Full Text
REGD. No. D. L.-33004/99
The Gazette of India
CG-DL-E-24102024-258203
EXTRAORDINARY
PART III—Section 4
PUBLISHED BY AUTHORITY
No. 841]
NEW DELHI, MONDAY, OCTOBER 21, 2024/ASVINA 29, 1946
INDIAN NURSING COUNCIL
NOTIFICATION
New Delhi, the 7th October 2024
INDIAN NURSING COUNCIL (POST BASIC DIPLOMA IN PALLIATIVE CARE SPECIALTY NURSING - RESIDENCY PROGRAM) REGULATIONS, 2023
F.No. 11-1/2024-INC (III).—In exercise of the powers conferred by sub-section (1) of Section 16 of Indian Nursing Council Act, 1947 (XLVIII of 1947), as amended from time to time, the Indian Nursing Council hereby makes the following regulations, namely:—
1. SHORT TITLE AND COMMENCEMENT
i. These Regulations may be called the Indian Nursing Council (Post Basic Diploma in Palliative Care Specialty Nursing - Residency Program) Regulations, 2023.
ii. These shall come into force on the date of notification of the same in the Official Gazette of India.
2. DEFINITIONS
In these Regulations, unless the context otherwise requires,
i. 'the Act' means the Indian Nursing Council Act, 1947 (XLVIII of 1947) as amended from time to time;
ii. 'the Council' means the Indian Nursing Council constituted under the Act;
iii. 'SNRC' means the State Nurse and Midwives Registration Council, by whichever name constituted, by the respective State Governments;
iv. 'RN & RM' means a Registered Nurse and Registered Midwife (RN & RM) and denotes a nurse who has completed successfully, recognised Bachelor of Nursing (B.Sc. Nursing) or Diploma in General Nursing and Midwifery (GNM) course, as prescribed by the Council and is registered in a SNRC as Registered Nurse and Registered Midwife;
v. 'Nurses Registration & Tracking System (NRTS)' means a system developed by the Council and software developed in association with National Informatics Centre (NIC), Government of India, and hosted by NIC for the purpose of maintenance and operation of the Indian Nurses Register. It has standardised forms for collection of the data of Registered Nurse and Registered Midwife (RN & RM)/Registered Auxiliary Nurse Midwife (RANM)/Registered Lady Health Visitor (RLHV) upon Aadhar based biometric authentication;
vi. 'NUID' is the Nurses Unique Identification Number given to the registrants in the NRTS system;
vii. ‘General Nursing and Midwifery (GNM)' means Diploma in General Nursing and Midwifery qualification recognized by the Council under Section 10 of the Act and included in Part-I of the Schedule of the Act.
POST BASIC DIPLOMA IN PALLIATIVE CARE SPECIALTY NURSING - RESIDENCY PROGRAM
I. INTRODUCTION
Nurses comprise the largest group of healthcare providers globally. Nurses are a vital resource for ensuring the provision of safe and effective care for the global population. Nurses spend more time with patients and families than any other health professionals as they face serious illnesses. Expert nursing care reduces the distress, and burdens of those facing death, and the ability to offer support for unique physical, social, psychological, and spiritual needs of the patients and their families. Collectively, nurses have demonstrated a commitment to palliative care, with some nurses showing even greater initiative in the care of patients at end-of-life.
Palliative care has evolved as a specialty over the past decades. There is an increasing demand for palliative care facilities and trained personnel specially nurses at the secondary and tertiary level hospitals in India. There is a great need for nurses to be trained and equipped for taking care of palliative care patients at different settings such as hospitals, hospice and in community. Palliative care refers to the optimization of quality of life for both the patients with serious illness and their families using special measures to anticipate, treat and prevent suffering. This care encompasses the continuum of illnesses including physical, psychosocial, emotional, and spiritual needs of seriously ill patients. Like geriatrics and hospice care, palliative care generally uses a multidisciplinary team that consists of medicine, nursing, social work, and spiritual care to meet the multifaceted needs of patients with serious illness, or who are at the end-of-life. This Post Diploma in Palliative Care Specialty Nursing program is directed towards the preparation of nurses with specialized skills to be able to practice as palliative care nurses in any palliative care settings to provide high quality and family-centered care. Palliative care specialist nurses can provide excellent care to those suffering from serious life-limiting illnesses.
