Indian Nursing Council (Post Basic Diploma in Oncology Specialty Nursing - Residency Program), Regulations, 2020
Published vide Notification No. F. No. 11-1/2019-INC, dated 22.02.2021.
Last Updated 25th February, 2021 [act3823]
[22.02.2021] F. No. 11-1/2019-INC. - 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 Indian Nursing Council (Post Basic Diploma in Oncology Specialty Nursing - Residency Program), Regulations, 2020.
ii. These Regulations 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 Indian Nursing 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 Oncology Specialty Nursing - Residency Program 2020
I. Introduction
Cancer is a major health problem worldwide and significant cause of mortality and morbidity in all age groups. Cancer prevention and treatment is one of the national health priorities. Developments in scientific knowledge and advances in technology coupled with increased patient knowledge about their disease and its treatment have led to an increase in public's expectation in relation to cancer care. Oncology nursing practice is characterized by dynamic and highly complex care and it encompasses preventive, promotive, curative, and palliative care for the patients. The severe and recurrent nature of cancer, coupled with the devastating effects of the diagnosis of cancer on patients and their families and the intensive treatment with chemotherapy, radiotherapy and/or immune suppressive medications leads to complex situations necessitating timely interventions. 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 specialty nursing programs making it as a one-year post basic diploma residency programs utilizing competency-based training approach. The existing one-year Post Basic Diploma in Oncology Nursing of the Council is being reframed as a residency program using revised guidelines that aim to prepare specialist nurses who can provide competent care to cancer patients, whose diagnostic, treatment and care needs are complex and intensive.II. Philosophy
The Council believes that registered nurses who are only generalists need to be further trained as specialist nurses to function in various emerging speciality areas of practice and the training should be competency based. One such area that demands specialist nurses is Oncology Nursing. Expanding roles of nurses and advances in Oncology and technology necessitates additional training to prepare nurses with specialized skills, knowledge and attitude to deliver competent, intelligent and appropriate care to patients with cancer.III. Curricular Framework
The Post Basic Diploma in Oncology 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 Oncology Nursing practice such as Professionalism, Communication & patient education, 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 Oncology Specialty Nursing-I and Oncology Specialty Nursing-II. Oncology Specialty Nursing-I includes Context/Introduction to Oncology Nursing, and Basic Sciences applied to Oncology Nursing (application of basic science knowledge in the diagnosis, treatment and care of clinical conditions under Oncology Specialty Nursing). Specialty Nursing-II includes nursing management of patients with cancer comprising assessment, diagnosis, treatment and specialized interventions and patient safety & quality including illness specific considerations. The curricular framework is illustrated in the following figure-1.
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 with Cancer. It further aims to prepare technically qualified and trained specialist nurses who will function effectively and optimally at Cancer/Oncology Units/Centres of Tertiary/Quaternary Hospitals providing high standards of care.Competencies
On completion of the program, the oncology specialist nurse will be able to:
1. Demonstrate professional accountability for the delivery of nursing care as per the Council standards that is consistent with moral, altruistic, legal, ethical, regulatory and humanistic principles in oncology 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 care and enhance their coping abilities through crisis and bereavement.
4. Demonstrate understanding of clinical leadership and resource management strategies and use them in oncology/cancer care and settings promoting collaborative and effective teamwork.
5. Identify, evaluate and use the best current evidence in cancer care and treatment coupled with clinical expertise and consideration of patient's preferences, experience and values to make practical decisions in oncology nursing practice.
6. Participate in research studies that contribute to evidence-based oncology nursing care interventions with basic understanding of research process.
7. Apply basic sciences in the assessment, diagnosis and treatment of the physiological, physical, psychological, social and spiritual problems of patients and their families with cancer.
8. Apply nursing process in caring for patients with cancer.
9. Describe the principles of radiotherapy, chemotherapy, hormone therapy, immunotherapy, surgery, targeted therapy and tumor vaccines in treatment of cancer patients.
10. Demonstrate specialized practice competencies/skills relevant in providing care to patients under different treatment regimes.
11. Demonstrate skill in managing patients undergoing hematopoietic stem cell transplantation.
12. Identify treatment related adverse effects and emergencies and manage them effectively.
13. Understand the method of drug procurement, storage, administering and maintenance of chemotherapy, targeted and immune therapy and demonstrate sound practice.
14. Understand the maintenance of special equipment such as thawing machine, platelet agitator, biosafety cabinet, aphaeresis machine, sonicator, stem cell storage refrigerator and blood refrigerator.
15. Demonstrate safe delivery of various therapies to patients and protect them from harm.
16. Provide occupational safety to health team members caring for cancer patients receiving various cancer therapies against health hazards.
17. Conduct clinical audit and participate in quality assurance activities in oncology and stem cell units/centres.
18. Provide palliative care to patients with emphasis to end of life care promoting comfort and dignity respecting individual cultural and spiritual needs and differences.
V. Program Description & Scope of Practice
The Post Basic Diploma in Oncology Specialty Nursing program is a one-year residency program with main focus on competency-based training. Theory includes foundational courses and specialty courses besides practicum. The theory component comprises 10% and practicum 90% (Clinical and Lab). On completion of the program and certification, and registration as additional qualification with respective SNRC, the oncology specialist nurses should be employed only in the oncology/cancer specialty centre/ hospital/department/unit as oncology specialist nurses. They will be able to practice as per the competencies trained during the program particularly the specialized procedural competencies/clinical skills as per the Log Book of the Council syllabus. The specialist nurses can be privileged to practice those specialized procedural competencies by the respective institution as per 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 Oncology Specialty Nursing - Residency Program
1. The program may be offered at
• College of Nursing offering degree programs in nursing attached to parent speciality hospital/tertiary hospital having minimum of 200 beds with advanced diagnostic, therapeutic and state of the art oncology (including BMT/stem cell transplant) units with chemotherapy, radiotherapy, palliative care, supportive care and specialized nursing care facilities.
OR• Hospitals offering DNB/Fellowship programs in oncology having minimum of 200 beds with advanced diagnostic, therapeutic and state of the art oncology (including BMT/stem cell transplant) units with chemotherapy, radiotherapy, palliative care, supportive care and specialized nursing care facilities.
• The above eligible institution shall get recognition from the concerned SNRC for Post Basic Diploma in Oncology Specialty Nursing for the particular academic year, which is a mandatory requirement.
• 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 provision of the Act.
2. Nursing Teaching Faculty
a. Full time teaching faculty in the ratio of 1:10.
b. Minimum number of faculty should be two.
c. Qualification:
i. M.Sc. Nursing with Medical Surgical Nursing/Oncology Specialty Nursing - 1 (Oncology Specialty Nursing preferred)
ii. Post Basic Diploma in Oncology Speciality Nursing with Basic B.Sc. (Nursing)/P.B.B.Sc. (Nursing) - 1
d. Experience: Minimum three years of experience in Oncology Specialty Nursing.
e. Guest Faculty: Multi-disciplinary in related specialities.
f. Preceptors:
• Nursing Preceptor: Full time qualified GNM with 6 years of experience in Oncology Specialty Nursing or B.Sc. (Nursing) with 2 years' experience in Oncology Specialty Nursing or M.Sc. (Nursing) with one-year Oncology Specialty Nursing experience working in the Oncology specialty care unit.
