of students admitted. 6. School and College of nursing can share laboratories, if they are same campus under same name and under same trust, that is the institution is one but offering different nursing programmes. The class rooms should be available as per the requirement stipulated by Indian Nursing Council of each programme.
  • 32. 1. Class rooms • There should be at least four classrooms with the capacity of accommodating the number of students admitted in each class. • The rooms should be well ventilated with proper lighting system. • There should be built in Black/Green/White Boards. Also there should be a desk/ dais/a big table and a chair for the teacher and racks/cupboards for keeping teaching aids or any other equipment needed for the conduct of classes also should be there.
  • 33. Departments: College should have following departments: 1. Fundamentals of Nursing including Nutrition 2. Medical Surgical Nursing 3. Community Health Nursing 4. Obstetric and Gynaecological Nursing 5. Child Health Nursing 6. Psychiatry and Mental Health Nursing
  • 34. 2. Laboratories There should be at least Seven laboratories as listed below: • Nursing Foundations and Medical Surgical • Community Health Nursing • OBG and Paediatrics • Nutrition • Computer with 10 computers • Pre Clinical Science Lab. (Biochemistry, • Microbiology, Biophysics, Anatomy & Physiology)
  • 35. 3. Auditorium • Auditorium should be spacious enough to accommodate at least double the sanctioned/actual strength of students, so that it can be utilised for hosting functions of the college, educational conferences/ workshops, examinations etc. • It should have proper stage with green room facilities. It should be well – ventilated and have proper lighting system. • There should be arrangements for the use of all kinds of basic and advanced audio-visual aids. 4. Multipurpose Hall • College of Nursing should have multipurpose hall, if there is no auditorium
  • 36. 5. Library • There should be a separate library for the college. The size of the Library should be of minimum 2400 sqr. ft. It should be easily accessible to the teaching faculty and the students. • Library should have seating arrangements for at least 60 students for reading and having good lighting and ventilation and space for stocking and displaying of books and journals. • The library should have at least 3000 books. In a new College of Nursing the total number of books should be proportionately divided on yearly basis in four years. • .
  • 37. • Atleast 10 sets of books in each subject to facilitate for the students to refer the books. The number of journals should 15 out of which one- third shall be foreign journals and subscribed on continuous basis. • There should be sufficient number of cupboards, book shelves and racks with glass doors for proper and safe storage of books, magazines, journals, newspapers and other literature
  • 38. In the library there should be provision for: - Staff reading room for 10 persons. - Rooms for librarian and other staff with intercom phone facility - Video and cassette / CD room (desirable) - Internet facility.
  • 39. 6. Offices Requirements (a) Principal’s Office • There should be a separate office for the Principal with attached toilet and provision for visitor’s room. • Independent telephone facility is a must for the Principal’s office with intercom facility connected/linked to the hospital and hostel and a computer with internet facility. • The size of the office should be 300 sqr. ft. (b) Office for Vice-Principal • There should be a separate office for the Vice-Principal with attached toilet and provision for visitor’s room. • Independent telephone facility is a must for Vice principal’s office with intercom facility connected/linked to the hospital and hostel and a computer with internet facility. The size of the office should be 200 sqr. ft.
  • 40. (c) Office for Faculty Members • There should be adequate number of office rooms in proportion to the number of teaching faculty. One office room should accommodate 2 teachers only. Separate toilet facility should be provided for the teaching faculty with hand washing facility. There should be a separate toilet for male teachers. The size of the room should be 200 sqr. ft. Separate chambers for heads of the department should be there. 7. Common Rooms • A minimum of 3 common rooms should be provided. One for the teaching faculty, one for the student and one for the office staff. • Sufficient space with adequate seating arrangements, cupboards, lockers, cabinets, built-in-shelves and racks should be provided in all the common rooms. Toilet and hand washing facilities should be made available in each room.
  • 41. 8. Record Room • There should be a separate record room with steel racks, built- in shelves and racks, cupboards and filing cabinets for proper storage of records and other important papers/ documents belonging to the college. 9. Store room 10. Room for Audio-Visual Aids • This room should be provided for the proper and safe storage of size 600 sq. ft. for all the Audio- Visual Aids.
