Indian Nursing Council (Post Basic Diploma in Critical Care Specialty Nursing - Residency Program) Regulations, 2022
Published vide Notification No. F. No. 11-1/2022-INC, dated 24.06.2022
Last Updated 28th July, 2022 [act5013]
F.No. 11-1/2022-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 the Indian Nursing Council (Post Basic Diploma in Critical Care Specialty Nursing - Residency Program) Regulations, 2022. ii. These shall come into force on the date of notification of the same in the Official Gazette of India. 2. Definitions. - In these Regulations, unless the context otherwise requires,
i. 'the Act' means the Indian Nursing Council Act, 1947 (XLVIII of 1947) as amended from time to time;
ii. 'the Council' means the Indian Nursing Council constituted under the Act;
iii. 'SNRC' means the State Nurse and Midwives Registration Council, by whichever name constituted, by the respective State Governments;
iv. 'RN & RM' means a Registered Nurse and Registered Midwife (RN & RM) and denotes a nurse who has completed successfully, recognised Bachelor of Nursing (B.Sc. Nursing) or Diploma in General Nursing and Midwifery (GNM) course, as prescribed by the Council and is registered in a SNRC as Registered Nurse and Registered Midwife;
v. 'Nurses Registration & Tracking System (NRTS)' means a system developed by the Council and software developed in association with National Informatics Centre (NIC), Government of India, and hosted by NIC for the purpose of maintenance and operation of the Indian Nurses Register. It has standardised forms for collection of the data of Registered Nurse and Registered Midwife (RN & RM)/ Registered Auxiliary Nurse Midwife (RANM)/Registered Lady Health Visitor (RLHV) upon Aadhar based biometric authentication;
vi. 'NUID' is the Nurses Unique Identification Number given to the registrants in the NRTS system;
vii. 'General Nursing and Midwifery (GNM)' means Diploma in General Nursing and Midwifery qualification recognized by the Council under Section 10 of the Act and included in Part-I of the Schedule of the Act.
Post Basic Diploma In Critical Care Specialty Nursing - Residency Program I. Introduction. - The National Health Policy document (NHP, 2017) emphasizes the need to expand tertiary care services, prepare specialist nurses and standardization of clinical training for nurses. Responding to this, the Council planned to redesign the existing 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 Critical Care Nursing of the Council is being reframed as a residency program using revised guidelines that aim to prepare critical care specialist nurses who can provide competent care to critically ill patients at the institutional levels, whose diagnostic, treatment and care needs are complex. Critical care medicine has evolved rapidly, alongside nursing too has rapidly progressed. The emerging trauma scenario and disaster events of mass nature are adding significant strain on the individual's life as well as the family and the social system. It affects all strata of population. It is essential for the health care system to meet such needs in a specialized manner. Critical care nursing is an emerging specialty which emphasizes on the skills of nurses in caring for critically ill patients. The number of patients who require intensive care are on the rise. Nurses need to be efficient and competent to care for these patients. Advanced skills in managing airway, breathing, and circulation is a mandate for the nurses to handle patients during an emergency situation. Patient's needs like nutrition, communication, end of life care etc. need to be focused for better quality care of patients. Family care is also another major component which is neglected at times. A nurse working in a critical care area should be equipped in counselling skills to meet the family needs in terms of emotional and social aspects. The critical care specialist nurses play a great role in the effective management of critically ill patients. II. Philosophy. - The Council believes that registered nurses 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 critical care nursing. Expanding roles of nurses and advances in critical care alongside technology necessitates additional training to prepare nurses with specialized skills and knowledge to deliver competent, intelligent and appropriate care to critically ill patients. III. Curricular Framework. - The Post Basic Diploma in Critical Care Specialty Nursing 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 critical care nursing practice such as professionalism, communication, patient education & counselling, clinical leadership & resource management, and evidence based & applied research are short courses that aim to provide the students with the knowledge, attitude and competencies essential to function as accountable, safe and competent specialist nurses. The major specialty courses are organized under Critical Care Specialty Nursing I and Critical Care Specialty Nursing II. Critical Care Specialty Nursing I includes context/ introduction to critical care nursing, basic sciences applied to critical care nursing (application of basic science knowledge in the diagnosis and treatment of clinical conditions under critical care nursing specialty). Critical Care Specialty Nursing II includes nursing management of specific clinical conditions comprising assessment, diagnosis, treatment and specialized interventions and patient safety and quality including specialty/illness considerations. The curricular framework for this residency program is illustrated in the following figure-1.
Figure-1. Curricular Framework: Critical Care Specialty Nursing - Residency Program
IV. Aim/purpose & Competencies Aim. - The program is designed to prepare nurses with specialized skills, knowledge, and attitude in providing high quality and standards of care to critically ill patients in tertiary/quaternary hospitals. It further aims to prepare technically qualified and trained critical care specialist nurses who will manage and supervise care of critically ill patients and involve in the education of health care team members and in research to produce evidence for better care. Competencies. - On completion of the program, the critical care 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 critical care 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 critical care settings promoting collaborative and effective teamwork.
5. Identify, evaluate and use the best current evidence in critical care and treatment coupled with clinical expertise and consideration of patient's preferences, experience and values to make practical decisions in critical care nursing practice.
6. Participate in research studies that contribute to evidence-based interventions with basic understanding of research process in critical care nursing.
7. Apply basic sciences in the assessment, diagnosis and treatment of the physiological, physical, psychological, social and spiritual problems of patients with critical conditions and their families.
8. Demonstrate skills in basic and advanced life support.
9. Apply nursing process in caring for patients with critical conditions.
10. Demonstrate specialized practice competencies/skills relevant in providing care to critically ill patients under different treatment regimes.
11. Practice infection control and patient safety protocols.
12. Conduct clinical audit and participate in quality assurance activities in critical care units.
13. Identify treatment related adverse effects and emergencies and manage them effectively.
14. Understand the method of drug procurement, storage, administering and maintenance of all categories of medication and demonstrate sound practice.
15. Provide palliative care to patients with emphasis to end of life care promoting comfort and dignity respecting individual cultural and spiritual needs and differences.