• Medical Preceptor: Specialist (Oncology 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)
3. Budget
There should be 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.4. 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 Oncology 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 Oncology 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 Karamchari.
ii. Facilities for office, equipment and supplies such as
• Stationery,
• Computer with printer,
• Xerox machine,
• Telephone and Fax.
5. Clinical Facilities
a. Parent speciality hospital/tertiary hospital having minimum of 200 beds with advanced diagnostic, therapeutic and state of the art oncology (including BMT/stem cell transplant) units with chemotherapy, radiotherapy, palliative care, supportive care and specialized nursing care facilities.
b. Regional Oncology Centres/Hospitals having minimum of 200 beds with advanced diagnostic, therapeutic and state of the art oncology (including BMT/stem cell transplant) units with chemotherapy, radiotherapy, palliative care, supportive care and specialized nursing care facilities.
c. Hospital must have a minimum of 30 specialty beds with advanced diagnostic, treatment and care facilities.
d. Nurse staffing of units as per the Council norms.
e. Student patient ratio: 1 : 3
6. Admission Terms and Conditions/Entry Requirements
The student seeking admission to this program should:
a. Be a registered nurse (RN&RM) or equivalent with any SNRC having NUID number.
b. Possess a minimum of one year clinical experience as a staff nurse preferably in the oncology unit prior to enrolment.
c. Be physically fit.
d. Selection must be based on the merit obtained in entrance examination and interview held by the competent authority.
e. Nurses from other countries must obtain an equivalence certificate from the Council before admission.
7. Number of Seats
For hospital having 200 beds and 30 specialty beds, number of seats = 10,
For hospital having 500 beds or more and with 60 specialty beds, the number of seats = 20.
8. Number of candidates
1 candidate for 3 specialty beds
9. Salary
a. In-service candidates will get regular salary.
b. Stipend/Salary for the other candidates will be given as per the salary structure of the hospital where the program is conducted.
Vii. Examination Regulations And Certification Examination Regulations
Examining and Diploma Awarding Authority. - Respective Examination Board/SNRC/University approved by the Council.1. Eligibility for Appearing in the Examination
a. Attendance: Theory & Practical - 80%. However, 100% Clinical attendance have to be completed prior to certification.
b. Candidate who successfully completes the necessary requirements such as Log Book and clinical requirements is eligible and can appear for final examination.
2. Practical Examination
a. OSCE: Objective Structured Clinical Examination (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 and experience stated as above) and one medical internal examiner who should be preceptor for 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.
4. Certification
a. TITLE: Post Basic Diploma in Oncology 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 Oncology Specialty Nursing - Residency Program.
ii. Candidate has completed 80% theory and 100% clinical requirements.
iii. Candidate has passed the prescribed examination.
VIII. Scheme of Examination
|
Courses |
Int. Ass. Marks |
Ext. Ass. Marks |
Total Marks |
Exam Hours (External) |
|
Theory (Experiential/Residential Learning) |
25 (10+15) |
75 (35+40) |
100 |
3 |
|
Oncology Specialty Nursing (Part I and Part II) 3 (Part I – Oncology Specialty Nursing I including Foundations, Part II – Oncology Specialty Nursing II) |
||||
|
Practicum (Oncology Specialty Nursing) |
75 (25+50) (OSCE – 25 & Observed Practical – 50) |
150 (50+100) (OSCE – 50 & Observed Practical – 100) |
225 |
Minimum 5- 6 hours in the clinical area |
|
• OSCE including Viva • Observed Practical/Clinical (Direct observation of actual performance at real settings) including viva – mini clinical evaluation exercise for 3-4 hours (Nursing process application and direct observation of procedural competencies) |
||||
|
Grand Total |
100 |
225 |
325 |
|
IX. Program Organization/structure
1. Courses of Instruction
2. Implementation of Curriculum
3. Clinical Practice (Residency Postings)
4. Teaching Methods
5. Methods of Assessment
6. Clinical Log Book and Procedures Book
1. Courses of Instruction - Delivered through mastery of learning (Skill Lab Practice) and experiential learning (including Clinical Practice) approaches|
Unit |
Courses |
Theory (Hrs) |
Lab/Skill Lab (Hrs) |
Clinical (Hrs) |
|
I |
Foundations to Oncology Specialty Nursing Practice |
40 |
|
|
|
|
1. Professionalism |
|
|
|
|
|
2. Communication, patient education and counselling in specialty nursing |
|
|
|
|
|
3. Clinical leadership and resource management in the specialty care setting |
|
|
|
|
|
4. Evidence based and applied research in specialty nursing |
|
|
|
|
|
Oncology Specialty Nursing Courses |
|
|
|
|
II |
Oncology Specialty Nursing I |
40 |
10 |
|
|
|
1. Context/Introduction to specialty nursing |
|
|
|
|
|
2. Basic sciences applied to specialty care – diagnosis and treatment of clinical conditions (Anatomy & Physiology, Microbiology, Pharmacology & Pathophysiology) |
|
|
|
|
|
Oncology Specialty Nursing II |
|
|
|
|
|
3. Nursing management of clinical conditions including assessment, diagnosis, treatment and specialized interventions |
120 |
30 |
|
|
|
4. Patient safety and quality |
|
|
1730 |
|
|
5. Specialty/Illness specific considerations (Supportive care/palliative care/rehabilitation, Impact of illness on individual, family and community) |
|
|
|
|
|
Total = 1970 hours |
200 (5 wks) |
40 (1 wk) |
1730 (38 wks) |
|
S.No. |
Clinical Area |
Weeks |
Remarks |
|
1 |
Oncology OPD & Pain Clinic |
4 |
Own Oncology Specialty Hospital/ Cancer Centres |
|
2 |
Medical Oncology Ward/ICU |
8 |
|
|
3 |
Chemotherapy Unit |
4 |
|
|
4 |
Radiotherapy Unit |
4 |
|
|
5 |
Operation Theatre |
2 |
|
|
6 |
Surgical Oncology Ward/ICU |
8 |
|
|
7 |
Pediatric Oncology Ward/ICU |
2 |
|
|
8 |
BMT/Stem cell transplant unit |
4 |
|
|
9 |
Community Oncology |
2 |
|
|
10 |
Palliative Care Ward |
2 |
|
|
11 |
•Hospice/Palliative Care Centres • Visit to National/Regional Palliative Care Centre |
1 1 |
Own/attachment |
|
|
Total |
42 |
|
4. Teaching Methods
Theoretical, Skill Lab and Clinical teaching can be done in the following methods and integrated during clinical posting:-• Case/Clinical presentation and case study report
• Drug study and presentation
• Bedside clinic/Nursing rounds/Interdisciplinary rounds
• Journal clubs/Clinical seminar
• Faculty lecture and Discussion in the clinical area
• Demonstration and 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 National/Regional Oncology/Palliative/BMT/Stem Cell Transplant Centres.
