In exercise of the powers conferred by sub section 1 of Section 16 of Indian Nursing Council Act,

CG-DL-E-23102024-258163 EXTRAORDINARY PART III—Section 4 i. ;s fofu;e dgs tk;saxsA ii. ;s fofu;e Hkkjr ds jkti= esa budh vfèklwpuk dh frfFk ls çHkkoh gksaxsA bu fofu;eksa esa] tc rd fd lanHkZ ls vU;Fkk visf{kr u gks] 6837 GI/2024 (1) iv. ^vkj,u ,aM vkj,e* dk vfHkçk; ,d iathÑr mip;kZ ,oa iathÑr çlkfodk ¼vkj,u ,aM vkj,e½ ls gS I. II. III. fof'k"V uÉlx O;kolkf;d dq'kyrk esa ç;qDr lkekU; foKku vkSj ijke'kZ vkadyu vkSj fof'k"V eè;orZuksa lfgr uSnkfud usr`Ro vkSj lalkèku uÉlx çcaèku çcaèku 'kksèk lacafèkr foospu IV. V. VI. a. 1%10 ds vuqikr esa iw.kZdkfyd f'k{k.k ladk;A b. f'k{k.k ladk; esa U;wure nks lnL; gksus pkfg;sA c. ;ksX;rk ,oa la[;k% iksLV csfld fMIyksek & 1 d. vuqHko% dkÆM;ksFkksjsfld Lisf'k;fyVh uÉlx esa U;wure rhu o"kZ dk uSnkfud vuqHkoA e. vfrfFk ladk;% lacafèkr fof'k"Vrkvksa esa cgq&fo"k;dA f. çhlsIVj% a. U;wure 200 'kS¸;k okys vius Lo;a ds ,sls fof'k"V vLirky@r`rh;d vLirky ftuesa o{k&xºoj bl dk;ZØe esa ços'k ikus okys Nk= dks] a. ,u;wvkbZMh uacj ds lkFk fdlh ,d ,l,uvkjlh esa ,d iathÑr ulZ ¼vkj,u ,aM vkj,e½ ;k led{k gksuk pkfg;sA b. ukekadu ls igys vfèkekur% dkÆM;ksFkksjsfld bdkbZ esa LVkQ ulZ ds in ij U;wure ,d o"kZ dk ij gksuk pkfg;sA e. vU; ns'kksa ds ulks± dks ços'k ls igys ifj"kn~ ls lerqY;rk çek.k i= çkIr djuk gksxkA a. lsokjr vH;fFkZ;ksa dks fu;fer osru feyrk jgsxkA b. vU; vH;fFkZ;ksa dks dk;ZØe dk lapkyu djus okys vLirky dh osru lajpuk ds vuqlkj othQk@osru feysxkA VII. ifj"kn~ }kjk vuqeksfnr lacafèkr ijh{kk cksMZ@ ,l,uvkjlh@fo'ofo|ky;A a. mifLFkfr% lS)kafrd ,oa çk;ksfxd & 80 çfr'krA ijUrq çek.ki= feyus ls igys 100 çfr'kr uSnkfud VIII. | | 25 ¼10 $ 15½ | 75 ¼35 $ 40½ | 100 | 3 | |---|---|---|---|---| | dkÆM;kFs kksjfsld Lisf'k;fyVh uÉlx ¼Hkkx-I o Hkkx-II½ ¿Hkkx-I & dkÆM;kFs kksjfsld Lisf'k;fyVh uÉlx I ds lkFk&lkFk dkÆM;ksFkksjsfld Lifs'k;fyVh uÉlx vH;kl ds ewy] Hkkx-II & dkÆM;ksFkksjsfld Lisf'k;fyVh uÉlx IIÀ | | | | | | | 75 ¼25 $ 50½ ¼vks,llhbZ&25 ,o a çk;ksfxd voyksdu&50½ | 150 ¼50 $ 100½ ¼vks,llhbZ&50 ,o a çk;ksfxd voyksdu&100½ | 225 | uSnkfud {k=s es a U;wure 5&6 ?kVa s | | • ekSf[kd ijh{kk lfgr oLrqfu"B lajfpr uSnkfud ijh{kk ¼vks,llhbZ½ • i;Zofs{kr çk;ksfxd@uSnkfud voyksdu% ekSf[kd ijh{kk ds lkFk&lkFk okLrfod ifjfLFkfr;ks a es a çR;{k voykds u & 3&4 ?kVa s dk y?kq uSnkfud vkadyu vH;kl ¼uÉlx çfØ;k vkosnu o dk;Zfofèkd n{krk dk çR;{k voyksdu½ | | | | | IX. 1- vuqns'k ikB&;kstuk 2- ikBîØe dk dk;kZUo;u 3- uSnkfud vH;kl ¼vkoklh; inLFkkiu½ 4- çf'k{k.k fofèk;ka 5- vkadyu fofèk;ka 6- ykWx cqd vkSj uSnkfud vgZrk,a | I II | 1- O;kolkf;d dq'kyrk 2- fof'k"V uÉlx dk;ZØe esa laokn] jksxh f'k{kk o ijke'kZ 3- fo'k"sk ns[kHkky ifjfLFkfr;kas esa uSnkfud usrRo vkSj ` lalkèku çcaèku 4- fof'k"V uÉlx dk;ZØe esa lk{; vkèkkfjr vkSj vuqç;qDr 'kksèk I 1- fof'k"V uÉlx dk lanHkZ@ifjp; 2- fo'k"sk ns[kHkky es a ç;qDr lkekU; foKku & ,ukVkWeh o fQft;kys kWth] ekbØkcs k;ksykWth] QkekZdksykWth o iSFkksfQft;kys kWth tSlh uSnkfud fLFkfr;ksa dk funku vkSj mipkj II 1- vkadyu] funku] mipkj vkSj fo'k"sk eè;orZu ds lkFk uSnkfud ifjfLFkfr;kas esa uÉlx çcèa ku 2- jksxh lqj{kk vkSj xq.koÙkk 3- fof'k"V@chekjh fof'k"V foops u ¼lgk;d n[s kHkky@ ç'kked n[s kHkky@iquokZl] O;fDr] ifjokj vkSj leqnk; ij chekjh dk çHkko½ | 40 50 110 | 10 30 | 1730 | |---|---|---|---|---| × × çf'k{k.k vofèk ds nkSjku Nk=ksa dk fuEukafdr uSnkfud {ks=ksa esa inLFkkiu fd;k tk;sxkA | 1 | dkÆM;kFs kksjfsld okMZ | 12 | |---|---|---| | 2 | 'kY; fpfdRlk d{k & vksVh ¼dkÆM;d vkSj Fkksjfsld½ | 8 | | 3 | vkikrdkyhu n[s kHkky bdkbZ | 4 | | 4 | dSFk ySc ds lkFk Mk;XuksfLVd ySc | 2 | | 5 | dkÆM;kFs kksjfsld xgu n[s kHkky bdkbZ | 12 | | 6 | f'k'kq dkÆM;kFs kksjfsld xgu ns[kHkky bdkbZ | 2 | | 7 | cká jkxs h foHkkx | 2 | | I | 6 | O;kolkf;d dq'kyrk dh le> dk çn'kZu vkSj dkÆM;kFs kksjfsld uÉlx vH;kl esa O;kolkf;d dq'kyrk dk çn'kZu djuk | • vfHkçk; vkSj fl)kra % dkÆM;kFs kksjfsld Lisf'k;fyVh uÉlx vH;kl esa tokcngs h] lqfoKrk] n';rk vkSj uSfrdrk ` • O;kolkf;d ewY; vkSj O;kolkf;d O;ogkj • ifj"kn dh vkpkj lafgrk] ~ O;kolkf;d vkpj.k lafgrk vkSj vH;kl ekud • dkÆM;kFs kksjfsld uÉlx vkSj ân; rFkk QsQMs ds çR;kjkis .k + ls lacafèkr uSfrd eqís • ulZ dh çlkjh Hkwfedk% ulZ çfsDV'kuj • O;kolkf;d laxBu • lrr uÉlx f'k{kk | • ifjppkZ | • dkÆM;kFs kksjfsld uÉlx ls lacafèkr vkpkj lafgrk dk o.kZu djuk | |---|---|---|---|---|---| | | | dkÆM;kFs kksjfsld uÉlx vkSj ân; çR;kjksi.k ds fpfdRlh;& fofèkd igyqvksa dk o.kZu djuk | • dkÆM;kFs kksjfsld uÉlx ls lacfaèkr dkuuw vkSj fu;e • miHkksDrk laj{k.k vfèkfu;e • ykijokgh vkSj dnkpkj • fpfdRlh;&fofèkd igyw • fjdkWMZ vkSj fjiksVZ • dkÆM;kFs kksjfsld Lisf'k;fyLV ulk±s dh dkuwuh ftEesnkfj;ka | • O;k[;ku | • jksfx;kas dk fjdkWMZ j[kuk | | II | 12 | dkÆM;kFs kksjfsld jksfx;kas] ifjtuks a vkSj O;kolkf;d lg;ksfx;ksa ls vkilh esytksy ds lkFk LokLF; ifj.kkeksa eas lqèkkj ykus ds fy;s lk>k fu.kZ; ysdj çHkkoh <xa ls laokn LFkkfir djuk mipkj vkSj n[s kHkky es a çHkkoh <xa ls Hkkxhnkjh fuHkkus ds fy;s jksfx;kas rFkk ifjtuks a dks f'kf{kr djuk vkSj ijke'kZ nsuk dkÆM;kFs kksjfsld bdkbZ es a uÉlx vfèkdkfj;kas] Nk=ksa vkSj iSjkesfMdy LVkQ dks çf'kf{kr djuk | • laokn ç.kkyh vkSj rduhd • ân; rFkk o{k&xºoj lacaèkh ¼dkÆM;kFs kksjfsld½ fodkjks a ls ihfMr rFkk xyr funku okys + jksfx;kas dk s nq%[kn lekpkj lqukuk • laLÑfr vuqlkj laons ukiwoZd laokn • uÉlx n[s kHkky ;kstukvksa dk fodkl vkSj vfHkys[k • laokn esa mi;ksxh lwpuk çkS/kfsxdh midj.k • nyh; laokn • f'k{k.k vkSj vè;;u ds fl)kar • LokLF; f'k{kk ds fl)kra • lwpuk dh t:jrks a dk vkadyu vkSj jksxh çf'k{k.k ds lkFk&lkFk çR;kjksi.k jksxh çf'k{k.k • dkÆM;kFs kksjfsld uÉlx ds fy, çklafxd jksxh çf'k{k.k lkexzh fodflr djuk • ijke'kZ rduhd • ifjokj ds fy, vkuqoaf'kd ijke'kZ • nq%[kn lekpkj] xgu mipkj] ladVdkyhu eè;orZu vkSj ej.kklUu jksxh vkSj mlds ifjtukas dks ijke'kZ nsuk • ân;@QsQMs ds çR;kjksi.k + jksfx;kas vkSj ifjtukas ds fy, ijke'kZ | • O;k[;ku • nq%[kn lekpkj nus s es a Hkfwedk fuHkkuk • led{k çf'k{k.k • ijke'kZ l= | • fMftVy fjdkWMZl ~ • dkÆM;kFs kksjfsld fodkjkas ls xzlr jksfx;kas ds fy;s lkefwgd LokLF; çf'k{k.k dk;ZØe dk lapkyu djuk • çklafxd fo"k; ij jksxh çf'k{k.k lkexzh rS;kj djuk | |---|---|---|---|---|---| | III | 12 | uSnkfud urs Ro vkSj ` çcaèku j.kuhfr;kas dh le> dk çn'kZu djuk vkSj lg;kxs h ,oa çHkkoh nyh; dk;Z dks c<kok nsu s ds fy;s + mudk dkÆM;kFs kksjfsld n[s kHkky rFkk | • urs Ro vkSj çcaèku ` • dkÆM;kFs kksjfsld uÉlx n[s kHkky ds çcèa ku ds rRo & ;kts uk] vk;kts u] LVkQ] fjiksfV±x] fjdkWfM±x vkSj ctV • uSnkfud urs Ro vkSj bldh ` pqukSfr;ka | • O;k[;ku | • dkÆM;kFs kksjfsld foHkkx es a dk;Zjr dfu"B uÉlx vfèkdkfj;kas@ LVkQ ulk±s ds fy;s MîwVh jksLVj rS;kj djuk | | | | lek;kts u es a mi;kxs djuk 'kY;&fpfdRlk ds mijkar dkÆM;kFs kksjfsld jksfx;kas dh n[s kHkky dju s ds fy, bdkbZ rS;kj djuk uSnkfud ijh{k.k djuk vkSj dkÆM;kFs kksjfsld vkbZlh;w vkSj okMZ es a xq.koÙkk vk'oklu xfrfofèk;ksa eas Hkkx ysuk | • dkÆM;kFs kksjfsld bdkb;ks a es a ekuo lalkèku çcaèku • lkexzh çcaèku • ,d vkn'kZ dkÆM;ksFkksjsfld okMZ@vkbZlh;w] Ms ds;j vkSj çR;kjksi.k bdkbZ dh :ij[s kk rS;kj djuk • HkkoukRed cqf)eÙkk vkSj Lo&çcaèku dkS'ky • vra %fo"k;d ny ds lnL; ds :i esa dk;Z djuk • dkÆM;kFs kksjfsld jkfsx;kas dh n[s kHkky ds fy;s uhfr;kas dks çklafxd cuku s es a Hkkxhnkj cuuk • dkÆM,d lhlh;w] dkÆM;kFs kksjfsld vkbZlh;w vkSj okMZ dh O;oLFkk djuk • uÉlx vkWfMV • uÉlx ekud • xq.koÙkk vk'oklu | • ekWMîwy & çR;k;u vkSj vH;kl ekud | • vkn'kZ dkÆM;kFs kksjfsld okMZ vkSj Ms ds;j dh :ijs[kk rS;kj djuk • dkÆM;kFs kksjfsld lhlh;w vkSj okMZ esa jksxh ns[kHkky ds fy;s ,lvksih fodflr djuk | |---|---|---|---|---|---| | IV | 10 | 'kksèk çfØ;k dk o.kZu djuk vkSj ewyHkrw lkaf[;dh; ijh{k.k djuk dkÆM;kFs kksjfsld uÉlx ds fy, çklafxd O;kolkf;d vH;kl es a lk{; vkèkkfjr@lokZsÙke çFkkvks a dks ykxw djuk | • uÉlx 'kksèk vkSj 'kkès k çfØ;k dk ifjp; • MsVk çLrqfr] ewyHkwr lkfa[;dh; ijh{k.k vkSj blds vuqç;kxs • dkÆM;kFs kksjfsld uÉlx es a 'kkès k çkFkfedrk,a • dkÆM;kFs kksjfsld uÉlx vH;kl ds fy;s çklafxd leL;kvkas@ç'ukas dh vfHkO;fDr • dkÆM;kFs kksjfsld uÉlx vH;kl es a lk{; vkèkkfjr@lokZsÙke çFkkvks a dh igpku djus ds fy;s lkfgfR;d leh{kk • nSfud O;kolkf;d vH;kl esa lk{; vkèkkfjr eè;orZu dk dk;kZUo;u • 'kksèk es a uSfrdrk | • O;k[;ku • ekWMîwy% oSKkfud çi= ys[ku | • dkÆM;kFs kksjfsld jksfx;kas ds xr ikap o"kZ ds lkfa[;dh; vkadMs rS;kj djuk + • dkÆM;kFs kksjfsld uÉlx eè;orZu@ lk{; vkèkkfjr vH;kl ifj;kts uk ij lkfgfR;d leh{kk dk lapkyu djuk | I | I | 4 ¼Vh½ | lkekU; dkÆM;kFs kksjfsld fodkjkas dh egkekjh foKku dh O;k[;k djuk] tkfs[ke dh igpku vkSj de dju s dh j.kuhfr;ka | • dkÆM;kFs kksjfsld fodkjkas dh egkekjh foKku & çlkj vkSj lkfa[;dh • tksf[ke dkjd vkSj igpku • tksf[ke de djus dh j.kuhfr;ka | • O;k[;ku vkSj ifjppkZ | • vkadMkas dh çLrqfr + | |---|---|---|---|---|---| | II | 2 ¼Vh½ | dkÆM;kFs kksjfsld uÉlx fl)kra ksa dh O;k[;k djuk dkÆM;kFs kksjfsld fo'ks"kK ulk±s dh Hkwfedk | • dkÆM;kFs kksjfsld fo'ks"kK uÉlx ds