DEVELOPMENT

AND

MAINTANANCE

OF

STANDARDS

AND

ACCREDITATION IN NURSING EDUCATION INSTITUTIONS Standards are professionally developed expressions of the range of acceptable variations from a norm or criterion" -Avedis Donabedian.

INTRODUCTION Standards ensures practicing things in the right way and doing things in how they actually be done. Standard and quality go hand in hand. The standard is also bound to ethical values. A standards has its own scientific backgrounds for any type of institutions. Only nursing institutions which maintains standards can bring forth nurses who can perform standard nursing care. Standard is a broad statement of quality- a definite, adequately required, aimed at a possible level of excellence. It agrees upon an achieved level of performance which is considered proper and adequate for a specific purpose against which actual performance is mapped. DEFINITION OF STANDARDS

Standards may be defined as "Benchmark of achievement which is based on a desired level of excellence.

Standards are pre-determined elements against which aspects of the quality of medical service or education may be compared.

STANDARDS IN NURSING EDUCATION Standard is an established rules or basis of comparison in measuring or judging capacity, quality context and value of objects in same category. Selected standards are

reliable and relevant for the category being compared. It is a definite level of excellence, or adequately required, aimed at or possible. It agreed upon achieved level of performance, considered proper and adequate for a specific purpose against which actual performance is compared. It is an acknowledged measure of comparison for quantitative or qualitative value. Importance of standards A standard is a means of determining what something should be. Standards of setting up of a nursing education institution is the concreate statements or intensions and requirements upon which the available resources are compared. Quality improvement in nursing education is the primary aim of maintaining or sticking on to this standards. Keeping of standards of nursing education institutions and maintaining it will bring forth individuals who can effectively practice and survive in the current systems of health management and who can understand and solve the changing needs of the society. Audits and inspections helps to maintain these standards in nursing educational institutions. Purposes of standards Give directions and guidelines for performance. Improves quality of nursing education. Provides a baseline for evaluating quality of nursing education. Improves proper documentations.

 Helps to make out the degree to which the standards are met and to make necessary corrections and improvements in time. Act as a basis for decision making. Helps to justify the demands of a institution. Helps the authorities to prepare themselves and to guide the faculty. Characteristics of standards Must be realistic, acceptable and attainable. Must be understandable and stated in unambiguous terms. Must be based on current needs of society and health care environment. Must be directed towards the ideal. Must be able to apply to various settings. Must be developed by the members of the nursing profession. Must be reviewed and revised periodically. Sources of standards for nursing education institutions. o Professional organizations. Eg .TNAI o Licensing bodies. Eg .INC o Institutions o State and central government Types of standards Structure standards: It involves setup of the institutions. The philosophy goals and objectives, structure of the organization, facilities and the equipments and the qualification of the faculty are also the

components. The use of structure standards implies that if the structure is adequate, reliable and desirable, standards will be met and quality products will be produced.

Process standards: It refers to the performance or behavior. The process standards involves the activities concerned with the functioning of a nursing institution. The processs standards assist in measuring the degree of skills, with which the education process is carried out Outcome standards: It refers to the end result or outcome of a nursing education institutions, whether it is able to bring out qualified professional nurse who are competent in their profession. STANDARDS FOR SETTING UP OF NURSING EDUCATIONAL

PROGRAMMES(INC) Minimum standard requirement for starting ANM course A school for training of the ANM should be located in a community Health Centre (PHC annexe) or a Rural Hospital (RH) having minimum bed strength of 30 and maximum 50 and serving an area with community health programmes. The school should also be affiliated to a district hospital or a secondary care hospital in order to provide experiences of secondary level health care and an extensive gynae-obstertical care. An organization having a hospital with 150 beds with minimum 30-50 obstetrics and gynecology beds, and 100 delivery cases monthly can also open ANM school. The should also have an affiliation of PHC/CHC for the community Health Nursing field

experience. Existing ANM schools attached to District Hospitals should have PHC annexe (accommodation facility for 20-30 students) for community health field experience.

Physical Facilities Office room Class-room Nursing laboratory Nutrition laboratory Library cum study Audio visual aid 1 2 1 1 1 1

Clinical Facilities

School has to be affiliated to district hospital or a secondary care hospital with minimum 150 beds.

Bed occupancy on the average to be between 60% -70%.