5. Method of Assessment
• Written test (Case or scenario based)
• Practical examination - OSCE and Observed Practical (Direct observation of actual clinical performance at real settings)
• Written assignments
• Project
• Case studies/care plans/clinical presentation/drug study
• Clinical performance evaluation
• Completion of clinical procedural competencies and clinical requirements.
For assessment guidelines refer Appendix-26. Clinical Log Book/Procedures Book
At the end of each clinical posting, Clinical Log Book (Specific Procedural Competencies/Clinical Nursing 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
Foundations To Oncology Specialty Nursing Practice: Professionalism, Communication, Patient Education & Counseling, Clinical Leadership & Resource Management And Evidence Based And Applied Research In Oncology Specialty Nursing Practice Total Theory: 40 Hours 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 oncology nursing practice.Course Content
|
Unit |
Time (Hrs) |
Learning Outcomes |
Content |
Teaching/ Learning Activities |
Assignments/ Assessment Methods |
|
I |
6 |
Demonstrate understanding of professionalism and exhibit professionalism in the practice of oncology nursing
Describe medico-legal aspects of oncology nursing |
Professionalism • Meaning and elements – Accountability, knowledgeable, visibility and ethical in oncology specialty nursing practice • Professional values and professional behaviour • INC Code of ethics, code of professional conduct and practice standards • Ethical issues related to oncology nursing • Expanding role of specialist nurses • Professional organizations • Continuing nursing education
Medico-Legal Issues • Legislations and regulations related to oncology and oncology nursing practice • Consumer protection act • Negligence and malpractice • Medico-legal aspects • Records and reports • Legal responsibilities of oncology specialist nurses |
• Discussion
• Lecture |
• Write about code of ethics related to oncology nursing
• Maintain record of patients |
|
II |
12 |
Communicate effectively with cancer patients, families and professional colleagues fostering mutual respect and shared decision making to enhance health outcomes.
Educate and counsel patients and families to participate effectively in treatment and care |
Communication • Channels and Techniques of communication • Supportive communication principles and skills to provide information, psychological support and emotional support • Breaking bad news to cancer patients • Culturally sensitive communication • Behaviour change communication • Development of nursing care plans and records • Information technology tools in support of communication • Team communication Patient and Family Education • Principles of teaching and learning • Principles of health education • Assessment of informational needs and patient education • Health promotion and health education – cancer awareness and risk reduction • Developing patient education materials Counselling • Counselling techniques • Patient and family counselling during breaking bad news, intensive treatment, crisis intervention and end of life stage |
• Module: Communication
• Lecture
• Breaking bad news – Role play
• Peer teaching
• Counselling sessions
|
• Digital records
• Conduct a group health education program for the patients with cancer
• Prepare patient education materials on relevant topic
|
|
III |
12 |
Demonstrate understanding of clinical leadership and management strategies and use them in oncology care and settings promoting collaborative and effective teamwork.
Prepare the unit for chemotherapy
Conduct clinical audit and participate in quality assurance activities in oncology units/ centre
|
Clinical Leadership and Resource Management • Leadership and Management • Elements of management of oncology nursing care – planning, organizing, staffing, reporting, recording and budgeting • Clinical leadership and its challenges • Delegation • Managing human resources in oncology units • Material management • Designing of an ideal oncology ward/ unit, day care and stem cell transplant unit • Emotional intelligence and selfmanagement skills • Working as interdisciplinary team member • Participation in making policies relevant to care of patients with cancer • Preparation of unit for patients with cancers – chemotherapy unit and BMT/HSCT unit Quality Assurance Program in Oncology Unit and Stem Cell Transplant Unit
• Nursing audit • Nursing standards • Quality assurance |
• Lecture
• Demo – Preparation of Chemotherapy unit
• Module: Accreditation and Practice Standards |
• Plan a duty roster for the junior nursing officers/Staff nurses working in the oncology units
•Assignment: Designing an ideal oncology ward/unit
• Develop SOPs for oncology ward |
|
IV |
10 |
Describe research process and perform basic statistical tests
Apply evidence based/best practices in professional practice |
Evidence based and Application of Research • Introduction to nursing research and research process • Data presentation, basic statistical tests and its application • Research priorities in oncology nursing • Formulation of problem/question that are relevant to oncology nursing practice • Review of literature to identify evidence based/best practices in oncology nursing practice • Implementation of evidence based interventions in daily professional practice • Ethics in research |
• Lecture
• Module: Writing of scientific paper |
• Preparation of statistical data of oncology unit for last five years
• Conduct literature review on nursing interventions relevant to oncology/ Evidence based practice project
• Group research project |
Oncology Specialty Nursing - I
Context/introduction To Oncology Nursing & Basic Sciences Applied To Oncology Nursing Practice (Applied Psychology, Sociology, Physics, Microbiology, Pathology, Anatomy, Physiology & Pharmacology)
Theory: 40 Hours and Lab: 10 Hours Course description: This course is designed to help students to develop understanding and in-depth knowledge regarding the context of cancer care provision and application of basic sciences in the diagnosis, treatment and care of patients suffering from cancer.Course Content
|
Unit |
Time (Hrs) |
Learning outcomes |
Content |
Teaching/ Learning Activities |
Assignments/ Assessment Methods |
|
I |
5 (T) |
Describe epidemiology of cancer, risk identification and reduction strategies |
Epidemiology of Cancer • Prevalence and statistics • Risk factors & multifactorial causes and identification • Risk reduction strategies • Cancer screening including genetic screening and early detection • Cancer prevention |
• Lecture and Discussion |
• Presentation of statistics – National/WHO cancer registry • Assignment – National cancer screening programs in India |
|
II |
3 (T) |
Explain principles of oncology nursing Role of oncology specialist nurses |
Roles & Responsibilities of Oncology Specialist Nurses • Principles and standards of oncology nursing practice • Role of oncology specialist nurses • Scope of oncology nursing practice • Cancer care settings and roles & responsibilities of cancer nurses in different settings • Nursing process |
• Lecture and Discussion |
|
|
III |
8(T) |
Explain psychosocial aspects in cancer nursing |
