NURSING REGULATORY MECHANISMS

JORRY POULOSE

2ND YEAR MSc NURSING

JIPMER, PONDICHERRY

REGULATION

Regulation refers to the processes used to designate

that an individual, programme, institution or product

have met established standards set by an agent

(governmental or non-governmental) recognised as

qualified to carry out this task.- Styles & Affara, 1997,

GOALS OF REGULATION

Define the profession and its members

Determine the scope of practice

Set standards of education

Set standards of ethical and competent practice

Establish systems of accountability

Establish credentialing processes

REGULATORY BODY

Public authority or Government agency

DEFINITION

“Regulatory body is the formal organization

designated by a statute or an authorized

governmental agency to implement the regulatory

forms and process whereby order, consistency and

control are brought to the profession and its practice.”

- ICN,1997

IMPORTANCE OF REGULATORY BODIES

To provide quality health care service to the public.

To support and assist professional members.

Set and enforce standards of nursing practice.

Monitor and enforce standards for nursing education.

Set the requirements for registration of nursing

professionals.

To exercise legal control over institution within their

respective area.

NURSING REGULATORY

MECHANISMS

Main functions

To protect patient or society

To define the scope of nursing practice

To identify the minimum level of nursing care that must

be provided to clients

The regulatory bodies that define the laws

and regulations in nursing practice by the

nursing councils at the international, national

and state levels

International council of nurses

Indian nursing council

State nursing council

ACCREDITATION

“Accreditation is the process whereby an organization

or agency recognizes a college of university of

programme of study as having met certain

predetermined qualifications of standards”

- Selden, 1962

A process of review and approval by which

an institution, programme or specific

service is granted a time-limited

recognition of having met certain

established standards beyond those that are

minimally acceptable.

-ICN

Organization or agency recognizes a college or

university or a program of study as having met certain

predetermined qualifications and standard

voluntary review process of educational programs by a

professional organization

PURPOSES OF ACCREDITATION

For the maintenance of adequate administration

requirement.

Maintaining a uniform standard for nursing education

and nursing service.

Stimulation of institutional self-improvement by

evaluation and inspection.

It safeguards the institution from social education and

political pressures.

It helps in the registration of nurses.

It prescribes the syllabus.

It grants recognition to school and colleges.

It guides the school/college of nursing, according to

recommendation and criteria.

It also services to prepare the competent to serve the

public.

FUNCTIONS OF ACCREDITATION

It aims to protect the autonomy of various health

service programmes.

It preserves the quality of nursing education.

It protects the public from ill prepared nurses.

It protects the institutions unsound and unsafe political

pressure.

It helps the practitioner for the broad scope of nursing

practice.

TYPES OF ACCREDITATION

AGENCIES

i. National accrediting agency

ii. National professional accrediting agency

iii. State accrediting bodies

NATIONAL AGENCIES

Concerned with appraising the total activities of the

institutions of higher learning, and with safe guarding

the quality of liberal education, the foundation of

professional programs in colleges and universities.

Each agency establishes criteria for the evaluation of

institutions in its region it reviews those institutions

periodically, and it publishes from time to time a list of

those agencies which it has accredited.

Central advisory board of education

All India council for Elementary education

All India council for secondary education

University grants commission

All India council for technical education

National assessment and Accreditation council

NATIONAL PROFESSIONAL ACCREDITING

AGENCY

Aim to foster research, to improve service to the

public and the number of individuals admitted to the

profession.

Medical Council of India

Indian Nursing Council

Dental council of India

Pharmacy council of India

Central council of Indian system of Medicine

Indian nursing council, (INC) is the official accrediting

agency for all programs of nursing, which include

Diploma (GNM), Bsc Nursing (both basic and post

basic), Msc N /M.phil (Masters) and PhD (Doctoral

programs in Nursing)

INDIAN NURSING COUNCIL

AIMS

To establish uniform standard of training

throughout the state

Prohibit training centre, which are inadequate

Prohibit practice of nursing by non –qualified

nurses.

FUNCTIONS AND ROLE OF INC

Prescribing Syllabus

Inspection

NATURE OF INSPECTION BY INC

First Inspections

Re Inspection

Periodic Inspections

STATE ACCREDITING BODIES

A state nursing councils, which is called reciprocity,

was possible only if uniform standards of nursing

education were maintained.

