Full Text
PART III—Section 4
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NOTIFICATION
New Delhi, the 7th October 2024
F.No. 11-1/2024-INC (V).—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 {Nurse Practitioner in Transplant Nursing
ii. These shall come into force on the date of notification of the same in the Official Gazette of India.
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
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
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
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.
NURSE PRACTITIONER IN TRANSPLANT NURSING (NPTN) -
Introduction and Background
In India, reshaping health systems in all dimensions of health has been recognized as an important need in the
National Health Policy, 2017. It emphasizes human resource development in the areas of education and training
alongside regulation and legislation. The government recognizes significant expansion in tertiary care services both in
public and private health sectors. In building their capacity, it is highly significant that the health care professionals
require advanced educational preparation in specialty and super-specialty services. To support specialized and super-
specialized health care services, specialist nurses with advanced preparation are essential. Developing training
programs and curriculum in the area of tertiary care is recognized as the need of the hour. Nurse Practitioners (NPs)
will be able to meet this demand provided they are well trained and empowered to practice. With establishment of new
cadres in the Center and State level, master level prepared NPs will be able to provide cost effective, competent, safe,
and quality driven specialized nursing care to patients in the transplant settings in tertiary care centers. Nurse
Practitioners have been prepared and functioning in USA since 1960s, UK since 1980s, Australia since 1990s and
anesthesia and other specialties can be prepared to function in tertiary care settings. Rigorous educational preparation
will enable them to work collaboratively to promote organ donation, prevent organ rejection and to promote donor and
recipient’s health. A curricular structure/framework is proposed by the Council towards preparation of the Nurse
Practitioner in Transplant Nursing (NPTN) at master’s level. The special feature of this program is that it is a clinical
residency program emphasizing a strong clinical component with 15% of theoretical instruction and 85% of
practicum. Competency based training is the major approach and NP education is based on competencies adapted
from International Council of Nurses (ICN, 2020), National Organization of Nurse Practitioner Faculties (NONPF,
2022), and AACN (2021). Every course is based on achievement of pertinent competencies specific to that level.
Nurse Practitioner in Transplant Nursing (NPTN) – Residency Program is intended to prepare registered B.Sc.
Nurses to provide advanced nursing care to organ donors and recipients. The nursing care is focused on stabilizing
patients’ condition, preventing acute complications and maximizing restoration of health. These NPs are required to
practice in the transplant care units. The program consists of various courses of study that are based on strong
scientific foundations including evidenced based practice and the management of complex health systems. These are
built upon the theoretical and practice competencies of B.Sc. trained nurses. On completion of the program and
registration with respective SNRC they are authorized to practice all competencies listed in the log book of the
Council syllabus and independently perform donor and recipient assessment, order diagnostic tests, perform
diagnostic and therapeutic procedures, handle medical equipment, administer drugs and therapies as per institutional
protocols/standing orders. While exercising this authority, the Nurse Practitioners in Transplant Nursing are
accountable for demonstrating competencies in -
| Participation in Government and non-governmental activities in promoting organ donation and |
The said postgraduate degree will be registered as an additional qualification by the SNRC.
The Council believes that there is a great need to establish a postgraduate program titled Nurse Practitioner in
Transplant Nursing (NPTN) to meet the challenges and demands of tertiary health care services in India which is
reflected in the National Health Policy, 2017 to provide quality care to patients requiring organ transplant and their
The Council believes that postgraduates from a residency program focused on strong clinical component and
competency-based training must be able to demonstrate clinical competence based on sound theoretical and evidence-
education, collaborative learning, preceptored clinical learning with medical and nursing preceptors, experiential
practices. Medical faculty are invited to participate as preceptors in the training.
The Council also believes that a variety of educational strategies can be used in the clinical settings to address the
deficit of qualified Transplant Nursing faculty. It is hoped to facilitate developing policies towards
registration/licensure and create cadre positions for appropriate placement of these postgraduate Nurse Practitioners in
Transplant Nursing to function in Transplant care units/Departments of tertiary care centers.