  • 42. 11. Other Facilities • Indoor games hall of size 4000 ft. Safe drinking water and adequate sanitary/toilet facilities should be available for both men and women separately in the college in each floor common toilets for teachers (separate for male and female) i.e 4 toilets with Wash basins. • Common toilets for students (separate for male and female) 12 with Wash Basins for 60 students. 12. Fire Extinguisher • Adequate provision for extinguishing fire should be available as per the local bye-laws. 13. Playground • Playground should be spacious for outdoor sports like Volleyball, football, badminton and for Athletics.
  • 43. Hostel Block (60 Students): 1. Single Room, Double Room 2. Sanitary One latrine & One Bath room (for 5 students) 3. Visitor Room 4. Reading Room 5. Store 6. Recreation Room 7. Dining Hall 8. Kitchen & Store 9. Pantry 10. Sick room 11. Guest room 12. Warden’s room 13.Canteen 14. Transport
  • 44. Residential Accommodation: • Crèche There should be a crèche in the college campus. • Staff for the Hostel: 1. Warden (Female) -3: Qualification- B.Sc. Home Science or Diploma in Housekeeping/ Catering. Minimum three wardens must be there in every hostel for morning, evening and night shifts. If number of students s more than 150, one more warden/ Asst. Warden/ House keeper for every additional 50 students. 2. Cook-1: For every 20 students for each shift. 3. Kitchen & Dining Room helper- 1: For every 20 students for each shift. 4. Sweeper-3 5. Gardener-2 6. Security Guard/ Chowkidar-3
  • 45. QUALIFICATIONS & EXPERIENCE OF TEACHERS OF COLLEGE OF NURSING • Post Qualification & Experience 1 Principal –cum-Professor - M.Sc. (N) with 15 years experience after M.Sc.(N) out of which 12 years should be teaching experience with minimum of 5 years in collegiate programme. Ph.D. (N) is desirable 2 Vice Principal -cum-Professor- M.Sc. (N) with 12 years experience after M.Sc.(N) out of which 10 years should teaching experience with minimum of 5 years in collegiate programme. Ph.D. (N) is desirable
  • 46. 3 Professor- M.Sc. (N) with 10 years experience after M.Sc.(N) out of which 7 years should be teaching experience. Ph.D. (N) is desirable 4 Associate Professor- M.Sc. (N) with 08 years experience after M.Sc.(N) including 5 years teaching experience. Ph.D. (N) desirable 5Assistant Professor- M.Sc. (N) with 3 years experience after M.Sc.(N) 6 Tutor- M.Sc.(N) Or B.Sc.(N)/P.B.B.Sc.(N) with 1 year experience
  • 47. S.N o. Designation GNM 20-60 B.Sc.(N) 40-60 PB.B.Sc (N) 20-60 M.Sc.(N) 10-25 1. Professor cum PRINCIPAL 1 1 2. Professor cum VICE- PRINCIPAL 1 1 3. Professor 0 1 4. Associate Professor 2 1 5. Assistant Professor 3 2 3 6. Tutor 6-18 10-18 2-10
  • 48. Other Staff (Minimum requirements) (To be reviewed and revised and rationalized keeping in mind the mechanization and contract service) • Ministerial a) Administrative Officer 1 b) Office Superintendent 1 c) PA to Principal 1 d) Accountant/Cashier 1 • Upper Division Clerk 2 • Lower Division Clerk 2 • Store Keeper 1 a) Maintenance of stores 1 b) Classroom attendants 2 c) Sanitary staff As per the physical space d) Security Staff As per the requirement
  • 49. • Peons/Office attendants 4 • Library a) Librarian 2 b) Library Attendants as per the requirement • Hostel a) Wardens 2 b) Cooks, As per the requirement c) Sanitary Staff, Ayas/Peons As per the requirement d) Security Staff As per the requirement e) Gardeners & Dhobi Depends on structural facilities (desirable)
  • 50. 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.
  • 51. Cont…. 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.  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.
  • 52. College Management Committee Following members should constitute the Board of Management of the College. Principal Chairperson Vice-Principal Member Professor/Reader/Senior Lecturer Member Chief Nursing Officer/ Nursing Superintendent Member Representative of Medical Superintendent Member • Admission /Selection Committee Principal Chairperson Vice-Principal Professor Chief Nursing Officer or Nursing superintendent
  • 53. CLINICAL FACILITIES • College of nursing should have a 100 bedded Parent Hospital. i. Distribution of beds in different areas/ for 40 annual intake is • Medical 30 • Surgical 30 • Obst. & Gynaecology 30 • Paediatrics 20 • Ortho 10 ii. Bed Occupancy of the Hospital should be minimum 75%. iii. The size of the Hospital/Nursing Home for affiliation should not be less than 100 beds.