Teaching facility - Teaching faculty for 20-40 annual admission:

Category Principal

Minimum qualification and experience M.Sc. Nursing with 3 years of teaching experience or B.Sc(N) with 5 years of teaching experience.

Nursing Tutor

B.Sc.Nursing/Diploma

in

Nursing

Education

&

Administration/Diploma in Public Health Nursing with 2 years clinical experience.

Guidelines to start ANM course

Any organization under the central government, state government, local body or a private or public trust, mission, voluntary registered under society registration act or a company registered under companys act wishes to open and ANM training school, should obtain the no objection/essentiality certificate from the state government.

If any nursing programme is recognised by Indian Nursing Council, then the institution will be exempted from noc/essentiality certificate for A.N.M. from the state government.

The Indian Nursing Council on receipt of the proposal from the institution to start ANM training program, will undertake the first inspection to assess suitability with regard to physical infrastructure, clinical facility and teaching faculty in order to give permission to start the programme.

After the receipt of the permission to start ANM training program from Indian nursing council, the institution shall obtain the approval from the state nursing council and examination board.

Institution will admit the students only after taking approval of state nursing council and examination board.

The Indian Nursing Council will conduct inspection every year till the first batch completes the programme. Permission will be given year by year till the first batch completes.

Minimum standard requirement for starting GNM course Physical facilities for teaching block Teaching Block Area in sq.ft

Lecture hall Nursing foundation lab CHN lab Nutrition lab OBG and peadiatric lab Pre-clinical science lab Computer lab Multipurpose hall Common room for boys and girls Staff room Principal room Vice principal room Library A.V aids room One room for each head of the departments Faculty room Provision for toilet Total Hostel Block

4320 1500 900 900 900 900 1500 3000 2000 1000 300 200 2400 600 800 2400 1000 23720 sq.ft

Hostel block Room for students Sanitary

Area in sq.ft 2400 One latrine and one bath room for 5 students. 500 sq.ft

Visitor room

500

Reading room Store Recreation room Dining hall Kitchen and store Total

250 500 500 3000 1500 30750

Proportionately the size of the built-up area will increase according to the number of students admitted. School and College of nursing can share laboratories, if they are in same campus under same name and under same trust, that is the institution is one but offering different nursing programmes. However they should have equipments and articles proportionate to the strength of admission. And the class rooms should be available as per the requirement stipulated by Indian Nursing Council of each programme

Clinical Facilities School of nursing should have a 120-150 bedded Parent/Affiliated Hospital for 40 annual intake in each programme:

Distribution of beds in different areas Medical 30 Surgical 30 Obst. & Gynaecology 30 Pediatrics 20 Ortho 10 Bed Occupancy of the Hospital should be minimum 75%.

 The size of the Hospital/Nursing Home for affiliation should not be less than 50 beds. Other Specialities/Facilities for clinical experience required are as follows:

o o o o o o o o o o o o o

Major OT Minor OT Dental Eye/ENT Burns and Plastic Neonatology with Nursery Communicable disease Community Health Nursing Cardiology Oncology Neurology/Neuro-surgery Nephrology etc. ICU/ICCU

Affiliation of psychiatric hospital should be of minimum 30-50 beds. The Nursing Staffing norms in the affiliated Hospital should be as per the INC norms. The affiliated Hospital should give student status to the candidates of the nursing programme. Affiliated hospitals should be in the radius of 15-30 kms. 1:3 student patient ratio to be maintained.

If the institution is having both GNM and B.Sc(N) programme, it would require 240 bedded parent/affiliated hospital for 40 annual intake in each programme to maintain 1:3 student

patient ratio. Teaching facility - Qualification of Teaching Staff: Principal M.Sc nursing with 3 years of teaching experience or B.Sc nursing with 5 years of teaching experience Vice-principal M.Sc nursing or B.Sc nursing with 3 years of teaching experience Tutor M.Sc nursing or B.Sc nursing or diploma in nursing education and administration with 2 years of professional experience.