The program is designed to prepare registered nurses both diploma and B.Sc. to acquire comprehensive knowledge, advanced skills and positive attitude in palliative care nursing which will enable nurses to deliver safe, competent, legal and ethical nursing care to patients requiring palliative care. Further, it is designed to equip nurses with managerial skills and knowledge that will enable them to take up roles in planning, managing, and supervising palliative care of patients and train other clinical nurses and students in various palliative care settings. The palliative care specialist nurse will be able to advise on planning and setting up of palliative care units and improve the care and comfort of the death and dying.
II. PHILOSOPHY
The Council believes that registered nurses need to be further trained as specialist nurses to function in various emerging specialty areas of practice and the training should be competency based. One such area that demands specialist nurses is palliative care. Expanding roles of nurses and advances in palliative care necessitates additional training to prepare nurses with specialized skills and knowledge to deliver competent, intelligent and appropriate care to patients in palliative care centers.
III. CURRICULUM FRAMEWORK
The Post Basic Diploma in Palliative Care Specialty Nursing is a one-year residency program. The curriculum is conceptualized encompassing foundational short courses and major specialty courses for specialty nursing.
The foundations to the program include professionalism, communication, patient education and counselling, clinical leadership & resource management and evidenced based and applied research. These are short courses that aim to provide the students basic concepts needed for palliative care nursing and also the knowledge, attitude and competencies essential for clinical practice to function as accountable, sincere, safe and ethical palliative care specialist nurses. The clinical specialty courses are divided into two major parts which are Palliative Care Specialty Nursing I and Palliative Care Specialty Nursing II. The Palliative Care Specialty Nursing I comprises of context/introduction to palliative care nursing, that includes principles and practices of palliative care nursing, roles and responsibilities of palliative care specialist nurses, basic sciences applied to palliative care nursing such as applied anatomy and physiology, infection prevention and control, pharmacological management, psychosocial, spiritual aspects, legal and ethical issues relevant to palliative care, grief and bereavement, models of palliative care and alternative therapy in palliative care. Palliative Care Specialty Nursing II consists of nursing management of patients requiring palliative care that includes pain and symptom management, management of specific palliative nursing care needs, palliative care in life threatening disease conditions, palliative care in special population, palliative care for children and elderly, palliative care emergencies, home based palliative care, psychiatry in palliative care, and end-of-life care.
The curricular framework for the Post Basic Diploma in Palliative Care Specialty Nursing - Residency Program is illustrated in the following figure-1.
POST BASIC DIPLOMA IN PALLIATIVE CARE SPECIALTY NURSING - RESIDENCY PROGRAM
Foundations to Palliative Care Nursing - Courses
Palliative Care Specialty Nursing – Courses
* Professionalism
* COURSES
* Context/Introduction to specialty nursing practice
* Basic sciences applied to specialty care
* Communication, patient education and counseling
* Clinical leadership and resource management
* Palliative Care Nursing Education for Specialist Practice
* Nursing Management incl. assessment and specialized interventions
* Patient safety & quality, and illness specific considerations
* ONE YEAR RESIDENCY PROGRAM (For Registered Nurses & Midwives)
* Theory - 10% and Practicum – 90% (Skill Lab + Clinical)
Figure-1. Curricular Framework for Post Basic Diploma in Palliative Care Specialty Nursing - Residency Program
IV. AIM/PURPOSE
The Post Basic Diploma in Palliative Care Specialty Nursing program aims to develop nurses with specialized skills, knowledge and attitude in providing quality care to terminally ill suffering patients. The goal is to prepare technically qualified and trained specialist nurses who will function effectively by applying principles of palliative care management in patients and develop skills and attitude in providing comprehensive and competent nursing care to adults and children requiring palliative care in different settings such as hospitals, hospice and community providing high standards of care.
COMPETENCIES
On completion of the program, the palliative care specialist nurse will be able to:
1. Demonstrate professional accountability for the delivery of nursing care which are as per the Council standards that consistent with moral, altruistic, legal, ethical, regulatory and humanistic principles in palliative care nursing
2. Communicate effectively with patients, families and professional colleagues fostering mutual respect and shared decision making to enhance health outcomes.