16. Conduct training programs for various categories of nursing personnel.
17. Participate in research to promote evidence based critical care nursing practice.
V. Program Description and Scope Of Practice. - The Post Basic Diploma in Critical Care Specialty Nursing is a one-year residency program designed to prepare registered nurses (GNM or B.Sc.) with specialized knowledge, skills and attitude in providing advance quality care to critically ill patients and their families. Emphasize is laid on clinical competency with relevant theory with a main focus on competency-based training. Theory includes foundational courses and specialty courses besides practicum. The theory component comprises 10% and practicum 90% (Clinical & Lab). On completion of the program and certification, and registration as additional qualification with respective SNRC, the critical care specialist nurses should be employed only in any critical care unit of a multi-specialty hospital. 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 Critical Care Specialty Nursing - Residency Program The program may be offered at.1. College of Nursing offering degree programs in nursing attached to parent specialty hospital/tertiary hospital having minimum of 200 beds with advanced diagnostic, therapeutic and state of the art critical/intensive care units with optimum monitoring and life support equipment/facilities required to provide effective care to patients with critical conditions and specialized nursing care facilities.
Or
Hospitals offering DNB/Fellowship programs in critical care having minimum of 200 beds with advanced diagnostic, therapeutic and state of the art critical care/intensive care units with optimum monitoring and life support equipment/facilities required to provide effective care to patients with critical conditions and specialized nursing care facilities.
2. The above eligible institution shall get recognition from the concerned SNRC for Post Basic Diploma in Critical Care Specialty Nursing for the particular academic year, which is a mandatory requirement.
3. The Council shall after receipt of the above documents/proposal would then conduct statutory inspection of the recognized training nursing institution under Section 13 of the Act in order to assess the suitability with regard to availability of teaching faculty, clinical and infrastructural facilities in conformity with Regulations framed under the provisions of the Act.
1. Nursing Teaching Faculty
a. Full time teaching faculty in the ratio of 1:10.
b. Minimum number of faculty should be two.
c. Qualification and Number:
i. M.Sc. Nursing with Medical Surgical Nursing/Critical Care Specialty Nursing/NPCC-1 (M.Sc. in Critical Care Nursing or NPCC are preferred)
ii. Post Basic Diploma in Critical Care Specialty Nursing with Basic B.Sc. Nursing/P.B.B.Sc. Nursing-1
d. Experience: Minimum three years of clinical experience in Critical Care Specialty Nursing.
e. Guest Faculty: Multi-disciplinary in related specialities.
f. Preceptors:
• Nursing Preceptor: Full time qualified GNM with six years of experience in Critical Care Specialty Nursing or B.Sc. Nursing with two years' experience in Critical Care specialty nursing or M.Sc. Nursing with one year of Critical Care Specialty Nursing experience working in any of the critical/intensive care unit.
• Medical Preceptor: Specialist (Intensivist) doctor with PG qualification (with 3 years' post PG experience/faculty level/consultant level preferable).
• Preceptor Student Ratio: Nursing 1:10, Medical 1:10 (Every student must have a medical and nursing preceptor)
2. Budget. - 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.
3. Physical and Learning Resources at Hospital/College
a. One classroom/conference room at the clinical area.
b. Skill lab for simulated learning at hospital/college. Skill Lab Requirements are listed in Appendix-1.
c. Library and computer facilities with access to online journals:
i. College library having current books, journals and periodicals related to critical care nursing specialty, anatomy & physiology, microbiology, pharmacology, pathophysiology, Nursing Administration, Nursing Education, Nursing Research and Statistics.
Or
Permission to use medical college/hospital library having current books, journals and periodicals related to Critical Care Specialty Nursing, anatomy & physiology, microbiology, pharmacology, pathophysiology, Nursing Administration, Nursing Education, Nursing Research and Statistics.
ii. Computer with internet facility.
d. E-Learning facilities
e. Teaching Aids - Facilities for use of:
i. Overhead Projectors,
ii. Video viewing facility,
iii. LCD Projector,
iv. CDs, DVDs and DVD players,
v. Appropriate equipment, manikins and simulators for skill learning.
f. Office facilities:
i. Services of typist, peon, Safai Karmachari.
ii. Facilities for office, equipment and supplies such as
• Stationery,
• Computer with printer,
• Xerox machine,
• Telephone and Fax.
4. Clinical Facilities
a. Parent specialty hospital/tertiary hospital having minimum of 200 beds with advanced diagnostic, therapeutic and state of the art critical/intensive care units with optimum monitoring and life support equipment/facilities required to provide effective care to patients with critical conditions and specialized nursing care facilities.
b. Regional centres/critical care (Cardiac/cardiothoracic, medical, surgical, neuro ICU etc.) specialty hospitals having minimum of 200 beds with advanced diagnostic, therapeutic and state of the art critical/intensive care units with optimum monitoring and life support equipment/facilities required to provide effective care to patients with critical conditions and specialized nursing care facilities.
c. Hospital must have a minimum of 20 CCU/ICU beds with advanced diagnostic, treatment and care facilities.
d. Nurse staffing of units as per the Council recommended norms.
e. Student patient ratio: 1:1-2.
5. 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 critical care unit prior to enrolment.
c. Be physically fit.
d. Selection must be based on the merit obtained in an entrance examination and interview held by the competent authority.
e. Nurses from other countries must obtain an equivalence certificate from the Council before admission.
6. Number of Seats:
For hospital having 200 beds and 20 CCU/ICU beds, number of seats = 10-20,
For hospital having 500 beds and more with 30 CCU/ICU beds, the number of seats = 15-30.
7. Number of Candidates:
1 candidate for 1-2 specialty beds.
8. Salary:
a. In-service candidates will get regular salary.
b. Stipend/Salary for the other candidates as per the salary structure of the hospital where the program is conducted.
Examination Regulations
Examining and Diploma Awarding Authority: Respective Examination Board/SNRC/University approved by the Council.
1. Eligibility for appearing for the Examination
a. Attendance: Theory & 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/Critical Care Nursing/NPCC) 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.