For School of nursing with 60 students (i.e., an annual intake of 20 students):

Teaching faculty Principal Vice principal Tutor Additional tutor for interns Total

No.required 1 1 4 1 7

Guidelines to start G.N.M. course Any organization under the Central Government, State Government, Local body or a Private or Public Trust, Mission, Voluntary registered under Society Registration Act or a Company registered under companys act wishes to open a School of Nursing

should obtain the No Objection/Essentiality certificate from the State Government. If any Nursing Programme is recognised by Indian Nursing Council, then the institution will be exempted from NOC/Essentiality certificate for G.N.M. from the state Government. The Indian Nursing Council on receipt of the proposal from the Institution to start nursing programme, will undertake the first inspection to assess suitability with regard to physical infrastructure, clinical facility and teaching faculty in order to give permission to start the programme. After the receipt of the permision to start the nursing programme from Indian Nurisng Council, the institution shall obtain the approval from the State Nursing Council and Examination Board. Institution will admit the students only after taking approval of State Nursing Council and Examination Board. The Indian Nursing Council will conduct inspection every year till the first batch completes the programme. Permission will be given year by year till the first batch completes.

Minimum standard requirement for starting B.Sc nursing course Physical facilities for teaching block Teaching Block Lecture hall Nursing foundation lab CHN lab Nutrition lab OBG and peadiatric lab Area in sq.ft 4320 1500 900 900 900

Pre-clinical science lab Computer lab Multipurpose hall Common room for boys and girls Staff room Principal room Vice principal room Library A.V aids room One room for each head of the departments Faculty room Provision for toilet Total

900 1500 3000 2000 1000 300 200 2400 600 800 2400 1000 23720 sq.ft

Hostel Block

Hostel block Room for students Sanitary

Area in sq.ft 2400 One latrine and one bath room for 5 students. 500 sq.ft

Visitor room Reading room Store Recreation room Dining hall

500 250 500 500 3000

Kitchen and store Total

1500 30750

Clinical Facilities College of nursing should have a 120-150 bedded Parent/Affiliated Hospital for 40 annual intake in each programme:

Distribution of beds in different areas

o o o o o

Medical - 30 Surgical - 30 Obst. & Gynecology - 30 Pediatrics-20 Ortho - 10

Bed Occupancy of the Hospital should be minimum 75%. The size of the Hospital/Nursing Home for affiliation should not be less than 50 beds.

Other Specialties/Facilities for clinical experience required are as follows:

o o o o o o o o

Major OT Minor OT Dental Eye/ENT Burns and Plastic Neonatology with Nursery Communicable disease Community Health Nursing

o o o o o

Cardiology Oncology Neurology/Neuro-surgery Nephrology etc. ICU/ICCU

Affiliation of psychiatric hospital should be of minimum 30-50 beds. The Nursing Staffing norms in the affiliated Hospital should be as per the INC norms.

The affiliated Hospital should give student status to the candidates of the nursing programme.

Affiliated hospitals should be in the radius of 15-30 kms. 1:3 student patient ratio to be maintained.

If the institution is having both GNM and B.Sc(N) programme, it would require 240 bedded parent/affiliated hospital for 40 annual intake in each programme to maintain 1:3 student patient ratio. Qualifications and experience of teachers of college of nursing Professor cum principal M.Sc nursing with total 10 years of experience , minimum of 5 years of teaching experience Professor cum vice principal M.Sc nursing with total 10 years of experience , minimum of 5 years of teaching experience Reader/ associate professor M.Sc nursing with total 7 years of experience , minimum of 3 years of teaching experience

Lecturer Tutor / clinical instructer

M.Sc nursing with 3 years of experience M.Sc nursing or B.Sc nursing with 1 year experience or basic B.Sc nursing with post diploma in clinical speciality

Guidelines to start B.Sc. Course Any organization under the Central Government, State Government, Local body or a Private or Public Trust, Mission, Voluntary registered under Society Registration Act or a Company registered under companys act wishes to open a School/College of Nursing, should obtain the No Objection/Essentiality certificate from the State government. If any Nursing Programme is recognised by Indian Nursing Council, then the institution will be exempted from NOC/Essentiality certificate for B.Sc. (N) from the state Government. The Indian Nursing council on receipt of the proposal from the Institution to start nursing College, will undertake the first inspection to assess suitability with regard to physical infrastructure, clinical facility and teaching faculty in order to give permission to start the programme. After the receipt of the permission to start the nursing programme from Indian Nursing Council, the institution shall obtain the approval from the State Nursing Council and University. Institution will admit the students only after taking approval of State Nursing Council and University. The Indian Nursing Council will conduct inspection every year till the first batch completes the programme. Permission will be given year by year till the first batch

completes.