Psychosocial, Cultural and Spiritual Aspects in Cancer Nursing • Human behavior and coping with Cancer • Factors influencing psychosocial adjustment for patients suffering from cancer • Sociocultural attitudes of public to cancer • Spiritual and cultural care • Management of psychosocial problems • Guidance & Counselling |
• Lecture
•Counselling – Review steps |
|
|
IV |
8 (T) 2 (L) |
Explain medical surgical asepsis and infection control in oncology setting |
Infection Control in Oncology Unit • Immunity • Infection • Principles of asepsis, sterilization and disinfection • Standard safety measures • Biomedical waste management • Barrier Nursing and infection control practices |
• Lecture • Demonstration |
Written Assignment: Infection control practices in oncology unit |
|
V |
6 (T) 2 (L) |
Review related anatomy, physiology and pathophysiology |
Applied Anatomy, Physiology and Pathophysiology • Cell structure and physiology – normal and malignant cells • Biology of cancer – Carcinogenesis • Definitions – dysplasia, metaplasia, neoplasia, benign and malignant tumors • Genomics and genetics • Metastasis and spread of cancer • Pathophysiology of cancer (molecular biology of cancer • Blood and lymphatics: ∘ Blood – microscopic structure – RBC, WBC, Platelets ∘ Hemoglobin – Structure, synthesis and breakdown ∘ Functions of blood ∘ Bone marrow, Hematopoietic stem cell biology and hematopoiesis ∘ Blood coagulation ∘ Normal Hematological values ∘ Lymphatic system and circulation of lymph ∘ Immunity – Formation of T-cells & B-cells , types of immune response, antigens, cytokines and antibodies • Review of other systems – relevant to site specific cancers |
• Lecture
• Self-study and guided reading
• Lecture
• Self-study
• Demonstration at Laboratory – blood slides preparation and microscopic examination |
• Describe slide of normal and abnormal peripheral blood smear/bone marrow |
|
VI |
8 (T) 6 (L) |
Applied pharmacotherapy for various types of cancer |
Pharmacology and Pharmacokinetics of Cancer Medication • Chemotherapeutic agents • Hematinics – Iron therapy, vitamins, adjuvant therapies • Erythropoietin and coagulants • Immune suppressants • Analgesics, sedatives and narcotics • Antibiotics and antiseptics • Mechanism of action, side effects, drug interaction, adverse effects • Blood and blood components • Principles of drug administration & special precautions • Role of nurse and care of drugs |
• Lecture
• Demonstration of chemotherapy administration |
• Drug Study and presentation |
|
VII |
2 (T) |
Explain principles of radiation physics |
Principles of Radiation Physics • Nature of radioactivity • Radioactive elements • Radiobiology • Types and sources • Principles of radiation protection |
•Lecture |
Assignment: Radiation protective measures to be taken by nurses |
Oncology Specialty Nursing - II
Nursing Management Of Clinical Conditions Including Assessment, Diagnosis, Treatment And Specialized Interventions, Patient Safety And Quality And Specialty/illness Specific Considerations (Supportive Care/palliative Care/rehabilitation)
Theory: 120 Hours and Lab: 30 Hours Course description: This course is designed to help students to develop knowledge and competencies required for assessment, diagnosis, treatment, nursing management, and supportive/palliative care to patients with cancer.|
Unit |
Time (Hrs) |
Learning outcomes |
Content |
Teaching/ Learning Activities |
Assignments/ Assessment Methods |
|
I |
10 (T) 4 (L) |
Explain and demonstrate skill in assessment of adult and pediatric patients with cancer |
Assessment of cancer patients • Assessment of adult and pediatric patients with cancer (Comprehensive assessment – by history and physical exam – physical, psychological, social cultural and spiritual assessment) • Assessment of symptoms – (cancer related, treatment related) – pain, fatigue and nutritional status • Interpret data and make nursing diagnosis |
• Discussion and Demonstration |
• Perform comprehensive assessment of adult and pediatric patients in OPD/wards and write assessment report |
|
II |
8 (T) 2 (L) |
Describe diagnostic tests and investigations and nurses’ responsibilities |
Diagnostic Tests & Investigations • Staging and grading • Tumor markers and biomarkers • Cytology tests, biopsies, endoscopy, laparoscopy, histopathology, CT scan, MRI, Radio nuclide imaging, Ultrasound, functional and metabolic imaging, use of radioisotopes, pap smear, mammography • Nurses’ responsibilities in diagnostic tests |
• Lecture and Demonstration |
• Write about tumor staging and grading |
|
III |
12 (T) 8 (L) |
Develop skill in assisting & performing procedures and use of equipment in cancers for adult and pediatric patients |
Assisting Procedures and Use of Diagnostic and Therapeutic Equipment • Assisting in bone marrow aspiration and biopsy • Assisting in hematopoietic stem cell collection and preservation • Assisting in insertion of CVADs (PICC, Hickman Catheter, Chemo port and central lines) and care • Diagnostic and therapeutic equipment used in Apheresis, Platelet agitator, Bio-safety cabinet, Thawing machine, Stem cell, cryopreservation, Blood component refrigerator and Fumigator |
• Demonstration |
•Arrange workshop on insertion and care of CVADs |
|
IV |
12 (T) 4 (L) |
Describe cancer treatment modalities |
Cancer Treatment Modalities • Goals of treatment – cure, control or palliation • Multi professional team decision making • Local & systemic cancer treatments and active surveillance • Chemotherapy • Combined treatment modalities • HSCT • Hormone therapies • Immunotherapies • Radiotherapy • Surgery • Targeted therapy • Tumor vaccines |
• Lecture cum discussion
• Guided reading |
• Assignment on targeted therapy |
|
V |
15 (T) 4 (L) |
Describe the nursing management of patients with cancer
Discuss the role of nurses in safe administration of cancer therapies within their scope |
Nursing Management of Patients with Cancer • Explain nursing process and use the nursing process approach in the provision of nursing care to patients with cancer • Nursing interventions specific to the needs/problems and symptoms related to cancer and treatment • Specific symptom management Nurses’ Role in Safe Administration of Cancer Therapies • National policies on safety • Extravasation • Chemotherapy spillage • Personnel protective equipment • Radiation safety • Safe handling, storage, administration and disposal of cytotoxic drugs • Routes of administration • Safety at home • Self-care strategies • Surgical safety |
|
|
|
VI |
5 (T) 2 (L) |
Explain principles of pain management in cancer patients |
Pain Management in Cancer Patients • Pain – types, nature of cancer pain • Pathophysiology of pain • Assessment of pain and principles of pain control • Pain management – PCA, pharmacological and non-pharmacological measures • Alternative system of medicine for pain management |
• Discussion |
• Assignment on alternative system of medicine for pain relief |
|
VII |
6 (T) 2 (L) |
Discuss management of other symptoms |
Symptomatic Management in Cancer Patients • Nausea and vomiting, dysphagia • Dyspepsia & hiccup, dyspnoea • Constipation & diarrhea, intestinal obstruction • Cancer cachexia • Fungating wounds • Anxiety & depression, insomnia • Lymph edema • Nurses role in managing these symptoms • Nutritional assessment and management |
• Lecture and discussion • Demonstration on barrier nursing |
|
|
VIII |