An educational framework for the Nurse Practitioners in Transplant Nursing (NPTN) curriculum is proposed as
This program is designed to assist students in developing expertise and in-depth understanding in the field of
Transplant Nursing. It will help students to develop advanced skills for nursing intervention in Transplant Nursing. It
will further enable the student to function as educator, manager and researcher in the field of Transplant Nursing.
The NP program is a nursing residency program with a focus on competency-based training. The duration is of
two years with the curriculum consisting of theory that includes core courses, advanced practice courses and clinical
courses besides clinical practicum which is a major component (Refer Curricular framework).
The Nurse Practitioner in Transplant Nursing program prepares registered B.Sc. nurses for advanced practice
roles as clinical experts, managers, educators and consultants leading to M.Sc. Nursing (NP in Transplant Nursing)
On completion of the program, the Nurse Practitioner in Transplant Nursing will be able to -
1. Assume responsibility and accountability to provide competent care to donors and recipients and family
centered care in transplant care settings;
2. Demonstrate clinical competence/expertise in providing transplant care which includes donor and recipient
assessment, education, diagnostic reasoning, complex monitoring, and therapies of donors & recipients, and
liaising with resource agencies;
3. Apply theoretical, pathophysiological and pharmacological principles and evidence base in implementing
therapies/interventions in transplant care;
4. Identify the conditions requiring transplant using differential diagnosis and carry out treatment/ interventions
to stabilize and restore patient’s health and minimize or manage complications independently or
collaboratively as a part of transplant care team;
5. Collaborate with other health care professionals in the transplant care team, across the continuum of
V. Minimum requirements to start the Nurse Practitioner in Transplant Nursing (NPTN) program
The institution must accept the accountability for the NPTN program and its students and offer the program
congruent with the Council standards. It must fulfill the following requirements:
Any institution who wishes to start Nurse Practitioner in Transplant Nursing program shall obtain an
Essentiality Certificate/Government Order from the State.
b. The following institutions are exempted from obtaining Essentiality Certificate:
by the Council under Sections 13 and 14 of the Act;
The institute should have a parent hospital/tertiary care centre with a minimum of 200 beds. It must have a
b. It is preferable to have a medical college/nursing college attached to the parent hospital.
The hospital should have a transplant unit with a minimum of 10 beds and performing 50 transplants per year.
Transplant unit should have a Charge Nurse preferably with B.Sc. Nursing or M.Sc. Nursing qualification;
b. The nurse patient ratio should be 1 : 1 for the acute care unit;
For the remaining beds the nurse patient ratio should be 1 : 6 for every shift;
d. There must be provision of additional 40% trained nursing staff towards leave reserve;
Doctor patient ratio can be 1 : 5.
i. Nursing Preceptor: Full-time qualified GNM with 6 years’ experience in Transplant unit or B.Sc.
Nursing with 2 years’ experience in transplant unit or M.Sc. in Medical Surgical Nursing/Pediatric
The above faculty shall perform dual role or be senior nurses with M.Sc. Nursing qualification employed in
the transplant unit.
d. Guest lecturers for pharmacology, pathophysiology, and organ transplantation.
6. Physical and Learning Resources at Hospital/College
One class room/conference room at the clinical area;
Library and computer facilities with access to online journals;
7. List of Equipment for Transplant Unit (enclosed Appendix 1)
year clinical experience, preferably in any transplant setting prior to enrollment;
b. Must have undergone the B.Sc. Nursing in an institution found suitable by the Council and have been
registered by the respective SNRC;
Must have scored not less than 55% aggregate marks in the B.Sc. Nursing program;
d. Selection must be based on the merit of an entrance examination and interview held by the competent
Must be physically fit.
Number of candidates: 1 candidate for 4-5 transplant unit beds.
2. Stipend/Salary for the other candidates as per the salary structure of the hospital where the course is
Eligibility for appearing in the Examination
Attendance: Minimum 80% for theory and practical before appearing for final University examination but must
complete 100% in practical before the award of degree.
There is no minimum cut off for the internal assessment marks, as internal and external marks are added together
for declaring pass.