Certification
a. Title: Post Basic Diploma in Critical Care 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 Critical Care Specialty Nursing - Residency Program
ii. Candidate has completed 80 % theory and 100% clinical requirements
iii. Candidate has passed the prescribed examination.
|
Courses |
Int. Ass. Marks |
Ext. Ass. Marks |
Total Marks |
Exam Hours |
|
A. Theory (Experiential/Residential Learning) |
25 (10+15) |
75 (35+40) |
100 |
3 |
|
Critical Care Specialty Nursing (Part I & Part II) {Part I - Critical Care Specialty Nursing I including Foundations to Critical Care Specialty Nursing practice, Part II - Critical Care Specialty Nursing II} |
||||
|
B. Practicum (Critical Care 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 |
|
1. Courses of Instruction
2. Implementation of Curriculum
3. Clinical Practice (Residency Posting)
4. Teaching Methods
5. Methods of Assessment
6. Log Book & Clinical Requirements.
1. Courses of Instruction - Delivered through mastery of learning (Skill Lab Practice) and experiential learning (Clinical Practice) approaches|
Unit |
Courses |
Theory (hours) |
Lab/Skill Lab (hours) |
Clinical (hours) |
|
I
II |
Foundations to Critical Care Specialty Nursing Practice 1. Professionalism 2. Communication, patient education and counseling in specialty nursing 3. Clinical leadership and resource management in the specialty care setting 4. Evidence based and applied research in specialty nursing Critical Care Specialty Nursing Courses Critical Care Specialty Nursing I 1. Context/Introduction to specialty nursing 2. Basic sciences applied to specialty care - diagnosis and treatment of clinical conditions (Anatomy & Physiology, Microbiology, Pharmacology & Pathophysiology)
Critical Care Specialty Nursing II 3. Nursing management of clinical conditions including assessment, diagnosis, treatment and specialized interventions 4. Patient safety and quality 5. Specialty/Illness specific considerations (Supportive care/ palliative care/rehabilitation, Impact of illness on individual, family and community) |
40
50
110 |
10
30 |
1730 |
|
|
Total = 1970 hours |
200 (5 weeks) |
40 (1 week) |
1730 (38 weeks) |
◼ Annual Leave + Casual Leave + Sick Leave + Public Holidays = 6 weeks
◼ Exam preparation and Exam = 2 weeks
◼ Theory and Practical = 44 weeks
2. Implementation of the Curriculum Block classes - 2 weeks × 40 hours per week = 80 hours, Residency - 42 weeks × 45 hours per week = 1890 hours Total: 1970 hours◼ Block classes (Theory and Skill Lab Experience = 2 weeks × 40 hours per week (80 hours) (Theory = 74 hours, Skill Lab = 6 hours. Total = 80 hours)
◼ Clinical practice including Theory and Skill Lab = 42 weeks × 45 hours per week (1890 hours) (Theory = 126 hours, Skill Lab = 34 hours, Clinical = 1730 hours. Total = 1890 hours)
Theory = 200 (74+126) hours, Skill Lab = 40 (6+34) hours, Clinical = 1730 hours 126 hours of theory and 34 hours of skill lab learning can be integrated during clinical experience. Mastery learning and experiential learning approaches are used in training the students throughout the program. Skill lab requirements are listed in Appendix 1. 3. Clinical Practice (Residency Postings) Clinical Residency Experience: A minimum of 45 hours per week is prescribed, however, it is flexible with different shifts and OFF followed by on call duty every week or fortnight. Clinical Placements: The students will be posted to the under mentioned clinical area during their training period:|
S.No. |
Clinical Area |
Week(s) |
|
1 |
Emergency care unit |
4 |
|
2 |
Coronary and cardiothoracic intensive care unit |
6 |
|
3 |
Medical intensive care unit (Respiratory, renal, gastroenterology, endocrine) |
10 |
|
4. |
Neurological intensive care unit |
6 |
|
5. |
Surgical intensive care unit |
10 |
|
6. |
Paediatric intensive care unit |
4 |
|
7. |
Burns ICU and plastic surgery unit |
2 |
|
|
Total |
42 |
• Case/Clinical presentation
• Case study report
• Drug study and presentation
• Bedside clinic/Nursing rounds/Interdisciplinary rounds
• Clinical seminars/Conference
• Journal clubs
• 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/Term papers
• Workshops
• 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 regional critical care/stem cell centre and palliative care centres.
5. Methods of assessment• Written test
• Practical test
• Written assignments
• Project
• Case studies/care plans/ clinical presentation
• Clinical performance evaluation
• Completion of clinical procedural competencies and clinical requirements
For assessment guidelines refer Appendix-2 6. Log Book and Clinical Requirements At the end of each clinical posting, Clinical Log Book (Specific Procedural Competencies/Clinical Skills) (Appendix 3), Clinical Requirements (Appendix 4) and clinical experience details (Appendix 5) have to be signed by the concerned clinical faculty/preceptor. X. Course Syllabus1. Foundations To Critical Care Nursing Practice Professionalism, Communication, Patient Education & Counseling, Clinical Leadership & Resource Management and Evidence Based and Applied Research In Critical Care 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 critical care nursing practice.Course Content
|
Unit |
Time (hours) |
Learning Outcomes |
Content |
Teaching / Learning Activities |
Assignments/ Assessment Methods |
|
I |
3 (T) |
Demonstrate understanding of professionalism and exhibit professionalism in the practice of critical care nursing |
Professionalism • Professionalism - meaning and elements - accountability, knowledgeable, visibility and ethics in critical care nursing specialty practice • Professional values and professional behaviour • Indian Nursing Council (INC) Code of ethics, code of professional conduct and practice standards • Ethical issues related to critical care nursing • Expanding role of Nurse - Nurse practitioner • Professional organizations • Continuing nursing education |
• Discussion |
• Write about code of ethics related to critical care nursing |
|
II |
3 (T) |
Describe medicolegal aspects of critical care nursing |
Medico-Legal Issues • Legislations and regulations related to critical care nursing • Consumer protection act • Negligence & malpractice • Medico-legal aspects • Records & reports • Legal responsibilities of critical care specialist nurses |
• Lecture |
• Maintain record of patients |
|
III |
12 (T) |