fl)kra • dkÆM;kFs kksjfsld fo'ks"kK ulk±s dh Hkwfedk • dkÆM;kFs kksjfsld fo'ks"kK uÉlx vH;kl dk nk;jk | • O;k[;ku vkSj ifjppkZ | | | III | 10 ¼Vh½ | dkÆM;kFs kksjfsld uÉlx n[s kHkky es a eukslkekftd igyqvksa dh O;k[;k djuk | • ekuo O;ogkj vkSj dkÆM;kFs kksjfsld foÑfr;ks a ls eqdkcyk djuk • dkÆM;kFs kksjfsld foÑfr;ks a ls ihfMr jksfx;ks a ds fy, + eukslkekftd lek;kts u dk s çHkkfor djus okys dkjd • eukslkekftd leL;kvkas dk çcèa ku • ekxZn'kZu vkSj ijke'kZ | • O;k[;ku • ijke'kZ% pj.kks a dh leh{kk djuk | • ijke'kZ l= vk;kfstr djuk | | IV | 8 ¼Vh½ 2 ¼,y½ | dkÆM;kFs kksjfsld lsVvi esa fpfdRlh;&'kY; fpfdRlh; viw;u vkSj laØe.k fu;a=.k dh O;k[;k djuk | • vi;w u] jksxk.kquk'ku vkSj dhVk.kq'kkès ku ds fl)kra • ekud lqj{kk mik; • tSo&fpfdRlh; vif'k"V çcèa ku • cSfj;j uÉlx vkSj laØe.k fu;a=.k çFkk | • O;k[;ku • çn'kZu | • dkÆM;kFs kksjfsld vkbZlh;w es a laØe.k fu;a=.k ds fy, ,lvksih rS;kj djuk | | V | 6 ¼Vh½ 2 ¼,y½ | ân; rFkk QsQMs dh + lajpuk vkSj dk;ks± dh O;k[;k djuk | • fny dk Hkzw.k fodkl • ân; dh lajpuk • pkyu ç.kkyh • ân; dk ifjlapj.k | • O;k[;ku • Lo&vè;;u • ân; rFkk QsQMs ds + e‚My vkSj ueuw s | • ç'uksÙkjh | | | | | • jDr okfgdk,a • 'olu ç.kkyh dh lajpuk vkSj dk;Z • QsQMkas dk Hkzw.k fodkl + • QsQMs ds xq.k + • oasfVys'ku vkSj fNMdko + | | | |---|---|---|---|---|---| | VI | 10 ¼Vh½ 4 ¼,y½ | fofHkUu ?kkrd vkSj xSj&?kkrd dkÆM;kFs kksjfsld fodkjkas ds fy, QkekZdksFksjsih dh O;k[;k djas | • ihMkuk'kd@çnkguk'kh ,tsVa + • çfrtSfod] iwfruk'kd • dkÆM;d vkikr fLFkfr esa mi;kxs dh tku s okyh vkS"kfèk;ka • ,aVh&FkzksEcksykbfVd ,tsaV • buksVªksfid ,tsVa • mPp jDrpki jksèkh vkS"kfèk;ka • ,aVh&dks,xqysaVl ~ • ,aVh,fjFkfed vkS"kfèk;ka • okfgdk&foLQkjd | • O;k[;ku vkSj ifjppkZ | • vkS"kfèk iqLrd tek djuk • buksVªksIl dh x.kuk ij ç'uksÙkjh • vkS"kfèk çLrqfr | | VII | 5 ¼Vh½ 2 ¼,y½ | dkÆM;kFs kksjfsld vkikr fLFkfr ds nkSjku jksfx;ksa ds çcèa ku dk çn'kZu | • lhihvkj&ch,y,l vkSj ,,y,l • oasVhysVj] MhfQfczysVj] ils esdj dk mi;kxs • iqutÊou ds ckn n[s kHkky | • fleqys'ku • midj.k dh okLrfodrk | • vks,llhbZ | | VIII | 5 ¼Vh½ | dkÆM;kFs kksjfsld tkap ds fy, jksxh dh rS;kjh ds ckjs es a crk,a | fcuk phjQkM okyh ¼xjS&buofslo½ + • bZlhth & vlkekU; bZlhth vkSj O;k[;k • bdkds kÆM;ksxzkQh • iYekus jh QaD'ku VsLV • dkÆM,d e‚fuVÇjx rduhd] psLV yhM vkSj eksfMQkbM yhM Iyls esaV • vk.kqfod uSnkfud çfØ;k,a • pqEcdh; vuqukn besÇtx • lhus dk ,Dl&js phjQkM okyh ¼buofslo½ + • czkasdkLs dkis h vkSj xzkfQDl • lhohih vkSj tsohih • jDr xSl vkSj budk egRo • dkÆM,d dSFkhVsjkbts'ku vkSj ,aft;kxs zkQh • èkeuh; fuxjkuh] Loku xat fuxjkuh • lhus dh Mk;XukfsLVd jsfM;ksxzkQh vkSj lhoh,l unS kfud ijh{k.kk sae saul Zdh Hkfwedk | • i;Zo{s k.k | • vks,llhbZ vkSj ç'uksÙkjh | II | I | 15 ¼Vh½ | ân; rFkk o{k&xºoj lacèa kh ¼dkÆM;kFs kksjfsld½ fodkjkas ds dkj.k] iSFkksfQft;kys kWth] çdkj] uSnkfud fo'ks"krk,a] funku] jksx funku vkSj fpfdRlh;] 'kY; fpfdRlh; çcèa ku dh O;k[;k djuk vkSj blls ihfMr jksfx;ks a + dks uÉlx n[s kHkky çnku dju s es a dkS'ky çn'kZu djuk | fuEukafdr ds dkj.k] uSnkfud vfHkO;fDr] funku] jksx funku] lacfaèkr iSFkksfQft;kys ‚th vkSj uÉlx çcaèku% • fny dh èkeuh dk jksx • fofHkUu çdkj ds ,utkbuk • dkÆM;kes sxkyh • ek;ksdkÆM;y jksèkxyu] datsfLVo dkÆM;d QsY;j • gVZ QsY;j] Qq¶Qqlh; ,fMek] 'k‚d • mPp jDrpki • vkeokrh okYo jksx • nkgd ân; jkxs ] laØked vUrâZn'kkFs k] ek;ksdkÆMfVl] ~ ifsjdkÆMfVl • dkÆM;kes k;ksiSFkh] Mk;sysVsM] jfsLVªfDVo] gkbijVª‚fQd | • ifjppkZ] O;k[;ku | • ç'uksÙkjh] fufgr dk;Z | |---|---|---|---|---|---| | II | 10 ¼Vh½ | Qq¶Qqlh; fodkjks a ds dkj.k] iSFkksfQft;kys kWth] çdkj] uSnkfud fo'ks"krk,a] funku] jksx funku vkSj fpfdRlh;] 'kY; fpfdRlh; çcèa ku dh O;k[;k djuk vkSj blls ihfMr jksfx;ks a + dks uÉlx n[s kHkky çnku dju s es a dkS'ky çn'kZu djuk | fuEukafdr ds dkj.k] uSnkfud vfHkO;fDr] funku] jksx funku] lacfaèkr iSFkksfQft;kys ‚th vkSj uÉlx çcaèku% • Qq¶Qqlkoj.k • U;weks] ges k s vkSj ik;FkksjSDl • vra jkyh; QsQMksa ds jkxs + • ,D;wV vkSj Ø‚fud v‚ClVªfDVo iYekus jh fMtht ¼fLFkfr;ka ftlds dkj.k ;s jkxs gk s ldr s gSa½ • czkfsUdbDVsfll • rh{.k 'olu foQyrk • o;Ld 'olu ladV ÇlMªkes • Qq¶Qqlh; vra %'kY;rk • QsQMkas dh èkefu;kas es a mPp + jDrpki | • ifjppkZ] O;k[;ku | • ç'uksÙkjh] fufgr dk;Z | | III | 5 ¼Vh½ 2 ¼,y½ | ils esdj ds mi;ksx vkSj mldks yxkus dk çn'kZu djuk | • vLFkk;h vkSj LFkk;h ils esdj ds çdkj • çR;ds çdkj ds fy, y{k.k • iÇslx çfØ;k ds fl)kra • ils esdj yxku s ls igys] blds nkSjku vkSj ckn esa jksxh f'k{k.k | • ifjppkZ] O;k[;ku • fleqys'ku | • ç'uksÙkjh] fufgr dk;Z] vks,llhbZ | |---|---|---|---|---|---| | IV | 5 ¼Vh½ 3 ¼,y½ | ân&laoguhdj.k ds nkSj ls xqtj jg s jksfx;kas dh rS;kjh vkSj n[s kHkky dh O;k[;k djuk | • ijD;wVsfu;l Vªkalywfeuy dksjksujh ,aft;ksIykLVh( LVsVa ] cSywu] çdkj% y{k.k] çfØ;k vkSj tfVyrk,a • laoguhdj.k ds fy, ystj Fksjis h | • ifjppkZ] O;k[;ku • fleqys'ku | • ç'uksÙkjh] fufgr dk;Z] vks,llhbZ | | V | 10 ¼Vh½ 5 ¼,y½ | vrkyrk ds fofHkUu çdkjksa dk s vyx djuk v‚VkseVs sM ,DlVuZy MhfQfczys'ku ¼,bZMh½ dk mi;kxs çnÆ'kr djuk | • lkbul vrkyrk • èkeuh; vrkyrk • taD'kuy ;k uksMy vrkyrk • oasfVªdqyj vrkyrk • ,oh Cy‚d • iSFkksfQft;kys ‚ftdy çfrfØ;k,a • vrkyrk dks fQj ls 'kq: djuk vkSj o'khdj.k fpfdRlk • Lopkfyr çR;kjkis .k ;kXs ; dkÆM;kos VZj MhfQfczysVj | • ifjppkZ] O;k[;ku • fleqys'ku | • ç'uksÙkjh] fufgr dk;Z] vks,llhbZ] ekey s dh çLrqfr | | VI | 5 ¼Vh½ 2 ¼,y½ | psLV Mªsuts ds mi;kxs dk çn'kZu djuk fofHkUu çdkj ds psLV Mªus ts vkSj muds mi;kxs ksa dh O;k[;k djuk | • vMa j okVj lhy Mªsuts ds fl)kra • midj.k] LFkkiuk] vkadyu] jkxs h n[s kHkky] tfVyrk,a • v‚VksVªkla ¶;wtu ds fl)kra ] y{k.k] tfVyrk,a] ns[kHkky] LFkkiuk | • ifjppkZ] O;k[;ku • fleqys'ku | • ç'uksÙkjh] fufgr dk;Z] vks,llhbZ | | VII | 15 ¼Vh½ 3 ¼,y½ | fofHkUu çdkj ds tUetkr ân; jksx] blds dkj.k] uSnkfud vfHkO;fDr] funku] jksx funku] lacafèkr iSFkksfQft;kys ‚th] vkSj fpfdRlh;] 'kY; fpfdRlh; uÉlx çcèa ku dh O;k[;k djuk | fuEukafdr ds dkj.k] uSnkfud vfHkO;fDr] funku] jksx funku] lacfaèkr iSFkksfQft;kys ‚th vkSj uÉlx çcaèku% • ân; dk Hkzw.kh; fodkl • oxÊdj.k & fl;kukfsVd vkSj vfl;kuksfVd ân; jkxs • QSykVs l dh VsVªky‚th ~ • vkfVZfj;y lsIVy nks"k] osfaVªdqyj lsIVy nk"sk] bZlsuesta j ÇlMªkse | • ifjppkZ] O;k[;ku | • ç'uksÙkjh] fufgr dk;Z] ekey s dh çLrqfr | | | | | • iVs asV MDVl vkVsZfj;kls l] ,ih ÇoMks • Vªadl vkVZsfj;kls l • cMh èkefu;kas dk LFkkukUrj.k + • Qq¶Qqlh; f'kjkijd dusD'ku dh dqy folaxfr • iYekus jh LVsuksfll] ,Vªfsl;k • egkèkeuh dk leUo; • ,cLVhu dh folaxfr • Mcy vkmVysV jkbV osfaVªdy] Çlxy osafVªdy] gkbiksIykfLVd ys¶V gkVZ ÇlMªkes | | | |---|---|---|---|---|---| | VIII | 10 ¼Vh½ | f'k'kqvkas es a ân; rFkk o{k&xºoj lacaèkh ¼dkÆM;kFs kksjfsld½ fodkjkas ds dkj.k] iSFkksfQft;kys kWth] çdkj] uSnkfud fo'ks"krk,a] funku] jksx funku vkSj çcaèku dh O;k[;k djuk | • of) vkSj fodkl dh leh{kk ` • f'k'kq ns[kHkky vkSj ifjtukas ds eukslkekftd igyw • vkWij's ku ls igy] blds nkSjku vkSj ckn esa ân; rFkk o{k&xºoj lacaèkh ¼dkÆM;kFs kksjfsld½ n[s kHkky • f'k'kqvkas es a nnZ dk vkadyu vkSj çcèa ku | • ifjppkZ] O;k[;ku | • ç'uksÙkjh] fufgr dk;Z] ekey s dh çLrqfr | | IX | 25 ¼Vh½ 10 ¼,y½ | fofHkUu ân; rFkk o{k&xºoj lacaèkh ¼dkÆM;kFs kksjfsld½ 'kY; fpfdRlkvkas ls xqtj jg s jksxh dh uÉlx n[s kHkky dk o.kZu djuk | • y{k.k] jksxh dk p;u • vkWij's ku ls igy vkadyu vkSj rS;kjh( jkxs h f'k{k.k • v‚ijs'ku ds nkSjku ns[kHkky% vksiu&gVZ ltZjh ds fl)kar] midj.k] ,uLs Fkhfl;k] dkÆM;kis Yeksujh ckbZikl • dksjksujh vkVZjh ckbZikl xzkǶVx ds fy, 'kY;&fpfdRlh; çfØ;k,]a gkfy;k çxfr vkSj xzk¶V ds çdkj] okYo çfrLFkkiu ;k iquÆuekZ.k] ân; çR;kjksi.k] mi'kked 'kY;&fpfdRlk vkSj fofHkUu LVasV] laoguh; 'kY;&fpfdRlk] vU; gkfy;k çxfr • Fkksjfsld ltZjh% ykcs sDV‚eh] U;weksusDV‚eh] Vîwej ,fDl'ku] yax Vªkla IykVa vkfn • v‚ijs'ku ds rqjra ckn dh n[s kHkky% vkadyu] v‚ij's ku ds | • ifjppkZ] O;k[;ku | • ç'uksÙkjh] fufgr dk;Z] ekey s dh çLrqfr | | | | | ckn dh leL;k,a vkSj eè;orZu % jDrlzko] dkÆM;d VSEiksuSM] yk s dkÆM;d vkmViqV] baQkD'kZu] isjhdkÆM;y b¶;wtu] U;weksFkksjSDl] gseksFkkjs SDl ] dksxqykis SFkh] FkeZy bacsysla ] bu,MHDosV oasfVys'ku@ij¶;wtu] U;wjksy‚ftdy leL;k] xqnZs dh leL;k] euksoSKkfud leL;k • lhus dh fQft;ksFksjsih • nnZ vkda yu vkSj uÉlx eè;orZu] iwjd fpfdRlk@fpfdRlk dh oSdfYid ç.kkyh • lh,chth] okYo ltZjh] vkSj vU; 'kY; fpfdRlkvkas ds nkSjku vkSj ckn esa n[s kHkky • dkÆM;d 'kY;&fpfdRlk ds ckn iquokZl | | | |---|---|---|---|---|---| | X | 10 ¼Vh½ 5 ¼,y½ | vojksèkd ok;qekxZ oky s jkxs h dh uÉlx n[s kHkky dh O;k[;k djuk vkSj isVasV ok;qekxZ vkSj larfIr ` LFkkfir dju s es a dkS'ky dk çn'kZu djuk fofHkUu çdkj ds oasfVysVj] muds mi;kxs vkSj LFkkiuk dk o.kZu djuk | • vkadyu • Ñf=e ok;qekxZ dk mi;kxs • ,aMksVªSfp;y baVqcS"k.s k] Vªsfd;ksLVkseh vkSj bldh n[s kHkky • tfVyrk] U;wure dQ fjlko] Vîcw ks a dks lqjf{kr djuk v‚Dlhtu forj.k ç.kkyh • ukd ços'kuh ¼usty dsuqyk½ • v‚Dlhtu ekLd] osapqjh ekLd • vkaf'kd iqu%'okl cSx • ckb&iSi vkSj lh&iSi ekLd • çR;ds ds mi;kxs ] Qk;n]s uqdlku] uÉlx fufgrkFkZ edS fsudy ofsaVy'sku • ;kaf=d osafVys'ku ds fl)kra • ;kaf=d osafVys'ku vkSj osafVysVj ds çdkj • oasfVys'ku ds rjhds] ykHk] uqdlku] tfVyrk,a • ihbZbZih fpfdRlk] y{k.k] fQft;ksy‚th vkSj tfVyrk,a • ohfuxa vkWQ osaVhysVj • oasfVysVj yxs jkxs h dk uÉlx vkadyu vkSj eè;orZu | • ifjppkZ] O;k[;ku • fleqys'ku | • ç'uksÙkjh] fufgr dk;Z] ekey s dh çLrqfr • vks,llhbZ | | • ,chth vlkekU;rk dk s Bhd dju s ls lacafèkr osVa hysVj lek;kts u • oasfVysVj yxs th.kZ jkxs h dh n[s kHkky | |---| dqy vofèk% 1770 ?kaVs ¼40 $ 1730½ | dkÆM;kFs kksjfsl d okMZ | 12 lIrkg | lhus eas nnZ ds jksfx;kas dk çkFkfedrk fuèkkZj.k djuk ân; rFkk o{k&xºoj lacaèkh ¼dkÆM;kFs kksjfsld½ fodkjkas ls ihfMr + jksfx;kas dk s l{ke n[s kHkky çnku djuk | • iwoZoÙk yus k ` • 'kkjhfjd tkap • uSnkfud ijh{k.kksa eas lgk;rk djuk • Fkzacksykbfll • funku vkSj fpfdRlh; çfØ;kvksa ds fy, jksxh dh rS;kjh • bZlhth djuk vkSj bZlhth dh O;k[;k djuk • ân; lacèa kh fodkjksa la ihfMr jksxh ds + fy, uÉlx çfØ;k dk vuqç;kxs | • LokLF; vkadyu dh fjiksVZ • fofHkUu bZlhth oos QkWeks a dks igpkuuk vkSj mudh O;k[;k djuk | • uSnkfud vkadyu • ekey s dk vè;;u • uSnkfud çLrqfr | |---|---|---|---|---|---| | 'kY;& fpfdRlh; d{k & vksVh | 8 lIrkg | fofHkUu dkÆM;kFs kksjfsld 'kY;&fpfdRlkvkas | • o;Ld vkSj f'k'kq dkÆM;d | • dkÆM;d vkSj QsQMkas dh + 'kY;&fpfdRlk | • uSnkfud vkadyu • ekey s dk vè;;u • uSnkfud çLrqfr | | ¼ân; rFkk o{k½ | | es a lgk;rk dju s ds dkS'ky dks le>kuk vkSj çnÆ'kr djuk | 'kY;&fpfdRlk esa lgk;rk djuk • QsQMkas dh + 'kY;&fpfdRlk esa lgk;rk djuk | es a bLrseky gksu s oky s LVasV vkSj byDs Vª‚fud lkeku ds çdkj | | |---|---|---|---|---|---| | vkikrdkyhu bdkbZ | 4 lIrkg | lQy ch,y,l vkSj ,lh,y,l dk çn'kZu djuk | • jksfx;kas dk çkFkfedrk fuèkkZj.k djuk • cqfu;knh thou leFkZu çn'kZu djuk • mUur thou leFkZu çn'kZu djuk • ilyh VVw u s ¼fjc ÝSDpj½ oky s jksfx;ksa dk çcaèku djuk | • ch,y,l vkSj ,lh,y,l ds chp vra j | • uSnkfud vkadyu • çkFkfedrk fuèkkZj.k çkVs ksdkWy • lhus ds nnZ dk vkadyu | | dSFk ySc lfgr uSnkfud ç;kxs 'kkyk | 2 lIrkg | dkÆM;kys ‚th çfØ;kvks a ds fy, jksxh dh rS;kjh dk çn'kZu djuk | • uSnkfud vkSj fpfdRlh; dkÆM;kys ‚th çfØ;kvks a esa lgk;rk djuk | | • uSnkfud vkadyu • uSnkfud çLrqfr | | dkÆM;kFs kksjfsl d vkbZlh;w | 12 lIrkg | dkÆM;kFs kksjfsld 'kY;&fpfdRlk ls xqtju s oky s jksfx;kas dk s l{ke n[s kHkky çnku djuk dkÆM;d vkikr fLFkfr;kas es a lgk;d midj.kks a ds mi;kxs es a dkS'ky çnÆ'kr djuk | • dkÆM;kFs kksjfsld 'kY;&fpfdRlk ls xqtj jg s o;Ld vkSj f'k'kq jkfsx;kas dk 'kY;&fpfdRlk ds i'pkr çcèa ku • baVªk&,vksÆVd cSywu iai] ,DLVªkdksikZsfj;y esEczsu v‚Dlhtus'ku] oasfVªdqyj vflLV fMokbl ij jksfx;ks a dk çcaèku • MhfQfczysVj dk mi;kxs ] islesdj ds lkFk jksxh dk çcaèku | | • uSnkfud vkadyu • ekey s dk vè;;u • uSnkfud çLrqfr | | f'k'kq dkÆM;kFs kksjfsl d xgu n[s kHkky bdkbZ | 2 lIrkg | dkÆM;kFs kksjfsld fodkj oky s xaHkhj :i ls chekj f'k'kqvkas dh n[s kHkky dju s es a l{kerk çnÆ'kr djuk | • æo çcèa ku • xaHkhj :i ls chekj f'k'kqvkas dh fuxjkuh • xaHkhj :i ls chekj f'k'kqvkas dh n[s kHkky | • f'k'kqvkas dh ` of) vkSj ` fodkl | • uSnkfud vkadyu • uSnkfud çLrqfr | | cká jkxs h foHkkx ¼vksihMh½ | 2 lIrkg | dkÆM;kFs kksjfsld fodkjkas ls ihfMr + jksfx;kas dk xgu vkadyu djuk | ân; vkSj QsQMksa ds + fodkjkas ls ihfMr + jksfx;kas dk vkda yu buofsto dkÆM;d çfØ;kvks a ds fy, jkxs h dh rS;kjh djuk | dkÆM,d vkda yu 'olu vkadyu | ân; vkSj 'olu lacèa kh fodkjksa ls ihfMr jksfx;ks a ds + vkadyu dh fjiksVZ | | 1 | xís] pknj vkSj rfd;k ds lkFk&lkFk lacafèkr l;aktuk s ds lkFk bysDVªkWfud vkbZlh;w 'kS¸;k ¼çR;ds 5&10 Nk=ks a ds fy;s ,d½ | 1 | |---|---|---| | 2 | cqfu;knh jkxs h ns[kHkky midj.kksa vkSj O;fDrxr lqj{kk midj.kksa ds lkFk cMs lkbM VªkWyh | 1 | | 3 | MªÇslx VªkWyh@vkos j cMs VªkWyh | 1 | | 4 | gkFk èkkus s ds fy;s vko';d oLrqvkas vkSj Mªk;j ds lkFk Çld ¼xgjh gkSnh½ | 1 | | 5 | vkbZoh LVSaM | 1 | | 6 | <ôu ds lkFk jxa &vkèkkfjr vif'k"V fMCcs | 1 | | 7 | vkWDlhtu] fpfdRlh; ok;q vkSj oSD;we ds fy;s nhokj ij yxs iksVZ | 1 | | 8 | LVSaM vkSj vkWDlhtu çokg ehVj ds lkFk ikVs sZcy vkWDlhtu flysaMj | | | 9 | ucs qykbtj ekLd ds lkFk ucs qykbtj e'khu ¼o;Ld ,o a f'k'kq½ | 1$1 | | 10 | vkWDlhtu ekLd ¼o;Ld ,oa f'k'kq½ | 1$1 | | 11 | Vh ihl ds lkFk ospa qjh ekLd | | | 12 | ukd ços'kuh ¼o;Ld ,oa f'k'kq½ | 1$1 | | 13 | o;Ld vkSj f'k'kq dQ ds lkFk jDr pki midj.k & chih ,ijVs l | | | 14 | LVFs kksLdkis ds lkFk jDrpki ekid & chih ekWfuVj ¼o;Ld ,oa f'k'kq½ | 1$1 | | 15 | Xywdkes hVj | 1 | | 16 | nLrkosthdj.k çokg pkVZ | | | 1 | ekWfuVj LVSaM lfgr lgk;d midj.kks a ds lkFk dkÆM;d@eYVhekWMy ekWfuVj ¼ges kMs k;ukfed ekWfuVÇjx½ | 1 | | 2 | bZlhth e'khu | 1 | | 3 | ØS'k dkVZ | 1 | | 4 | fMfQfczysVj ¼o;Ld ,oa f'k'kq iSMy½ | 1$1 | | 5 | oasfVysVj | 1 | | 6 | vca q cSx ¼o;Ld ,oa f'k'kq½ | 1$1 | | 7 | ,uvkbZoh ekLd ¼o;Ld ,o a f'k'kq½ | 1$1 | | 8 | çSlj cSx | 1 | | 9 | cSu lÆdV ¼o;Ld ,oa f'k'kq½ | 1$1 | | 10 | LVSaM ds lkFk flÇjt iai | 1 | | 11 | LVSaM ds lkFk bu¶;wtu iai | 1 | | 12 | mPp ,dkxzrk eq[kkSVk ¼o;Ld ,oa f'k'kq½ | 1$1 | | 13 | bZ;j çksc ¼larfIr fuxjkuh½* ` | 1 | | 14 | ,lkQs stys VSEijspj çksc* | 1 | | 15 | fciSi e'khu | 1 | | 16 | ySÇjft;y ekLd ,;jo s ¼o;Ld vkSj f'k'kq½ | 1$1 | |---|---|---| | 17 | bZlh,evk s ¼,DLVªkdksikZsfj;y esEczsu v‚Dlhtus'ku½ lsV | 1 | | 18 | ,chth e'khu | 1 | | 19 | vkbZ,chih e'khu | 1 | | 1 | baVqc/s k.k Vªs ¼o;Ld½ | 1 | | 2 | baVqc"sk.k Vªs ¼f'k'kq½ | 1 | | 3 | VªsdksLVkWeh Vªs | 1 | | 4 | lhohih Vªs | 1 | | 5 | dSFkhVsjkbts'ku Vªs | 1 | | 6 | vkbZohZ dSU;qys'ku Vªs | 1 | | 7 | ,yih Vªs | 1 | | 8 | FkksjSlsUVsfll Vªs | 1 | | 9 | iSjklsUVsfll Vªs | 1 | | 10 | jDr uewuk laxzg.k Vªs | 1 | | 11 | vkikrdkyhu vkS"kfèk Vªs | 1 | | 12 | vkfVZfj;y ykbu Vªs | 1 | | 13 | lwVj fjewoy Vªs | 1 | | 14 | lD'ku Vªs | 1 | | 15 | vkbZlhMh@psLV Mªsust Vªs | 1 | | 16 | ihihbZ fdV | 1 | | 17 | fLiyts fdV ¼jDr vkSj jlk;u½ | 1 | | 18 | Vîcw ] dSFksVj] fofHkUu vkdkjksa dh ykbu | | | 19 | dkS'ky vko';drkvkas ds vuqlkj vkS"kfèk] rjy inkFkZ] lhÇjt] chth lsV] ekbØkfsMªi lsV] vkbZoh lsV] vkfVZfj;y ykbu] lsaVªy ykbu | | | 20 | thok.kqjfgr fyuu diM s dk caMy + | 1 | I. A. I I II II B. I I II II II. A. | I | | |---|---| | 1 | jksxh çf'k{k.k lkexzh rS;kj djuk | | 2 | ân; rFkk o{k&xºoj lacaèkh ¼dkÆM;kFs kksjfsld½ fodkjks a ls ihfMr jksfx;ks a ds çf'k{k.k grs q jksxh çf'k{k.k ;kts uk rS;kj + djuk | | 3 | uÉlx vfèkdkfj;kas@LVkQ ulk±s ds fy;s MîwVh jkLs Vj rS;kj djuk | |---|---| | 4 | lkfgfR;d leh{kk ys[ku ¼lk{; vkèkkfjr uÉlx eè;orZu@çFkkvks a dh igpku djuk vkSj fjiksVZ fy[kuk½ | | 5 | çdk'ku ds fy;s ikMa qfyfi rS;kj djuk@isij çts sVa s'ku | | 6 | bZchih ifj;kts uk ¼lkefwgd ifj;kts uk½ & lk{; vkèkkfjr uÉlx gLr{kis ij dk;kZUo;u fo"k;% ;k 'kksèk ifj;kts uk ¼lkewfgd½ fo"k;% | | II | | | 1-1 | ân; rFkk o{k&xºoj lacaèkh ¼dkÆM;ksFkkjs sfld½ fodkjkas ls ihfMr o;Ld jksfx;ksa ds iwoZoÙk dh tkudkjh ysuk vkSj + ` 'kkjhfjd ijh{k.k djuk | | 1-2 | ân; rFkk o{k&xºoj lacaèkh ¼dkÆM;ksFkkjs sfld½ fodkjkas ls ihfMr f'k'kq jksfx;ks a ds iwoZoÙk dh tkudkjh ysuk vkSj 'kkjhfjd + ` ijh{k.k djuk | | 2-1 | bdkds kÆM;ksxzke | | 2-2 | vYVªklkmaM | | 2-3 | lhVh LdSu | | 2-4 | ,evkjvkbZ | | 2-5 | iSV LdSu | | 2-6 | bZlhth | | 2-7 | ,aft;kxs zkQh | | 2-8 | dkÆM;d dSFkhVsjkbts'ku | | 3-1 | vkbZlhih fuxjkuh | | 3-2 | mUur thou leFkZu | | 3-3 | lhus eas Vîcw yxkuk | | 3-4 | vra %'okluyh; baVqcs"k.k | | 3-5 | oasfVysVj yxkuk | | 3-6 | lsVa ªy ykbu yxkuk | | 3-7 | vkÆVfj;y ykbu yxkuk | | 3-8 | dkÆM;d iÇslx | | 3-9 | Vªsfd;ksLVkseh | | 3-10 | MhfQfczysVj dk mi;kxs | | 3-11 | czkasdkLs dkis h | | 3-12 | iYl vkWDlhesVªh | |---|---| | 3-13 | èkeuh; jDr pki ¼chih½ ekiu | | 3-14 | f'kjkijd igqap 'kq# djuk | | 3-15 | ,chth fo'y"s k.k | | 3-16 | vkWDlhtu yxkuk | | 3-17 | Vªsfd;ksLVkseh ns[kHkky | | 3-18 | ewy thou leFkZu | | 3-19 | mUur thou leFkZu | | 3-20 | vksjks@xzluh ok;qekxZ dk vuqç;ksx | | 3-21 | lhih,ih ¼lrr ldkjkRed ok;qekxZ ncko½ | | 3-22 | baVjdksLVy Mªus st dh n[s kHkky | | 3-23 | ucs qykbts'ku | | 3-24 | e‚fuVlZ dk mi;kxs | | 3-25 | bu¶;wtu iEi dk ç;kxs | | 3-26 | vra %f'kjh; fpfdRlk | | 3-27 | dkÆM;kFs kksjfsld bkdbZ es a HkrhZ vkSj NqVVh | | 3-28 | ~ vkWjkxs SfLVªd Vîwc bal'kZu | | 3-29 | ckWMh okeZj dk mi;kxs | | 3-30 | vkS"kfèk nsuk | | 3-31 | jDr vkSj jDr mRikn p<kuk | | | + | | 4-1 | ân; rFkk o{k&xºoj lacaèkh 'kY;&fpfdRlk ds fy;s jkfsx;kas dks rS;kj djuk | | 4-2 | 'kY;fpfdRlk ds ckn dh n[s kHkky | | 4-3 | jksxh f'k{kk vkSj ijke'kZ | | 4-4 | ?kj ij n[s kHkky dh rS;kjh djuk | | 5-1 | dkÆM;kFs kksjfsld bdkbZ esa laØe.k fu;a=.k ds fy;s ekud lapkyu çfØ;k ¼,lvkis h½ rS;kj djuk | | 5-2 | jDrkèkku ds fy;s ekud lapkyu çfØ;k ¼,lvkis h½ rS;kj djuk | | 5-3 | erçk; dks thfor dju s ds fy;s ekud lapkyu çfØ;k ` ¼,lvksih½ rS;kj djuk | | 5-4 | vksiu gkVZ ltZjh djkus okys jkfsx;kas ds fy, uÉlx ekudks a dk fodkl | | 5-5 | bdkbZ dk ijh{k.k djuk | | 6-1 | jksxk.kquk'ku@folaØehdj.k | | 6-2 | èkew zhdj.k | |---|---| | 7-1 | lgefr ysuk | | 7-2 | Vhdkdj.k | | 7-3 | ekxZn'kZu vkSj ijke'kZ | | 1-1 | fo"k;% | |---|---| | 1-2 | fo"k;% | | | ijke'kZ fjiksVZ & 1 | | 3-1 | LokLF; vkda yu ¼o;Ld½ & iwoZoÙk vkSj 'kkjhfjd ijh{k.k ` ¼rhu fyf[kr fjikVs Z½ 3-1-1- 3-1-2- 3-1-3- | | 3-2 | LokLF; vkda yu ¼f'k'kq½ & iwoZoÙk vkSj 'kkjhfjd ijh{k.k ` ¼nk s fyf[kr fjikVs Z½ 3-2-1- 3-2-2- | | | fo"k;% | |---|---| | | ¼uÉlx@ var%fo"k;d nkSjs½ | | 5-1 | uSnkfud fLFkfr dk uke ¼o;Ld½% | | 5-2 | uSnkfud fLFkfr dk uke ¼f'k'kq½% | | | ¼nk s fyf[kr fjikVs Z çLrqr dh tkuh gSa½ | | 6-1 | vkS"kfèk dk uke% | | 6-2 | | | 6-3 | | | 6-4 | | | | mnkgj.k% ân;@QsQMk çR;kjksi.k bdkbZ@ + dksbZ vU; dkÆM;kd@Fkksjsfld Lisf'k;fyVh dsæa | INDIAN NURSING COUNCIL NOTIFICATION New Delhi, the 7th October, 2024 INDIAN NURSING COUNCIL (POST BASIC DIPLOMA IN CARDIOTHORACIC SPECIALTY NURSING - RESIDENCY PROGRAM) REGULATIONS, 2023 F.No. 11-1/2024-INC (I).