Declaration of Results
The candidate is declared to have passed the exam if the score is 60% and above. This score is the aggregate of
both internal and external University examination in theory and practical in every course/subject and less than 60% is
For calculating the rank, the aggregate of the two years’ marks will be considered.
If a candidate fails in theory or practical, he/she must appear for the paper in which he/she has failed.
Rank will not be declared for candidates who fail in any subject. Maximum period to complete the program is 4
OSCE type of examination is to be followed alongside viva (oral examination) - Refer OSCE Guidelines found in
Maximum number of students for practical exam per day is 10 students.
Examination is to be held in clinical area only.
The team of three practical examiners will include:
i. one internal examiner {M.Sc. Nursing faculty with two years of experiences in teaching the NPTN
ii. one external examiner (same as above); and
iii. one medical internal examiner who should have served as preceptor for NPTN program.
Submission of Research Proposal: 6-9 months after date of admission in the first year.
Research Committee: There shall be a separate research committee in the college/hospital to guide and oversee
the progress of the research (minimum of 5 members with Principal or CNO who is M.Sc. Nursing qualified).
Ethical clearance must be obtained by the Institutional Review Board/Hospital Ethics Committee since it
Topic Selection: The topic should be relevant to Transplant Nursing that will add knowledge or evidence for
nursing intervention. The research should be conducted in any of the transplant settings.
Data Collection: 7 weeks are allotted for data collection, which can be integrated during clinical experience after
6 months in first year and before 6 months in second year.
Writing the Research Report: 6-9 months in second year.
Submission of Dissertation Final: 3 months before completion of the second year.
(Marking guide used for other M.Sc. Nursing specialties can be used for evaluation).
VII. Assessment (Formative and Summative)
(See Appendix 2 for Assessment Guidelines)
Scheme of Final Examination
| S.No. | Title | Theory % | | | Practical % | | |
| 2 | Research Application and Evidence Based Practice in Transplant Nursing | 3 hours | 30 | 70 | | | |
| S.No. | Title | Theory % | | | Practical % | | |
| 3 | Advanced Skills in Leadership, Management and Teaching | 3 hours | 30 | 70 | | | |
| 1 | Foundations of Transplant Nursing Practice | 3 hours | 30 | 70 | | 100 | 100 |
| 4 | Dissertation and viva | | | | | 50 | 50 |
VIII. Courses of Instruction
| II | Research Application and Evidence Based Practice in Transplant Nursing | 56 | 24 | 336 (7 weeks) |
| III | Advanced Skills in Leadership, Management and Teaching | 56 | 24 | 192 (4 weeks) |
*Theory + Lab= 96 hours can be given for 2 weeks in the form of introductory block classes and workshops
A. Clinical Residency experience: A minimum of 48 hours per week is prescribed, however, it is flexible with
different shifts and OFF followed by on call duty.
B. 8 hours duty with one day OFF in a week and ON CALL duty one per week
Ist year: 44 weeks (excludes 2 weeks of introductory block classes and workshop)
C. Teaching Methods: Teaching - Theoretical, Lab and Clinical can be done in the following methods and
In depth drug study, presentation, and report
Faculty lecture in the clinical area
D. Procedures/Log Book: At the end of each clinical posting, Clinical Log Book (Specific Procedural
Competencies/Clinical Skills) (Appendix 3) and Clinical Requirements (Appendix 4) are to be updated and
signed by the preceptor.
E. Institutional Protocol/Standing Orders based administration of drugs & ordering of investigations and
therapies: The students will be trained to independently perform donor and recipient assessment, order diagnostic
tests, perform diagnostic and therapeutic procedures, handle medical equipment, administer drugs and therapies
as per institutional protocols/Standing Orders (Appendix 5 Standing Orders). Administration of emergency drugs
is carried out in consultation with concerned physicians and endorsed later by written orders.
Implementation of Curriculum - Tentative Plan
Topic for every teaching method will be specified in the detailed plan by the respective teacher/institution concerned.