20 (T) 4 (L) |
Discuss the management of site specific cancers/common cancers in India – Lung cancer, prostate cancer, colorectal cancer, breast cancer, cervical cancer, oral cancer, Head & neck and hematological cancers
|
Management of Patients with Common Cancers • Etiology • Clinical manifestations, diagnosis and management of Lung cancer, prostate cancer, colorectal cancer, breast cancer, cervical cancer, oral cancer, Head & neck cancers • Hematological cancers – lymphomas and leukemia |
• Lecture
• Self-study |
• Case presentation |
|
IX |
4(T) |
Describe major pediatric cancers Explain principles of management of Pediatric Hematological cancers |
Management of Common Cancers in Pediatric Age Group • Common cancers in Pediatric age group patients and management ∘ Leukemia, Lymphoma, Neuroblastoma ∘ Wilm’s tumor, soft tissue sarcoma, retinoblastoma • Nursing management of children with pediatric malignancies including hematological cancers |
• Lecture • Group Presentations |
• Write a case study |
|
X |
6 (T) |
Explain about hematopoietic stem cell transplant |
Hematopoietic Stem Cell Transplant (HSCT) • Types and source of hematopoietic stem cell • Indications of HSCT • Patient preparations for HSCT • Procedure of HSCT • After care of patients with HSCT • GVHD – Graft versus Host Disease • Other complications of HSCT • Special considerations for managing pediatric patients for HSCT • Special considerations for geriatric patients after HSCT |
• Lecture • Demonstration |
• Develop nursing standards on management of patients undergoing HSCT • Conduct Health Education session for the post HSCT patients |
|
XI |
10 (T) |
Cancer treatment related, toxic effects, emergencies and management |
Cancer and Treatment related Toxic Effects, Emergencies and Management • Chemotherapy induced nausea, vomiting and diarrhea • Alopecia • Stomatitis • Fatigue • Extravasation • Dermatitis • Cystitis • Sexual dysfunction • Depression • Acute cerebral edema • Acute reactions to chemotherapy, targeted therapy, immunotherapy and radiotherapy • Anaphylaxis • Anemia • Hemorrhagic cystitis, hypercalcemia • Hypersensitivity reaction • Neutropenic sepsis and septic shock • Pathogenic fracture • Peripheral neuropathy • Post-surgery complications • Spinal cord compression • Thrombocytopenia • Tumor lysis • Superior vena cava syndrome |
|
|
|
XII |
2 (T) |
Explain concept of palliative care and Hospice |
Palliative Care and Hospice • Palliative care ∘ Concept and elements of palliative care ∘ Global and Indian perspective of palliative care ∘ Quality of life issues ∘ Communication skill ∘ Nursing perspective of palliative care • Hospice • End of Life Care ∘ Care of the terminally ill ∘ Grief and grieving process ∘ Bereavement support |
• Lecture • Visit to Hospice/ Palliative care centre (Regional/ National) |
•visit report |
|
XIII |
4 (T) |
Explain rehabilitation of patients living with cancer (Cancer survivors) |
Rehabilitation of Cancer Patients • Rehabilitation after various cancer therapies • Supportive care for the cancer patients |
• Lecture |
• Literature review on supportive care of cancer patients |
|
XIV |
2 (T) |
Discuss sexuality and cancer |
Impact of Cancer on Sexuality • Effect of radiotherapy/chemotherapy/ surgery on sexuality of the cancer patient • Nursing management of cancer patients experiencing sexual dysfunction • Sexual counselling |
|
|
|
XV |
4 (T) |
Explain concept of quality and patient safety in oncology units & HSCT unit |
Quality and Patient Safety in Oncology Units • Patient safety indicators in oncology units and HSCT unit • Quality control in oncology units and HSCT unit • Occupational safety |
• Lecture |
• Conducting unit audit and writing audit report |
Practicum (Skill Lab and Clinical)
Total Hours: 1770 hours (40 + 1730) (Skill Lab: 40 hours and Clinical: 1730 hours) Practice Competencies: At the end of the program, students will be able to:1. Perform and document comprehensive health assessment of cancer patients throughout the cancer care continuum
2. Establish, monitor and maintain supportive and therapeutic relationships with cancer patients
3. Assist and perform special procedures in oncology units
4. Insert PICC line and assist in insertion of other vascular access devices
5. Care for Vascular access devices
6. Administer chemotherapy and biological therapy
7. Care for patients undergoing radiotherapy
8. Prepare and care for patients undergoing splenectomy
9. Provide symptomatic relief for specific cancer symptoms and treatment related side/toxic effects and continuing care
10. Prepare and care for patients undergoing stem cell transplant
11. Assess and manage special group like pediatric and geriatric patients with cancer
12. Perform health education and counselling support to cancer patients
13. Provide emergency care during oncological emergencies
14. Provide palliative care to cancer patients
15. Maintain and store drugs and keep daily record of them.
Clinical Postings
|
Areas |
Duration (weeks) |
Clinical Learning Outcomes |
Skills/Procedural Competencies |
Assignments |
Assessment Methods |
|
Oncology OPD/ Pain Clinic/ Day care |
4 weeks |
Assist/perform health assessment of cancer patients
Assist in diagnostic procedures
Administer chemotherapy |
• History taking and physical examination • Assessment of nutritional status • Screening for cancer • Assisting in diagnostic procedures – bone marrow aspiration and biopsy, FNAC • Pap smear • Assessment and management of pain • Alternative therapies • Administration of chemotherapy and monitoring of patients • Health education |
• Clinical practice • Pain assessment report • Drug study • Health Talk |
• Clinical Evaluation • Evaluation of report • Evaluation of Drug study report • Evaluation of health talk |
|
Medical Oncology ward/ICU |
8 weeks |
Provide nursing care for patients suffering from medical oncological disorders
Administer chemotherapy/ biotherapy
Perform/assist in placing VADs and long-term IV access catheters
Provide emergency care during oncological emergencies
Educate and perform counselling to patients and their relatives |
• Prepare personalized care plan and implement nursing interventions • Establish supportive and therapeutic relationship with patients • Prepare patients for chemotherapy • Perform prechemotherapy investigations • IV cannulation • Administer Chemotherapy • Administer biotherapy • Care of VADs • Insertion of long-term IV access – PICC, Hickman catheter and daily care and maintenance • Central line removal • Heparin lock • Antibiotic lock • Airway management • Endotracheal intubation • Care of tracheostomy • Advanced cardiac life support • Defibrillation • IV cannulation – open method • ABG analysis • Cardiac monitoring • CVP monitoring • ECG recording • Setting of ventilators • Administration of emergency drugs • Teach patients and families about cancer treatment, progress and impact of cancer • Support during all phases of disease process • Counsel patients and the relatives • Preparation for discharge and homecare |
• Health assessment report
• Case study report
• Drug study
• Clinical practice/ simulation
• Health Talk |
• Clinical evaluation
• Case study
• Drug study evaluation
• Clinical evaluation
• Evaluation of health talk |
|
Chemotherapy unit |
4 weeks |
Administer chemotherapeutic drugs following safety precautions |