3. Educate and counsel patients and families to participate effectively in treatment and care and enhance their coping abilities through crisis and bereavement.
4. Demonstrate understanding of clinical leadership and resource management strategies and use them in palliative care settings promoting collaborative and effective team work.
5. Identify, evaluate and use the best current evidence in palliative care and treatment coupled with clinical expertise and consideration of patient's preferences, experience and values to make practical decisions in palliative care nursing practice.
6. Participate in research studies that contribute to evidence-based palliative care nursing interventions with basic understanding of research process.
7. Apply basic sciences in the assessment, diagnosis and treatment of the physiological, physical, psychological, social and spiritual problems of patients and their families requiring palliative care.
8. Apply nursing process in the care of patients requiring palliative care.
9. Describe the principles of radiotherapy, chemotherapy, diet therapy, and surgery in treatment of patients with palliative care needs.
10. Demonstrate specialized practice competencies/skills relevant in providing palliative care.
11. Identify treatment related to palliative emergencies and manage them effectively.
12. Ensure access to care and community resources and contribute to improve quality and cost-effective services.
13. Develop understanding of the method of drug procurement, storage, administering and maintenance of chemotherapy and demonstrate sound practice.
14. Conduct clinical audit and participate in quality assurance activities in palliative care unit.
15. Demonstrate safe delivery of various therapies to patients and protect them from occupational harm.
16. Demonstrate specialized practice competencies/skills relevant in supporting end-of-life care, loss, grief and bereavement.
17. Create a healing environment to promote a peaceful death.
18. Provide end-of-life care to patients with emphasis to promoting comfort and dignity respecting individual cultural and spiritual needs and differences.
V. PROGRAM DESCRIPTION AND SCOPE OF PRACTICE
The Post Basic Diploma in Palliative Care Specialty Nursing is a one-year residency program with a main focus on competency-based training. It is designed to prepare registered nurses (GNM or B.Sc.) with specialized knowledge, skills and attitude in providing advance quality care to patients and their families requiring palliative care. Theory includes foundation courses, specialty courses and clinical practicum. The theory component comprises of 10% and practicum 90% (Clinical and Lab).
On completion of the program and certification, and registration as additional qualification with respective SNRC, the palliative care specialist nurses should be employed only in palliative care settings either in hospital, hospice or community. They will be able to practice as per the competencies trained during the program particularly the specialized procedural competencies/clinical skills as per the log book of the Council syllabus. The specialist nurses can be privileged to practice those specialized procedural competencies by the respective institution as per institutional protocols. Specialist nurse cadres/positions should be created at government/public/ private sectors. The diploma will be awarded by respective Examination Board/SNRC/University approved by the Council.
VI. MINIMUM REQUIREMENTS/GUIDELINES FOR STARTING THE POST BASIC DIPLOMA IN PALLIATIVE CARE SPECIALTY NURSING - RESIDENCY PROGRAM
The program may be offered at
1. College of Nursing offering degree programs in nursing attached to parent specialty hospital/tertiary hospital having minimum of 200 beds with diagnostic, therapeutic and state of the art palliative care units with chemotherapy, radiotherapy, palliative care, supportive care and specialized nursing care facilities.
OR
Hospitals offering DNB/Fellowship programs in oncology/palliative care having minimum of 200 beds with diagnostic, therapeutic and state of the art palliative care units with chemotherapy, radiotherapy, palliative care, Hospice, supportive care and specialized nursing care facilities.
2. The above eligible institution shall get recognition from the concerned SNRC for Post Basic Diploma in Palliative Care Specialty Nursing – Residency Program for the particular academic year, which is a mandatory requirement.
3. The Council shall after receipt of the above documents/proposal would then conduct statutory inspection of the recognized training nursing institution under Section 13 of the Act in order to assess suitability with regard to availability of teaching faculty, clinical and infrastructural facilities in conformity with Regulations framed under the provisions of the Act.