Communicate effectively with critical care 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 • Breaking bad news to patients and relatives with critical care conditions and disorders with poor prognosis • Culturally sensitive communication • Information technology tools in support of communication • Team communication Patient & Family Education • Principles of teaching and learning • Principles of health education • Assessment of informational needs and patient education • Developing patient education materials |
Module: Communication
• Lecture
• Breaking bad news - Role play
• Peer teaching • Patient engagement exercise, e.g. Discharge planning |
• Digital records
• Conduct a group health education program for the patients with critical care disorders |
|
IV |
12 (T) |
Demonstrate understanding of clinical leadership and management strategies and use them in critical care settings promoting collaborative and effective teamwork Conduct clinical audit and participate in quality assurance activities in critical care unit |
Counselling • Counseling techniques • Patient and family counseling during breaking bad news, intensive treatment, crisis intervention and end of life stage Clinical Leadership & Resource Management • Leadership & Management • Elements of management of Critical care nursing care - planning, organizing, staffing, reporting, recording and budgeting • Clinical leadership and its challenges • Delegation • Managing human resources in critical care units • Material management • Designing of an ideal critical care unit • Emotional intelligence and self management skills • Working as interdisciplinary team member • Participation in making policies relevant to care of critical care patients Quality Assurance program in Critical care unit • Nursing audit • Nursing standards • Quality assurance |
• Counselling sessions
• Lecture
• Module: Accreditation & Practice Standards |
• Prepare patient education materials on relevant topic
• Plan a duty roster for the junior nursing officers/Staff nurses working in the critical care unit
• Assignment on designing of ideal critical care unit
• Develop SOPs for critical care nursing practice in CCU/ICU |
|
V |
10 (T) |
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 critical care nursing • Formulation of problem /question that are relevant to critical care nursing practice • Review of literature to identify evidence based/best practices in critical care 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 critical care unit for last five years • Conduct literature review on critical care nursing interventions/ Evidence based practice project |
2. Critical Care Specialty Nursing I
Context/introduction To Critical Care Nursing & Basic Sciences Applied To
Critical Care Nursing Practice (Applied Psychology and Sociology, Anatomy & Physiology, Microbiology, Pharmacology & Pathophysiology) Theory: 50 hours & Lab: 10 hours Course description. - This course is designed to help students to develop understanding and in-depth knowledge regarding the context of critical care provision and application of basic sciences in the diagnosis and treatment of patients suffering from critical care conditions.Course Content
|
Unit |
Time (hours) |
Learning Outcomes |
Content |
Teaching/ Learning Activities |
Assignments/ Assessment Methods |
|
I |
6 (T) |
Explain the concepts, principles, and scope of critical care nursing and role of critical care specialist nurses Demonstrate skill in setting up of Critical care unit including monitors, equipment, and ventilators |
Introduction to Critical Care Nursing • Historical review • Concepts of critical care nursing • Principles of critical care nursing • Scope of critical care nursing • Role of critical care specialist nurses • Critical care unit set up including equipment and supplies • Types of monitors, ventilators, computers in ICU • Management of ICU • Various clinical bundles in critical care |
• Lecture
• Discussion
• Demonstration on setting up of a monitor, infusion and syringe pump |
• Assignment on drawing an ideal ICU
• Return demonstration on setting up of a monitor, infusion and syringe pump |
|
II |
6 (T) 2 (L) |
Describe the hospital acquired infections (HAI) in ICU and demonstrate the strategies to prevent HAIs |
Infection Control in Intensive Care Unit • Hospital Acquired Infections (HAIs) in intensive care unit: Ventilator Associated Pneumonia (VAP), Catheter Line Associated Blood Stream Infection (CLABSI), Catheter Associated Urinary Tract Infection (CAUTI) • Multi Drug Resistant Organism (MDRO): Methyl Resistant Staphylococcus Aureus (MRSA), Carpenem Resistant Organisms (CRO), Vancomycin Resistant Enterococcus (VRE) • Disinfection & Sterilization in ICU • Microbiological Surveillance • Standard Precautions, Prophylaxis for staff |
• Lecture
• Discussion
• Demonstration on care bundles to prevent HAI |
• Assignment on protocol on care of patients with Multi Drug Resistant Organisms |
|
III |
10 (T) |
2 (L)Elaborate on applied anatomy and physiology of various systems such as Neurological system, Respiratory system, Gastrointestinal system, Endocrine system, Genitourinary system, Reproductive system & Sensory organs |
Applied Anatomy & Physiology Review • Neurological system • Respiratory system • Cardiovascular system • Gastrointestinal system • Endocrine system • Musculoskeletal system • Genitourinary system • Reproductive system • Sensory organs |
• Lecture
• Discussion
• Video show |
• Quiz |
|
IV |
8 (T) |
Explain the pharmacotherapeutic agents used in critical care |
Pharmacology Review • Pharmacokinetics • Principles of drug administration, role of nurses and care of drugs • Drugs used in adult critical care unit • Toxicology: Antidote • Pediatric dosages and implications of critical care drugs on children • Pharmacotherapeutics in obstetrics • Adverse Drug reaction & toxicity |
• Lecture
• Discussion |
• Drug book
• Quiz on Calculation of inotropes
• Drug Presentation |
|
V |
6 (T) 2 (L) |
Elaborate on psychophysiological and psychosocial impact of critical care unit on patients Describe the dynamics of healing in critical care |
Concept of Holistic Care applied to Critical Care Nursing Practice: Psychophysiological & Psychosocial impact of critical care unit on patients • Risk factors, Assessment of patients, critical care psychosis, Prevention & nursing care for patients affected with psychophysiological & psychosocial problems of critical care unit, caring for the patient's family, family teaching. The dynamics of healing in critical care unit • Dynamics of touch, Relaxation, Spirituality and Prayer, Massage, Music therapy, Guided Imagery • Stress and burnout syndrome among health team members |
• Lecture
• Discussion |
• Case study presentation |
|
VI |
4 (T) |
Explain the principles of pain management in critically ill patients |