Minimum standard requirement for starting Pc. B.Sc course Physical facilities for teaching block Teaching Block Lecture hall Nursing foundation lab CHN lab Nutrition lab OBG and peadiatric lab Pre-clinical science lab Computer lab Multipurpose hall Common room for boys and girls Staff room Principal room Vice principal room Library A.V aids room One room for each head of the departments Faculty room Provision for toilet Total Area in sq.ft 4320 1500 900 900 900 900 1500 3000 2000 1000 300 200 2400 600 800 2400 1000 23720 sq.ft

Hostel facility

Hostel block Room for students Sanitary

Area in sq.ft 2400 One latrine and one bath room for 5 students. 500 sq.ft

Visitor room Reading room Store Recreation room Dining hall Kitchen and store Total

500 250 500 500 3000 1500 30750

Clinical Facilities College of nursing should have a 120-150 bedded Parent/Affiliated Hospital for 40 annual intake in each programme:

Distribution of beds in different areas

o o o o

Medical - 30 Surgical - 30 Obst. & Gynecology - 30 Pediatrics Ortho - 10 20

Bed Occupancy of the Hospital should be minimum 75%.

The size of the Hospital/Nursing Home for affiliation should not be less than 50 beds.

Other Specialties/Facilities for clinical experience required are as follows:

o o o o o o o o o o o o o

Major OT Minor OT Dental Eye/ENT Burns and Plastic Neonatology with Nursery Communicable disease Community Health Nursing Cardiology Oncology Neurology/Neuro-surgery Nephrology etc. ICU/ICCU

Affiliation of psychiatric hospital should be of minimum 30-50 beds. The Nursing Staffing norms in the affiliated Hospital should be as per the INC norms.

The affiliated Hospital should give student status to the candidates of the nursing programme.

Affiliated hospitals should be in the radius of 15-30 kms. 1:3 student patient ratio to be maintained.

If the institution is having both GNM and B.Sc(N) programme, it would require 240 bedded

parent/affiliated hospital for 40 annual intake in each programme to maintain 1:3 student patient ratio.

Teaching facilities Qualifications & experience of teachers of college of nursing

Professor cum principal

M.Sc nursing with total 10 years of experience , minimum of 5 years of teaching experience

Professor cum vice principal

M.Sc nursing with total 10 years of experience , minimum of 5 years of teaching experience

Reader/ associate professor

M.Sc nursing with total 7 years of experience , minimum of 3 years of teaching experience

Lecturer Tutor / clinical instructer

M.Sc nursing with 3 years of experience M.Sc nursing or B.Sc nursing with 1 year experience or basic B.Sc nursing with post diploma in clinical speciality

Guidelines to start P.C.B.Sc. course Any organization under the Central Government, State Government, Local body or a Private or Public Trust, Mission, Voluntary registered under Society Registration Act or a Company registered under companys act wishes to open a M.Sc. Nursing

programme, should obtain the No Objection/Essentiality certificate from the State Government. If any Nursing Programme is recognised by Indian Nursing Council, then the institution will be exempted from NOC/Essentiality certificate for P.C.B.Sc. (N) from the state Government. The Indian Nursing council on receipt of the proposal from the Institution to start nursing program, will undertake the first inspection to assess suitability with regard to physical infrastructure, clinical facility and teaching faculty in order to give permission to start the programme. After the receipt of the permission to start the nursing programme from Indian Nursing Council, the institution shall obtain the approval from the State Nursing Council and University. Institution will admit the students only after taking approval of State Nursing Council and University. The Indian Nursing Council will conduct inspection every year till the first batch completes the programme. Permission will be given year by year till the first batch completes. Super Speciality Hospital can start M.Sc.(N) programme, however they have to get NOC/Essentiality certificate from respective State Government to start the M.Sc. (N) programme.

Minimum standard requirement for starting M.Sc nursing course

M.Sc.

(N)

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

o o o

Professor cum coordinator 1 Reader / Associate Professor 1 Lecturer 2

The above faculty shall perform dual role.

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

(N)

Professor-cum-Principal - 1 Professor-cum-Vice Principal - 1 Reader / Associate Professor - 5 Lecturer - 8 Tutor --------------Total - 34 / Clinical Instructor 19

One in each specialty and all the M.Sc(N) qualified teaching faculty will participate in all collegiate programmes.