1. Nursing Teaching Faculty
a. Full time teaching Faculty in the ratio of 1:10
b. Minimum number of faculty should be two
c. Qualification and Number:
i. M.Sc. Nursing with Medical Surgical Nursing/Paediatric Nursing/Obstetrics & Gynaecology Nursing/Oncology Nursing/Palliative Care Specialty Nursing - 1
ii. Post Basic Diploma in Haematology/Oncology Specialty Nursing with Basic B.Sc. Nursing/ P.B.B.Sc. Nursing - 1
d. Experience: Minimum three years of clinical experience in Haematology/Oncology Specialty Nursing
e. Guest Faculty: Multi-disciplinary in related specialities (Gynae, Paediatric, Community Health Nursing)
f. Preceptors:
• Nursing Preceptor: Full time qualified GNM with 6 years' experience in specialty nursing (Palliative/Oncology Nursing) or B.Sc. Nursing with 2 years' experience in Oncology/Palliative Nursing or M.Sc. Nursing with one-year in Palliative Nursing experience working in the specialty care unit
• Medical Preceptor: Specialist (Oncology/Palliative specialist) doctor with PG qualification (with 3 years post PG experience/faculty level/consultant level preferable)
• Preceptor Student Ratio: Nursing 1:10, Medical 1:10 (Every student must have a medical and nursing preceptor)
2. Budget
These should have budgetary provision for staff salary, honorarium for guest faculty, and part time teachers, clerical assistance, library and contingency expenditure for the program in the overall budget of the institution.
3. Physical and Learning Resource at Hospital/College
a. Classroom/conference room in the specific Clinical area.
b. Skill lab for simulated learning at the hospital & College. Skill Lab Requirements are listed in Appendix 1.
c. Library and computer facilities with access to online journals
i. College library having current books journals and periodicals related to Palliative nursing specialty, Nursing Administration, Nursing Education, Nursing Research and Statistics
ii. Computer with internet facility
d. E-Learning facilities
e. Teaching Aids - Facilities for use of
i. Overhead Projectors
ii. Video viewing facility
iii. LCD Projector
iv. CDs, DVDs and DVD players
v. Appropriate equipment, manikins and simulators for skill learning
f. Office facilities
i. Services of Typist, Office Attendant, House Keeping Staff
ii. Facilities for office, equipment and supplies such as
• Stationery
• Computer with Printer
• Xerox Machine
• Telephone and Fax
4. Clinical Facilities
a. Parent specialty hospital/tertiary hospital having minimum of 200 beds with advanced diagnostic, therapeutic and palliative care units with medical oncology, radiation oncology, haematology, and specialized nursing care facilities.
b. Hospital must have a minimum of 30 specialty beds with advanced diagnostic, treatment and care facilities.
c. Regional oncology centres/oncology specialty hospitals having minimum of 200 beds with advanced diagnostic, therapeutic and palliative units with medical oncology, radiation oncology, haematology, and specialized nursing care facilities.
d. The palliative care unit should have inpatient facility, and a daily functioning palliative care OPD including home visits every week for patients in and around the town.
e. Nurse staffing of units as per the council recommended norms.
f. Student patient ratio - 1:3
5. Admission Terms and Conditions/Entry Requirements
The student seeking admission to this program should:
a. Be a registered nurse and midwife (R.N.&R.M.) or equivalent with any SNRC having NUID number.
b. Possess a minimum of one-year clinical experience as a staff nurse preferably in oncology/haematology/ palliative care settings prior to enrolment.
c. Be Physically fit.
d. Selection must be based on the merit of an entrance examination and interview held by the competent authority.
e. Nurses from other countries must obtain an equivalence certificate from the Council before admission.
6. Number of Seats
• For hospital having 200 beds and 30 specialty beds, number of seats = 10,
• For hospital having 500 beds and more with 60 specialty beds, the number of seats = 20
7. Number of Candidates
• One candidate for 3 specialty beds.
8. Salary
a. In-service candidates will get regular salary.
b. Stipend/Salary will be given to other candidates as per the salary structure of the hospital where the program is conducted.
VII. EXAMINATION REGULATIONS AND CERTIFICATION
EXAMINATION REGULATIONS
Examining and Diploma Awarding Authority: Respective Examination Board/SNRC/University approved by the Council.
1. Eligibility for appearing in the examination
a. Attendance: Theory & Practical - 80%. However, 100% Clinical attendance have to be obtained prior to certification.
b. Candidate who successfully completes the necessary requirements such as log book and clinical requirements is eligible to appear for final examination.