Providing the registration to the nurses

Maintains a register of names of professional nurses

All degree holding nurses also have to get the

registration in state council.

LICENSURE/REGISTRATION

Licensure is defined as the “process by which an

agency of state government grant permission to an

individual to engage in a given profession upon

finding that the applicant has attained the

essential degree of competency necessary to

perform a unique scope of practice”(NCSBN,2004).

A document issued by a body charged with the

exclusive right to determine eligibility for practice in a

specified profession, or field in the profession. It is

generally used within a regulatory system that prohibits

practice without a license.

-ICN

PURPOSE:-

Licensure offers protection to the public

It ensure minimum competency among

professional.

It ensures minimum standard among the

professionals.

It help to prevent malpractice.

It helps to regulate the professional conduct.

Licensing permits a person to offer special skills and

knowledge to the public in a particular jurisdiction

when such practice would otherwise be unlawful. A

particular jurisdiction or area is covered by the

license.

In India all nurses are required to be licensed to

work in any part of the country, for that they have

to be registered in any of the state nursing

council. All over India each state running their

own nursing council.

Registration councils are functioning in all states

of India and they are affiliated to INC.

NURSING LICENSURE

The process, sanctioned by the law, of granting

exclusive power or privilege to persons meeting

established standards, which allows them to

engage in a given occupation or profession, and to

use a specific title.-ICN

CURRENT LICENSURE

ACTIVITIES

Nurses are required to apply for licensure in

each state in which they practice

Nurses will be responsible for following the laws

and regulations of those states

COMPONENTS OF NURSING

PRACTICE ACTS

Two essential components

1. To protecting the health and safety of the public

2. Protection of the title of RN

Nursing practice act describes the requirements

for licensure

Registered nurse, is reserved for those meeting

the requirements to practice nursing in the state.

PROCESS OF REGISTRATION

It is the process by which individuals are assessed

and given status on a registry attesting to

individual’s ability and current competency. Its

purpose is to keep a continuous record of the past

and current achievements of an individual.

TNMC REGISTRATION

Process of Providing Authority to use an

Exclusive Title to those persons to enter in the

"State Register" Maintained under the Law of the

State.

TAMILNADU CANDIDATES (PRIMARY)

Register the Qualification in the concern State.

Primary Registration means the candidates who

obtain Recognized Qualification within Tamil

Nadu and Registering the same Qualification in

Tamil Nadu Nurses and Midwives Council as per

the Act.

1) Candidates may apply in person or by Postal

with the required documents to this Council for

Registration

2) Bulk Registration may be done through the

Head of the Institution for all the Candidates

TAMILNADU CANDIDATE’S (PRIMARY)

ADDITIONAL QUALIFICATION

Registration of Additional Qualification done by

this Council for the Candidates who has

Obtained Nursing Qualification after Registering

their Basic Qualification in Tamilnadu Nursing

Council.

OTHER STATE CANDIDATES (SECONDARY)

Register the Qualification in the concern State

where you have trained. Subsequently Registering

the same Qualification once again in Other State

within India where you would like to practice

nursing/do higher education is Secondary

Registration.

After surrendering your parental Registration

Certificate at your Council and should obtain a

NOC from the Parental Council to Registration

in Tamilnadu to practise the profession within

Tamilndau.

GENERAL INSTRUCTIONS

(1) For Bulk Registration, along with the above

procedure, Candidate's Colour Photo (Passport

Size) to be submitted & write the Candidate Name

behind the photo. One photo to be fixed in the

Application form and Do Not Staple. And also CD

to be submitted with Scaned Photo and it has been

Saved in file name as Candidate Name (Photo file

size 20 to 40 kb in .JPG format only).

(2) Other State Trained Candidates should

surrender their Concerned State Nursing

Council´s Registered Nurse & Midwife Certificates

to the parent Council where ever they have

Registered.

(3) Two Xerox copies of parent Council's RN and

RM Certificates should be enclosed.

(4) Other State Candidates after surrendering their

parent Council's RN, RM certificates they should

obtain NOC from the parent Council to Register in

TNNMC.

(5) For Dispatching the Bulk Registration

Certificate, Self addressed Envelope along with

Necessary Stamp to be sent.