Theoretical Basis for Advanced Nursing Practice
1. Analyses the global healthcare trends and challenges.
2. Analyses the impact of healthcare and education policies in India on nursing consulting the documents available.
3. Develops in depth understanding of the healthcare delivery system in India, and its challenges.
4. Applies economic principles relevant to delivery of healthcare services in Transplant Nursing.
5. Manages and transforms health information to effect health outcomes such as cost, quality and satisfaction.
6. Accepts the accountability and responsibility in practicing the Nurse Practitioner’s roles and competencies.
7. Actively participates in collaborative practice involving all healthcare team members in transplant care and
performs the prescriptive roles within the authorized scope.
8. Engages in ethical practice having a sound knowledge of law, ethics, and regulation of advanced nursing practice.
9. Uses the training opportunities provided through well planned preceptorship and performs safe and competent.
10. Applies the knowledge of nursing theories in providing competent care to donors and the recipients.
11. Predicts future challenges of Nurse Practitioner’s roles in variety of healthcare settings particularly in India.
Hours of Instruction: 40 hours
| S.No. | Topic | Hours |
| 2 | Health System in India - Health Care Delivery System in India - Changing Scenario (Competency 3) | 2 |
| 6 | ANP - Definition, Scope, Philosophy, Accountability, Roles and Responsibilities (Collaborative Practice and Nurse Prescribing Roles) (Competency 6 and 7) | 3 |
| 7 | Regulation (accreditation of training institutions and Credentialing) and Ethical Dimensions of advanced nursing practice role (Competency 8) | 3 |
| 9 | Training for NPs - Preceptorship (Competency 9) | 2 |
| 10 | Future Challenges of NP practice (Competency 11) | 4 |
| 11 | Theories of Nursing applied to APN (Competency 10) | 3 |
| 1 | Identify Health Care and Education Policies and analyze its impact on nursing | |
| 2 | Describe the legal position in India for NP practice. What is the future of nurse prescribing policies in India with relevance to these policies in other countries? | |
| 3 | Examine the nursing protocols relevant to NP practice found in transplant care units | |
AACN (2021) The Essentials: Core Competencies for Professional Nursing Education - Entry Level and
Advanced Level Nursing Education, American Association of Colleges of Nursing
II. Research Application and Evidence Based Practice in Transplant Nursing
1. Applies sound research knowledge and skills in conducting independent research in Transplant Nursing.
2. Participates in collaborative research to improve patient care quality.
3. Interprets and uses research findings in advanced practice to produce EBP.
4. Tests/evaluates current practice to develop best practices and health outcomes and quality care in advanced
5. Analyzes the evidence for nursing interventions carried out in Transplant Nursing practice to promote safety and
effectiveness of care.
| S.No. | Topic | Hours |
| 1 | Research and Advanced Practice Nursing: Significance of Research and inquiry related to Advanced nursing role (Competency 1) | 2 |
| 2 | Research agenda for APN practice: Testing current practice to develop best practice, health outcomes and indicators of quality care in advanced practice (Competency 3, 4, 5) promoting research culture | 5 |
| 3 | Research Knowledge and Skills: Research competencies essential for APNs (interpretation and use of research, evaluation of practice, participation in collaborative research) Introduction to Evidence Based Practice (EBP) project - PiCOT question, steps of planning, implementation, evaluation and dissemination (project proposal and project report) Research Methodology Phases/steps (Research question, Review of literature, conceptual framework, research designs, sampling, data collection, methods and tools, Analysis and Reporting) Writing research proposal and research report (Competency 1 and 2) | 40 (5 days workshop) |
| 5 | Evidence based practice (Competency 3, 4, 5) Concepts, principles, importance and steps Integrating EBP to transplant nursing Areas of evidence in transplant care Barriers to implement EBP Strategies to promote EBP | 4 |
Lab/Skill Lab and Assignments: 24 hours
Writing exercises on research question, objectives, and hypothesis
Scientific paper writing - preparation of manuscript for publication
Writing systematic review - analyze the evidence for a given nursing intervention in Transplant unit
Gray J. & Grove S.K. (2020) Burns & Groves: The Practice of Nursing Research: Appraisal, Synthesis and
ed.) New Delhi: Wolters & Kluwer
Schmidt N.A. & Brown J.M. (2021) Evidence-based Practice for Nurses Appraisal and Application of Research,