2. Practical Examination
a. OSCE: Objective Structured Clinical Examination type of examination (for Basic competency assessment) will be conducted alongside viva (oral examination) both in the internal and final examination. (Detailed guidelines are given in guidebook)
b. Observed Practical/Clinical: Final internal and external examination will also include assessment of actual clinical performance in real settings including viva and mini clinical evaluation exercise for 3-4 hours (Nursing process application and direct observation of procedural competencies). Minimum period of assessment in the clinical area is 5-6 hours. (Evaluation guidelines are given in guidebook)
c. Maximum number of students per day: 10 students.
d. Practical Examination should be held in clinical area only.
e. The team of practical examiners will include one internal examiner [(M.Sc. faculty with two years of experience in teaching the respective specialty program/M.Sc. faculty (Medical Surgical Nursing/Paediatric Nursing/Obstetrics & Gynaecology Nursing) with 5 years of Post PG experience], one external examiner (nursing faculty with the same qualification & experience stated as above) and one medical internal examiner who should be preceptor for the respective specialty program.
f. The practical examiner and the theory examiner should be the same nursing faculty/from same specialty.
3. Standard of Passing
a. In order to pass, a candidate should obtain at least 60% marks in aggregate of internal assessment and external examination both together, in each of the theory and practical papers. Less than 60% is considered fail.
b. Students will be given opportunity of maximum of 3 attempts for passing.
c. If the student fails in either theory or practical, he/she needs to appear for the exam failed either theory or practical only.
CERTIFICATION
a. TITLE - Post Basic Diploma in Palliative Care Specialty Nursing
b. A diploma is awarded by the Examination Board/SNRC/University approved by the Council, upon successful completion of the prescribed study program, which will state that
i. Candidate has completed all the courses of study under the Post Basic Diploma in Palliative Care Specialty Nursing - Residency Program
ii. Candidate has completed 80% Theory and 100% Clinical requirements
iii. Candidate has passed the prescribed examination
VIII. SCHEME OF EXAMINATION
+-------------------------------------------------------------+--------------+---------------+-------------+-------------------+
| Courses | Int. Ass. | Ext. Ass. | Total | Exam Hours |
| | Marks | Marks | Marks | (External) |
+=============================================================+==============+===============+=============+===================+
| Theory (Experiential/Residential Learning) | | | | |
+-------------------------------------------------------------+--------------+---------------+-------------+-------------------+
| Palliative Care Specialty Nursing (Part I & Part II) | 25 (10+15) | 75 (35+40) | 100 | 3 |
| {Part I - Palliative Care Specialty Nursing I, and | | | | |
| Part II - Palliative Care Specialty Nursing II} | | | | |
+-------------------------------------------------------------+--------------+---------------+-------------+-------------------+
| Practicum: Palliative Care Specialty Nursing | 75 (25+50) | 150 (50+100) | 225 | |
+-------------------------------------------------------------+--------------+---------------+-------------+-------------------+
| • OSCE including Viva | (OSCE-25 & | (OSCE-50 & | | Minimum 5-6 |
| | Observed | Observed | | hours in the |
| • Observed Practical/Clinical (Direct observation of | Practical-50) | Practical-100) | | clinical area |
| actual performance at real settings) including viva - | | | | |
| with clinical evaluation exercise for 3-4 hours for | | | | |
| Internal Practical Exam (Nursing process application | | | | |
| and direct observation of procedural competencies) | | | | |
+-------------------------------------------------------------+--------------+---------------+-------------+-------------------+
| Grand Total | 100 | 225 | 325 | |
+-------------------------------------------------------------+--------------+---------------+-------------+-------------------+
IX. PROGRAM ORGANIZATION/STRUCTURE
1. Courses of Instruction
2. Implementation of Curriculum
3. Clinical Practice (Residency Posting)
4. Teaching Methods
5. Methods of Assessment
6. Log Book & Clinical Requirements