Teacher Student Ratio = 1 : 10 for M.Sc.(N) programme.

Qualifications & experience of teachers of college of nursing Sr. No. 1 Post Professor-cumPrincipal - 14 years experience after M.Sc. (N) in College of Nursing . Qualification & Experience - Masters Degree in Nursing

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

- 3 years experience in administration (Years of experience is relaxable if suitable candidate is not available) (If a candidate is not available, minimum 5 years of experience in college of nursing, with an aggregate of 14 years teaching experience)

Desirable : Independent published work of high standard / doctorate degree / M.Phil. 3 Reader Professor - 10 years experience after M.Sc.(N) in a College of Nursing. (If a candidate is not available, 5 years of experience in College of Nursing with an aggregates of 10 years teaching experience. / Associate - Master Degree in Nursing.

Desirable : Independent published work of high standard /doctorate degree / M.Phil. 4 Lecturer - Master Degree in Nursing.

- 3 years teaching experience after M.Sc. (N)

External /Guest faculty may be arranged for the selected units in different subjects as required No part time nursing faculty will be counted for calculating total no. of faculty required for a college. Irrespective of number of admissions, all faculty positions (Professor to Lecturer) must be filled. For M.Sc.(N) programme appropriate number of M.Sc. faculty in each speciality be appointed subject to the condition that total number of teaching faculty ceiling is maintained. All nursing teachers must possess a basic university or equivalent qualification as laid down in the schedules of the Indian Nursing Council Act, 1947. They shall be registered under the State Nursing Registration Act. Nursing faculty in nursing college except tutor/clinical instructors must possess the requisite recognized postgraduate qualification in nursing subjects. Holders of equivalent postgraduate qualifications, which may be approved by the Indian Nursing Council from time to time, may be considered to have the requisite recognized postgraduate qualification in the subject concerned. All teachers of nursing other than Principal and Vice-Principal should spend at least 4 hours in the clinical area for clinical teaching and/or supervision of care every day.

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

Super Speciality Hospital can start M.Sc.(N) programme, however they have to get NOC/Essentiality certificate from respective State Government to start the M.Sc. (N) programme.

PhD in nursing in India

National consortium for Ph.D in Nursing (Ph.D Consortium) has been constituted by Indian Nursing Council (INC) in collaboration with Rajiv Gandhi University of Health Sciences and W.H.O., under the Faculty of Nursing to promote doctoral education in various fields of nursing.

National Consortium for Ph.D. has been constituted by Indian Nursing Council to promote research activities, in various fields of Nursing. Ph. D Consortium of Indian Nursing Council in collaboration with Rajiv Gandhi University of Health Sciences, intends to initiate Ph.D. degree programme in Nursing under the aegis of RGUHS.

6 study centres namely College of Nursing, NIMHANS, Bangalore, R.A.K. College of Nursing, New Delhi, C.M.C. College of Nursing, Vellore, C.M.C. College of Nursing, Ludhiana, Govt. College of Nursing, Thiruvanthapuram, Govt. College of Nursing, Hyderabad, has been recognized by National Consortium for Ph.D. in Nursing. These centres will be connected by Video conferencing facilities. MOU has been signed between INC, WHO and RGUHS

Manipal University is offering PhD programes for the faculty. Some other universities like IGNOU, Sri Ramachandra University and Vinayaka Mission University in Tamil Nadu is offering PhD programmes in Nursing.

GLOBAL STANDARDS

ICN STANDARDS FOR BASIC NURSING AND MIDWIFERY EDUCATION

Standards related to program graduates

1 Out come standards Graduates demonstrate established competencies in nursing and midwifery practice. Graduates demonstrate sound understanding of the determinants of health. Graduates of an initial programme in nursing or midwifery meet regulatory body standards leading to professional licensure/registration as a nurse or a midwife. Graduates are awarded a professional degree. Graduates are eligible for entry into advanced education programmes. Nursing or midwifery schools employ methods to track the professional success and progression of education of each graduate. 2. Programme graduate attribute Nursing or midwifery school graduates will be knowledgeable practitioners who adhere to the code of ethics and standards of the profession. Nursing or midwifery schools prepare graduates who demonstrate: use of evidence in practice, cultural competence the ability to practise in the health-care systems of their respective countries and meet population needs, critical and analytical thinking, the ability to manage resources and practise safely and effectively,