—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 Cardiothoracic Specialty Nursing - Residency Program) Regulations, 2023. ii. These shall come into force on the date of notification of the same in the Official Gazette of India. 2. DEFINITIONS In these Regulations, unless the context otherwise requires, i. ‘the Act’ means the Indian Nursing Council Act, 1947 (XLVIII of 1947) as amended from time to time; ii. ‘the Council’ means the Indian Nursing Council constituted under the Act; iii. ‘SNRC’ means the State Nurse and Midwives Registration Council, by whichever name constituted, by the respective State Governments; iv. ‘RN & RM’ means a Registered Nurse and Registered Midwife (RN & RM) and denotes a nurse who has completed successfully, recognised Bachelor of Nursing (B.Sc. Nursing) or Diploma in General Nursing and Midwifery (GNM) course, as prescribed by the Council and is registered in a SNRC as Registered Nurse and Registered Midwife; v. ‘Nurses Registration & Tracking System (NRTS)’ means a system developed by the Council and software developed in association with National Informatics Centre (NIC), Government of India, and hosted by NIC for the purpose of maintenance and operation of the Indian Nurses Register. It has standardised forms for collection of the data of Registered Nurse and Registered Midwife (RN & RM)/Registered Auxiliary Nurse Midwife (RANM)/Registered Lady Health Visitor (RLHV) upon Aadhar based biometric authentication; vi. ‘NUID’ is the Nurses Unique Identification Number given to the registrants in the NRTS system; vii. ‘General Nursing and Midwifery (GNM)’ means Diploma in General Nursing and Midwifery qualification recognized by the Council under Section 10 of the Act and included in Part-I of the Schedule of the Act. POST BASIC DIPLOMA IN CARDIOTHORACIC SPECIALTY NURSING - RESIDENCY PROGRAM I. INTRODUCTION The National Health Policy document (NHP, 2017) emphasizes the need to expand tertiary care services, prepare specialist nurses and standardization of clinical training for nurses. Responding to this, the Council planned to redesign the existing specialist nursing programs making it as a one-year post basic diploma residency programs utilizing competency-based training approach. Post Basic Diploma in Cardiothoracic Nursing – Residency Program includes revised guidelines that aim to prepare specialist nurses who can provide competent care to patients with cardiothoracic disorders whose diagnostic, treatment and care needs are complex and intensive. Cardio related problems of the Indians are fast becoming major health problems owing to the rapid change in the life style. It has caused a great concern among the health professionals to meet this challenge. It affects all levels of the people. Since 1983 the NHP has guided the health care system in meeting the needs of the people to a great extent. The policy recognizes the need for establishing the training courses for the super-specialty nurses required for tertiary care institutions. Post Basic Diploma in Cardiothoracic Nursing – Residency Program is designed to prepare specially trained Cardiothoracic Nurses. The outcome of the program will be to have more nurses prepared as cardiothoracic nurses for providing competent nursing care in various health care settings. II. PHILOSOPHY The Council believes that registered nurses need to be trained in cardiothoracic nursing in clinical settings in order to provide competent care to patients with cardiothoracic problems. Expanding roles of nurses and advances in technology necessitates additional training to prepare them for effective participation in cardiothoracic care. III. CURRICULAR FRAMEWORK The Post Basic Diploma in Cardiothoracic Specialty Nursing is a one-year residency program and its curriculum is conceptualized encompassing short foundational courses and major specialty courses for specialty nursing practice. The foundations to cardiothoracic specialty nursing practice such as professionalism, communication, patient education and counselling, clinical leadership and 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 Cardiothoracic Specialty Nursing I and Cardiothoracic Specialty Nursing II to include context/introduction to cardiothoracic nursing, basic sciences applied to cardiothoracic nursing (application of basic science knowledge in the diagnosis and treatment of clinical conditions under cardiothoracic specialty nursing), nursing management including assessment, diagnosis, treatment and specialized interventions (in management of specific clinical conditions) and patient safety and quality including specialty/illness considerations. The curricular framework for the residency program is illustrated in the following figure 1. POST BASIC DIPLOMA IN CARDIOTHORACIC SPECIALTY NURSING – RESIDENCY PROGRAM Foundations to Cardiothoracic Nursing Courses Cardiothoracic Specialty Nursing Courses Professionalism Context/Introduction to specialty nursing practice Communication, patient education Basic sciences applied to specialty care & counseling Nursing Management incl. assessment Clinical leadership and resource management and specialized interventions Cardiothoracic Specialty Patient safety & quality, and Illness specific Nursing education for Evidence based and applied research Specialist considerations Practice ONE-YEAR RESIDENCY PROGRAM (For Registered Nurses & Midwives) Theory – 10% & Practicum – 90% (Skill Lab + Clinical) Figure 1. Curricular Framework for Cardiothoracic Specialty Nursing – Residency Program IV. AIM/PURPOSE & COMPETENCIES Aim The program is designed to prepare nurses with specialized skills, knowledge and attitude in providing quality care to patients with cardiothoracic disorders. It further aims to prepare technically qualified and trained specialist nurses who will function effectively and optimally at cardiothoracic centres of tertiary/quaternary hospitals providing high standards of care. Competencies On completion of the program, the cardiothoracic 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 cardiothoracic 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 cardiothoracic care and settings promoting collaborative and effective teamwork. 5. Identify, evaluate and use the best current evidence in cardiothoracic care and treatment coupled with clinical expertise and consideration of patient’s preferences, experience and values to make practical decisions in cardiothoracic nursing practice. 6. Participate in research studies that contribute to evidence-based cardiothoracic 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 cardiothoracic disorders. 8. Describe the concepts and principles of cardiothoracic nursing. 9. Demonstrate skills in advanced cardiac life support. 10. Apply nursing process in caring for patients with cardiothoracic disorders. 11. Communicate effectively with patients having cardiothoracic problems and their family members. 12. Demonstrate skills in management of cardiothoracic services/units. 13. Participate effectively as a member of the cardiac care team. 14. Make a plan for organization of cardiac and thoracic units. 15. Provide end of life care promoting comfort and dignity respecting individual cultural and spiritual needs and differences. 16. Teach and supervise nurses and allied health workers. V. PROGRAM DESCRIPTION AND SCOPE OF PRACTICE The Post Basic Diploma in Cardiothoracic Specialty Nursing – Residency Program is designed to prepare registered nurses (GNM or B.Sc.) with specialized knowledge, skills and attitude in providing advance quality care to patients with cardiothoracic disorders and their families. Emphasis is laid on clinical competency with relevant theory. 