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Core Purpose

Indian Nursing Council notification promulgating the Indian Nursing Council (Post Basic Diploma in Emergency and Disaster Specialty Nursing - Residency Program) Regulations, 2023, establishing a one-year specialist nursing residency program.

Detailed Summary

The Indian Nursing Council, exercising powers under sub-section (1) of Section 16 of the Indian Nursing Council Act, 1947 (XLVIII of 1947), issued F.No. 11-1/2024-INC (II) dated 7th October 2024 making the Indian Nursing Council (Post Basic Diploma in Emergency and Disaster Specialty Nursing - Residency Program) Regulations, 2023, effective from the date of gazette notification. The Regulations define key terms including the Act, the Council, State Nurse and Midwives Registration Council (SNRC), Registered Nurse and Registered Midwife (RN & RM), the Nurses Registration & Tracking System (NRTS) developed with the National Informatics Centre, the Nurses Unique Identification Number (NUID), and General Nursing and Midwifery (GNM) under Section 10 of the Act. The Regulations establish a one-year, competency-based Post Basic Diploma in Emergency and Disaster Specialty Nursing residency program (10% theory, 90% practicum) responding to the National Health Policy, 2017, comprising foundational courses and two specialty course modules (Emergency and Disaster Specialty Nursing I and II), with fourteen listed program competencies. The program may be offered at a College of Nursing attached to a tertiary hospital, or a hospital offering PG/Fellowship programs in Emergency Medicine, each with a minimum of 200 beds and an Emergency and Trauma Care Centre with ICU facility, subject to recognition by the concerned SNRC and statutory inspection by the Council under Section 13 of the Act; minimum requirements specify a 1:10 faculty ratio (at least two full-time faculty with specified M.Sc./diploma qualifications and a minimum of three years' clinical experience), preceptor and budget provisions, and specified physical, library and e-learning resources. Signed by Dr. T. Dileep Kumar, President, Indian Nursing Council.

Full Text

REGD. No. D. L.-33004/99 The Gazette of India CG-DL-E-25102024-258212 EXTRAORDINARY PART III—Section 4 PUBLISHED BY AUTHORITY No. 840] NEW DELHI, MONDAY, OCTOBER 21, 2024/ASVINA 29, 1946 6838 GI/2024 (1) Dr. T. DILEEP KUMAR, President [ADVT.-III/4/Exty./609/2024-25] INDIAN NURSING COUNCIL NOTIFICATION New Delhi, the 7th October 2024 INDIAN NURSING COUNCIL (POST BASIC DIPLOMA IN EMERGENCY AND DISASTER SPECIALTY NURSING - RESIDENCY PROGRAM) REGULATIONS, 2023 F.No. 11-1/2024-INC (II).—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 Emergency and Disaster 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 EMERGENCY AND DISASTER SPECIALTY NURSING - RESIDENCY PROGRAM I. INTRODUCTION The National Health Policy document (NHP, 2017) emphasizes the need to expand tertiary care services, prepare specialist nurses and standardization of clinical training for nurses. Responding to this, the Council planned to redesign the existing specialist nursing programs making it as a one-year post basic diploma residency programs utilizing competency-based training approach. Emergency and Disaster Specialty Nursing is a new specialty prepared by the Council using revised guidelines that aim to prepare specialist nurses who can provide competent care to patients in emergency and disaster situations where the diagnosis and treatment are complex and intensive. The health needs of the Indians are fast changing owing to the rapid change in the life style, advanced technology and awareness among the people. Illness requiring emergency care is also on the rise. The emerging trauma scenario and disaster events of mass nature are adding significant strain on the individual's life as well as the family and the social system. It affects all levels of people. This demands adequate number of nurses specially trained in emergency and disaster nursing who will function as emergency and disaster specialist nurse. It is essential for the health care system to meet such needs effectively. Post Basic Diploma in Emergency and Disaster Specialty Nursing is designed to develop specially trained nurses for emergency and disaster management. The outcome of the program will be to have more nurses prepared for emergency and disaster situations to provide competent care at the institutional and community levels. II. PHILOSOPHY The Council believes that registered nurses need to be further trained as specialist nurses to function in various emergency and disaster situations and the training should be competency based. Expanding roles of nurses and advances in technology necessitates additional training to prepare nurses with specialized skills and knowledge to deliver competent, intelligent and individualised care to patients in emergency and disaster situations. III. CURRICULAR FRAMEWORK The Post Basic Diploma in Emergency and Disaster Specialty Nursing education is a one-year residency program and its curriculum is conceptualized encompassing foundational short courses and major specialty courses for specialty nursing practice. The foundations to emergency and disaster nursing practice such as professionalism, communication, patient education & counselling, clinical leadership & resource management, and evidence based & applied research are short courses that aim to provide the students with the knowledge, attitude and competencies essential to function as accountable, sincere, safe and competent specialist nurses. The major specialty courses are organized under Emergency and Disaster Specialty Nursing I and Emergency and Disaster Specialty Nursing II. Emergency and Disaster Specialty Nursing I includes context/introduction to emergency nursing and basic sciences applied to emergency nursing, and the concepts in emergency care. Emergency and Disaster Specialty Nursing II includes nursing management of specific emergency conditions comprising emergency assessment, diagnosis, treatment and patient safety & quality including illness specific considerations. Medical, Surgical, Paediatric, Psychiatric, Obstetrical & gynaecological emergencies including trauma and disaster management are part of Emergency and Disaster Specialty Nursing II. The curricular framework for the Emergency and Disaster Specialty Nursing – Residency Program is illustrated in the following figure 1. POST BASIC DIPLOMA IN EMERGENCY AND DISASTER SPECIALTY NURSING RESIDENCY PROGRAM Foundations to Emergency and Emergency and Disaster Disaster Nursing Courses Specialty Nursing Courses Professionalism COURSES Context/Introduction to specialty nursing practice Basic sciences applied to specialty care Nursing Management incl. assessment and specialized interventions Patient safety & quality, and Illness specific considerations Emergency and Disaster Nursing Specialty for Specialist Practice Evidence based and applied research Clinical leadership and resource management Communication, patient education & counseling ONE-YEAR RESIDENCY PROGRAM (For Registered Nurses & Midwives) Theory - 10% & Practicum – 90% (Skill Lab + Clinical) Figure 1. Curricular Framework for Emergency and Disaster Specialty Nursing – Residency Program IV. AIM/PURPOSE & COMPETENCIES Aim/Purpose The Program is designed to prepare nurses with specialized skills, knowledge and attitude in providing quality care to patients in Emergency and Disaster situations. It further aims to prepare technically qualified and trained specialist nurses who will function effectively and optimally at Emergency centres of Tertiary/Quaternary hospitals providing high standards of care. Competencies On completion of the program, the Emergency and Disaster specialist nurse will be able to: 1. Demonstrate professional accountability for the delivery of nursing care as per the Council standards that are consistent with moral, altruistic, legal, ethical, regulatory and humanistic principles in emergency nursing practice. 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 enhance their coping abilities through emergency and crisis situations. 4. Demonstrate understanding of clinical leadership and resource management strategies and use them in emergency and disaster situations promoting collaborative and effective teamwork. 5. Identify, evaluate and use the best current evidence in emergency care and disaster management coupled with clinical expertise and values to make practical decisions. 6. Participate in research studies that contribute to evidence-based emergency nursing care and disaster management interventions with basic understanding of research process. 7. Apply the concepts and principles of emergency and disaster nursing and basic sciences in the emergency assessment, diagnosis and treatment of the physiological, physical, psychological, social & spiritual problems of patients and their families with various emergency conditions. 