• Preparation and administration of chemotherapeutic drugs • Adherence of Cytotoxic safety precautions while preparing, handling and administration of drugs • Monitoring of patients during chemotherapy • Extravasation management • Spill management • Safe disposal of drugs and related waste |
• Preparation of SOP for chemotherapy unit |
• Evaluation of SOP |
|
Radiotherapy unit |
4 weeks |
Assess, prepare, provide care and monitor patients undergoing radiotherapy |
• Preparation of patient for radiotherapy • Monitor patient for side effects • Mucositis care • Use of radiation safety precautions |
• Clinical seminar • Preparation of nursing standards for patients undergoing radiotherapy |
• Seminar evaluation • Evaluation of standards |
|
Operation Room |
2 weeks |
Assess, prepare and provide intraoperative care to oncology patients undergoing surgeries – e.g. Splenectomy |
? Providing intraoperative care to patients undergoing surgeries • Assist in scrubbing and after care |
• Clinical experience in Operation Room |
• Clinical evaluation |
|
Surgical Oncology ward/ICU |
8 weeks |
Assist in teletherapy/ treatment planning Assist in radiotherapy Perform pre- and post-operative assessment and care of patients undergoing surgeries for oncological conditions and splenectomy Administer blood and blood products Provide emergency care during oncological emergencies |
• Assisting in teletherapy/ treatment planning • Assisting in Radiotherapy, Brachytherapy – LDR, HDR and Interstitial Implantation • Preparation of patients for surgery • Assisting in FNAC (Fine needle aspiration cytology) • Perform post-operative care • Gastric gavage • Care of surgical flaps • Care of Ostomies • Collect blood for grouping and cross matching • Administer blood and blood products • Iron infusion and care • Management of transfusion reactions • Airway management • Endotracheal intubation • Care of tracheostomy • Advanced cardiac life support • Defibrillation • IV cannulation-open method • ABG analysis • Cardiac monitoring • CVP monitoring • ECG recording • Setting of ventilators • Administration of emergency drugs |
• Case study report
• Clinical practice
• Drug study |
• Case study evaluation
• Clinical evaluation
• Drug study evaluation |
|
Pediatric oncology ward |
4 weeks |
Provide nursing care for children suffering from cancer |
• Physical assessment of children • Infection control practices and barrier nursing • Care during blood transfusion • Care of VADs • Administration of chemotherapy • Diet planning • Counselling for parents • Discharge planning and home care |
• Case study report/ presentation
• Health talk |
• Evaluation of case study report
• Evaluation of health talk |
|
BMT/Stem Cell Transplant unit |
4 weeks |
Preparation of patient for bone marrow transplant (Stem cell transplant) Perform posttransplant care |
• Perform pre-transplant investigations • Counselling for patients and relatives • Prepare the unit for receiving the patient • Maintenance of asepsis (barrier nursing) • Practice standard safety measures • Monitor patient for side effects/complications • Planning and administering diet • Health education • Preparation for discharge and home care • Care of stem cell transplant recipient |
• Clinical practice
• Counselling report |
• Clinical evaluation
• Evaluation of counselling report |
|
Community Oncology |
2 weeks |
Perform screening for cancer in the community Provide care and follow up of cancer patients at home |
• Screening for cancer along with the community health nurses • Follow up, support and counselling |
• Screening report |
• Evaluation of the report |
|
Palliative Care ward
Palliative Care Centres/Hospice |
2 weeks
1 week |
Provide palliative care to cancer patients |
• Symptom management • Pain management • Counselling and support to patients and families • Care of dead body and mortuary formalities |
• Pain assessment report |
|
|
Visit to National/ Regional Palliative Care Centre |
1 week |
Visit to hospice and national/regional palliative care centre |
• Make visit plan and prepare report |
• Visit report |
•Evaluation of report |
Appendix - 1
Skill Lab Requirements
Note: In addition to the basic skill lab requirements of the College of Nursing, the following are necessary.
|
S.No. |
Skill Lab Requirement |
Number |
Skill |
|
1 |
Hospital Bed with mattress |
05 |
Patient Unit preparation |
|
2 |
Hospital Linen set |
15 sets |
|
|
3 |
Patient Linen set |
10 sets |
|
|
4 |
OT Towels |
20 |
|
|
5 |
IV stand |
05 |
|
|
6 |
Bed side lockers |
05 |
|
|
7 |
Overhead table |
05 |
|
|
8 |
Patient comfort devices |
|
|
|
9 |
Suction Machine and suction catheters |
01 |
Emergency procedures – CPR, ET tube insertion, defibrillation, suctioning of airway, oxygen administration |
|
10 |
Multipara monitor |
01 |
|
|
11 |
Oxygen supply |
01 |
|
|
12 |
Crash Cart Trolley |
01 |
|
|
13 |
Endotracheal Tube of different sizes |
30 |
|
|
14 |
Laryngoscope with adult and Pediatric blades |
01 set |
|
|
15 |
Orpharyngeal airways – adult and Pediatric |
05 |
|
|
16 |
Nasopharyngeal airways – adult and Pediatric |
05 |
|
|
17 |
ACLS manikin with ECG simulator |
01 set |
|
|
18 |
Advanced airways – LMA, Esophageal tube |
02 each |
|
|
19 |
Ambu bag with Oxygen Mask |
01 set |
|
|
20 |
AED/Defibrillator |
01 |
|
|
21 |
Oxygen cylinder with fittings |
01 set |
|
|
22 |
ECG machine |
01 |
Recording of ECG |
|
23 |
Tracheostomy set – • Tracheostomy tube – adult and pediatric size (Metal and disposable) – • BP handle with blade – 01 • Sharp scissors curved – 01 • Sharp scissors straight – 01 • Sharp hook – 01 • Blunt hook – 01 • Double hook retractor – 02 • Sinus forceps – 01 • Haemostat straight – 02, curved – 02 • Mosquito forceps – 02 • Blunt dissectors – 01 • Dissecting forceps toothed – 01, plain – 01 • Tracheal dilator – 01 • Needle holder – 01 • Suturing needle and suture materials • Tracheostomy tube three sizes • Syringe and needle for Local anaesthesia • OT towel • Sterile gauze, abdominal swab, gloves, gown • Sponge holding forceps – 02 • Suction catheters of different sizes |
02 set |
Tracheostomy and care |
|
24 |
Thoracentesis and water-seal drainage set – A sterile tray containing – • 16/18 G needle • Sterile bottle to collect specimen • Sponge holding forceps – 01 • Syringe 5 ml , 20 ml • Chest tube • BP handle with blade • Small bowel • Artery forceps – 01 • Mosquito forceps – 01 • Needle holder – 01 • Suture material • Water-seal drainage system • Sterile water • Sterile/disposable gown, gloves, mask, gauze pieces, abdominal swabs, OT towels and towel clips |
02 set |
Thoracentesis |
|
25 |
Abdominal Paracentesis Set – Sterile tray containing • Sterile and disposable Mask, Cap, Gloves, gown • Slit OT Towel • Sponge holding forceps • Dissecting forceps • Sterile bowls – 3 • Gauze 63 pieces • Cotton swabs • Aspiration needle – 16 G/18 G • Syringes – 5 ml, 10 ml • Needle 21 G • Two way valve • Specimen bottles • Kidney tray • Drainage bag with tubings |
|
Abdominal paracentesis |
|
26 |
Lumbar Puncture Set – containing the following sterile articles – • Hand wipe, gown, gloves for physician • Drapes/OT Towels • Sponge holding forceps • Sterile gauze pieces and cotton balls • Spinal needles of various sizes • 3-way stopcock • Specimen bottles |
|
Lumbar puncture |
|
27 |