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 cardiothoracic specialist nurses should be employed only in cardiothoracic 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 CARDIOTHORACIC SPECIALTYT NURSING-RESIDENCY PROGRAM The program may be offered at 1. College of Nursing offering degree programs in nursing attached to parent hospital having minimum of 200 beds with advanced diagnostic, therapeutic and state of the art cardiothoracic units with optimum monitoring and life support equipment/facilities required to provide effective care to patients with cardiothoracic disorders and specialized nursing care facilities. OR Hospitals offering DNB/Fellowship programs in cardiothoracic surgery having minimum of 200 beds with advanced diagnostic, therapeutic and state of the art cardiac and thoracic care units/CT intensive care units with optimum monitoring and life support equipment/facilities required to provide effective care to patients with cardiothoracic conditions and specialized nursing care facilities. 2. The above eligible institution shall get recognition from the concerned SNRC for Post Basic Diploma in Cardiothoracic 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. 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/Cardiothoracic Specialty Nursing - 1 ii. Post Basic Diploma in Cardiothoracic Specialty Nursing with Basic B.Sc. d. Experience: Minimum three years of clinical experience in Cardiothoracic Specialty Nursing. e. Guest Faculty: Multi-disciplinary in related specialities. f. Preceptors: • Nursing Preceptor: Full time qualified GNM with six years of experience in Cardiothoracic Specialty Nursing or B.Sc. Nursing with two years of experience in Cardiothoracic Specialty Nursing or M.Sc. Nursing with one year of Cardiothoracic Specialty Nursing experience working in any of the cardiothoracic units/ICUs. • Medical Preceptor: Specialist doctor with PG qualification (with 3 years’ post PG experience/faculty level/consultant level preferable). • Preceptor Student Ratio: Nursing 1:10, Medical 1:10 (Every student must have a medical and nursing preceptor) 2. Budget 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 Cardiothoracic Specialty Nursing, 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 Cardiothoracic 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 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 cardiothoracic unit/intensive care units with optimum monitoring and life support equipment/facilities required to provide effective care to patients with cardiothoracic disorders and specialized nursing care facilities. b. Hospital must have a minimum of 20 specialty beds including cardiothoracic ICU (Minimum of 10 ICU beds) with advanced diagnostic, treatment and care facilities. c. Regional centres/cardiothoracic specialty hospitals having minimum of 200 beds with advanced diagnostic, therapeutic and state of the art cardiothoracic unit/intensive care units with optimum monitoring and life support equipment/facilities required to provide effective care to patients with cardiothoracic disorders and specialized nursing 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 cardiothoracic 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 specialty beds, number of seats = 10-20, For hospital having 500 beds and more with 30 specialty 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. 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 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 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 or from the same specialty. 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 Cardiothoracic 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 Cardiothoracic Specialty Nursing - Residency Program ii. Candidate has completed 80% theory and 100% clinical requirements iii. Candidate has passed the prescribed examination. VIII. SCHEME OF EXAMINATION | Courses | Internal Assessment Marks | External Assessment Marks | Total Marks | Exam Hours | |---|---|---|---|---| | A. Theory (Experiential/Residential Learning) | 25 (10 + 15) | 75 (35 + 40) | 100 | 3 | | Cardiothoracic Specialty Nursing (Part I & Part II) {Part I – Cardiothoracic Specialty Nursing I including Foundations to Cardiothoracic Specialty Nursing practice, Part II – Cardiothoracic Specialty Nursing II} | | | | | | B. Practicum (Cardiothoracic 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 Posting) 4. Teaching Methods 5. Methods of Assessment 6. Log Book & Clinical Requirements 1. Courses of Instruction | Unit | Courses | Theory | Lab/Skill Lab | Clinical | |---|---|---|---|---| | | | (hours) | (hours) | (hours) | | I II | Foundations to Cardiothoracic 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 Cardiothoracic Specialty Nursing Courses Cardiothoracic 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) Cardiothoracic 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) | Note: In Specialty Nursing I & II, theory and lab hours may be different in each specialty nursing based on their content and training needs. Total weeks available in a year: 52 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 (10% : 90%) 126 hours of theory and 34 hours of skill lab learning can be integrated during clinical experience. Mastery learning and experiential learning approaches are used in training the students throughout the program. Skill Lab Requirements are listed in Appendix 1. 3. Clinical Practice Clinical Residency Experience: A minimum of 45 hours 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. | Units/Departments | No. of Weeks | |---|---|---| | 1. | Cardiothoracic wards | 12 | | 2. | OTs (Cardiac and thoracic) | 8 | | 3. | Emergency unit | 4 | | 4. | Diagnostic labs including Cath lab | 2 | | 5. | Cardiothoracic ICU | 12 | | 6. | Pediatric Cardiothoracic ICU | 2 | | 7. | OPD | 2 | | | TOTAL | 42 | The residency students will follow the same duty schedule as staff nurses/nursing officers with different shift duties. In addition to that 4 hours every week is dedicated for their learning that can be offered in terms of theory (faculty lecture – 1 hour, nursing & interdisciplinary rounds - 1 hour, clinical presentations, case study report, clinical assignments – 1 hour and skill lab practice - 1 hour) to cover a total of 126 hours of theory and 34 hours of skill lab practice. A small group research project (research/Quality Improvement-QI) can be conducted during clinical posting applying the steps of research process and written report to be submitted. 4. Teaching Methods Theoretical, skill lab & clinical teaching can be done in the following methods and integrated during clinical posting. • Clinical conference • Case/clinical presentation • Case study report • Drug study and presentation • Bedside clinic/Nursing rounds/Interdisciplinary rounds • Clinical seminars • 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/QI project • Clinical assignments • Term papers • Workshops • Educational visits Ex. Heart/Lung transplantation unit/Any other Cardiac/thoracic specialty centre 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. 5. Clinical Log Book/Procedures Book 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. FOUNDATIONS TO CARDIOTHORACIC SPECIALTY NURSING PRACTICE: PROFESSIONALISM, COMMUNICATION, PATIENT EDUCATION & COUNSELING, CLINICAL LEADERSHIP & RESOURCE MANAGEMENT AND EVIDENCE BASED AND APPLIED RESEARCH IN CARDIOTHORACIC NURSING PRACTICE 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 cardiothoracic nursing practice. | Unit | Time (hours) | Learning Outcomes | Content | Teaching Learning Activities | Assessment Methods | |---|---|---|---|---|---| | I | 6 | Demonstrate understandin g of professionali sm and exhibit professionali sm in the practice of cardiothoracic nursing | PROFESSIONALISM • Meaning and elements: Accountability, knowledgeable, visibility and ethics in cardiothoracic specialty nursing practice • Professional values and professional behaviour • The Council’s code of ethics, code of professional conduct and practice standards • Ethical issues related to cardiothoracic nursing and heart and lung transplant • Expanding role of Nurse: Nurse practitioner • Professional organizations • Continuing nursing education | • Discussion | • Write about code of ethics related to cardiothoracic nursing | | | | Describe medico-legal aspects of cardiothoraci c nursing and heart transplant | Medico-Legal Issues • Legislations and regulations related to cardiothoracic nursing • Consumer protection act • Negligence & malpractice • Medico-legal aspects • Records & reports • Legal responsibilities of cardiothoracic specialist nurses | • Lecture | • Maintain record of patients | | II | 12 | Communicate effectively with | Communication • Channels and techniques of communication | Module • Lecture | • Digital records | | Unit | Time (hours) | Learning Outcomes | Content | Teaching Learning Activities | Assessment Methods | |---|---|---|---|---|---| | | | cardiothoracic 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 Teach Nursing officers, students and paramedical staff in cardiothoracic unit | • Breaking