Pain Management Pain & sedation in critically ill patients • Theories of pain • Types of pain • Pathophysiology of pain • Pain assessment • Systemic responses to pain • Pain management • Sedation in critically ill patients • Placebo effect |
• Lecture
• Discussion
• Demonstration
• Assessment of pain and sedation |
• Assignment on placebo effect |
|
VII |
8 (T) 4 (L) |
Explain nutritional management of patients with critical illness |
Nutritional Management in the critically ill patient • Assessing nutritional status of patient • Implications of undernourishment in critically ill patients • Fluid & electrolyte management • Administering nutrition support • Therapeutic diet - various disease conditions, total parenteral and enteral nutrition. |
• Lecture • Discussion
• Demonstration on connecting TPN
• Self-study on supplementation along with TPN and jejunostomy schedule |
• Return Demonstration |
|
VIII |
2 (T) |
Demonstrate skill in providing care for dying patients and provide counselling |
Care of Dying Patients • Spiritual support to the dying • Grief and grieving process • Bereavement support • Organ donation & counselling • Care of dead |
• Lecture
• Group discussion |
• Case presentation |
3. Critical Care 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: 110 hours & 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 various critical conditions.Course Content
|
Unit |
Time (hours) |
Learning Outcomes |
Content |
Teaching/ Learning Activity |
Assignments/ Assessment Methods |
|
I |
10 (T) |
Demonstrate skill in assessing GI system of critically ill patient Describe the causes, pathophysiology, clinical types, clinical features, diagnosis, prognosis, and management: medical, surgical and demonstrate skill in providing nursing care for patients with gastrointestinal disorders |
Gastrointestinal System • Assessment and Monitoring of GI system Monitoring of Nutritional status, Intra-abdominal pressure, various imaging studies • Common Gastrointestinal disorders − Acute Gastrointestinal Bleeding − Hepatic Disorders - Fulminant hepatic failure & Hepatic encephalopathy − Acute Abdomen − Acute pancreatitis, Acute intestinal obstruction − Perforative peritonitis − Intra-abdominal hypertension. • Management Modalities − Liver Transplant |
• Lecture cum Discussion |
• Case Presentation |
|
II |
9 (T) 5 (L) |
Describe the causes, pathophysiology, clinical types, clinical features, diagnosis, prognosis, and management: medical, surgical and demonstrate skill in providing nursing care for patients with renal disorders |
Renal System •Assessment and diagnostic studies •Common renal disorders − Acute Kidney Injury (AKI) − Chronic Renal failure − Acute tubular necrosis • Management Modalities − Hemodialysis − Peritoneal Dialysis − Continuous Ambulatory Peritoneal Dialysis − Continuous arterio venous hemodialysis − Renal Transplant. |
• Lecture cum Discussion
• Demonstration on starting & connecting hemodialysis & Peritoneal dialysis |
• Return demonstration |
|
III |
10 (T) 5 (L) |
Demonstrate skill in assessing nervous system of critically ill patient Explain the Causes, pathophysiology, clinical types, clinical features, diagnosis, prognosis, and management: medical, surgical and nursing management of various neurological disorders |
Nervous System • Assessment and diagnostic test: Bi spectral Index monitoring, Train of Four Monitoring, Intra cranial Pressure (ICP) Monitoring, Monitoring of brain stem reflexes • Common neurological disorders − Cerebrovascular disease − Cerebrovascular accident − Seizure disorders − Guillain-Barre Syndrome − Myasthenia Gravis • Problems related to thermoregulation: Hypothermia & Hyperthermia − Unconsciousness − Persistent vegetative state − Coma − Intracranial Hypertension − Herniation Syndrome − Encephalopathy • Management Modalities − Craniotomy |
• Lecture
• Demonstration on assessment • Demonstration on connection of body warmer |
• Return demonstration on monitoring of ICP & brain stem reflexes
• Case presentation on various neurological disorders |
|
IV |
6 (T) |
Elaborate the causes, pathophysiology, clinical types, clinical features, diagnosis, prognosis, and management: medical, surgical and nursing management of various endocrine disorders |
Endocrine System • Hypoglycemia • Diabetic ketoacidosis • Thyroid crisis • Myxedema coma • Adrenal crisis • Syndrome of Inappropriate/ hypersecretion of Antidiuretic Hormone (SIADH) • Diabetes Insipidus |
• Lecture • Discussion on protocol on insulin infusion |
|
|
V |
15 (T) |
Demonstrate skill in performing trauma assessment Explain the mechanism of injury, clinical features, diagnosis and management: medical, surgical and nursing management of various injuries, various types of shock, SIRS, MODS, Drug Overdose, poisoning & AIDS |
Management of Other Emergency Conditions • Trauma: Mechanism of injury, Assessment - Primary Survey & Secondary survey, Thoracic injuries, abdominal injuries, Bladder trauma, Pelvic fractures, Head injuries, Spinal cord injuries, & Complications of trauma • Shock: Shock syndrome, Hypovolemic shock, cardiogenic shock, Anaphylactic shock, neurogenic shock, Septic shock. • Inflammatory Response: Systemic Inflammatory Response Syndrome (SIRS), Multiple Organ Dysfunction Syndrome (MODS) • Disseminated Intravascular Coagulation (DIC) • Drug Overdose and poisoning • AIDS: Acquired Immuno- Deficiency Syndrome |
• Lecture
• Discussion • Demonstration on assessment & immobilisation of cervical spine using collar |
• Return Demonstration on assessment such as primary survey and secondary survey |
|
VI |
20 (T) 5 (L) |
Demonstrate skills in performing assessment of cardiovascular system Describe the causes, pathophysiology, clinical types, clinical features, diagnostics, prognosis, management: medical, surgical and nursing management of cardiovascular disorders Demonstrate skill in performing Cardio Pulmonary Resuscitation & defibrillation |
Intensive Cardiothoracic Nursing • Assessment & diagnostic tests: ECG, Cardiac enzymes studies, Holter monitoring, Stress test, Echocardiography, Coronary angiography, Nuclear medicine studies, Hemodynamic monitoring includes ABP, CVP and PiCCO. • Common Cardiovascular disorders: − Hypertensive Crisis − Coronary Artery Disease − Acute Myocardial Infarction Cardiomyopathy − Deep Vein Thrombosis − Valvular Diseases − Heart Block − Cardiac Arrhythmias & Conduction Disturbances − Aneurysms − Endocarditis − Heart Failure − Management Modalities − Cardiopulmonary Resuscitation: BCLS/ACLS − Thrombolytic Therapy − Pacemaker - Temporary & Permanent − Percutaneous Transluminal Coronary Angioplasty − Cardioversion − Intra-Aortic Balloon Pulsations − Defibrillations − Cardiac Surgeries − Coronary Artery Bypass Grafts (CABG/MICAS) − Valvular Surgeries − Heart Transplantation − Autologous Blood Transfusion − Radiofrequency Catheter Ablation |