Colostomy Care • Colostomy care set containing pouches (closed, drainable)/urostomy bag with Skin barrier, wafer, colostomy paste, colostomy powder, deodorizer, Belts |
05 set |
Colostomy care |
|
28 |
Colostomy Irrigation • Irrigation set – irrigation container, tubings with clamp, Stoma cone, Lubricating gel, Irrigating sleeve belt |
|
Colostomy irrigation |
|
29 |
Bone marrow aspiration needles • Salah’s Needle • Klimas’s Needle |
05 05 |
Bone marrow aspiration and biopsy |
|
Bone marrow biopsy needle (Jamshidi’s needle) |
05 |
||
|
Bone Marrow Biopsy Simulator |
01 |
||
|
Fixative for biopsy: Isotonic Buffered Formalin(IBF)/Acetic acid zinc formula (AZF)/B5 Solution |
05 |
||
|
EDTA/Heparinised vacutainer |
20/20 |
||
|
Inj. Lidocaine 2% |
01 |
||
|
Slides |
50 |
||
|
Spreader |
10 |
||
|
20 ml syringe |
25 |
||
|
Pasteur Pipette |
05 |
||
|
Siliconised glass dish |
05 |
||
|
Culture Tube |
10 |
||
|
30 |
BT Set |
20 |
Blood transfusion/IV infusion |
|
Normal Saline |
20 |
||
|
Blood/Blood component simulator |
20 |
||
|
Blood bag Carriage/container |
05 |
||
|
Intravenous cannula 16/18 F |
30 |
||
|
IV simulator arm for transfusion |
01 |
||
|
Infusion Pump |
02 |
||
|
Pediatric chamber IV set and adult IV set |
50 |
||
|
31 |
Disposable Lancet |
50 |
Peripheral blood smear |
|
Pipette and Tubing |
05 set |
||
|
Slides |
50 |
||
|
Alcohol Prep pads |
50 |
||
|
Spreader |
10 |
||
|
32 |
Central line pack/PICC catheter set |
10 |
PICC/Hickman/ Central line insertion & CVP monitoring |
|
Mefilon dressing/Biopatch Central line dressing |
25 |
||
|
Extension line & Three way Adaptor |
20 |
||
|
Ultrasound guided PICC/ECG guided PICC/Hickman/CVAD’s training simulator |
01 |
||
|
Hair clipping devices |
01 |
||
|
Tegaderm |
20 |
||
|
PICC stat lock fixator/griplock fixator |
10 |
||
|
Chlorhexidine swab stick |
20 |
||
|
Heparin/Antibiotic/VAD Block |
20 |
||
|
PICC/Hickman/Central line care packs |
20 |
||
|
CVP manometer |
05 |
||
|
33 |
Manikin with chemoport |
01 |
Chemotherapy |
|
Infusion Pump |
02 |
||
|
Biosafety cabinet |
01 |
||
|
Huber Needle/Non coring needle |
05 |
||
|
NS prefilled syringes |
05 |
||
|
34 |
Pap smear set – |
02 set |
Pap smear collection |
|
• Cuscos double valves self-retaining speculum |
|||
|
• Ayres spatula |
|||
|
• Cytobrush |
|||
|
• Slides |
|||
|
• Spray fixative |
|||
|
35 |
Standard Safety Protection Devices |
20 sets |
Infection Control |
|
Barrier Nursing Unit |
01 |
||
|
Hand washing area |
01 |
||
|
Biomedical waste disposal unit |
01 |
||
|
36 |
Nutrition Lab for preparation of Neutropenic diet |
01 |
|
|
|
For Other procedures |
|
|
|
37 |
Bowls with lid 10 cm |
10 |
Instruments for other procedures |
|
38 |
Bowls 10 cm |
10 |
|
|
39 |
Instrument Tray with Lid |
10 |
|
|
40 |
Plain Artery Forceps |
10 |
|
|
41 |
Toothed Artery Forceps |
10 |
|
|
42 |
Mosquito Artery Forceps |
10 |
|
|
43 |
Plain Dissecting Forceps |
10 |
|
|
44 |
Toothed Dissecting Forceps |
10 |
|
|
45 |
Sponge holding Forceps |
10 |
|
|
46 |
Towel Clip |
20 |
|
|
47 |
Sharp Scissors |
05 |
|
|
48 |
Records (Chemo Chart, Consent Form, Clinical Charts, Blood Transfusion Chart, Nurses Note) |
– |
Recording |
|
49 |
LCD TV |
01 |
Video assisted Demonstration |
|
50 |
Health Teaching modules for patients |
– |
Health Teaching |
Appendix - 2
Assessment Guidelines (Theory And Practicum)
I. Theory A. Internal Assessment Oncology Specialty Nursing (Part I - Oncology Nursing-I including Foundations and Part II - Oncology Nursing-II) - Total: 25 marks • Test Papers and Quiz - 10 marks • Written assignments - 10 marks (Code of ethics relevant to Oncology Nursing practice, literature review on EBP in oncology nursing/Infection control practices, Nutritional care of patients with oncological conditions) • Group project: 5 marks B. External/final Exams Oncology Specialty Nursing (Part I - Oncology Nursing-I Including Foundations and Part II - Oncology Nursing-II) - Total: 75 marks Part I - 35 marks (Essay type 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 Assessment - 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 and 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 Exam (Actual performance in clinicals) - 20 marks B. External/final Exam - 150 Marks Osce - 50 marks, Observed practical - 100 marks Detailed guidelines are given in Guidebook.Appendix - 3
Clinical Log Book
(Specific Procedural Competencies/Clinical Nursing Skills)
|
S.No. |
Specific Competencies/Skills |
Number Performed/Assisted/ Observed (P/A/O) |
Date and Signature of the Faculty/Preceptor |
|
I |
Foundations To Oncology Specialty Nursing |
||
|
1 |
Preparation of patient education materials |
P |
|
|
2 |
Patient education plan for teaching patients with hematologic disorders |
P |
|
|
3 |
Preparation of duty roster for nursing officers/staff nurses |
P |
|
|
4 |
Writing literature review/systematic review (Identify evidence-based nursing interventions/practices) |
P |
|
|
5 |
Preparation of a manuscript for publication/paper presentation |
P |
|
|
6 |
Group research project Topic: |
P |
|
|
II |
Oncology Specialty Nursing |
||
|
1 |
Health Assessment |
||
|
1.1 |
History taking and physical examination for adult patient with cancer including nutritional assessment |
P |
|
|
1.2 |
History taking and physical examination for pediatric patient with cancer including nutritional assessment |
P |
|
|
2 |
Diagnostic Procedures |
||
|
2.1 |
CT Scan |
O |
|
|
2.2 |
MRI |
O |
|
|
2.3 |
Ultrasound |
O |
|
|
2.4 |
Mammography |
O |
|
|
2.5 |
Radio nuclide imaging |
O |
|
|
2.6 |
Bone Scan |
O |
|
|
2.7 |
Thyroid function tests |
O |
|
|
2.8 |
Functional and metabolic imaging |
O |
|
|
|
Assisting Diagnostic Procedures |
||
|
2.9 |
Bone marrow aspiration/biopsy |
A |
|
|
2.10 |
Fine needle aspiration cytology (FNAC) |
A |
|
|
2.11 |
Thoracentesis |
A |
|
|
2.12 |
Paracentesis |
A |
|
|
2.13 |
Lumbar puncture & CSF Tap |
A |
|
|
2.14 |
Chest tube insertion and intercostal drainage |
A |
|
|
3 |
Venous Access Devices (Vad) Care |
|
|
|
3.1 |
Insertion of VADs |
|
|
|
|
• PICC |
P |
|
|
|
• Hickman |
P |
|
|
|
• Central Line |
A/P (As per institutional protocol) |
|
|
3.2 |
Daily care and maintenance of VADs |
P |
|
|
3.3 |
Heparin lock |
P |
|
|
3.4 |
Antibiotic lock |
P |
|
|
3.5 |
VAD block |
P |
|
|
3.6 |
Line removal |
P |
|
|
4 |
Care At Oncology Opd, Pain Clinic, Day Care, Medical Oncology Ward & Chemotherapy Unit |
||
|
|
Care At Oncology Opd, Pain Clinic, Day Care |
||
|
4.1 |
Screening For Cancer (Opd) |
P |
|
|
4.2 |
Pap smear |
A/P as per institutional protocol |
|
|
4.3 |
Assessment and management of pain |
P |
|
|
4.4 |
Nerve block |
A/P as per institutional protocol |
|
|
4.5 |
Alternative therapies |
A/P |
|
|
|
Care At Medical Oncology Ward & Chemotherapy Unit |
||
|
4.6 |
Consent taking |
P |
|
|
4.7 |
Preparation of patients for pre-chemo investigations |
P |
|
|
4.8 |
Preparation of patients for chemotherapy |
P |
|
|
4.9 |
Administration of chemotherapeutic drugs (Drug infusion and dose modification)/biotherapy |
P |
|
|
4.10 |
Adherence of cytotoxic safety precautions while preparing, handling and administration of drugs |
P |
|
|
4.11 |
Monitoring of patients for side effects during chemotherapy |
P |
|
|
4.12 |
Intrathecal chemotherapy |
A/P |
|
|
4.13 |
Extravasation management |
P |
|
|
4.14 |
Spill management |
P |
|
|
4.15 |
Safe disposal of drugs and related waste |