1. Courses of Instruction: Delivered through mastery of learning (Skill Lab practice) and experiential learning (including Clinical practice) approaches
+-------+---------------------------------------------------------------+-------------+-------------------+-----------------+
| Unit | Courses | Theory | Lab/Skill Lab | Clinical |
| | | (Hours) | (Hours) | (Hours) |
+=======+===============================================================+=============+===================+=================+
| I | Foundations to Palliative Care Specialty Nursing | 40 | - | - |
+-------+---------------------------------------------------------------+-------------+-------------------+-----------------+
| | 1. Professionalism | | | |
| | 2. Communication, breaking bad news, and education & | | | |
| | counseling | | | |
| | 3. Clinical leadership and resource management in the specialty | | | |
| | care setting including quality care | | | |
| | 4. Evidence based and applied research in specialty nursing | | | |
+-------+---------------------------------------------------------------+-------------+-------------------+-----------------+
| II | Palliative Care Specialty Nursing I | 50 | 10 | - |
| | 1. Introduction to palliative care nursing | | | |
| | 2. Principles and practices of palliative care nursing | | | |
| | 3. Roles and responsibilities of palliative care specialist nurse | | | |
| | 4. Applied anatomy and physiology | | | |
| | 5. Infection prevention and control | | | |
| | 6. Pharmacological management | | | |
| | 7. Psychosocial and spiritual concerns of palliative care | | | |
| | 8. Ethical and legal issues relevant to end-of-life care | | | |
| | 9. Grief and bereavement | | | |
| | 10. Models of palliative care | | | |
| | 11. Alternative therapy in palliative care | | | |
+-------+---------------------------------------------------------------+-------------+-------------------+-----------------+
| III | Palliative Care Specialty Nursing II | 110 | 30 | 1730 |
| | Nursing Management of Patients requiring Palliative Care | | | |
| | 1. Pain assessment and management | | | |
| | 2. Symptoms assessment and management in palliative care - | | | |
| | application of nursing process | | | |
| | 3. Management of patients with specific palliative nursing care | | | |
| | needs | | | |
| | 4. Palliative care in life threatening disease conditions | | | |
| | 5. Palliative care in special population | | | |
| | 6. Palliative care for children | | | |
| | 7. Palliative care for elderly | | | |
| | 8. Palliative care emergencies | | | |
| | 9. Home based palliative care | | | |
| | 10. Psychiatry in palliative care | | | |
| | 11. End-of-life care and nurses' role | | | |
+-------+---------------------------------------------------------------+-------------+-------------------+-----------------+
| TOTAL = 1970 hours | 200 | 40 | 1730 |
| | (5 weeks) | (1 week) | (38 weeks) |
+---------------------------------------------------------------+-------------+-------------------+-----------------+
Total weeks available in a year: 52 weeks
• Annual Leave + Casual Leave + Sick Leave + Public Holidays = 6 weeks
• Exam Preparation and Exam = 2 weeks
• Theory and Practical = 44 weeks
2. Implementation of the Curriculum (Theory - 10% and Skill Lab + Clinical - 90%)
• Block classes - 2 weeks × 40 hours per week = 80 hours
• Residency - 42 weeks × 45 hours per week = 1890 hours
• Total = 1970 hours
• Block classes (Theory and Skill Lab experience) = 2 weeks × 40 hours per week (80 hours)
• {Theory = 74 hours, Skill Lab = 6, Total = 80 hours}
• Clinical Practice including Theory and Skill Lab = 42 weeks × 45 hours per week (1890 hours)
• {Theory = 126 hours, Skill Lab = 34 hours, Clinical = 1730 hours, Total 1890 hours}
• Theory = 200 (74 + 126) hours, Skill Lab = 40 (6 +34) hours, Clinical = 1730 hours
126 hours of Theory and 34 hours of Skill Lab learning can be integrated during Clinical experience. Mastery learning and experimental learning approaches are used in training the students throughout the program. Skill Lab Requirements are listed in Appendix 1.
3. Clinical Practice
a. Clinical Residency Experience: A minimum of 45 hours per week is prescribed, however, it is flexible with different shifts and OFF followed by on call duty every week or fortnight.
b. CLINICAL PLACEMENTS: THE STUDENTS WILL BE POSTED TO THE UNDER MENTIONED CLINICAL AREAS DURING THEIR TRAINING PERIOD.