8. Apply nursing process in caring for patients with non-trauma related emergencies. 9. Apply nursing process in caring for patients with trauma related emergencies. 10. Demonstrate specialized practice competencies/skills relevant in providing care to patients with various emergencies and disaster situations. 11. Conduct clinical audit and participate in quality assurance activities in emergency departments and disaster situations. 12. Demonstrate the team management skills in organizing and conducting injury prevention programs. 13. Demonstrate leadership abilities in mobilization of resources and facilitating appropriate delivery of services in disaster situations. 14. Empower the active participation of local community in disaster management. V. PROGRAM DESCRIPTION & SCOPE OF PRACTICE The Post Basic Diploma in Emergency and Disaster Specialty Nursing is a one-year residency program designed to prepare registered nurses (GNM or B.Sc.) with specialized knowledge, skills and attitude in providing safe and competent care to patients and their families in emergency and disaster situations. Theory includes foundational courses and specialty courses besides practicum with the main focus on competency-based training. The theory component comprises 10% and practicum 90% (Clinical & Lab). On completion of the program and certification, and registration as additional qualification with respective SNRC, the specialist nurses should be employed only in the Emergency Department/Unit of a multispecialty hospital. They will be able to practice as per the competencies trained during the program 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 institution 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 EMERGENCY AND DISASTER NURSING RESIDENCY PROGRAM The program may be offered at 1. College of Nursing offering degree programs in nursing attached to parent tertiary hospital having minimum of 200 beds with advanced diagnostic, therapeutic and state of the art Emergency and Trauma Care Centre with ICU facility. OR Hospitals offering PG/Fellowship programs in Emergency Medicine having minimum of 200 beds with advanced diagnostic, therapeutic and state of the art Emergency and Trauma Care Centre with ICU facility. 2. Above eligible institution shall get recognition from the concerned SNRC for Post Basic Diploma in Emergency and Disaster Specialty Nursing 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/Emergency Specialty Nursing – 1 ii. Post Basic Diploma in Emergency and Disaster Specialty Nursing with Basic B.Sc. Nursing/ P.B.B.Sc. Nursing - 1 d. Experience: Minimum three years of clinical experience in Emergency and Disaster Specialty Nursing e. Guest Faculty: Multi-disciplinary in related specialities f. Preceptors: • Nursing Preceptor: Full time qualified GNM with 6 years of experience in specialty nursing (Emergency and Disaster Nursing) or B.Sc. Nursing with 2 years' experience in specialty nursing or M.Sc. Nursing with one-year specialty nursing experience working in the specialty care unit. • Medical Preceptor: Specialist (Emergency Medicine 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, honorariums 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 Resources at Hospital/College a. One classroom/conference room at the clinical area b. Skill lab for simulated learning at 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 Emergency and Disaster Specialty Nursing, Nursing Administration, Nursing Education, Nursing Research and Statistics OR Permission to use medical/hospital library having current books, journals and periodicals related to Emergency and Disaster Specialty Nursing, 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, peon, Safai Karmachari ii. Facilities for office, equipment and supplies such as • Stationery • Computer with printer • Xerox machine 4. Clinical Facilities a. Parent Specialty/tertiary hospital having minimum of 200 beds with advanced diagnostic, therapeutic and state of the art Emergency and Trauma Care Centre with ICU facility. b. Regional centres/Specialty hospitals having minimum of 200 beds with advanced diagnostic, therapeutic and state of the art Emergency and Trauma Care Centre with ICU facility. c. Hospital must have a minimum of 10 emergency beds with advanced diagnostic, treatment and care facilities d. Nurse staffing of units as per the Council recommended norms. e. Student patient ratio – 1:2 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 the Emergency Department 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. No. of Seats For hospital having 200 beds and 10 Emergency beds, number of seats – 5 For hospital having 500 beds and more than 10 emergency beds, the number of seats – 5 to 10 7. Number of Candidates One candidate for 2 emergency 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 A EXAMINATION REGULATIONS Examining and Diploma Awarding Authority: Respective Examination Board/SNRC/University approved by the Council. 1. Eligibility for appearing for the Examination a. Attendance: Theory and Practical – 80%. However, 100% Clinical attendance have to be completed prior to certification. b. Candidate who successfully completes the necessary requirements such as logbook and clinical requirements is eligible and can appear for the final exam. 2. Practical Examination a. OSCE: OSCE type of examination 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) 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. 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 Emergency and Disaster Specialty Nursing b. A diploma is awarded by 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 Emergency and Disaster 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 | Internal Assessment | External Assessment | Total Marks | External Exam | | | Marks | Marks | | (Hours) | +=====================================================+======================+======================+=============+================+ | Theory (Experiential/Residential Learning) | | | | | +-----------------------------------------------------+----------------------+----------------------+-------------+----------------+ | Emergency and Disaster Specialty Nursing | 25 | 75 | 100 | 3 | | (Part I & Part II) | (10+15) | (35+40) | | | | {Part I – Emergency and Disaster Specialty Nursing I| | | | | | including Foundations & | | | | | | Part II - Emergency and Disaster Specialty Nursing II} | | | | | +-----------------------------------------------------+----------------------+----------------------+-------------+----------------+ | Practicum: Emergency and Disaster Specialty Nursing | | | | | +-----------------------------------------------------+----------------------+----------------------+-------------+----------------+ | • OSCE including Viva | 75 | 150 | 225 | Minimum | | | (25+50) | (50+100) | | 5-6 hours in | | • Observed Practical/Clinical (Direct observation of actual | (OSCE-25 | (OSCE-50 & | | the clinical | | performance at real settings) including viva – mini clinical | & | Observed | | area | | evaluation exercise for 3-4 hours (Nursing process | Observed | Practical-100) | | | | application and direct observation of procedural | Practical-50) | | | | | 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 (Clinical Practice) Approaches +======+=================================================+============+===============+============+ | Unit | Courses | Theory | Lab/Skill Lab | Clinical | | | | (hours) | (hours) | (hours) | +======+=================================================+============+===============+============+ | I | Foundations to Emergency and Disaster Specialty | 40 | | | | | Nursing Practice | | | | | | 1. Professionalism | | | | | | 2. Communication, patient education & counselling | | | | | | in specialty nursing | | | | | | 3. Clinical leadership and resource management in | | | | | | the specialty care setting | | | | | | 4. Evidence based and applied research in | | | | | | specialty nursing | | | | +------+-------------------------------------------------+------------+---------------+------------+ | II | Emergency and Disaster Specialty Nursing courses| | | | | | Emergency and Disaster Specialty Nursing I | | | | | | 1. Introduction to specialty nursing | | | | | | 2. Basic sciences applied to specialty care – | 50 | 10 | | | | diagnosis and treatment of clinical | | | | | | conditions (Anatomy & Physiology, | | | | | | Microbiology, Pharmacology & Pathophysiology) | | | | | | 3. Basic concepts of Emergency care | | | | | | Emergency and Disaster Specialty Nursing II | | | | | | 1. Nursing management of various emergency | 110 | 30 | 1730 | | | conditions including emergency assessment, | | | | | | diagnosis, treatment and specialized | | | | | | interventions | | | | | | 2. Patient safety and quality | | | | | | 3. Disaster management | | | | +------+-------------------------------------------------+------------+---------------+------------+ | | TOTAL = 1970 hours | 200 | 40 | 1730 | | | | (5 weeks) | (1 week) | (38 weeks) | +======+=================================================+============+===============+============+ Total weeks available in a year: 52 weeks (Theory – 10% and Skill Lab + Clinical – 90%) • Annual Leave + Casual Leave + Sick Leave + Public Holidays = 6 weeks • Exam Preparation and Exam = 2 weeks • Theory and Practical = 44 weeks 2. Implementation of Curriculum 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 hours, 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 experiential learning approaches are used in training the students throughout the program. Skill lab requirements are listed in Appendix 1. 