P |
|
|
5 |
Care At Radiotherapy Unit |
||
|
5.1 |
Preparation of patient for radiotherapy |
P |
|
|
5.2 |
Monitor patient for side effects |
P |
|
|
5.3 |
Mucositis care |
P |
|
|
5.4 |
Use of radiation safety precautions |
P |
|
|
5.5 |
Transportation of radioactive materials |
O |
|
|
5.6 |
Brachytherapy/Interstitial implantation |
A |
|
|
5.7 |
Teletherapy/treatment planning |
A |
|
|
6 |
Care of Adult Patient In or & Surgical Oncology Ward |
||
|
6.1 |
Preparation of patients for surgery |
P |
|
|
6.2 |
Intraoperative care to cancer patients undergoing surgeries |
P |
|
|
6.3 |
Postoperative care |
P |
|
|
6.4 |
Administration of medications through syringe and infusion pumps (multidrug infusion) |
P |
|
|
6.5 |
Care of surgical flaps |
P |
|
|
6.6 |
Care of Ostomies |
P |
|
|
6.7 |
Patient education and counselling |
P |
|
|
6.8 |
Discharge preparation and home care |
P |
|
|
7 |
Care of Adult Patints In Medical/surgical Oncology Icus (Oncologic Emergencies) |
||
|
7.1 |
Airway management |
P |
|
|
7.2 |
Endotracheal intubation |
A/P |
|
|
7.3 |
Care of Tracheostomy |
P |
|
|
7.4 |
Advanced Cardiac life support |
A/P |
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7.5 |
Defibrillation |
A/P |
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7.6 |
IV Cannulation – open method |
A/P |
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7.7 |
ABG monitoring |
P |
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7.8 |
Cardiac monitoring |
P |
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7.9 |
CVP monitoring |
P |
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7.10 |
ECG recording and monitoring |
P |
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7.11 |
Setting of ventilators |
P |
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7.12 |
Administration of emergency drugs |
P |
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8 |
Caring For Pediatric Patient In Oncology Unit/icu |
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8.1 |
Blood sampling |
P |
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8.2 |
Pediatric phlebotomy |
P |
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8.3 |
Care during blood transfusion |
P |
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8.4 |
Care of VADs |
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8.5 |
Administration of chemotherapy (drug infusion and dose modification |
P |
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8.6 |
Pediatric neutropenic care |
P |
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8.7 |
Diet planning |
P |
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8.8 |
Counselling – child and parents |
P |
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9 |
Bone Marrow Transplant/stem Cell Transplant Unit |
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9.1 |
Pre-transplant investigations |
P |
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9.2 |
Health education & Counselling – patient and relatives |
P |
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9.3 |
Preparation of patient before transplant |
P |
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9.4 |
Maintenance of asepsis (Barrier Nursing) |
P |
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9.5 |
Monitoring patient for side effects |
P |
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9.6 |
Planning and administration of diet |
P |
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9.7 |
Collection and preservation of bone marrow stem cells |
A |
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9.8 |
Care of transplant recipient |
P |
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9.9 |
Management of engraftment syndrome |
A/P |
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9.10 |
Preparation for discharge and home care |
P |
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10 |
Quality Control |
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10.1 |
Preparation of SOP for infection control in oncology unit |
P |
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10.2 |
Preparation of SOP for chemotherapy |
P |
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10.3 |
Conducting unit audit |
P |
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11 |
Asepsis |
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11.1 |
Sterilization/Disinfection |
P |
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11.2 |
Fumigation |
P |
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12 |
Palliative Care Ward |
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12.1 |
Management of symptoms |
P |
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12.2 |
Pain management – Pharmacological/ non-pharmacological |
P |
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12.3 |
Counselling, guidance and support to patient and family |
P |
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s12.4 |
Care of dead body |
P |
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Appendix - 4
Clinical Requirements
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S.No. |
Clinical Requirement |
Date |
Signature of the Faculty |
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1 |
Health Talk (OPD, Ward/Day Care) |
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1.1 |
Topic: |
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1.2 |
Topic: |
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2 |
Counselling Patient & Family Counselling Report – 1 |
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3 |
Health Assessment |
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3.1 |
Health Assessment (adult) – History and Physical Examination (Two written reports) 3.1.1. 3.1.2. 3.1.3. |
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3.2 |
Health Assessment (Pediatric) – History and Physical Examination (Two written reports) 3.2.1. 3.2.2. |
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4 |
Journal Club/Clinical Seminar Topic: |
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5 |
Case Study/Clinical Presentation and Report – 2 (Nursing/interdisciplinary rounds) |
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5.1 |
Name of clinical condition: |
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5.2 |
Name of clinical condition: |
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6 |
Drug Study, Presentation and Report (Two written reports for submission) |
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6.1 |
Drug name: |
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6.2 |
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6.3 |
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6.4 |
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7 |
Designing Oncology Unit/Ward |
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8 |
Visit Report 1 – National/Regional Palliative Care/ Hospice Centres |
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9 |
Cancer Screening in the Community – Participation |
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|
Signature of the HOD/Principal
Appendix - 5
Clinical Experience Details
|
Name of ICU |
Clinical Condition |
Number of Days care given |
Signature of the Faculty |
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Signature of the HOD/Principal