 the ability to be effective client advocates and professional partners with other disciplines in health-care delivery, community service orientation, leadership ability and continual professional development Standards related to programme development/ revision 1. Governance Nursing or midwifery schools define and make public their mission,vision and objectives. Nursing or midwifery schools educate their students through the programme to meet the health-care needs of their societies. Nursing or midwifery schools clearly define the educational and clinical outcomes of the programme. Nursing or midwifery schools employ nursing or midwifery faculty with relevant expertise in the subject matter and the ability to develop and revise their programmes. Nursing or midwifery schools have in place and use a system of formative and summative assessment of the programmes educational and clinical objectives and outcomes. Nursing or midwifery schools define role descriptions for theoretical and clinical educators including, but not limited to, faculty, clinical supervisors, mentors, preceptors and teachers. 2. Accreditation Nursing or midwifery schools are an integral part of a higher education institution that meets internal standards, recognized accreditation and/ or governing body requirements.

Nursing or midwifery schools have criteria in place that meet accreditation standards for clinical practice components of their programmes, academic content and the demonstration of professional outcomes.

Nursing or midwifery schools and their programmes are recognized or accredited by credible, relevant professional and academic bodies and re-accredited as required.

3. Infrastructure Nursing or midwifery schools have accessible, current and relevant physical facilities including, but not limited to, classrooms, clinical practice sites, information and communications technology, clinical simulation laboratories and libraries. Nursing or midwifery schools have a system and policy in place that ensures the safety and welfare of students and faculty. Nursing or midwifery schools have professional support personnel and human resources to meet programme and student demand. Nursing or midwifery schools have a budget allocation and budget control that meets programme, faculty and student needs. Nursing or midwifery schools have a system in place for student-support services.

3. Partnership Nursing or midwifery schools demonstrate successful partnerships with the academic institution where their programme is located, with other disciplines, with clinical practice sites, with clinical and professional organizations and with international partners. Carriculam design 1. Carriculam design Nursing or midwifery schools design curricula and deliver programmes that take into account workforce planning flows and national and international health-care policies.

Nursing or midwifery schools plan and design curricula to meet national and international education criteria, and professional and regulatory requirements for practice.

Nursing or midwifery schools provide classroom and clinical learning that delivers the knowledge and skills required to meet the needs of their respective populations.

Nursing or midwifery schools establish and demonstrate balance between the theory and practice components of the curriculum.

Nursing or midwifery schools demonstrate use of recognized approaches to teaching and learning in their programmes, including, but not limited to, adult education, selfdirected learning, e-learning and clinical simulation.

Nursing or midwifery schools provide classroom and clinical learning based on established competencies and grounded in the most current,reliable evidence.

Nursing or midwifery schools enable the development of clinical reasoning, problem solving and critical thinking in their programmes.

Nursing or midwifery schools conduct regular evaluations of curricula and clinical learning, and include student, client, stakeholder and partne feedback.

Nursing or midwifery programmes offer opportunities for multidisciplinary content and learning experiences.

2. Core curriculum Nursing or midwifery curricula provide core content that will enable their graduates to meet the established competencies. Nursing programmes provide core content in nursing theory, practice, interventions and scope of practice.

Midwifery programmes provide core content in midwifery theory, practice, interventions and scope of practice for strengthening health systems through the primary health-care approach.

Nursing or midwifery programmes provide supervised clinical learning experience that support nursing or midwifery theory in diverse settings

3. Curriculum partnership Nursing or midwifery schools develop partnerships with other healthcare disciplines. Nursing or midwifery schools use interprofessional teamwork approaches in their classrooms and clinical learning experiences. Nursing or midwifery schools have access to, and arrangements for, the clinical learning sites required for programme delivery. 4. Assessment of students Nursing or midwifery schools assess student learning, knowledge and skill development throughout their programmes, using reliable evaluation methodologies. Nursing or midwifery schools use a variety of methods to assess the subject matter being studied including, but not limited to, student performance-based assessment and client/stakeholder feedback. Nursing or midwifery schools have student retention systems in place.

Faculty 1. Academic faculty The head of a nursing or midwifery programme is a nurse or midwife who holds a graduate degree, is educated and experienced in leadership and administration, and demonstrates knowledge as an educator.

The core academic faculty are nurses and midwives who demonstrate knowledge as educators and have a minimum of a bachelors degree preferably a graduate degree with advanced preparation and clinical competence in their specialty area.