III. Advanced Skills in Leadership, Management and Teaching
1. Applies principles of leadership and management in Transplant unit.
2. Manages stress and conflicts effectively in Transplant units using sound knowledge of principles.
4. Uses critical thinking and communication skills in providing leadership and managing patient care in Transplant
5. Builds teams and motivates others in Transplant care units.
7. Participates appropriately in times of innovation and change.
8. Uses effective teaching methods, media and evaluation based on sound principles of teaching.
9. Develops advocacy role in patient care, maintaining quality and ethics in Transplant units.
10. Provides counseling to families and patients.
| S. No. | Topic | Hours |
| 1 | Theories, styles of leadership and current trend | 2 |
| 2 | Theories, styles of management and current trends | 2 |
| 3 | Principles of leadership and management applied to transplant care settings | 4 |
| 4 | Stress management and conflict management - principles and application to transplant care environment, effective time management | 4 |
| 5 | Quality improvement and audit | 4 |
| 9 | Change and innovation | 2 |
| 10 | Staff performance and evaluation (performance appraisals) | 6 |
| 11 | Teaching-learning theories and principles applied to Transplant Nursing | 2 |
| 13 | Teaching methods/strategies, media: educating patients and staff in transplant settings | 8 |
| 14 | Staff education and use of tools in evaluation | 4 |
| 15 | APN - roles as a teacher | 2 |
| 16 | Advocacy roles in transplant care environment | 2 |
Preparation of staff patient assignment
Preparation of unit budget
Preparation of staff duty roster
Preparation of nursing care standards and protocols
Management of equipment and supplies
Monitoring, evaluation, and writing report of infection control practices
Development of teaching plan for staff and student
Preparation of teaching method and media for patients and staff
Planning and conducting OSCE/OSPE
Construction of tools for staff appraisal
Preparation of inventory
Assignment: Prepare Nursing care standards for one of the transplant units
Bastable S.B. (2019) Nurse as Educator: Principles of Teaching and Learning for Nursing Practice (5th ed.) New
Delhi: Jones & Bartlett Publishers Inc.
Clark C.C. (2010) Creative Nursing Leadership and Management, New Delhi: Jones & Bartlet Publishers Inc.
Roussel L. & Swansburg R.C. (2010) Management and Leadership for Nurse Administrators (5th ed.) New Delhi:
1. Integrates the knowledge of pathophysiological process in transplant care in developing diagnosis and plan of
2. Applies the pathophysiological principles in symptom management and secondary prevention of complications.
3. Analyzes the pathophysiological changes relevant to each condition requiring organ transplant recognizing the
value of diagnosis, treatment, care and prognosis.
Hours of Instruction: Theory: 60 hours
1. Applies the pharmacological principles in providing care to both donors and recipients in transplant care.
2. Analyzes pharmacotherapeutics and pharmacodynamics relevant to drugs used in the transplant care.
3. Performs safe drug administration based on principles and institutional protocols.
5. Applies sound knowledge of drug interactions in administration of drugs to patients in transplant care and guiding
their families in self-care management.