• Lecture
• Discussion
• Demonstration
• Demonstration on CPR |
• Return demonstration on hemodynamic monitoring
• Interpretation of normal ECG
• Interpretation of arrhythmias
• Return demonstration on CPR, use of defibrillator |
|
VII |
15 (T) 5 (L) |
Demonstrate skills in performing assessment of cardiovascular system Elaborate the causes, pathophysiology, clinical types, clinical features, prognosis, and management: medical, surgical and nursing management |
Respiratory System • Assessment and Diagnostic tests: Arterial Blood Gas analysis, ETCO2 Monitoring, Pulse oximetry, Chest X-ray, Pulmonary Angiography, Bronchoscopy, Pulmonary function Test, Ventilation perfusion scan, Lung ventilation scan. • Acid-base balance & imbalance • Common Pulmonary disorders − Status Asthmaticus − Interstitial Lung Disease − Pleural Effusion − Pulmonary Edema − Atelectasis − Pulmonary Embolism − Acute Respiratory Failure − Acute Respiratory Distress Syndrome (ARDS) − Chest Trauma − Haemothorax − Pneumothorax • Management Modalities − Airway Management − Ventilatory Management: Invasive, non-invasive, long term mechanical ventilations. − Bronchial Hygiene: Suctioning, Nebulization, deep breathing exercise, chest physiotherapy, postural drainage, intercoastal drainage, thoracic surgeries. |
• Lecture
• Discussion
• Demonstration
• Self-study
• Demonstration on prone positioning • Videos on techniques of airway management • Demonstration on setting up of mechanical ventilator & bronchial hygiene |
• Return demonstration on sampling, testing and interpreting of ABG analysis, ETCO2 monitoring & interpretation of normal & abnormal chest x-ray • Return demonstration on airway management • Return demonstration on setting up of mechanical ventilator & bronchial hygiene |
|
VIII |
5 (T) 5 (L) |
Explain the clinical types, classification, pathophysiology, clinical features, assessment, diagnosis, prognosis, and management: medical, surgical and demonstrate skill in caring for patients with burns |
Integumentary System • Burns • Management modalities − Fluid and electrolyte therapy - calculation of fluids and its administration − Wound care − Grafts and flaps − Reconstructive surgery |
• Lecture • Discussion • Seminar on various management modalities • Demonstration on burn dressing |
• Calculation of fluid and electrolyte requirement for patients with burns • Return demonstration on burn dressing |
|
IX |
10 (T) 2 (L) |
Explain the causes, pathophysiology, clinical types, clinical features, diagnostic, prognosis, and management: medical, surgical and nursing management of neonatal and pediatric emergencies and congenital disorders |
Neonatal & Paediatric Nursing • Assessment of newborn, Low Birth Weight infant • Common Neonatal emergencies − Asphyxia Neonatorum − Pathological Jaundice in Neonates − Neonatal Seizures − Metabolic Disorders − Intracranial Hemorrhage − Neonatal Sepsis − RDS/HMD (Respiratory Distress Syndrome/Hyaline Membrane Disease) − Status Asthmaticus. • Congenital Disorders − Cyanotic Heart Disease − Tracheoesophageal Fistula − Congenital Hypertrophic Pyloric Stenosis − Imperforate Anus • Paediatric Emergencies • Dehydration − Acute Broncho Pneumonia − Acute Respiratory Distress Syndrome − Poisoning − Foreign Bodies • Management Modalities − Management of Hypothermia, Ventilator Management • Psychosocial issues of the child and family |
• Lecture • Demonstration on assessment • Group Discussion |
• Written report on assessment of Newborn Low Birth Weight infant |
|
X |
10 (T) 3 (L) |
Elaborate the causes, pathophysiology, clinical types, clinical features, diagnostic, prognosis, and management: medical, surgical and nursing management of obstetrical emergencies |
Obstetrical Emergencies
• Common Obstetrical Emergencies − Antepartum Haemorrhage − Preeclampsia − Eclampsia − Obstructed Labour − Ruptured Uterus − Post-Partum Haemorrhage − Puerperal Sepsis − Obstetrical Shock |
• Lecture
• Discussion |
• Case Presentation |
Practicum (Sksill Lab & 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. Assess patients with critical care conditions
2. Assist and perform special procedures in critical care settings
3. Prepare and care for patients admitted in critically ill unit
4. Assess and manage special groups like pediatric and geriatric patients with critical care conditions/disorders
5. Care for Vascular access devices
6. Maintain and store drugs and keep daily record.
|
Areas |
Duration (week/s) |
Clinical Learning Outcomes |
Skills/Procedural Competencies |
Assignments |
Assessment Methods |
|
Emergency care |
4 |
Provide nursing care for patients suffering from critical conditions/ disorders Prepare and assist in resuscitation of patients Provide effective counselling |
• History taking • Physical assessment • Assisting in Diagnostic tests • Preparation of crash cart for emergency management • Performing basic life support • Assisting with advanced life support • Preparation of patients to shift to operating room / intensive care units • Provide patient and family counselling |
• Health assessment report
• Case study report
• Prepare an algorithm for BLS and ACLS
• Health counselling |
• Clinical evaluation
• Case report evaluation
• Clinical presentation |
|
Coronary and cardiothoracic intensive care unit |
6 |
Provide comprehensive care for patients with cardiac and respiratory critical conditions |
• History taking and physical examination of patients with cardiac and lung disorders • Interpretation of ECG • Preparation of patients for cardiac and respiratory investigations • Providing competent care to patients with medical and surgical emergency conditions • Use of defibrillator |
• Cardiothoracic assessment report |
• Clinical evaluation
• Case report evaluation
• Clinical presentation |
|
Medical intensive care unit (Respiratory, renal, gastroenterology, endocrine) |
10 |
Provide holistic care for patients with medical intensive care conditions |
• History taking and physical examination of patients with cardiac and lung disorders • Interpretation of ABG • Preparation of patients for diagnostic procedures • Interprets the clinical findings of the patients • Providing competent care to patients with medical and surgical emergency condition • Monitoring CVP and ABP of the patients |