Other health professionals who are guest lecturers in nursing or midwifery programmes hold a graduate degree and possess clinical and educational expertise in their specialty.

2. Clinical faculty Clinical faculty comprises nurses, midwives and other health professionals who hold a minimum of a university degree and possess clinical and educational expertise in their specialty area. Nurses and midwives with clinical expertise in the content area being taught are designated to supervise and teach students in that clinical practice area. Nursing or midwifery schools form partnerships to secure a variety of qualified people to be clinical supervisors and teachers. 3. Professional development faculty Nursing or midwifery schools have a policy and system in place that validates the updated clinical and educational expertise and competency of faculty. Nursing or midwifery schools have a system in place that provides faculty with opportunities for development in teaching, scholarship, practice and external professional activity. Nursing or midwifery schools have a system and policy in place and provide time and resources for competency development for staff. Nursing or midwifery schools have a policy and system in place for reward and recognition of staff in accordance with the requirements for promotion and tenure of the institution .

Programme admission 1. Admission policy and selection Nursing or midwifery schools have a transparent admission policy that specifies the process of student selection and the minimum acceptance criteria. Nursing or midwifery schools have a transparent non-discriminatory admission and selection process. Nursing or midwifery schools have a system and policy in place that takes into account different entry points of students, recognition of their prior learning, experience and progression options toward higher education goals. Nursing or midwifery schools have entry requirements that meet national criteria for higher education institutions including, but not limited to, completion of secondary education. 2. Student type and intake Nursing or midwifery schools admit students with backgrounds in basic science and mathematics who demonstrate skills in the language of instruction and in dealing with the clients. Nursing or midwifery schools admit students who have the ability to meet the requirements of the programme. Nursing or midwifery schools admit students who meet the institutions health and any other requirements, as well as any national requirements for selection. Nursing or midwifery schools seek students who demonstrate the will to serve in health and the ability to be independent learners.

ACCREDITATION Accreditation is vital for the welfare of an institution of higher education. Those institutions that fail to attain accreditation or are removed from the list of accrediting agency may be handicapped in a number of ways

Definition Selden defines accreditation as a process whereby any agency recognizes a college or school programme of study as having met certain predetermined qualifications or standards. Concepts of accreditation 1. The concept of accreditation of educational programmes in nursing is very important. Prospective nursing students should inquire about the accreditation status of any nursing programme they are considering 2. Employers of nurses are usually only interested in hiring or employing nurses who are graduates of accredited programmes. And acceptance into graduate programme in nursing is usually depend on graduation from an accredited baccalaureate programme. 3. It is an ongoing evaluation process where a nursing college is recognized after it has been evaluated and found to meet all pre determined qualifications and standards. 4. Accreditation refers to a voluntary review process of educational programmes by a professional organization. The organization is called an accrediting agency , and is invited to compare the educational quality of the programme with established standards and criteria.

5. Accrediting is carried on mainly by voluntary organizations. Although these organizations are advisory in nature and do not have legal powers to control institutions of higher education, they do exert influence. 6. Accreditations had extensive influence on the development of higher education. They have also been the focus of controversy. Purpose of accreditation Maintenance of adequate admission requirements Maintenance of minimum academic standards Stimulation of institutional self improvement. Protection of institutions of higher education against educationally and socially harmful pressures. Types of accreditation agencies 1. Regional accreditation agencies: These are concerned with appraising the total activities of institutions of higher learning and with guarding the quality of liberal education. 2. National professional accreditation agencies: Professional accrediting is supported by state licensing laws. Individuals who hold a common body of knowledge and who have a desire to attain high vocational status tend to form professional organizations. 3. State accrediting agencies: Accreditation may be a function of state agencies, department and state universities. These agencies may be voluntary, extra-legal( or legal).