3. Clinical Practice Clinical Residency Experience: A minimum of 45 hours/week is prescribed, however, it is flexible with different shifts and OFF followed by on call duty every week or fortnight. Clinical Placements: The students will be posted to the under mentioned clinical areas during their training period: +=======+===========================+======+=====================+ | S.No. | Clinical Area | Week | Remarks | +=======+===========================+======+=====================+ | 1 | Emergency Department/Unit | 22 | Own tertiary hospital | | 2 | Paediatric Emergency Department | 06 | | | 3 | Medical and Surgical ICU | 02 | | | 4. | Paediatric ICU | 01 | | | 5. | Orthopaedic Trauma Unit | 02 | | | 6. | Neuro Trauma Unit | 02 | | | 7. | Coronary Care Unit | 02 | | | 8. | Trauma Operating Room | 01 | | | 9. | Burns Unit | 01 | | | 10. | Obstetric emergency unit (Labour Room) | 01 | | | 11. | Psychiatric emergency unit | 01 | | | 12. | Community Disaster management | 01 | | +-------+-----------------------------------+------+---------------------+ The residency students will follow the same duty schedule as staff nurses/nursing officers with different shift duties. In addition to that, for 40 weeks 4 hours every week is dedicated for their learning that can be offered for theory (For example – faculty lecture – 1 hour, nursing & interdisciplinary rounds – 1 hour, clinical presentation – 1 hour, case study report, clinical assignments) 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 project (Research/QI) can be conducted during clinical posting applying the steps of research 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 assignments • Patient engagement exercise (engaging patients in care decisions to improve health outcomes using information technology) for example discharge planning and follow up • Educational visits to Ambulance facility 5. Method of Assessment • Written test (Case/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. Log Book and Clinical Requirements At the end of each Clinical Posting, Clinical Log Book (Specific Procedural Competencies/Clinical Skills) (Appendix 3), 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 EMERGENCY AND DISASTER NURSING PRACTICE: PROFESSIONALISM, COMMUNICATION, PATIENT EDUCATION & COUNSELING, CLINICAL LEADERSHIP & RESOURCE MANAGEMENT AND EVIDENCE BASED APPLIED RESEARCH IN EMERGENCY AND DISASTER NURSING PRACTICE Total Theory hours : 40 Course description: This course is designed to develop an understanding of professionalism, communication, patient education and counselling, clinical leadership and resource management and evidence based and applied research in emergency and disaster nursing practice. +======+===========+==============================+=======================================+========================+========================+ | Unit | Time | Learning Outcomes | Content | Teaching/Learning | Assessment Methods | | | (hours) | | | Activities | | +======+===========+==============================+=======================================+========================+========================+ | I | 6 | Demonstrate understanding of | Professionalism | • Discussion | • Write about code of | | | | professionalism and exhibit | • Meaning and elements – | | ethics related to | | | | professionalism in the | Accountability, knowledgeable, | | emergency and | | | | practice of emergency and | visibility and ethics in emergency | | disaster nursing | | | | disaster nursing | and disaster nursing practice | | | | | | | • Professional values and professional| | | | | | | behaviour | | | | | | | • The Council code of ethics, code of | | | | | | | professional conduct and practice | | | | | | | standards | | | | | | | • Ethical issues related to emergency | | | | | | | and disaster nursing | | | | | | | • Expanding role of Nurse – Nurse | | | | | | | practitioner | | | | | | | • Professional organizations | | | | | | | • Continuing nursing education | | | +------+-----------+------------------------------+---------------------------------------+------------------------+------------------------+ | | | Describe medico-legal aspects| Medico-Legal Issues | • Lecture | • Procedure followed in| | | | in Emergency and disaster | • Legislations and regulations related| | handling medico-legal| | | | nursing | to emergency and disaster nursing | | cases in the emergency| | | | | • Consumer Protection Act | | department | | | | | • Negligence & malpractice | | • Good Samaritan Law | | | | | • Medico-legal aspects in emergency | | | | | | | and disaster nursing | | | | | | | • Records & reports | | | | | | | • Legal responsibilities of | | | | | | | emergency nurses | | | +------+-----------+------------------------------+---------------------------------------+------------------------+------------------------+ +======+===========+==============================+=======================================+========================+========================+ | Unit | Time | Learning Outcomes | Content | Teaching/Learning | Assessment Methods | | | (hours) | | | Activities | | +======+===========+==============================+=======================================+========================+========================+ | II | 12 | Communicate effectively with | Communication | • Lecture | • Written assignment on| | | | patients, families and | • Channels and techniques of | • Breaking bad news – | challenges | | | | professional colleagues, | communication | Role play | encountered during | | | | fostering mutual respect and | • Crisis communication | • Peer teaching | crisis communication | | | | shared decision making to | • Culturally sensitive communication | • Counselling sessions | in emergency | | | | enhance health outcomes | • Information technology tools in | | department | | | | during emergency/disaster | support of communication | | • Digital records | | | | situations | • Team communication | | • Conduct a group health| | | | | • Breaking bad news to patients and | | education program for| | | | | relatives regarding poor prognosis | | the patients in the | | | | | and failed resuscitative measures | | emergency department | | | | Educate and counsel patients | Patient & family education | | • Prepare patient | | | | and families to participate | • Principles of teaching and learning | | education materials | | | | effectively in treatment and | • Principles of health education | | on relevant topics | | | | care | • Assessment of informational needs | | | | | | | and patient education | | | | | | | • Developing patient education | | | | | | | materials | | | | | | | Counselling | | | | | | | • Counselling techniques | | | | | | | • Patient and family counselling | | | | | | | during breaking bad news, crisis | | | | | | | intervention and end of life stage | | | +------+-----------+------------------------------+---------------------------------------+------------------------+------------------------+ | III | 12 | Demonstrate understanding of | Clinical Leadership & Resource | • Lecture cum | • Plan a duty roster | | | | clinical leadership and | Management | discussion | for the staff nurses | | | | management strategies and | • Leadership & Management | | working in the | | | | use them in emergency care | • Elements of management of | | emergency department | | | | settings promoting | Emergency nursing care – planning, | | • Plan an ideal | | | | collaborative and effective | organizing, staffing, reporting, | | emergency department | | | | team work | recording and budgeting | | with 10 beds | | | | Prepare the resuscitation | • Clinical leadership and its | | • Develop SOPs for | | | | unit within the emergency | challenges | | resuscitative unit of| | | | department | • Delegation | | emergency department | | | | | • Managing human resources in | | | | | | | emergency care units | | | | | | | • Material management | | | | | | Conduct clinical audit and | • Designing of an ideal emergency | | | | | | participate in quality | department | | | | | | assurance activities in | • Emotional intelligence and self- | | | | | | emergency care unit | management skills | | | | | | | • Working as interdisciplinary team | | | | | | | member | | | | | | | • Participation in making policies | | | | | | | relevant to care of acutely ill | | | | | | | patients | | | | | | | • Organization of resuscitation unit | | | | | | | within the emergency department to | | | | | | | care for critically ill patients | | | | | | | Quality Assurance program in | | | | | | | emergency department | | | | | | | • Nursing audit | | | | | | | • Nursing standards | | | | | | | • Quality assurance | | | +------+-----------+------------------------------+---------------------------------------+------------------------+------------------------+ | IV | 10 | Describe research process and| Evidence based and application of | • Lecture | • Preparation of | | | | perform basic statistical | research | • Module: Writing | statistical data of | | | | tests Apply evidence | • Introduction to nursing research | scientific paper | emergency department | | | | based/best practices in | and research process | | for the last year | | | | professional practice | • Data presentation, basic statistical| | • Conduct literature | | | | | tests and its application | | review on emergency | | | | | • Research priorities in emergency | | nursing | | | | | nursing | | interventions/ | | | | | • Formulation of problem/question | | Evidence based | | | | | that are relevant to emergency | | practice project | | | | | nursing practice | | | | | | | • Review of literature to identify | | | | | | | evidence based/best practices in | | | | | | | emergency nursing practice | | | | | | | • Implementation of evidence-based | | | | | | | interventions in daily professional | | | | | | | practice | | | | | | | • Ethics in research | | | +------+-----------+------------------------------+---------------------------------------+------------------------+------------------------+ 2. EMERGENCY AND DISASTER NURSING SPECIALTY I CONTEXT/INTRODUCTION TO EMERGENCY AND DISASTER NURSING & BASIC SCIENCES APPLIED TO EMERGENCY AND DISASTER NURSING PRACTICE (Applied Psychology, Sociology, Microbiology, Pathology, Anatomy, Physiology, Pharmacology, Introduction to Emergency Nursing & Basic Concepts of Emergency Care) Theory: 50 hours & Lab: 10 hours Course description: This course is designed to help students to develop understanding and in-depth knowledge regarding the context of emergency care provision and application of basic sciences in the diagnosis and treatment of patients suffering with emergency conditions. +======+===========+==============================+=======================================+========================+========================+ | Unit | Time | Learning Outcomes | Content | Teaching/Learning | Assessment Methods | | | (hours) | | | Activities | | +======+===========+==============================+=======================================+========================+========================+ | I | 4 (T) | Describe the evolution of | • Introduction of emergency nursing | • Lecture and | • Written assignment on| | | | emergency nursing and | • Evolution of emergency care | discussion | application of nursing| | | | enumerate the principles of | • Definition, concepts and principles | | process in emergency | | | | emergency and disaster | of emergency nursing | | conditions | | | | nursing | • Role of emergency nurses | | | | | | | • Scope of emergency nursing practice | | | | | | | • Nursing process application in | | | | | | | emergency care unit | | | +------+-----------+------------------------------+---------------------------------------+------------------------+------------------------+ | II | 8 (T) | Explain psychosocial aspects | • Human behaviour and coping with | • Lecture | • Conduct counselling | | | | in emergency and disaster | emergencies | • Crisis counselling | session | | | | nursing care | • Factors influencing psychosocial | • Role play | | | | | | adjustment for patients suffering | | | | | | | from acute illnesses | | | | | | | • Stress and coping in emergency | | | | | | | situations | | | | | | | • Crisis communication | | | | | | | • Guidance & counselling | | | | | | | • Role of individual, family, | | | | | | | community and society during | | | | | | | emergency and disaster | | | +------+-----------+------------------------------+---------------------------------------+------------------------+------------------------+ | III | 6 (T) | Explain medical surgical | • Principles of asepsis, | • Lecture | • Prepare SOP for | | | 2 (Lab) | asepsis and infection | sterilization & disinfection | • Demonstration | infection control in | | | | control in emergency | • Standard safety measures | | emergency care unit | | | | department | • Biomedical waste management | | • Written assignment: | | | | | • Infection control practices | | Infection control | | | | | | | practices in | | | | | | | emergency care unit | +------+-----------+------------------------------+---------------------------------------+------------------------+------------------------+ | IV | 12 (T) | Describe structure & functions| Applied Anatomy & Physiology Review | • Lecture | • Prepare a model on | | | 3 (Lab) | of various systems | • Neurological system | • Self-study | physiology of | | | | | • Respiratory system | • Visit to | respiratory system | | | | | • Cardiovascular system | Simulation Lab | (can be any system) | | | | | • Gastro intestinal system | | | | | | | • Endocrine system | | | | | | | • Musculoskeletal system | | | | | | | • Genitourinary system | | | | | | | • Sensory system | | | | | | | • Reproductive system | | | +------+-----------+------------------------------+---------------------------------------+------------------------+------------------------+ +======+===========+==============================+=======================================+========================+========================+ | Unit | Time | Learning Outcomes | Content | Teaching/Learning | Assessment Methods | | | (hours) | | | Activities | | +======+===========+==============================+=======================================+========================+========================+ | V | 14 (T) | Describe the basic concepts | Basic Concepts in Emergency Care | • Lecture | • Formulate guidelines | | | 5 (Lab) | in emergency care and to | Triage in Emergency Department | • Discussion | to triage patients in| | | | demonstrate skill in life | • Concepts of triage | • Demonstration | secondary level | | | | saving interventions | • Role of triage nurse | | hospital | | | | | • Triage skills | • Demonstrate the | • Perform CPR | | | | | Cardio Pulmonary Resuscitation | following: Oxygen | • Pain assessment and | | | | | Basic Life Support (BLS) | administration | administration of | | | | | • Advanced Cardiac Life Support (ACLS)| Setting up of | analgesics | | | | | • Defibrillation and cardioversion | ventilator | | | | | | Oxygenation | • Simulation | | | | | | • Oxygen therapy | | | | | | | • Endotracheal intubation | | | | | | | • Care of patient on ventilator, and | | | | | | | tracheostomy | | | | | | | • Fluid, electrolyte and acid base | | | | | | | balance | | | | | | | • Pain assessment and management | | | | | | | • Regulation of body temperature | | | | | | | • Unconsciousness | | | | | | | • Death & dying | | | +------+-----------+------------------------------+---------------------------------------+------------------------+------------------------+ | VI | 6 (T) | Explain pharmacotherapy for | Pharmacology | • Drug presentation | • Prepare a catalogue | | | | various emergencies | • Pharmacokinetics | | on emergency drugs | | | | encountered in emergency | • Anaesthetic agents | | | | | | department | • Analgesics/anti-inflammatory agents | | | | | | | • Pain management in emergency | | | | | | | department | | | | | | | - Antibiotics, antiseptic | | | | | | | - Drug reaction & toxicity | | | | | | | - Drugs used in emergency | | | | | | | department (inclusive of | | | | | | | inotropes) | | | | | | | - Drugs used in various body | | | | | | | systems | | | | | | | - Blood and blood components | | | | | | | - Principles of drug | | | | | | | administration | | | | | | | - Role of nurses and care of drugs | | | +------+-----------+------------------------------+---------------------------------------+------------------------+------------------------+ 3. EMERGENCY AND DISASTER NURSING SPECIALTY II Nursing management of emergency conditions including emergency assessment, diagnosis, treatment and specialized nursing interventions, patient safety and quality/Illness specific considerations Theory: 110 hours & Lab: 30 hours Course description: This course is designed to help students to develop knowledge and competencies required for emergency