• ABG interpretation |
• Clinical evaluation
• Case report evaluation
• Clinical presentation |
|
Neurological intensive care unit |
6 |
Care for patients with neurological emergency conditions |
• History taking and physical examination of patients with neurological critical conditions • Assessment of Glasco Coma Scale • Preparation of patients for diagnostic procedures • Interpretation of clinical findings of the patients • Assisting patients with neurological therapeutic procedures • Monitoring patients with neurological critical conditions |
• ABG interpretation |
• Clinical evaluation
• Case report evaluation
• Clinical presentation |
|
Surgical intensive care unit |
10 |
Provide comprehensive care to patients with surgical critical care conditions |
• History taking and physical examination of patients with cardiac and lung disorders • Interpretation of ABG • Preparation of patients for diagnostic procedures • Interpretation of clinical findings of the patients • Providing competent care to patients with medical and surgical emergency condition • Caring for patients on mechanical ventilation |
• ABG interpretation |
• Clinical evaluation
• Case report evaluation
• Clinical presentation |
|
Paediatric intensive care units |
4 |
Provide comprehensive care to children with critical conditions |
• History taking and physical examination of children with critical conditions • Preparation of children for diagnostic procedures • Interpretation of the clinical findings • Providing competent care to children with critical conditions |
• Growth and development of children - assessment |
• Clinical evaluation
• Case report evaluation
• Clinical presentation |
|
Burns and plastic surgery unit |
2 |
Provide competent care to patients with burns and other critical conditions requiring plastic surgery |
• History taking and physical examination of patients with cardiac and lung disorders • Fluid management in burns patients • Preparation of patients for diagnostic procedures • Interpretation of the clinical findings • Providing competent care to patients with burns and other critical conditions requiring plastic surgery |
• Fluid resuscitation in burns |
• Clinical evaluation
• Case report evaluation
• Clinical presentation |
Appendix 1
Skill Lab Requirements
(List Of Equipment for Icu Skill Lab)
|
S.No. |
Name of equipment |
Qty. |
|
General equipment |
||
|
1 |
Electronic ICU Cot with related attachments with mattress and bed linen (One for every 5-10 students) |
1 |
|
2 |
Bedside trolley with basic patient care equipment & personal protective equipment |
1 |
|
3 |
Dressing trolley/Over bed trolley |
1 |
|
4 |
Sink with hand wash essentials and drier |
1 |
|
5 |
IV stand |
1 |
|
6 |
Colour-coded waste bins with lids |
1 |
|
7 |
Wall mounted ports for oxygen, medical air and vacuum |
1 |
|
8 |
Portable Oxygen Cylinder with Stand and oxygen flow meters |
|
|
9 |
Nebulizer machine with Nebulizer mask (Adult & Paediatric) |
1+1 |
|
10 |
Oxygen mask (Adult & Paediatric) |
1+1 |
|
11 |
Nasal cannula (Adult & Paediatric) |
1+1 |
|
12 |
BP monitor with Stethoscope (Adult & Paediatric) |
1+1 |
|
13 |
Glucometer |
1 |
|
14 |
Documentation flow charts |
|
|
ICU specific equipment |
||
|
1 |
Cardiac/multimodal monitor (hemodynamic monitoring) with accessories including monitor stand |
1 |
|
2 |
ECG Machine |
1 |
|
3 |
Crash Cart |
1 |
|
4 |
Defibrillator (Adult and Paediatric paddles) |
1+1 |
|
5 |
Ventilator |
1 |
|
6 |
Ambu Bag (Adult and Paediatric) |
1+1 |
|
7 |
NIV Mask (Adult and Paediatric) |
1+1 |
|
8 |
Pressure Bag |
1 |
|
9 |
Bain Circuit (Adult & Paediatric) |
1+1 |
|
10 |
Syringe Pump with stand |
1 |
|
11 |
Infusion Pump with stand |
1 |
|
12 |
High concentration mask (Adult & Paediatric) |
1+1 |
|
13 |
Ear probe (saturation monitoring)* |
1 |
|
14 |
Esophageal temperature probe* |
1 |
|
15 |
Bipap |
1 |
|
Tray sets for various procedures |
||
|
1 |
Intubation Tray (Adult) |
1 |
|
2 |
Intubation Tray(Paediatric) |
1 |
|
3 |
Tracheostomy Tray |
1 |
|
4 |
CVP Tray |
1 |
|
5 |
Catheterization Tray |
1 |
|
6 |
IV Cannulation Tray |
1 |
|
7 |
LP Tray |
1 |
|
8 |
Thoracentesis Tray |
1 |
|
9 |
Paracentesis Tray |
1 |
|
10 |
Blood Sample Collection Tray |
1 |
|
11 |
Emergency Medications Tray |
1 |
|
12 |
Arterial Line Tray |
1 |
|
14 |
Suture Removal Tray |
1 |
|
15 |
Suction Tray |
1 |
|
16 |
ICD /chest drainage Tray |
1 |
|
17 |
PPE Tray |
1 |
|
18 |
Spillage Kit |
1 |
|
19 |
Tubes, catheters, lines of different sizes |
|
|
20 |
Drugs, fluids, syringes, BG sets, IV sets, Arterial lines, Central lines as per skill requirements |
|
1. Airway management trainer/simulator - adult and pediatric (adult and pediatric Intubation techniques, ET suctioning and tracheostomy care)
2. Hemodynamic monitoring simulation kit (monitoring intra-arterial blood pressure, CVP, and ICP)
3. ECG simulator
4. Adult and Pediatric CPR (BLS & ACLS modes) simulation mannequin
5. Adult and pediatric IV training arm kit, (IV line insertion, blood transfusion)
6. Arterial puncture arm simulator
7. Central venous simulator
8. Female and male catheterization mannequin
9. High fidelity simulator - clinical scenarios and management of emergency situations*
*If this is available and includes the above (1-8), individual trainer/simulator is not required. One high fidelity simulator for 5-10 students is the requirement.
Appendix 2
Assessment Guidelines (Theory & Practicum)
I. TheoryA. Internal Assessment
Critical Care Specialty Nursing (Part I - Critical Care Specialty Nursing I including Foundations to Critical Care Specialty Nursing practice & Part II - Critical Care Specialty Nursing II)- Total: 25 marks
• Test papers & Quiz - 10 marks
• Written assignments - 10 marks (Code of ethics relevant to critical care nursing practice, literature review on EBP in critical care nursing/ Infection control practices, Nutritional care of critically ill patients)
• Group project - 5 marks
B. External/final Exams
Critical Care Specialty Nursing (Part I - Critical Care Specialty Nursing I including Foundations to Critical Care Specialty Nursing practice & Part II - Critical Care Specialty Nursing II)- Total: 75 marks
Part I - 35 marks (Essay type 1 × 15 marks = 15, Short answers 4 × 4 marks = 16, Very short answers 2 × 2 marks = 4) and Part II - 40 marks (Essay 1 × 15 marks = 15, Short answers 5 × 4 marks = 20, Very short answers 5 × 1 mark = 5)
II. PracticumA. 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 & Case study report - 5 marks, Counseling 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 given in Guidebook.