bad news to patients with cardiothoracic disorders and with poor prognosis • Culturally sensitive communication • Development of nursing care plans and records • 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 including transplant patient education • Developing patient education materials relevant to cardiothoracic nursing Counselling • Counseling techniques • Genetic counseling for family • Patient and family counseling during breaking bad news, intensive treatment, crisis intervention and end of life stage • Counselling for transplant patients (Heart/Lung) and family | • Breaking bad news – Role play • Peer teaching • Counselling sessions | • Conduct a group health education program for the patients with cardiothoracic disorders • Prepare patient education materials on relevant topic | | III | 12 | Demonstrate understandin g of clinical leadership and management strategies and use them in cardiothoraci c care and settings promoting collaborative | Clinical Leadership & Resource Management • Leadership & Management • Elements of management of Cardiothoracic nursing care – planning, organizing, staffing, reporting, recording and budgeting • Clinical leadership and its challenges • Managing human resources in cardiothoracic units | • Lecture | • Plan a duty roster for the junior nursing officers/Staff nurses working in the cardiothoracic department | | Unit | Time (hours) | Learning Outcomes | Content | Teaching Learning Activities | Assessment Methods | |---|---|---|---|---|---| | | | and effective teamwork Prepare the unit for receiving postoperative cardiothoracic patients Conduct clinical audit and participate in quality assurance activities in cardiothoracic ICU and ward | • Material management • Designing of an ideal cardiothoracic ward/ICU, day care and transplant unit • Emotional intelligence and self- management skills • Working as interdisciplinary team member • Participation in making policies relevant to care of cardiothoracic patients • Organization of cardiac CCU, cardiothoracic ICU and ward Quality Assurance Program in Cardiothoracic Unit • Nursing audit • Nursing standards • Quality assurance | • Modules - Accreditation & Practice Standards | • Plan an ideal cardiothoracic ward and Day care • Develop SOPs for care of patient in cardiothoracic CCU and ward | | IV | 10 | Describe research process and perform basic statistical tests Apply evidence based/best practices in professional practice relevant to cardiothoracic nursing | Evidence based and Application of Research • Introduction to nursing research and research process • Data presentation, basic statistical tests and its application • Research priorities in cardiothoracic nursing • Formulation of problem/question that are relevant to cardiothoracic nursing practice • Review of literature to identify evidence based/best practices in cardiothoracic 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 cardiothoracic patients for last five years • Conduct literature review on cardiothoracic nursing interventions/Evid ence based practice project | CARDIOTHROACIC SPECIALTY NURSING I CONTEXT/INTRODUCTION TO CARDIOTHROACIC NURSING & BASIC SCIENCES APPLIED TO CARDIOTHROACIC NURSING PRACTICE (Applied Psychology, Sociology, Microbiology, Pathology, Anatomy, Physiology & Pharmacology) 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 cardiothoracic care provision and application of basic sciences in the diagnosis and treatment of patients suffering from cardiothoracic disorders. T-Theory, L-Lab | Unit | Time (hours) | Learning Outcomes | Content | Teaching Learning Activities | Assessment Methods | |---|---|---|---|---|---| | I | 4 (T) | Describe epidemiology of common cardiothoracic disorders, risk identification and reduction strategies | • Epidemiology of cardiothoracic disorders - Prevalence and statistics • Risk factors and identification • Risk reduction strategies | • Lecture & Discussion | • Presentation of statistics | | II | 2 (T) | Explain principles of cardiothoracic nursing Role of cardiothoracic specialist nurses | • Principles of cardiothoracic specialist nursing • Role of cardiothoracic specialist nurses • Scope of cardiothoracic specialist nursing practice | • Lecture & Discussion | | | III | 10 (T) | Explain psychosocial aspects in cardiothoracic nursing care | • Human behavior and coping with cardiothoracic malignancies • Factors influencing psychosocial adjustment for patients suffering from cardiothoracic malignancies • Management of psychosocial problems • Guidance & Counseling | • Lecture • Counselling: Review steps | • Conduct counselling session | | IV | 8 (T) 2 (L) | Explain medical surgical asepsis and infection control in cardiothoracic setup | • Principles of asepsis, sterilization & disinfection • Standard safety measures • Biomedical waste management • Barrier nursing & infection control practices | • Lecture • Demonstration | • Prepare SOP for infection control in cardiothoracic ICU | | V | 6 (T) 2 (L) | Describe structure and functions of heart & lungs | Structure and Function of Heart & Lungs • Embryonic development of heart • Structure of heart | • Lecture • Self-study • Models and specimens of | • Quiz | | Unit | Time (hours) | Learning Outcomes | Content | Teaching Learning Activities | Assessment Methods | |---|---|---|---|---|---| | | | | • Conduction system • Circulation of the heart • Blood vessels • Structure and functions of respiratory system • Embryonic development of lungs • Parts of the lung • Ventilation and perfusion | the heart and lung | | | VI | 10 (T) 4 (L) | Explain pharmacothera py for different malignant & non-malignant Cardiothoracic disorders | Pharmacokinetics • Analgesics/Anti- inflammatory agents • Antibiotics, antiseptics • Drugs used in cardiac emergencies • Anti-thrombolytic agents • Inotropic agents • Anti-hypertensive drugs • Anti-coagulants • Anti-arrhythmic drugs • Vasodilators | • Lecture & Discussion | • Submission of Drug book • Quiz on calculation of inotropes • Drug presentation | | VII | 5 (T) 2 (L) | Demonstrate management of patients during cardiothoracic emergencies | Cardio-thoracic emergency interventions • CPR-BLS and ALS • Use of ventilator, defibrillator, pacemaker • Post resuscitation care | • Simulation • Realia of equipment | • OSCE | | VIII | 5 (T) | Explain the preparation of patient for cardiothoracic investigations | Diagnostic Measures Non-Invasive • ECG - abnormal ECG & interpretation • Echocardiography • Pulmonary function test • Cardiac monitoring techniques, chest lead and modified lead placement • Nuclear diagnostic procedures • Magnetic Resonance Imaging • Chest X-Ray Invasive • Bronchoscopy and graphics • C.V.P. & J.V.P. • Blood gases and its significance • Cardiac catheterization and angiographies | • Observation | • OSCE and quiz | | Unit | Time (hours) | Learning Outcomes | Content | Teaching Learning Activities | Assessment Methods | |---|---|---|---|---|---| | | | | • Arterial monitoring, swan Ganz monitoring • Diagnostic radiographies of chest and C.V.S. Nurse’s role in diagnostic tests | | | CARDIO THORACIC SPECIALTY NURSING II NURSING MANAGEMENT OF PATIENTS WITH CARDIOTHORACIC CONDITIONS INCLUDING ASSESSMENT, DIAGNOSIS, TREATMENT AND SPECIALIZED INTERVENTIONS Theory: 110 hours & Lab 30 hours Course Description: This course is designed to help students to develop understanding and in-depth knowledge regarding nursing management of patients with cardiothoracic conditions including assessment, diagnosis, treatment and specialized interventions and patient safety and quality including specialty/illness considerations. T-Theory, L-Lab | Unit | Time (hours) | Learning Outcomes | Content | Teaching Learning Activities | Assessment Methods | |---|---|---|---|---|---| | I | 15 (T) | Describe the causes, pathophysiol ogy, types, clinical features, diagnosis, prognosis, Management : medical, surgical and demonstrate skill in providing nursing care for patients with cardiothoracic disorders | Cardiothoracic disorders Etiology, clinical manifestations, diagnosis, prognosis, related pathophysiology and nursing management of: • Coronary Artery Disease • Angina of various types • Cardiomegaly • Myocardial infarction, Congestive cardiac failure • Heart failure, Pulmonary edema, Shock • Hypertension • Rheumatic Valve Diseases • Inflammatory Heart Diseases, Infective Endocarditis, Myocarditis, Pericarditis • Cardiomyopathy, dilated, restrictive, hypertrophic | • Discussion, Lecture | • Quiz, assignments | | II | 10 (T) | Describe the causes, pathophysiol ogy, types, clinical features, diagnosis, prognosis, Management : medical, | Altered pulmonary conditions Etiology, clinical manifestations, diagnosis, prognosis, related pathophysiology and nursing management of: • Pleuritis effusion • Pneumo, haemo