Hours of Instruction: Theory: 54 hours
| I | 2 | Introduction to Pharmacology History Classification of drugs and schedules |
| II | 3 | Pharmacokinetics and Pharmacodynamics Introduction Absorption, distribution, metabolism and excretion of drug Plasma concentration, half life Loading and maintenance dose Therapeutic index and drug safety Potency and efficacy Principles of drug administration - The rights of drug administration - Systems of measurement - Enteral drug administration - Topical drug administration - Parenteral drug administration |
| III | 6 | Pharmacology and Cardiovascular alterations in Transplant care Pharmacological therapies used in pre-transplant cardiovascular diseases - dose, interactions, side effects, monitoring, and contraindications |
| IV | 6 | Pharmacology and Pulmonary alterations in Transplant care Pharmacological therapies used in pre-transplant pulmonary diseases - dose, interactions, side effects, monitoring and contraindications |
| VI | 8 | Pharmacology and Intestinal, Pancreas and Liver alterations in Transplant care Pharmacological therapies used in pre-transplant intestinal, pancreas and liver diseases - dose, |
| | | interactions, side effects, monitoring and contraindications |
| VII | 8 | Pharmacology and Hematological alterations in Transplant care Pharmacological therapies used in pre-transplant hematological diseases - dose, interactions, side effects, monitoring and contraindications |
| VIII | 15 | Pharmacological therapies in post-transplant care Pharmacological therapies used in transplant care - indications, dose, drug interactions, side effects, monitoring, drug assays and contraindications, cost and financial implications Supplements Analgesia Use of anti-coagulatants, anti-microbials, anti-fungals and anti-virals in managing the patient with complex co-morbidities Immunosuppressants - types, indication, contraindications, classification, mechanism of action and dosing guidelines and monitoring of drugs used in transplantation Immunoglobulin |
1. Applies the physical assessment principles in developing appropriate system wise examination skills
2. Uses advanced health assessment skills to differentiate between variations of normal and abnormal findings
3. Orders screening and diagnostic tests based on the examination findings and institutional protocols
4. Analyzes the physical examination findings and results of various investigations and works collaboratively with
emergency physicians for development of diagnoses
5. Documents assessment, diagnosis, and management and monitors follow up care in partnership with health care
team members, patients, and families
| XII | 6 | Assessment of Children Growth and development Nutritional assessment Specific system assessment |
List of skills to be practiced in the skill lab (48 hours include demonstration by the faculty and practice by the
Ordering and interpretation of screening and diagnostic tests (Enclosed Appendix 5)
Assessment of children and adults
(Foundations of Transplant Nursing Practice, Transplant Nursing I and Transplant Nursing II)
1. Appreciates trends and issues related to transplant care.
2. Applies advanced concepts of Transplant Nursing based on sound knowledge of these concepts.
3. Performs physical, psychosocial, and spiritual assessment of the donors and recipients of transplant care.
4. Assists in various diagnostic, therapeutic and surgical procedures related to donor and recipient care.
5. Demonstrates advance skills/competence in managing donors and recipients before and after transplant surgeries.
6. Works in collaboration with other healthcare team members and prepares care/clinical pathways in assessment
and management of patients requiring transplant care.
7. Identifies emergencies and complications related to transplantation and take appropriate measures.
8. Participates in national health programs to promote organ donation and health promotion and rehabilitation of
9. Applies ethically sound solutions to complex issues related to transplant care.
10. Practices principles of infection control relevant to transplant care.
11. Practices independently within the legal framework of the country in transplant care towards the interest of
patients, families, and communities.
12. Uses applicable communication, counseling, advocacy, and interpersonal skills to initiate, develop and
14. Supports patients and their families to cope with emotional and spiritual distress, grief and anxiety applying
15. Incorporates principles of end-of-life care in interacting with family members, whenever applicable.
16. Coordinates patient care activities recognizing the value of teamwork and be sensitive to the growing stress and
17. Applies/suggests innovations incorporating evidence-based nursing practice and identify the areas of research in
the field of Transplant Nursing.