+-------+---------------------------------------------------------------+-------+
| S.No. | Clinical Area | Weeks |
+=======+===============================================================+=======+
| 1. | Palliative Care (respiratory, cardio, renal and neuro wards) & OPD | 20 |
+-------+---------------------------------------------------------------+-------+
| 2. | Radiation Oncology Ward General/Private | 2 |
+-------+---------------------------------------------------------------+-------+
| 3. | Medical Oncology Ward General/Private | 2 |
+-------+---------------------------------------------------------------+-------+
| 4. | Hospice - Field Visits | 4 |
+-------+---------------------------------------------------------------+-------+
| 5. | Rural - Palliative care including home visits | 4 |
+-------+---------------------------------------------------------------+-------+
| 6. | Pediatric Oncology | 2 |
+-------+---------------------------------------------------------------+-------+
| 7. | Geriatric Ward & OPD | 2 |
+-------+---------------------------------------------------------------+-------+
| 8. | Gynae Oncology | 2 |
+-------+---------------------------------------------------------------+-------+
| 9. | Hematology | 3 |
+-------+---------------------------------------------------------------+-------+
| 10. | Counseling Centre | 1 |
+-------+---------------------------------------------------------------+-------+
| | TOTAL | 42 |
+-------+---------------------------------------------------------------+-------+
THE RESIDENCY STUDENTS WILL FOLLOW THE SAME DUTY SCHEDULE AS STAFF NURSES WITH DIFFERENT SHIFT DUTIES. IN ADDITION TO THAT 4 HOURS EVERY WEEK IS DEDICATED FOR THEIR LEARNING THAT CAN BE OFFERED FOR THEORY (FACULTY LECTURE - 1 HOUR, NURSING & INTERDISCIPLINARY ROUNDS - 1 HOUR, CLINICAL/CASE PRESENTATIONS, CLINICAL SEMINAR/CONFERENCE/JOURNAL CLUB, DRUG STUDY PRESENTATIONS AND CLINICAL ASSIGNMENTS - 1 HOUR AND SKILL LAB PRACTICE - 1 HOUR) TO COVER A TOTAL OF 126 HOURS OF THEORY AND 34 HOURS OF SKILL LAB PRACTICE. A SMALL GROUP RESEARCH/QI PROJECT CAN BE CONDUCTED DURING CLINICAL POSTING APPLYING THE STEPS OF RESEARCH/QI PROCESS AND WRITTEN REPORT TO BE SUBMITTED.
4. Teaching Methods
Theoretical, Skill Lab & Clinical teaching can be done in the following methods and integrated during clinical posting:
• Case/clinical presentation & Case study report
• Drug study & presentation
• Bedside clinic/Nursing rounds/Interdisciplinary rounds
• Journal clubs/Clinical seminar
• Faculty lecture & Discussion in the clinical area
• Demonstration & skill training in skill lab and at bedside
• Directed reading/Self-study
• Role-play
• Symposium/Group presentation
• Group research project
• Clinical assignment
• Field visits
5. Method of Assessment
• Written test (Case or scenario based)
• Practical examination - OSCE and Observed Practical (Direct observation of actual clinical performance at real settings)
• Written assignments
• Project
• Case studies/care plans/clinical presentation/drug study
• Clinical performance evaluation
• Completion of clinical procedural competencies and clinical requirements
For assessment guidelines refer Appendix 2.
6. Clinical Log Book/Procedures Book
At the end of each clinical posting, Clinical Log Book (Specific Procedural Competencies/Clinical Skills) (Appendix 3), and Clinical Requirements (Appendix 4) and Clinical Experience Details (Appendix 5) have to be signed by the concerned clinical faculty/preceptor.
X. COURSE SYLLABUS
1. FOUNDATIONS TO PALLIATIVE CARE SPECIALTY NURSING COURSE
PROFESSIONALISM, COMMUNICATION, PATIENT EDUCATION, CLINCIAL LEADERSHIP & RESOURCE MANAGEMENT INCLUDING QUALITY CARE, EVIDENCE BASED AND APPLIED RESEARCH IN PALLIATIVE CARE NURSING
Total Theory Hours: 40
Course Description: This course is designed to develop an understanding of professionalism, medico legal issues, communication and breaking bad news, patient & family education and counselling, clinical leadership, resource management, quality care, evidence based and applied research in palliative care nursing.