Accreditation agencies National accrediting agencies are concerned with appraising the total activities of institutions of higher learning, and with safe guarding the quality of liberal education , which is the foundation of professional programmes in colleges and universities. Each agency establishes criteria for the evaluation of institutions in its region and it reviews those institutions periodically, and publishes fro time to time a list of those agencies which it has accredited. India has the following national educational councils: 1. Central advisory board of education. 2. All India council for elementary education. 3. All India council for secondary education. 4. University grant commission. 5. All India council for technical education. 6. National Assessment and Accreditation council. National Professional Accrediting Agencies Professional accreditation is supported by state licensing laws. Individual who poses a common body of knowledge and have a desire to attain high vocational status tent to form professional organizations. These professional groups aims to foster research to improve service to the public and increase the number of individuals admitted to the profession. Controlling admission is vital to a professional group particularly in the early stages when the profession is struggling for status. Professional laws tent to restrict admission through the state licensing laws and through the accreditation of the colleges and universities which offer relevant programmes.

In India particularly in the field of health, the following national professional accrediting agencies exist: 1. Medical Council of India. 2. Indian Nursing Council. 3. Dental Council of India 4. Pharmacy Council of India 5. Central Council of Indian System of Medicine. Accreditation of Nursing Institutions Indian Nursing Council is the accrediting agency for all the nursing programmes, which includes Diploma(GNM), B.Sc nursing, Post basic nursing, M.Sc nursing, M.Phil and Ph.D. Accreditation by inspection 1. First inspection: First inspection is conducted on receipt of the proposal received from the institute to start any nursing programme prescribed by INC. the proposal should have the following requisite document Application form

The requisite annexure for school of nursing. Permission letter by start government/ essentiality certificate of the respective state government, duely attested by nottery. Duty attested registration certificate of society or trust deed. A bank draft for Rs. 25000 towards first inspection fee for school of nursing in favour of secretory INC , New Delhi Proposal for starting of nursing which includes in detail of teaching staff, clinical and physical fecility including budget.

The requisite annexure for college of nursing Permission letter by state government / essentiality certificate of the respective state government. Consent letter from university. Duely attested registration certificate of society or trust deed. A bank draft for Rs. 50000 towards first inspection fee for school of nursing in favour of secretory INC , New Delhi Proposal for starting of nursing which includes in detail of teaching faculty, clinical and physical facility including budget.

2. Periodic inspection: INC conduct periodic(after 3 years) inspection of the institution once the institution is found suitable. INC monitors the standards of nursing education and its adherence to the norms prescribed by it. Institutions are required to pay annual affiliation fees every year. However if the institution does not comply with the norms prescribed by INC for teaching, clinical and physical facilities, the institution will be declared un suitable. 3. Reinspection: reinspections are conducted for those institutions which are found un suitable by INC. the institutions and Government are informed about the deficiencies and advised to improve upon them. Once the institutions takes necessary steps to rectify the deficiencies and reinspection fees. On receipt of the compliance report and the fees from the institution it will be considered for reinspection. 4. Enhancement inspection: INC conducts inspection of the institution once the institution is found suitable by INC and on receipt of the fees and proposal for enhancement of seats.

Guide lines for establishment of new school/ colleges in India approved by INC Any organization under the central government, state government, local body or a private or public trust , mission, voluntary registered under society registration act wishes to open a nursing institution should obtain the no objection/ essentiality certificate from the state government. The INC on receipt of the proposal from the institution to start nursing programme will undertake the first inspection to assess suitability with regard to physical infrastructure , clinical facility and teaching faculty inorder to give permission to start the programme. After the receipt of permission to start the nursing programme from INC the institution shall obtain approval from the state nursing council and examination board or university. Institution will admit the student only after taking approval of state nursing council and examination board or university. The INC will conduct inspection every year till the first batch completes. The programme permission will be given year by year till the first batch completes. CONCLUSION The need for standards has arisen for several reasons the increasing complexities in health-care provision, the increasing number of health professionals at different levels, and the need to assure more equitable access to health care. The great variation in the levels of education for professional nurses and midwives around the world can no longer be neglected.

BIBLIOGRAPHY 1. Clement I. Mangement of Nursing Service and Education.1st publications; India: 2011. P 448-50 2. Raj D E B, Anbu T, Venkatesan B, Loganathan G. Management of nursing services and education. Ist ed. EMMES publication; Bangalore: 2010. P 377-9, 362-3, P 420 3. Basavanthappa B T. Nursing Administration. 1st ed. Jaypee publications; India: 2002. P 439-44 4. Minimum standard requirements. Available from: ed. Elsevier

http://www.indiannursingcouncil.org/fee-structure-nursing-programs.asp 5. Global standards for initial education for nursing and midwifery. Available from. www.who.int/hrh/...midwifery/hrh_global_standards_education.pdf