  • 54. vi. Other Specialities/Facilities for clinical experience required are as follows: • Major OT • Minor OT • Dental • Eye/ENT • Burns and Plastic • Neonatology with Nursery • Communicable disease • Community Health Nursing • Cardiology • Oncology • Neurology/Neuro-surgery • Nephrology etc. • ICU/ICCU
  • 55. v. Affiliation of psychiatric hospital should be of minimum 50 beds. vi. The Nursing Staffing norms in the affiliated Hospital should be as per the INC norms. vii. The affiliated Hospital should give student status to the candidates of the nursing programme. viii. Affiliated hospitals should be in the radius of 15-30 kms. ix. 1:3 student patient ratio to be maintained. • If the institution is having both GNM and B.Sc (N) programme, it would require 240 bedded parent/affiliated hospital for 40 annual intakes in each programme to maintain 1:3 student patient ratio. *Parent Hospital: The same trust which has established nursing institutions and has also established the hospital, then only it will be considered as “Parent Hospital” of that institute.
  • 56. 6) Evaluation of the program • The statement in each of the proceeding sections is evaluation criteria in themselves. In addition, the self evaluation report submitted by a faculty to the board of reviews should include the following: ▫ A description of the methods and the procedures uses by the faculty in the appraised of its program, including evidence of participation by students and graduates.
  • 57. ACCREDITATION BODIES FOR HOSPITAL • National Accreditation Board for Hospitals: NABH is an acronym for National Accreditation Board for Hospitals & Healthcare Providers is a constituent board of Quality Council of India, set up to establish and operate accreditation programme for healthcare organizations. NABH was established in year 2006. • Joint commission organization:
  • 58. LICENSURE • A nursing license is a credential granted by an individual state. Most states require that healthcare practitioners with direct patient contact be licensed. • Each individual state has the sole authority to license health care practitioners in their jurisdiction. • A license confers a legal property right to the holder. Consequently, the license cannot be taken away from the practitioner without due process. Legally speaking due process includes the right to a hearing and access to the courts in a proceeding to remove a legal right.
  • 59. A license differs from certification or registration. • Registration requires a practitioner only register their intent to practice within a jurisdiction. • Certification is a credential provided by an organization rather than the state and is usually granted after an applicant has completed an approved course of study and passed and examination.
  • 60. Nursing licensure: - A nursing license is a credential granted by an individual state. Most states require that health care practitioners with direct patient contact be licensed.
  • 61. Components of nursing practice • Each state develops rules and regulations to govern the practice of nursing within that state. • These rules are in the state’s nursing practice act or its accompanying rules and regulations to administer the act • Many nursing practice acts are patterned after the ANA or the National Council of state Boards of Nursing model practice acts, and all contain comparable information.
  • 62. Purposes of act: - 2 essential purposes • First each includes statements that refer to protecting the health and safety of the citizens of the jurisdiction. • The act describes the qualifications and responsibilities of those individuals covered by the regulations. • The second purpose is to protect the title of RN. The legal title RN is reserved for those who have met the requirements to practice nursing and who have attained licensure. • Thus unlicensed personnel are prevented from using the title of registered nurse.
  • 63. Licensure Requirements • An initial requirement in all jurisdictions is graduation from high school and an accredited nursing program. • Candidate for licensure must submit evidence of graduation as defined by the state. • Additional requirements for licensure may include the mental and physical health status of the applicant. • A temporary permit is still available for nurses moving from state to another. • To obtain a license to practice in another state, the nurse applies for licensure by endorsement
  • 64. Licensure by endorsement • The process of obtaining a nursing license in a new state (when already licensed in another state) is called licensure by endorsement. • In licensure by endorsement, each case is considered independently, based on rules and regulation of the state. • The same licensure examination and same passing standards are used nationwide, no state requires the examination be retaken. • Basic educational and legal requirements of the individual state where a license is sought must be met.
  • 65. Types • Mandatory: Anyone who practice nursing must be licensed • Permissive: The title RN is reserved for licensed but the practice of nursing is not prohibited to others who are not licensed or registered.