COURSE CONTENT
+-------+-----------+----------------------------------------------+---------------------------------------------+---------------------------------+---------------------------------+
| Unit | Time | Learning | Content | Teaching/Learning | Assignments/ |
| | (Hours) | Outcomes | | Activities | Assessment Methods |
+=======+===========+==============================================+=============================================+=================================+=================================+
| I | 6 | Demonstrate | Professionalism | • Discussion | • Assignment on |
| | | understanding of | • Meaning and elements: | | professional and |
| | | professionalism and | accountability, knowledge, visibility | | ethical values in |
| | | exhibit | and ethical issues | | palliative care |
| | | professionalism | • Professional values and professional | | nursing |
| | | | behaviour | | • Write about |
| | | | • INC Code of Ethics, Code of | | Code of Ethics |
| | | | Professional Conduct and Practice | | for Nurses |
| | | | Standards | | |
| | | | • Ethical issues related to palliative | | |
| | | | care nursing | | |
| | | | • Expanding role of the palliative care | | |
| | | | nurse | | |
| | | | • Professional organizations, | | |
| | | | objectives and functioning | | |
| | | | • Continuing nursing education | | |
| | Describe | Medico legal Issues | | • Maintain records |
| | medico- | • Legislation and regulations related | | in the palliative |
| | legal | to palliative care | • Lecture | care unit |
| | issues | • Consumer Protection Act | | |
| | applicable| • Negligence and malpractice | | |
| | to | • Medico-legal aspects | | |
| | palliative| • Records and reports | | |
| | care | • Legal responsibilities of the nurse in | | |
| | | the palliative care unit in inpatient | | |
| | | and outpatient area | | |
+-------+-----------+----------------------------------------------+---------------------------------------------+---------------------------------+---------------------------------+
| II | 12 | Apply the principles | Communication, breaking bad news, | | |
| | | of effective | Education & Counselling | | |
| | | communication | Communication & Breaking bad | | |
| | | within the | news | | |
| | | interdisciplinary | • Basic principles of communication | • Role-play on | • Digital records |
| | | team, the family and | • Channels and techniques of | communicating | |
| | | the patients | communication in the palliative care | with palliative | |
| | | | settings | patients | |
| | | | • Breaking bad news | Ex. breaking bad | • Observation and |
| | | | • Shared decision making | news | Assessment of |
| | | | • Collusion | | roles |
| | | | • Truth telling | | Ex. |
| | | | • Information technology tools for | | communication |
| | | | communication | | |
| | | | • Team communication | | |
| | Educate | Education for the family | | |
| | family | • Assessment of information needs | • Role-play on | • Preparation of |
| | members | and education | education of | patient |
| | regarding | • Development of educational | family & primary | information |
| | symptom | materials | care giver | materials |
| | management| Counselling | | |
| | plan of | • Definition of counselling | • Lecture | |
| | the | • Characteristics of counselling | • Discussion | • Assignment and |
| | palliative| • Barriers in counselling | | self-study |
| | patients | | • Role-play on | |
| | Develop | | | |
| | counselling| | | |
| | skills for| | | |
| | families | | | |
| | of | | | |
| | patients | | | |
| | admitted | | | |
| | in | | | |
| | palliative| | | |
| | care unit | | | |
+-------+-----------+----------------------------------------------+---------------------------------------------+---------------------------------+---------------------------------+
| III | 12 | Demonstrate | Clinical Leadership and Resource | | |
| | | understanding of | Management in the Palliative Care | | |
| | | clinical leadership | Unit | | |
| | | and management | • Principles of management | • Lecture cum | • Prepare the job |
| | | strategies and use | • Leadership and management | discussion | description of |
| | | them in palliative | • Elements of management of | | the in-charge/ |
| | | care settings | palliative care patients: Planning, | | senior palliative |
| | | promoting | organizing, staffing, reporting, | | care nurse |
| | | collaborative and | recording, budgeting | | • Prepare a |
| | | effective teamwork | • Clinical leadership and its | | survey of |
| | | | challenges | | problem issues |
| | | | • Problem solving | | of the palliative |
| | | | • Delegation | | care unit with |
| | | | • Managing human resources in the | | root cause |
| | | | palliative care unit | | analysis and the |
| | | | • Material management | | solutions |
| | | | • Designing a unit for palliative care | | • Plan a duty |
| | | | patients in hospital, community and | | roster for the |
| | | | hospice
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