REQUIREMENT FOR REGISTRATION BASIC

B.SC., NURSING

REGISTRATION PARTICULARS OF B.SC(N) - ORIGINAL CERTIFICATE

1 Filled Application form (Application can be downloaded from Council Website

“www.tamilnadunursingcouncil.com”)

2 Xerox copy of 12th Mark sheet (1 No.) or its Equivalent

3 Xerox copy of Transfer of Certificate (1 No.)

4 B.Sc(N) Provisional / Original Certificate

5 Xerox copy B.Sc(N) Provisional / Original Certificate (1 No.)

6 Original Certificate of Course Completion Certificate

7 Xerox copy of Course Completion Certificate (1 No.)

8 Final year Mark Sheet - Original (1 no.) Xerox Copy

9 Rs.2000/- Demand Draft Drawn in favour of “The Registrar, Tamilnadu Nurses and Midwives

Council, Chennai” payable at Chennai Branch and also.

10 CD to be Submitted with Scanned Photo to be Saved the file name as Candidate name (Photo

file size 20 to 40 kb in jpg format only).

REQUIREMENT FOR REGISTRATION M.SC.,

NURSING

REGISTRATION PARTICULARS OF M.SC(N) - ORIGINAL CERTIFICATE

1 Filled Application form (Application can be downloaded from Council Website

“www.tamilnadunursingcouncil.com”)

2 Xerox copy of 12th Mark Sheet (1 No.) or its Equivalent

3 Xerox copy of Transfer of Certificate (1 No.)

4 M.Sc(N) Provisional / Original Certificate

5 Xerox copy M.Sc(N) Provisional / Original Certificate (1 No.)

6 Original Certificate of Course Completion Certificate

7 Xerox Copy of Course Completion Certificate (1 No.)

8 Final year Mark Sheet - Original (1 no.) Xerox Copy

9 Xerox Copy of Registered Nurse & Midwife of this Council (Each 1 No.)

10 Rs.1000/- Demand Draft Drawn in favour of “The Registrar, Tamilnadu Nurses and

Midwives Council, Chennai” Payable at Chennai Branch and also.

11 CD to be Submitted with Scanned Photo to be saved the file name as Candidate

Name (Photo file size 20 to 40 kb in jpg format only).

RENEWAL OF LICENSURE

The process for periodic reissuing of the legal

authority to practice.

Renewal system in a proper way it will help to

improve the professional competencies in nursing.

In TNMC instructed that all the nurses renew

their registration every 5 years for that they need

a specific(150) credit hours.

JOURNAL REVIEW

The attitude of health care professionals towards

accreditation: A systematic review of the

literature

Done by:- Abdullah Alkhenizan and Charles Shaw1

Retrieved from Journal of Family Community

Med. 2012 May-Aug; 19(2): 74–80.

Aim:- To systematically review the literature of the

attitude of health care professionals towards

professional accreditation.

Study design:- This was a systematic

qualitative review of the literature of the

attitude of health care professionals towards

accreditation. A comprehensive updated

search of four electronic bibliographic

databases including Medline from 1996-

January 2011, Cinhal, from 1982-January

2011, Embase from 1980-January 2011, and

Health Star from 1980-January 2011 was

done. Here included the physicians, nurses

and allied health personnel.

ATTITUDE OF PHYSICIANS

In a qualitative Australian study (n = 72)

doctors were generally unaware of accreditation and

skeptical of it. Their concern was on how quality of

care was to be measured. Doctors felt accountable

within a professional framework, to themselves, the

patient and family, their peers and to their

profession; but not to accreditation bodies.In a cross-

sectional questionnaire of consultant radiologists,

87% of radiologists favored accreditation for virtual

colonoscopy.

ATTITUDE OF NURSES

In the large randomized controlled trial,

the (QAP) nurses’ overall perceptions of care

(n = 1048), at the accredited hospitals

increased significantly (59% to 61%),

compared to the control hospitals (declined

from 61% to 57.In a large rigorous survey

conducted in Lebanon (n = 1048), nurses

perceived a significant improvement of

results in quality in hospitals as an outcome

of accreditation.

CONCLUSION

Several studies have shown that health care

professionals were skeptical about accreditation

because of concerns about its impact on the

quality of health care services. Concerns raised

about the cost of accreditation programs by

health care professionals especially in developing

countries were consistent. Healthcare

professionals (especially physicians) have to be

educated on the potential benefits of

accreditation. It is also necessary to conduct a

rigorous, independent evaluation of the cost-

benefit analysis of accreditation of health

services.

THEORY APPLICATION