and pyothorax • Interstitial lung disease | • Discussion, Lecture | • Quiz, assignments | | Unit | Time (hours) | Learning Outcomes | Content | Teaching Learning Activities | Assessment Methods | |---|---|---|---|---|---| | | | surgical and demonstrate skill in providing nursing care for patients with pulmonary disorders | • Acute and chronic obstructive pulmonary disease (conditions leading to) • Bronchiectasis • Acute respiratory failure • Adult respiratory distress syndrome • Pulmonary embolism • Pulmonary hypertension | | | | III | 5 (T) 2 (L) | Demonstrate use of pacemaker and its settings | Nursing care of patient with temporary or permanent pacemaker • Types of temporary and permanent pacemakers • Indications for each type • Principles of pacing procedure • Patient teaching before, during and after pacing | • Discussion, Lecture • Simulation | • Quiz, assignments, OSCE | | IV | 5 (T) 3 (L) | Explain the preparation and care of patients undergoing coronary revasculariza tion | Nursing care of patient after coronary revascularization • Percutaneous Transluminal Coronary Angioplasty; Stent, Balloon, Types: Indications, procedure & complications • Laser therapy for revascularization | • Discussion, Lecture • Simulation | • Quiz, assignments, OSCE | | V | 10 (T) 5 (L) | Differentiate the different types of arrhythmias Demonstrate use of (Automated External Defibrillatio n) AED | Interpretation, management of Dysrhythmias and nurse’s role • Sinus arrhythmias • Atrial arrhythmias • Junctional or nodal arrhythmias • Ventricular arrhythmias • AV blocks • Pathophysiological responses • Recircuit arrhythmias and ablation therapy • Automatic implantable cardioverter defibrillator | • Discussion, Lecture • Simulation | • Quiz, assignments, OSCE, case presentation | | VI | 5 (T) 2 (L) | Demonstrate use of chest drainage Explain the different types of chest drainages and its uses | Nursing care of patient with chest drainage tubes • Principles of under-water seal drainage • Equipment, set up, assessment, care of patient, complications • Principles of autotransfusion, indications, complications, care, setup | • Discussion, Lecture • Simulation | • Quiz, assignments, OSCE | | Unit | Time (hours) | Learning Outcomes | Content | Teaching Learning Activities | Assessment Methods | |---|---|---|---|---|---| | VII | 15 (T) 3 (L) | Describe the different types of congenital heart diseases, its etiology, clinical manifestation, diagnosis, prognosis, related pathophysiol ogy, and medical, surgical and nursing management | Congenital Heart Diseases Etiology, clinical manifestations, diagnosis, prognosis, related pathophysiology and nursing management of: • Embryological development of heart • Classification – cyanotic and acyanotic heart disease • Tetralogy of Fallots • Atrial Septal Defect, Ventricular Septal Defect, Eisenmenger syndrome • Patent ductus arteriosus, AP window • Truncus arteriosus • Transposition of great arteries • Total anomaly of pulmonary venous connection • Pulmonary stenosis, atresia • Coarctation of aorta • Ebstein’s anomaly • Double outlet right ventricle, single ventricle, hypoplastic left heart syndrome | • Discussion, Lecture | • Quiz, assignments, case presentation | | VIII | 10 (T) | Explain the etiology, clinical manifestatio ns diagnosis, prognosis, related pathophysiol ogy and management of pediatric cardiothoracic disorders | Nursing care of pediatric patient with cardiothoracic disorders • Review of growth and development • Psychosocial aspects of pediatric care and family • Pre, peri and post-operative cardio- thoracic care • Pediatric pain assessment and management | • Discussion, Lecture | • Quiz, assignments, case presentation | | IX | 25 (T) 10 (L) | Describe the nursing care of patient undergoing various cardiothoracic surgeries | Nursing care of patient undergoing cardio thoracic surgery • Indications, selection of patient • Pre-operative assessment and preparation; patient teaching • Intra-operative care: Principles of open-heart surgery, equipment, anaesthesia, cardiopulmonary bypass | • Discussion, Lecture | • Quiz, assignments, case presentation | | Unit | Time (hours) | Learning Outcomes | Content | Teaching Learning Activities | Assessment Methods | |---|---|---|---|---|---| | | | | • Surgical procedures for Coronary Artery Bypass Grafting, recent advances and types of grafts, Valve replacements or reconstruction, cardiac transplant, palliative surgery and different stents, vascular surgery, other recent advances • Thoracic surgery: lobectomy, pneumonectomy, tumour excision, lung transplant etc. • Immediate post-operative care: assessment, post- operative problems and interventions: bleeding, cardiac tamponade, low cardiac output, infarction, pericardial effusion, pneumothorax, haemothorax, coagulopathy, thermal imbalance, inadequate ventilation/perfusion, neurological problems, renal problems, psychological problems • Chest physiotherapy • Pain assessment and nursing interventions, complimentary therapy/alternative systems of medicine • Intermediate and late post operative care after CABG, valve surgery, and others • Rehabilitation after cardiac surgery | | | | X | 10 (T) 5 (L) | Explain the nursing care of patient with obstructive airway and demonstrate skill in establishing patent airway and saturation | Nursing care of patient with obstructive airway • Assessment • Use of artificial airway • Endotracheal intubation, tracheostomy and its care • Complication, minimum cuff leaks, securing tubes Oxygen delivery systems • Nasal Cannula • Oxygen mask, Venturi mask • Partial rebreathing bag • Bi-PAP and C-PAP masks | • Discussion, Lecture • Simulation | • Quiz, assignments, case presentation • OSCE | | Unit | Time (hours) | Learning Outcomes | Content | Teaching Learning Activities | Assessment Methods | |---|---|---|---|---|---| | | | Describe the different types of ventilators, uses and settings | • Uses, advantages, disadvantages, nursing implications of each Mechanical Ventilation • Principles of mechanical ventilation • Types of mechanical ventilation and ventilators • Modes of ventilation, advantage, disadvantage, complications • PEEP therapy, indications, physiology and complications • Weaning off the ventilator • Nursing assessment and intervention of ventilated patient • Ventilator adjustments related to correcting ABG abnormality • Care of a chronic ventilated patient | | | PRACTICUM (Skill 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. Perform assessment of patients with cardiothoracic conditions 2. Perform triaging of patients with chest pain 3. Provide competent care to patients with cardiothoracic disorders applying nursing process 4. Prepare and assist/perform cardiology procedures and use assistive devices in cardiac emergencies 5. Demonstrate successful BLS and ACLS 6. Demonstrate skills in assisting for various cardiothoracic surgeries 7. Provide competent care to patients undergoing cardiothoracic surgeries 8. Demonstrate competency in caring for children with cardiothoracic disorders 9. Maintain and store drugs and keep daily record in cardiothoracic unit/ICU | Area | Duration (weeks) | Clinical Learning Outcomes | Skills/Procedural Competencies | Assignments | Assessment Methods | |---|---|---|---|---|---| | Cardiothoracic wards | 12 weeks | Perform triaging of patients with chest pain Provide competent care | • History taking • Physical examination • Assisting in diagnostic tests • Thrombolysis • Preparation of patient for diagnostic and therapeutic procedures | • Report of health assessment • Identify and interpret different | • Clinical evaluation • Case study • Clinical presentation | | Area | Duration (weeks) | Clinical Learning Outcomes | Skills/Procedural Competencies | Assignments | Assessment Methods | |---|---|---|---|---|---| | | | to patients with cardiothoracic disorders | • Performing ECG and interpretation of ECG • Application of nursing process for patient with cardiac disorders | ECG waveforms | | | OTs (Cardiac and thoracic) | 8 weeks | Explain and demonstrate skills in assisting for various cardiothoracic surgeries | • Assisting for adult and paediatric cardiac surgeries • Assisting for lung surgeries | • Types of stents and electronic items used in cardiac and lung surgeries | • Clinical evaluation • Case study • Clinical presentation | | Emergency unit | 4 weeks | Demonstrate successful BLS and ACLS | • Performing triaging of patients • Performing basic life support • Performing advanced life support • Managing patients with rib fracture | • Differentiate between BLS and ACLS | • Clinical evaluation • Triaging protocol • Chest pain assessment | | Diagnostic labs including Cath lab | 2 weeks | Demonstrate preparation of patient for cardiology procedures | • Assisting diagnostic