assessment, diagnosis, treatment, nursing management, and supportive care to patients with various emergencies. +======+===========+==============================+=======================================+========================+========================+ | Unit | Time | Learning Outcomes | Content | Teaching/Learning | Assessment Methods | | | (hours) | | | Activities | | +======+===========+==============================+=======================================+========================+========================+ | I | 35 (T) | Explain and demonstrate skill| Early management of trauma | • Lecture, discussion | • Perform emergency | | | 10 (Lab) | in emergency assessment of | • Concepts of trauma care, | and demonstration | assessment of patients| | | | patients with trauma | biomechanics of injury, trauma | • Demonstration of the | with trauma | | | | | prevention, road safety | following: | | | | | Understand the biomechanics | • Initial assessment & early | - Cervical spine | • Assignment on the | | | | of injury and demonstrate | management of trauma | immobilization | following: | | | | skill in early management of | • Management of: | - Splinting and | - Massive | | | | trauma | • Cranio-facial injuries | immobilization in | transfusion | | | | | • Musculo-skeletal injuries and | fracture | protocol | | | | | spinal injuries | - Application of | - Crush protocol in | | | | | • Cardiothoracic injuries | pelvic binder | emergency | | | | | • Abdominal injuries | - Log rolling | department | | | | | • Paediatric trauma | | | | | | | • Injuries during pregnancy | | | | | | | • Traumatic shock | | | | | | | • Pain management | | | | | | | • Burns | | | | | | | • Post-trauma rehabilitation | | | +------+-----------+------------------------------+---------------------------------------+------------------------+------------------------+ | II | 25 (T) | Describe etiology, | Application of nursing process | • Lecture, discussion | • Written assignment on| | | 5 (Lab) | pathophysiology, clinical | pertaining to care of patients with | and demonstration | nursing process | | | | manifestations, emergency | medical emergencies | • Role play and | application on | | | | assessment, diagnosis, | • Fluid, electrolyte & acid-base | video show | patients with medical| | | | medical and nursing | imbalances | | emergencies | | | | management of various | • Endocrine emergencies | | • Interpretation of ECG| | | | medical emergencies with | • Respiratory emergencies | | and ABG analysis | | | | nursing process application | • Cardiovascular emergencies | | • Administration of | | | | | • Poisoning, bites and stings | | antidotes in poisoning| | | | | • Thermoregulatory emergencies | | | | | | | • Neurological emergencies | | | | | | | • Gastrointestinal emergencies | | | | | | | • Genitourinary emergencies | | | | | | | • Shock and haemorrhage | | | | | | | • Environmental emergencies – drowning| | | +------+-----------+------------------------------+---------------------------------------+------------------------+------------------------+ | III | 5 (T) | Describe etiology, | • Application of nursing process | • Lecture cum | • Preparation for | | | 2 (Lab) | pathophysiology, clinical | pertaining to care of patients with | discussion | emergency operative | | | | manifestations, emergency | gastrointestinal emergencies like | • Video show | management | | | | assessment, diagnosis, | perforation, intestinal obstruction,| | | | | | medical and nursing | peritonitis, appendicitis, burst | | | | | | management of various | abdomen & acute abdomen | | | | | | surgical emergencies | | | | +------+-----------+------------------------------+---------------------------------------+------------------------+------------------------+ | IV | 5 (T) | Describe etiology, | Application of nursing process | • Lecture and | • Drugs used in | | | 2 (Lab) | pathophysiology, clinical | pertaining to care of patients with | discussion | obstetric emergencies| | | | manifestations, emergency | obstetrical emergencies | • Simulation | | | | | assessment, diagnosis, | • First trimester emergencies: ectopic| | | | | | medical and nursing | pregnancy, abortions | | | | | | management of various | • Antepartum emergencies: prolapsed | | | | | | obstetrical and | cord, antepartum hemorrhage, | | | | | | gynaecological emergencies | placenta previa, pre-eclampsia and | | | | | | | eclampsia, ruptured uterus | | | | | | | • Post-partum emergencies: post- | | | | | | | partum hemorrhage, obstetric shock | | | | | | | • Gynecological emergencies: ovarian | | | | | | | cyst/abscess | | | | | | | • Pelvic inflammatory disease | | | | | | | • Gynecological trauma | | | | | | | • Sexual assault | | | | | | | • Vaginal bleeding | | | +------+-----------+------------------------------+---------------------------------------+------------------------+------------------------+ | V | 20 (T) | Describe etiology, | Application of nursing process | • Lecture and | • Perform pediatric BLS| | | | pathophysiology, clinical | pertaining to care of patients with | discussion | and ACLS | | | | manifestations, emergency | paediatric emergencies | • Role play | • Prepare flip | | | | assessment, diagnosis, | Medical and Surgical emergencies of | • Video show | chart/video on | | | | medical and nursing | • Respiratory system | • Simulation | prevention of | | | | management of various | • Cardiovascular system | | accidents in children| | | | paediatric emergencies | • Neurological system | | | | | | | • Gastrointestinal system | | | | | | | • Genitourinary system | | | | | | | • Infectious disease emergencies | | | | | | | • Skin lesions and burns | | | | | | | • Poisoning, Foreign bodies, drowning | | | +------+-----------+------------------------------+---------------------------------------+------------------------+------------------------+ | VI | 5 (T) | Describe etiology, | Application of nursing process | • Lecture and | • Assignment on legal | | | | pathophysiology, clinical | pertaining to care of patients with | discussion | implications of | | | | manifestations, emergency | behavioural emergencies | | patients with DSH | | | | assessment, diagnosis, | • Suicide | | • Observation of ECT | | | | medical and nursing | • Homicide | | | | | | management of various | • Substance abuse – alcohol, drugs | | | | | | psychiatric emergencies | • Panic attack | | | | | | | • Acute depression | | | | | | | • Sexual assault | | | | | | | • Post-traumatic stress disorder | | | | | | | (PTSD) | | | +------+-----------+------------------------------+---------------------------------------+------------------------+------------------------+ | VII | 15 (T) | Explain in detail on the | Disaster management | • Lecture and | • Assignment - | | | 6 (Lab) | concepts of disaster | • Introduction & terminologies | discussion | Formulate protocol | | | | management | • Concepts & principles of disaster | | for in-hospital | | | | | management | | disaster management | | | | | • Types of disaster | | | | | | | • Disaster triage | | • Hazard vulnerability | | | | | • Hazard identification and risk | | mapping | | | | | analysis | | | | | | | • Disaster management cycle | • Disaster drill | | | | | | • Community disaster management | | | | | | | • In-hospital disaster management | | | | | | | • Mass casualty management | | • Training community | | | | | • Disaster management training | | volunteers on | | | | | program | | disaster management | | | | | • Psychosocial aspects in disaster | • Simulation on mass | | | | | | management | casualty management | | | | | | • Ethics in disaster management | • Workshop on disaster | | | | | | | management | | +------+-----------+------------------------------+---------------------------------------+------------------------+------------------------+ PRACTICUM (Sill Lab & Clinical) Total Hours: 1770 hours (Skill Lab: 40 hours and Clinical: 1730 hours) Practice Competencies: At the end of the program students will be able to: 1. Perform emergency assessment and triage 2. Assist and perform resuscitative measures based on ACLS (AHA) and ATLS guidelines 3. Perform emergency interventions based on the assessment findings 4. Provide nursing care to patients with non-trauma related emergencies 5. Provide nursing care to patients with trauma related emergencies 6. Monitor patients for early complications 7. Appreciate the MLC policies in patient care 8. Assess and manage special group like paediatric and geriatric patients with various emergency conditions 9. Organize the activities of emergency department as an important team member 10. Implement the concepts of disaster management in in Hospital as well as community-based disasters CLINICAL POSTINGS +========================+=============+==============================+==============================+========================+========================+ | Areas | Duration | Clinical Learning | Skills/Procedural | Assignments | Assessment Methods | | | (weeks) | Outcomes | Competencies | | | +========================+=============+==============================+==============================+========================+========================+ | Emergency Department | 22 weeks | Perform triage | • Emergency assessment | • Emergency assessment | • Clinical evaluation | | | | • Initiate and assist with | • Triaging patients | report | • Case study and | | | | resuscitation | • Resuscitative measures – | • Case presentation – | presentation | | | | • Provide nursing care for | CPR and early management of| trauma and non-trauma| | | | | patients with trauma and | trauma | patients | | | | | non-trauma related | • Emergency interventions | • Emergency drug study | | | | | emergencies | and drugs | | | | | | | • Identification of early | | | | | | | complications | | | | | | | • Use of non-invasive | | | | | | | ventilation | | | | | | | • Interpretation of ABG | | | | | | | analysis | | | | | | | • Application of splints and | | | | | | | supportive devices | | | | | | | • Application of MLC policies| | | | | | | in patient care | | | +------------------------+-------------+------------------------------+------------------------------+------------------------+------------------------+ | Paediatric Emergency | 06 weeks | • Initiate and assist with | • Emergency assessment of | • Emergency pediatric | • Clinical | | Department | | pediatric resuscitation | children | assessment report | evaluation/ | | | | • Provide nursing care to | • Pediatric resuscitation | • Case presentation on | Case study and | | | | children with various | • Pediatric triaging | children with | presentation | | | | emergencies | | emergencies | | | | | | | • Emergency drug study | | +------------------------+-------------+------------------------------+------------------------------+------------------------+------------------------+ | Medical and Surgical | 02 weeks | • Provide comprehensive care | • Managing patients on | | • Case presentation | | ICU | (01 week in | to critically ill patients | ventilator | | | | | each ICU) | in the ICU setup | • Advanced airway management | | | | | | • Provide comprehensive care | • Hemodynamic monitoring of | | | | | | to polytrauma patients in | patients | | | | | | the ICU setup | | | | +------------------------+-------------+------------------------------+------------------------------+------------------------+------------------------+ +========================+=============+==============================+==============================+========================+========================+ | Areas | Duration | Clinical Learning | Skills/Procedural | Assignments | Assessment Methods | | | (weeks) | Outcomes | Competencies | | | +========================+=============+==============================+==============================+========================+========================+ | Paediatric ICU | 01 week | • Provide comprehensive care | • Managing children on | • Special needs and | • Assignment | | | | to critically ill children | ventilator | requirement of children| evaluation | | | | in the ICU setup | • Advanced airway management | on ventilator | | | | | | • Invasive monitoring of | | | | | | | children | | | +------------------------+-------------+------------------------------+------------------------------+------------------------+------------------------+ | Orthopaedic trauma unit| 02 weeks | • Provide comprehensive care | • Managing patients with | | • Clinical evaluation | | | | to patients with orthopedic| splints/tractions/external | | | | | | injuries | fixators | | | | | | | • Crutch walking | | | +------------------------+-------------+------------------------------+------------------------------+------------------------+------------------------+ | Neuro trauma Unit | 02 weeks | • Provide comprehensive care | • Neurological assessment | • Glasgow | • Clinical evaluation | | | | to patients with traumatic | • Increased intra cranial | • Coma Scale Assessment| • Case presentation | | | | brain injuries | pressure management | | | | | | | • Application of brain death | | | | | | | criteria | | | | | | | • Counselling relatives for | | | | | | | organ donation | | | +------------------------+-------------+------------------------------+------------------------------+------------------------+------------------------+ | Coronary Care Unit | 02 weeks | • Provide comprehensive care | • Chest pain assessment | • Thrombolytic therapy | • Clinical evaluation | | | | to patients with | • ECG interpretation | | | | | | cardiovascular disorders | • Preparing patients for | | | | | | | percutaneous interventions | | | +------------------------+-------------+------------------------------+------------------------------+------------------------+------------------------+ | Trauma Operating Room | 01 week | • Assist with trauma related | • Set up of OR for emergency | | | | | | surgeries | surgery | | | | | | | • Assist for emergency | | | | | | | surgery | | | +------------------------+-------------+------------------------------+------------------------------+------------------------+------------------------+ | Burns Unit | 01 week | • Provide comprehensive care | • Fluid resuscitation in | • Burns formula | • Assignment | | | | to patients with burn | burns | • Nutritional | evaluation | | | | injury | • Burn wound management | requirement for | | | | | | | patients with burn | | | | | | | injury | | +------------------------+-------------+------------------------------+------------------------------+------------------------+------------------------+ | Obstetrical Emergency | 01 week | • Provide comprehensive care | • Obstetric assessment | • List the common | • Assignment | | Unit (Labour Room) | | to patients with obstetric | • Assisting with emergency | obstetric emergencies| evaluation | | | | emergencies | interventions | and its management | | +------------------------+-------------+------------------------------+------------------------------+------------------------+------------------------+ | Psychiatry emergency | 01 week | • Provide comprehensive care | • Psychiatric assessment | • Electro-convulsive | • Assignment | | Unit | | to patients with psychiatric| • Use of restraints | therapy | evaluation | +------------------------+-------------+------------------------------+------------------------------+------------------------+------------------------+ +========================+=============+==============================+==============================+========================+========================+ | Areas | Duration | Clinical Learning | Skills/Procedural | Assignments | Assessment Methods | | | (weeks) | Outcomes | Competencies | | | +========================+=============+==============================+==============================+========================+========================+ | Community Disaster | 01 week | • Empower community | • Community awareness on | • Hazard Identification| • Assignment evaluation| | Management | | volunteers to | various disasters | and Risk Analysis | | | | | • Disaster management | • Train the community | | | | | | | volunteers on disaster | | | | | | | management | | | +------------------------+-------------+------------------------------+------------------------------+------------------------+------------------------+ APPENDIX 1 SKILL LAB REQUIREMENTS Note: In addition to the basic skill lab requirement of College of Nursing, the following are necessary. +=======+=================================================+=========+=======================================+ | S.No. | Skill Lab Requirement | Number | Skill | +=======+=================================================+=========+=======================================+ | 1 | Patient trolley with mattress | 5 | Patient Unit Preparation | | 2 | Hospital Linen set | 10 sets | | | 3 | Patient Linen set | 10 sets | | | 4 | Towels | 10 | | | 5 | IV stand | 5 | | | 6 | Bed side lockers | 5 | | | 7 | Overhead table | 3 | | | 8 | Bowls with lid 10 cm | 5 | | | 9 | Bowls 10 cm | 5 | | | 10 | Instrument Tray with lid | 5 | | | 11 | Plain Artery Forceps | 5 | Instruments for Various Procedures | | 12 | Toothed Artery Forceps | 5 | | | 13 | Mosquito Artery Forceps | 5 | | | 14 | Plain Dissecting Forceps | 5 | | | 15 | Toothed Dissecting Forceps | 5 | | | 16 | Sponge holding Forceps | 5 | | | 17 | Towel clip | 5 | | | 18 | Bag Valve Mask device (AMBU Bag) – Adult | 5 | Emergency Equipment | | 19 | Bag Valve Mask device (AMBU Bag) – Paediatric | 5 | | | 20 | Oropharyngeal airway – different sizes | 5 each | | | 21 | Nasopharyngeal airway | 5 | | | 22 | Laryngeal Mask Airway | 10 | | | 23 | Suction catheter - Flexible | 5 | | | 24 | Suction catheter – Rigid | 5 | Articles for Emergency Procedures | | 25 | MacGills