Appendix 3
Clinical Log Book
(Specific Procedural Competencies/Clinical Skills)
|
S.No. |
Specific Competencies/Skills |
Number Performed/ Assisted/Observed (P/A/O) |
Date & Signature of the Faculty |
|
I |
Foundations To Critical Care Specialty Nursing |
||
|
1 |
Preparation of patient education materials |
P |
|
|
2 |
Patient education plan for teaching patients/relatives of critically ill patients |
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 |
EBP Project (Group Project) - Implementation on evidence based nursing intervention/s OR Research Project (Group) Topic: |
P |
|
|
II |
Critical Care Specialty Nursing |
||
|
1 |
Health Assessment |
||
|
1.1 |
History taking and physical examination for adult critically ill patient |
P |
|
|
1.2 |
History taking and physical examination for paediatric critically ill patient |
P |
|
|
1.3 |
Neurological assessment |
P |
|
|
1.4 |
Neonatal assessment |
P |
|
|
1.5 |
Burns assessment |
P |
|
|
1.6 |
Triaging |
P |
|
|
2 |
Diagnostic Procedures |
||
|
2.1 |
Echocardiogram |
O |
|
|
2.2 |
Ultrasound |
O |
|
|
2.3 |
CT scan |
O |
|
|
2.4 |
MRI |
O |
|
|
2.5 |
PET scan |
O |
|
|
2.6 |
Intravenous pyelogram |
O |
|
|
2.7 |
EEG |
O |
|
|
2.8 |
Bronchoscopy |
O |
|
|
2.9 |
ECG |
P |
|
|
2.10 |
Blood sampling for lab tests |
P |
|
|
3 |
Therapeutic Procedures/specialized Procedures In CCU |
||
|
3.1 |
Monitoring ICP |
A |
|
|
3.2 |
Advanced life support |
A |
|
|
3.3 |
Chest tube insertion |
A |
|
|
3.4 |
Endotracheal intubation |
A |
|
|
3.5 |
Central line - Insertion of central catheter and PICC |
A/P (as per institutional protocol) |
|
|
3.6 |
Care of central catheter and PICC |
P |
|
|
3.7 |
Arterial line |
A |
|
|
3.8 |
Cardiac pacing |
A |
|
|
3.9 |
Use of defibrillator |
P |
|
|
3.10 |
Endoscopy |
A |
|
|
3.11 |
Hemodialysis |
A |
|
|
3.12 |
Peritoneal dialysis |
A |
|
|
3.13 |
Pulse oximetry |
P |
|
|
3.14 |
Arterial BP monitoring |
P |
|
|
3.15 |
Venous access - Insertion of IV cannula |
P |
|
|
3.16 |
ABG analysis |
P |
|
|
3.17 |
Oxygen administration |
P |
|
|
3.18 |
Endotracheal Suctioning |
P |
|
|
3.19 |
Tracheal suctioning |
P |
|
|
3.20 |
Application of oropharyngeal airway |
P |
|
|
3.21 |
CPAP |
P |
|
|
3.22 |
Tracheostomy care |
P |
|
|
3.23 |
Care of intercostal drainage |
P |
|
|
3.24 |
Use of monitors for critically ill patients |
P |
|
|
3.25 |
Gastric lavage |
P |
|
|
3.26 |
Ventilator setting |
P |
|
|
3.27 |
Orogastric tube insertion |
P |
|
|
3.28 |
Use of body warmer |
P |
|
|
3.29 |
Administration of drugs |
P |
|
|
3.30 |
Use of infusion pump |
P |
|
|
3.31 |
Intravenous therapy |
P |
|
|
3.32 |
Administration blood and blood products |
P |
|
|
3.33 |
Care of patient with burns |
P |
|
|
4 |
Care of Critically ILL Patients |
||
|
4.1 |
Admission and discharge of critically ill patients |
P |
|
|
4.2 |
Postoperative care |
P |
|
|
4.3 |
Patient education & counselling |
P |
|
|
4.4 |
Home care |
P |
|
|
5 |
Quality Control |
||
|
5.1 |
Preparation of SOP for infection control in intensive care units |
P |
|
|
5.2 |
Preparation of SOP for burns management |
P |
|
|
5.3 |
Preparation of SOP for blood transfusion |
P |
|
|
5.4 |
Preparation of SOP for resuscitation |
P |
|
|
5.5 |
Conducting unit audit |
P |
|
|
6 |
Asepsis |
|
|
|
6.1 |
Sterilization/Disinfection |
P |
|
|
6.2 |
Fumigation |
P |
|
|
7 |
Others |
||
|
7.1 |
Consent taking |
P |
|
|
7.2 |
Immunization |
P |
|
|
7.3 |
Guidance & counselling |
P |
|
* - When the student is found competent to perform the skill, the faculty will sign it.
Students. - Students are expected to perform the listed skills/competencies many times until they reach level 3 competency, after which the faculty signs against each competency. Faculty. - Must ensure that the signature is given for each competency only after they reach level 3.• Level 3 competency denotes that the student is able to perform that competency without supervision.
• Level 2 Competency denotes that the student is able to perform each competency with supervision.
• Level 1 competency denotes that the student is not able to perform that competency/skill even with supervision.
Appendix 4
Clinical Requirements
|
S.No. |
Clinical Requirement |
Date |
Signature of the Faculty/Preceptor |
|
1 |
Health talk (Intensive Care Unit/Emergency Department) |
|
|
|
1.1 |
Topic: |
|
|
|
1.2 |
Topic |
|
|
|
2 |
Counselling Patients & Relatives Counselling report - 1 |
|
|
|
3 |
Health Assessment |
|
|
|
3.1 |
Health Assessment (adult) - History & Physical Examination (Three written reports) 3.1.1. 3.1.2. 3.1.3. |
|
|
|
3.2 |
Health Assessment (Pediatric) - History & Physical Examination (Two written reports) 3.2.1. 3.2.2 |
|
|
|
4 |
Clinical Seminar/Journal Club/ Clinical Conference Topic: |
|
|
|
5 |
Case study/Clinical presentation & Report - Adult critical care unit - 1 & Paediatric critical care unit (Nursing/interdisciplinary rounds) |
|
|
|
5.1 |
Name of clinical condition: |
|
|
|
5.2 |
Name of clinical condition: |
|
|
|
6 |
Drug study, presentation and report (Two written reports for submission) |
|
|
|
6.1 |
Drug name: 6.2 6.3 6.4 |
|
|
|
7 |
Designing Critical Care Unit |
|
|
|
Signature of the Faculty |
Signature of the HOD/Principal |
Appendix 5
Clinical Experience Details
|
Name of ICU |
Clinical Condition |
Number of days care given |
Signature of Faculty/Preceptor |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Signature of the Program Coordinator/Faculty |
Signature of the HOD/Principal |