  • 66. Permissive Nursing Licensure • Permissive licensure allowed nurses who met certain standards to use the title, registered nurse. Requirements included graduating from a nursing school that met predetermined standards and passing a comprehensive examination. • Permissive licensure allowed nurses to choose whether or not to obtain the additional registered nurse credential. Permissive licensure provided the public with protection by establishing a way for the public to identify a qualified practitioner. Permissive licensure did not protect the title “nurse”. Anyone could call themselves a nurse, however in order to be called a “registered nurse” the practitioner had to complete the requirements determined by the state.
  • 67. Mandatory nursing licensure • Permissive licensure allows for those meeting certain standards voluntarily to be licensed, whereas mandatory licensure requires that all individuals who wish to practice in the field be licensed to practice. • Mandatory nursing licensure requires that all the persons who wish to practice nursing meet established standards for education, pass standardized examinations, and secure a license to practice in the state, province or territory in which they wish to work. • The first mandatory licensure law took effect in NEW York in 1947 • Today mandatory licensure is the standard in the United States and Canada and in most other countries
  • 68. Types of Inspection for Licensing for Various Nursing Programs First Inspection • First Inspection is conducted on receipt of the proposal received from the institute to start any nursing program prescribed by Indian Nursing Council. The proposal should have the following requisite documents: • Application The requisite annexure for School of Nursing: ▫ Permission letter by State Government/Essentiality certificate of the respective State Government, duly attested by notary. ▫ Duly attested Registration Certificate of Society or Trust Deed ▫ A bank draft for Rs. 50,000/- towards first inspection fee for School of Nursing in favour of Secretary, Indian Nursing Council, New Delhi (ANM, GNM, Post Basic Diploma Course). ▫ Proposal for starting School of Nursing, which includes in detail teaching, clinical & physical facility including budget.
  • 69. • The requisite annexure for College of Nursing: ▫ Permission letter by State Government/Essentiality certificate of the respective State Government. ▫ Consent letter from the University. ▫ Duly attested Registration Certificate of Society or Trust Deed ▫ A bank draft for Rs. 1,00,000/- towards first inspection fee for College of Nursing in favour of Secretary, Indian Nursing Council, New Delhi {P.B.B.Sc.(N), B.Sc.(N), M.Sc.(N), M. Phil(N), Ph.D(N)} ▫ Proposal for starting College of Nursing, which includes in detail teaching, clinical & physical facility including budget.
  • 70. Re Inspection • Re-inspections are conducted for those institutions, which are found unsuitable by Indian Nursing Council. • The institutions and the 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 the deficiencies pointed out and re-inspection fees. • On receipt of the Compliance report & fees from the institution application will be considered for re-inspection.
  • 71. Periodic Inspection • Indian Nursing Council conducts periodical (after 1 year of 3 years) inspection of the institution once the institution is found suitable by Indian Nursing Council to monitor the standard of nursing education and the adherence of the norms prescribed by INC. • Institution are required to pay annual affiliation fees every year. However, if the institution does not comply to the norms prescribed by Indian Nursing Council for teaching, clinical & physical facilities, the institution will be declared unsuitable.
  • 72. Enhancement of Seats • Indian Nursing Council will conduct inspection after one year from the last inspection conducted subject to the condition that the students are admitted. • Proposal of enhancement of seats will be considered only from those institutions that are found suitable by Indian Nursing Council. • Indian Nursing Council will conduct inspection on above guidelines and on receipt of the fees and the proposal for Enhancement of seats.
  • 73. Renewal of licensure • In addition to outlining requirements for initial licensure, each nursing practice act includes the requirements and information necessary to renew ones nursing license. • These regulations define the length of time license is valid. Generally from 2-3 year • All nurses are expected to remain competent to practice through various means of continuing education.
  • 74. Bibliography: • B T Basavanthappa. Nursing administration. 1st ed. New Delhi: Jaypee Brothers Medical Publishers; 2002. 474 – 510. • Accreditation. Available at http://aam.govst.edu/projects/scomer/student_page1.html. Accessed on 20 March 2012. • Accreditation. Available at http://www.accreditation.org.au/accreditation/accreditationove rview/. Accessed on 5th March 2012. • Licensure. Available at http://whoindia.org/LinkFiles/Workshop_Health_Services_02- Nandraj-Anagha.pdf. Accessed on 5th March 2012. • ncdrc.nic.in/1_1.html • www.indiannursingcouncil.org