Forceps - Adult | 2 | | | 26 | MacGills Forceps - Paediatric | 2 | | | 27 | Bougie | 3 | | | 28 | Oxygen mask | 5 | | | 29 | Nasal prongs | 5 | | | 30 | Oxygen mask with reservoir bag | 5 | | | 31 | Endotracheal tube No. 3 | 5 | | | 32 | Endotracheal tube No. 7 | 5 | | | 33 | Laryngoscope - Adult | 3 | | | 34 | Laryngoscope – Paediatric | 2 | | | 35 | Suction Machine | 2 | | | 36 | Multipara monitor | 2 | | | 37 | Ventilator | 1 | | | 38 | Oxygen supply point | 2 | | | 39 | Oxygen flowmeter | 2 | | | 40 | Crash Cart Trolley | 1 | | | 41 | Bain's circuit | 2 | | | 42 | ECG machine | 1 | | | 43 | Defibrillator | 1 | | | 44 | Automated External Defibrillator | 1 | | | 45 | CPR - Manikin | 2 | | | 46 | Syringe pump | 5 | | | 47 | Glucometer with strips | 1 | | | 48 | BP apparatus | 3 | | | 49 | Stethoscope | 3 | | | 50 | Thermometer | 10 | | | 51 | Pulse oximeter | 1 | | | 52 | Xylocaine jelly | 5 | | | 53 | Central line insertion set | 1 | | | 54 | Tracheostomy set | 1 | | | 55 | Intercostal drainage set | 1 | Pharmacy supplies | | 56 | Lumbar puncture set | 1 | | | 57 | Blood culture set | 1 | | | 58 | Suture pack | 1 | | | 59 | Dressing pack | 2 | | | 60 | Suture scissors | 5 | | | 61 | Scalpel blade | 5 | | | 62 | Catheterization pack | 1 | | | 63 | IV cannula No. 18 | 20 | | | 64 | IV cannula No. 22 | 20 | | | 65 | IV set | 20 | | | 66 | BG set | 20 | | | 67 | 3-way with extension | 20 | | | 68 | Arterial line extension | 20 | | | 69 | Syringe 50 cc | 10 | | | 70 | Syringe 10 cc | 10 | | | 71 | Syringe 5 cc | 10 | | | 72 | Syringe 2 cc | 10 | | | 73 | Insulin syringe | 10 | | | 74 | Nasogastric tube No. 14 | 10 | | | 75 | Foley's catheter No. 16 | 10 | | | 76 | Urosac | 5 | | | 77 | Chest tube No. 28 | 2 | | | 78 | Chest drainage bottle | 2 | | | 79 | Normal Saline 1000 ml | 10 | | | 80 | Normal Saline 500 ml | 10 | | | 81 | Normal Saline 100 ml | 10 | | | 82 | Adrenaline | 10 | Emergency drugs | | 83 | Noradrenaline | 10 | | | 84 | Atropine | 10 | | | 85 | Soda bicarbonate | 10 | | | 86 | Calcium gluconate | 10 | Trauma Care | | 87 | Dextrose 50% | 5 | | | 88 | Tramadol | 10 | | | 89 | Xylocaine 2% | 5 | | | 90 | Cervical Collar - Adult | 10 | | | 91 | Cervical Collar - Paediatric | 10 | | | 92 | Splint - Thomas splint | 10 | | | 93 | Pelvic binder | 10 | | | 94 | Broad arm sling | 10 | | | 95 | Clavicular brace | 10 | | | 96 | Buddy splint | 10 | | | 97 | Bandages 6" | 20 | | | 98 | Bandages 4" | 20 | | | 99 | Bandages 2" | 20 | | | 100 | Dressing pads | 30 | | | 101 | Spine board | 1 | | | 102 | Scoop board | 1 | | | 103 | Wooden splints | 20 | | | 104 | Sand bags | 20 | | | 105 | Skin traction kit | 20 | | | 106 | Disaster preparedness kit – In-hospital | 2 | Disaster Management | | 107 | Disaster preparedness kit – Community | 2 | | | 108 | Life jacket | 10 | | | 109 | Gas mask | 10 | | | 110 | Safety shoes | 10 | | | 111 | Helmet | 10 | | | 112 | Dragon light | 10 | | | 113 | Emergency light | 10 | | | 114 | Mega Phone | 5 | | | 115 | Disaster triage tags | 50 | | | 116 | Disaster triage colour code bands | 50 | | | 117 | Antiseptic creams | 10 | | | 118 | Antibiotic creams/ointments | 10 | | | 119 | Standard safety protection devices | 20 sets | Infection Control | | 120 | Hand washing area | 1 | | | 121 | Biomedical waste disposal unit | 1 | | | 122 | Records (Triage form, Medication order sheet, | - | Recording | | | Nurses Record, Resuscitation record, Trauma | | | | | record) | | | | 123 | LCD TV | 1 | Video Assisted Demonstration | | 124 | Health Teaching modules for patients | - | Health Teaching | +-------+-------------------------------------------------+---------+---------------------------------------+ APPENDIX 2: ASSESSMENT GUIDELINES (THEORY & PRACTICUM) I. THEORY A. INTERNAL A.1 EMEDRGENCY AND DISASTER SPECIALTY NURSING (Part I: Emergency and Disaster Nursing I including Foundations & Part II: Emergency and Disaster Nursing II) – TOTAL: 25 marks • Test papers & Quiz – 10 marks • Written assignments – 10 marks (Code of ethics relevant to emergency and disaster nursing practice and infection control practices in emergency unit and protocol for in-hospital disaster management) • Group project – 5 marks B. EXTERNAL/FINAL A.2 EMERGENCY AND DISASTER SPECIALTY NURSING (Part I: Emergency and Disaster Nursing I including Foundations & Part II: Emergency and Disaster Nursing II) – TOTAL: 75 marks Part I: 35 marks (Essay 1×15=15 marks, Short answers 4×4=16 marks, Very short answers 2×2=4 marks) and Part II: 40 marks (Essay 1×15=15 marks, Short answers 5×4=20 marks, Very short answers 5×1=5 marks) II. PRACTICUM A. INTERNAL – 75 MARKS • OSCE - 25 marks (End of posting OSCE – 10 marks + Internal end of year OSCE – 15 marks) • Other Practical: 50 marks a) Practical Assignments – 20 marks (Clinical presentation & case study report – 5 marks, Counselling report/visit report – 5 marks, Drug study report – 5 marks, and Health talk – 5 marks) b) Completion of procedural competencies and clinical requirements – 5 marks c) Continuous clinical evaluation of clinical performance – 5 marks d) Final Observed Practical (actual performance in clinicals) – 20 marks B. EXTERNAL – 150 MARKS OSCE - 50 marks, Observed Practical – 100 marks (Detailed guidelines are given in Guidebook). APPENDIX 3: CLINICAL LOG BOOK FOR POST BASIC DIPLOMA IN EMERGENCY AND DISASTER SPECIALTY NURSING – RESIDENCY PROGRAM (Specific Procedural Competencies/Clinical Skills) +=======+=================================================+==========================+=======================================+ | S. No.| Specific Competencies/Skills | Number Performed/ | Date & Signature of the Faculty/ | | | | Assisted/Observed | Preceptor | | | | (P/A/O) | | +=======+=================================================+==========================+=======================================+ | I | FOUNDATIONS TO EMERGENCY AND DISASTER NURSING | | | | 1 | Preparation of patient education materials | P | | | 2 | Patient education plan for teaching patients with | P | | | | emergency conditions | | | | 3 | Preparation of duty roster for nursing | P | | | | officers/staff nurses | | | | 4 | Writing literature review/systematic review | P | | | | (Identify evidence-based nursing | | | | | interventions/practices) | | | | 5 | Preparation of a manuscript for publication/paper | P | | | | presentation | | | | 6 | Group research project | P | | | | Topic: | | | +-------+-------------------------------------------------+--------------------------+---------------------------------------+ | II | EMERGENCY AND DISASTER NURSING SPECIALTY | | | | 1 | EMERGENCY ASSESSMENT | | | | 1.1 | History taking and physical examination for | P | | | | patients with non-trauma related conditions | | | | 1.2 | History taking and physical examination for | P | | | | patients with trauma related conditions | | | | 1.3 | Triaging patients in emergency and disaster unit| p | | +-------+-------------------------------------------------+--------------------------+---------------------------------------+ | 2 | EMERGENCY INTERVENTIONS | | | | 2.1 | Head tilt chin lift manoeuvre | P | | | 2.2 | Jaw thrust manoeuvre | P | | | 2.3 | Oral suction | P | | | 2.4 | Application of oropharyngeal airway | P | | | 2.5 | Application of nasopharyngeal airway | P | | | 2.6 | Application of laryngeal mask airway | P | | | 2.7 | Emergency endotracheal tube intubation | A | | | 2.8 | Rapid sequence intubation | A | | | 2.9 | Oxygen administration | P | | | 2.10 | Care of patient on non-invasive ventilation | P | | | 2.11 | Care of patient on invasive ventilation | P | | | 2.12 | Care of tracheostomy | P | | | 2.13 | Advanced cardiac life support | P | | | 2.14 | Defibrillation | P | | | 2.15 | Cardioversion | P | | | 2.16 | Intra venous cannulation | P | | | 2.17 | Administration of emergency drugs | P | | | 2.18 | Haemodynamic monitoring | P | | | 2.19 | Administration of inotropes | P | | | 2.20 | Monitoring of patients on inotropes | P | | | 2.21 | Taking ECG | P | | | 2.22 | Interpreting ECG | P | | | 2.23 | Central line insertion | A | | | 2.24 | Arterial blood gas sampling | P/A (As per | | | | | institutional protocol) | | | 2.25 | Arterial blood gas analysis | P | | | 2.26 | Abdominal paracentesis | A | | | 2.27 | Lumbar puncture | A | | | 2.28 | Blood transfusion | P/A (As per | | | | | institutional protocol) | | | 2.29 | Naso-gastric tube insertion | P | | | 2.30 | Gastric lavage | P | | | 2.31 | Administration of antidote | P | | | 2.32 | Administration of anti-snake venom | P | | | 2.33 | Evaporative cooling | P | | | 2.34 | Catheterization | P | | +-------+-------------------------------------------------+--------------------------+---------------------------------------+ | 3 | TRAUMA NURSING | | | | 3.1 | Application of cervical collar | P | | | 3.2 | Trauma endotracheal intubation | A | | | 3.3 | Needle thoracotomy | A | | | 3.4 | Tube