and therapeutic cardiology procedures | | • Clinical evaluation • Clinical presentation | | Cardiothoracic ICU | 12 weeks | Provide competent care to patients undergoing cardiothoracic surgeries Demonstrate skill in use of assistive devices in cardiac emergencies | • Postoperative management of adult and paediatric patients undergoing cardiothoracic surgeries • Management of patients on Intra- aortic balloon pump, Extracorporeal Membrane Oxygenation, Ventricular assist device • Use of defibrillator, management of patient with pacemaker | | • Clinical evaluation • Case study • Clinical presentation | | Pediatric cardiothoraci c intensive care Unit | 2 weeks | Demonstrate competency in caring for critically ill children with cardiothoracic disorders | • Fluid management • Monitoring of critically ill children • Care of critically ill child | • Growth and developmen t of children | • Clinical evaluation • Clinical presentation | | Area | Duration (weeks) | Clinical Learning Outcomes | Skills/Procedural Competencies | Assignments | Assessment Methods | |---|---|---|---|---|---| | OPD | 2 weeks | Perform thorough assessment of patients with cardiothoracic disorders | • Assessment of patients with cardiac and lung disorders • Preparation of patient for invasive cardiac procedures | • Cardiac assessment • Respiratory assessment | • Reports of assessment of patients with cardiac and respiratory disorders | APPENDIX 1 SKILL LAB REQUIREMENTS (List of Equipment for Cardiothoracic ICU Skill Lab) | S.No. | Equipment | Numbers | |---|---|---| | 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 (deep 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 & Pediatric) | 1 + 1 | | 10 | Oxygen mask (Adult & Pediatric) | 1 + 1 | | 11 | Venturi mask with T piece | | | 12 | Nasal cannula (Adult & Pediatric) | 1 + 1 | | 13 | BP apparatus with adult and pediatric cuffs | | | 14 | BP monitor with Stethoscope (Adult & Pediatric) | 1 + 1 | | 15 | Glucometer | 1 | | 16 | 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 & Pediatric paddles) | 1 + 1 | | 5 | Ventilator | 1 | | 6 | Ambu Bag (Adult & Pediatric) | 1 + 1 | | 7 | NIV Mask (Adult & Pediatric) | 1 + 1 | | 8 | Pressure Bag | 1 | | 9 | Bain Circuit (Adult & Pediatric) | 1 + 1 | | 10 | Syringe pump with stand | 1 | | 11 | Infusion pump with stand | 1 | | S.No. | Equipment | Numbers | |---|---|---| | 12 | High concentration mask (Adult & Pediatric) | 1 + 1 | | 13 | Ear probe (saturation monitoring)* | 1 | | 14 | Esophageal temperature probe* | 1 | | 15 | Bipap machine | 1 | | 16 | Laryngeal mask airway (Adult & Pediatric) | 1 + 1 | | 17 | ECMO (Extracorporeal membrane oxygenation) set | 1 | | 18 | ABG machine | 1 | | 19 | IABP machine | 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 | | 13 | Suture Removal Tray | 1 | | 14 | Suction Tray | 1 | | 15 | ICD/chest drainage Tray | 1 | | 16 | PPE Kit | 1 | | 17 | Spillage Kit (Blood and Chemical) | 1 | | 18 | Tubes, catheters, lines of different sizes | | | 19 | Drugs, fluids, syringes, BG sets, Microdrip set, IV sets, Arterial lines, Central lines as per skill requirements | | | 20 | Sterile linen bundle | 1 | Mannequin (manikin)/Simulator 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 simulator for 5-10 students is the requirement. APPENDIX 2 ASSESSMENT GUIDELINES (THEORY & PRACTICUM) I. THEORY A. INTERNAL ASSESSMENT CARDIOTHORACIC SPECIALTY NURSING (Part I: Cardiothoracic Specialty Nursing I including Foundations to Cardiothoracic Specialty Nursing practice & Part II: Cardiothoracic Specialty Nursing II) - TOTAL: 25 marks • Test papers & Quiz - 10 marks • Written assignments - 10 marks (Code of ethics relevant to Cardiothoracic nursing practice, literature review on EBP in Cardiothoracic nursing/Infection control practices, Nutritional care of patients with cardiothoracic disorders) • Group project - 5 marks B. EXTERNAL/FINAL EXAMS CARDIOTHORACIC SPECIALTY NURSING (Part I: Cardiothoracic Specialty Nursing I including Foundations to Cardiothoracic Specialty Nursing practice & Part II: Cardiothoracic 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. PRACTICUM A. INTERNAL ASSESSMENT - 75 marks • OSCE - 25 marks (End of posting OSCE - 10 marks + Internal end of year OSCE - 15 marks) • Other Practical including observed 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/Assiste d/ Observed (P/A/O) | Date & Signature of the Faculty | |---|---|---|---| | I | FOUNDATIONS TO CARDIOTHORACIC SPECIALTY NURSING | | | | 1 | Preparation of patient education materials | P | | | 2 | Patient education plan for teaching patients with cardiothoracic disorders | P | | | 3 | Preparation of duty roster for nursing officers/staff nurses | P | | | S.No. | Specific Competencies/Skills | Number Performed/Assiste d/ Observed (P/A/O) | Date & Signature of the Faculty | |---|---|---|---| | 4 | Writing literature review (Identify evidence-based nursing interventions/practices and write a report) | P | | | 5 | Preparation of a manuscript for publication/paper presentation | P | | | 6 | EBP Project (Group project) - Implementation on evidence-based nursing intervention/s Topic: OR Research Project (Group) Topic: | P | | | II | CARDIOTHORACIC SPECIALTY NURSING | | | | 1 | HEALTH ASSESSMENT | | | | 1.1 | History taking and physical examination for adult patient with cardiothoracic disorders | P | | | 1.2 | History taking and physical examination for pediatric patient with cardiothoracic disorders | 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 | ECG | O | | | 2.7 | Angiography | O | | | 2.8 | Cardiac catheterization | A | | | 3 | THERAPEUTIC PROCEDURES | | | | 3.1 | Monitoring ICP | P | | | 3.2 | Advanced life support | P | | | 3.3 | Chest tube insertion | A | | | 3.4 | Endotracheal intubation | P | | | 3.5 | Ventilator setting | P | | | 3.6 | Central line insertion | A | | | 3.7 | Arterial line insertion | A | | | 3.8 | Cardiac pacing | A | | | 3.9 | Tracheostomy | A | | | 3.10 | Use of defibrillator | P | | | 3.11 | Bronchoscopy | A | | | 3.12 | Pulse oximetry | P | | | 3.13 | Arterial B P monitoring | P | | | 3.14 | Starting a venous access | P | | | S.No. | Specific Competencies/Skills | Number Performed/Assiste d/ Observed (P/A/O) | Date & Signature of the Faculty | |---|---|---|---| | 3.15 | ABG analysis | P | | | 3.16 | Oxygen administration | P | | | 3.17 | Tracheostomy care | P | | | 3.18 | Basic life support | P | | | 3.19 | Advanced life support | P | | | 3.20 | Application of Oro/pharyngeal Airway | P | | | 3.21 | CPAP (Continuous Positive Airway Pressure) | P | | | 3.22 | Care of intercostal drainage | p | | | 3.23 | Nebulization | P | | | 3.24 | Use of monitors | P | | | 3.25 | Use of infusion pump | P | | | 3.26 | Intravenous therapy | p | | | 3.27 | Admission and discharge in cardiothoracic unit | P | | | 3.28 | Orogastric tube insertion | P | | | 3.29 | Use of body warmer | P | | | 3.30 | Administration of drugs | p | | | 3.31 | Administration blood and blood products | P | | | 4 | CARE OF PATIENTS UNDERGOING CARDIOTHORACIC SURGERY | | | | 4.1 | Preparation of patients for cardiothoracic surgery | P | | | 4.2 | Postoperative care | P | | | 4.3 | Patient education & counselling | P | | | 4.4 | Preparation for home care | P | | | 5 | QUALITY CONTROL | | | | 5.1 | Preparation of SOP for infection control in Cardiothoracic ICU | P | | | 5.2 | Preparation of SOP for blood transfusion | P | | | 5.3 | Preparation of SOP for resuscitation | P | | | 5.4 | Development of nursing standards for patients undergoing open heart surgery | P | | | 5.5 | Conducting unit audit | P | | | 6 | ASEPSIS | | | | 6.1 6.2 | Sterilization/Disinfection | P | | | | 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 (Cardiothoracic OPD, Ward/Day care) | | | | 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 1& Pediatric 1 (Nursing/interdisciplinary rounds) | | | | 5.1 | Name of clinical condition (Adult): | | | | 5.2 | Name of clinical condition (Pediatric): | | | | 6 | Drug study, presentation and report (Two written reports for submission) | | | | 6.1 | Drug name: | | | | 6.2 | | | | | 6.3 | | | | | 6.4 | | | | | 7 | Designing cardiothoracic unit | | | | 8 | Visits - Reports | | | | | Example: Heart/Lung transplantation unit/Any other Cardiac/thoracic specialty centre | | | Signature of the Program Coordinator/Faculty Signature of the HOD/Principal APPENDIX 5 CLINICAL EXPERIENCE DETAILS | Name of Cardiothoracic Unit/ICU | Clinical Condition | Number of days care given | Signature of Faculty/Preceptor | |---|---|---|---| Signature of the Program Coordinator/Faculty Signature of the HOD/Principal Dr. T. DILEEP KUMAR, President [ADVT.-III/4/Exty./608/2024-25] and Published by the Controller of Publications, Delhi-110054. GORAKHA NATH YADAVA YADAVA Date: 2024.10.23 11:44:02 +05'30'