thoracotomy | A | | | 3.5 | Massive transfusion protocol | A | | | 3.6 | Assessment of GCS | P | | | 3.7 | Assessment of pupils | P | | | 3.8 | Log rolling | P | | | 3.9 | Application of splints | P | | | 3.10 | Application of posterior slab using POP | A | | | 3.11 | Crush protocol | A | | | 3.12 | Wound management | A | | | 3.13 | Suturing | P | | | 3.14 | Suture removal | P | | | 3.15 | Pain Management – Administration of narcotic | P | | | | analgesic | | | | 3.16 | Local anaesthesia - Infiltration | A | | | 3.17 | Local anaesthesia - Nerve block | A | | | 3.18 | Administration of ketamine | P | | | 3.19 | Monitoring of patients on ketamine | P | | | 3.20 | Trauma Radiology – Interpretation of X-rays | P | | | 3.21 | Interpretation of CT scan | P | | | 3.22 | Interpretation of MRI | P | | | 3.23 | Preparation of patients for emergency operative | P | | | | management | | | +-------+-------------------------------------------------+--------------------------+---------------------------------------+ | 4 | PAEDIATRIC EMERGENCY | | | | 4.1 | Emergency assessment – History collection and | P | | | | physical examination | | | | 4.2 | Triaging children in emergency and disaster unit| P | | | 4.3 | Airway management | P | | | 4.4 | Oxygen administration | P | | | 4.5 | Nebulisation | P | | | 4.6 | IV cannulation | P | | | 4.7 | Intra osseous cannulation | A | | | 4.8 | Advanced cardiac life support in children | P | | | 4.9 | Fluid resuscitation in children | P | | | 4.10 | Assessment of GCS in children | P | | | 4.11 | Care of critically ill children in ICU | P | | | 4.12 | Care of children on ventilator | P | | +-------+-------------------------------------------------+--------------------------+---------------------------------------+ | 5 | MEDICAL AND SURGICAL ICU | | | | 5.1 | Care of critically ill patient on ventilator | P | | | 5.2 | Care of invasive lines | p | | +-------+-------------------------------------------------+--------------------------+---------------------------------------+ | 6 | ORTHOPEDIC TRAUMA UNIT | | | | 6.1 | Care of patients with operative management | P | | | 6.2 | Crutch walking | P | | +-------+-------------------------------------------------+--------------------------+---------------------------------------+ | 7 | NEUROTRAUMA UNIT | | | | 7.1 | Neurotrauma assessment | P | | | 7.2 | Management of increased ICP | P | | +-------+-------------------------------------------------+--------------------------+---------------------------------------+ | 8 | CORONARY CARE UNIT | | | | 8.1 | Assessment of patient with chest pain | P | | | 8.2 | Taking ECG | P | | | 8.3 | Interpreting ECG | P | | | 8.4 | Preparing for percutaneous intervention | P | | | 8.5 | Thrombolysis | A | | +-------+-------------------------------------------------+--------------------------+---------------------------------------+ | 9 | TRAUMA OPERATING ROOM | | | | 9.1 | Assist with orthopaedic trauma surgery | A | | +-------+-------------------------------------------------+--------------------------+---------------------------------------+ | 10 | BURNS UNIT | | | | 10.1 | Care of patient with burn injury | P | | | 10.2 | Burns dressing | P | | +-------+-------------------------------------------------+--------------------------+---------------------------------------+ | 11 | OBSTETRICAL EMERGENCY UNIT (Labour Room) | | | | 11.1 | Obstetric assessment | P | | | 11.2 | High risk delivery | A | | | 11.3 | Preparation of patient for emergency LSCS | P | | +-------+-------------------------------------------------+--------------------------+---------------------------------------+ | 12. | PSYCHIATRIC EMERGENCU UNIT | | | | 12.1 | Assessment of patients with psychiatric | P | | | | emergency | | | | 12.2 | Use of restraints | P | | | 12.3 | Electroconvulsive therapy | A | | +-------+-------------------------------------------------+--------------------------+---------------------------------------+ | 13 | DISASTER NURSING | | | | 13.1 | Hazard identification and risk analysis of | P | | | | emergency and disaster/community | | | | 13.2 | Mass casualty management in emergency and | A | | | | disaster | | | | 13.3 | Developing protocol for disaster management – | P | | | | hospital/ onsite | | | +-------+-------------------------------------------------+--------------------------+---------------------------------------+ | 14 | QUALITY CONTROL | | | | 14.1 | Preparation of SOP for infection control in | P | | | | emergency and disaster | | | | 14.2 | Development of SOP for triaging patients in | P | | | | emergency and disaster | | | | 14.3 | Conducting unit audit | P | | +-------+-------------------------------------------------+--------------------------+---------------------------------------+ *When the student is found competent to perform the skill, the faculty will sign it.* Students: Students are expected to perform the listed skills/competencies many times until they reach level 3 competency, after which the faculty signs against each competency. Faculty: Must ensure that the signature is given for each competency only after they reach level 3. • Level 3 competency denotes that the student is able to perform that competency without supervision • Level 2 Competency denotes that the student is able to perform each competency with supervision • Level 1 competency denotes that the student is not able to perform that competency/skill even with supervision APPENDIX 4: CLINICAL REQUIREMENTS +=======+=================================================+======+=======================================+ | S. No.| Clinical Requirement | Date | Signature of the Faculty/Preceptor | +=======+=================================================+======+=======================================+ | 1 | Emergency Assessment | | | | 1.1 | Health Assessment (Adult) – History & Physical | | | | | Examination (Three written reports) | | | | 1.1.1 | | | | | 1.1.2 | | | | | 1.1.3 | | | | | 1.2 | Triaging of Patients (Adults) | | | | 1.2.1 | | | | | 1.2.2 | | | | | 1.2.3 | | | | | 1.2.4 | | | | | 1.2.5 | | | | | 1.3 | Health Assessment (Paediatric) – History & | | | | | Physical Examination (Two written reports) | | | | 1.3.1 | | | | | 1.3.2 | | | | | 1.4 | Triaging of Patients (Paediatric) | | | | 1.4.1 | | | | | 1.4.2 | | | | | 1.4.3 | | | | +-------+-------------------------------------------------+------+---------------------------------------+ | 2 | Clinical Seminar/Journal Club/ Clinical | | | | | Conference | | | | | Topic: | | | | 1. | | | | | 2. | | | | +-------+-------------------------------------------------+------+---------------------------------------+ | 3 | Case Study/Clinical Presentation and Report | | | | | Emergency Department-2 & Paediatric Emergency | | | | | Department-1 (Nursing/Interdisciplinary Rounds) | | | | 3.1 | Name of Clinical Condition: | | | | 3.2 | Name of Clinical Condition: | | | | 3.3 | Name of Clinical Condition: | | | +-------+-------------------------------------------------+------+---------------------------------------+ | 4 | Drug Study, Presentation and Report | | | | 4.1 | Drug Name: | | | | 4.2 | | | | | 4.3 | | | | | 4.4 | | | | +-------+-------------------------------------------------+------+---------------------------------------+ | 5 | Planned Home Care Teaching | | | | 5.1 | | | | | 5.2 | | | | | 5.3 | | | | +-------+-------------------------------------------------+------+---------------------------------------+ | 6 | Group Health Talk | | | | 6.1 | | | | | 6.2 | | | | +-------+-------------------------------------------------+------+---------------------------------------+ | 7 | Crisis Counselling Report | | | | 8 | Ideal Physical Layout of Emergency Department | | | | 9 | Maintenance of Medico Legal Records and Reports | | | | 10 | Report on Ambulance System in India | | | +-------+-------------------------------------------------+------+---------------------------------------+ Signature of the Program coordinator/Faculty Signature of the HOD/Principal APPENDIX 5: CLINICAL EXPERIENCE DETAILS +========================+===================+==========================+=======================================+ | Name of Clinical Unit | Clinical Condition| Number of days care given| Signature of Faculty/Preceptor | +========================+===================+==========================+=======================================+ | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | +------------------------+-------------------+--------------------------+---------------------------------------+ Signature of the Program coordinator/Faculty Signature of the HOD/Principal Dr. T. DILEEP KUMAR, President [ADVT.-III/4/Exty./609/2024-25] Uploaded by Dte. of Printing at Government of India Press, Ring Road, Mayapuri, New Delhi-110064 and Published by the Controller of Publications, Delhi-110054.

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