18. Familiarizes with the legal formalities and documentation processes associated with transplantation.
19. Designs a layout of Transplant Unit and develop Standard Operating Protocols for Transplantation care.
20. Performs the role of NP in Transplant Nursing/transplant nurse coordinator/specialist as a member of the medical
VII. Foundations of Transplant Nursing Practice
| I | 10 | Introduction to Transplant Nursing Introduction to the course Historical development of organ transplantation: type, trends and issues, transplant modalities |
| | | Terminologies Definition and scope of Transplant Nursing Concept, principles, and nursing perspectives of Transplant Nursing Transplant care unit set up including equipment and supplies Transplant team roles and function Role of nurse in the organ transplant Current and future challenges and innovations in transplant care |
| II | 15 | Concept of Holistic Care applied to Transplant Nursing Practice Application of nursing process and integrated care/clinical pathways in caring for patients requiring transplant care Admission and monitoring of patients in transplant care unit Overview of transplant care Airway management Optimal circulation and tissue oxygenation Hemodynamic monitoring Temperature maintenance Pain management Fluid and electrolyte balance Organ protection Infection control Cardio-pulmonary-brain resuscitation BLS ACLS PALS Oxygenation and oximetry, care of patient with oxygen delivery devices Ventilation and ventilator support (including humidification and inhaled drug therapy), care of patient with invasive and noninvasive ventilation Restraints in transplant care - physical, chemical and alternatives to restraints Death in transplant care unit - end of life care/care of dying, and care of family Stress and burnout syndrome among health team members |
| III | 10 | Appraisal of the Patients undergoing Transplant Surgeries Assessment of the critically ill pre/post-transplant patients Cardiac assessment Respiratory assessment Renal assessment Neurological assessment Gastrointestinal assessment Monitoring of the critically ill pre/post-transplant patients Arterial blood gas (ABG) |
| V | 8 | Psychosocial and Spiritual Alterations: Assessment and Management Stress and psychoneuroimmunology Post-traumatic stress reaction Acute psychosis, anxiety, agitation, delirium Spiritual challenges in transplant care Coping with stress and illness Issues in transplant science - socio-cultural, ethical, psychological, and financial/economic issues |
| VI | 4 | Patient and Family Education and Counseling Informational needs of recipient and families in transplant care Challenges of patient and family education Counseling needs of patient and family and the challenges Crisis and grief counseling, and communication |
| VII | 6 | Fluid, Electrolyte, and Acid Base Alterations Review of fluid, electrolyte, and acid base balance Assessment and management of fluid, electrolyte, and acid base imbalances |
| VIII | 4 | Thermoregulation and Management Review on thermoregulation Hyperthermia Hypothermia Management of patients with thermoregulatory issues |
| IX | 6 | Infection Control in Transplant Unit Nosocomial infection Disinfection, sterilization Standard safety measures Reverse barrier nursing Staff prophylaxis Antimicrobial therapy - review Infection control policies and protocols Pre- and post-transplant - common symptoms of infection and management guidelines Recipient infection prevention - vaccinations, medications, and identification of strategies for safe living |
| X | 12 | Legal and Ethical Issues in Transplant Care - Nurse’s Role Legal Aspects Legislations and regulations related to transplant care - Transplantation of Human Organs and Tissues Act (THOTA) Legal responsibilities of nurses National guideline for organ transplant National and State organ transplant program and registry National Organ and Tissue Transplant Organization (NOTTO) Regional Organ and Tissue Transplant Organization (ROTTO) State Organ and Tissue Transplant Organization (SOTTO) Brain Stem Death Declaration in India and its procedure Presumed consent Policies and protocol related to organ donation Documentation related to organ donation Ethical Issues Introduction Code of ethics, code of professional conduct and practice standards of nursing in India Ethical aspects of organ donation and transplantation Ethical decision making in transplant care - withholding treatment, managing scarce resource in transplant care Strategies for promoting ethical decision making Do Not Resuscitate (DNR), Euthanasia, Living will |
| XI | 8 | Quality assurance Philosophy, aims and objectives of transplant units Design of transplant care units Quality assurance models applicable to transplant care units Standards, Protocols, Policies, Procedures Infection control policies and protocols |
| XII | 3 | Evidence based Practice in Transplant Nursing Evidence based practice in transplant care Barriers to implementation Strategies to promote implementation |
List of skills to be practiced in the skill lab (48 hours include demonstration by the faculty and practice by the
Oxygenation and oximetry, care of patient with oxygen delivery devices
Devices to measure oxygen/oxygenation
mask with reservoir bags
Ventilation and ventilator support
Setting up of ventilators
Connecting to ventilator
Weaning from ventilator
Circulation and perfusion (including hemodynamic evaluation and waveform graphics)
Insertion and removal of arterial line
Insertion and removal of central line
Fluids and electrolytes
Fluid calculation and administration
Administration of blood and blood products
Inotrope calculation, titration, and administration
Use of fluid dispenser, syringe pump and infusion pumps
Evaluation of acid base status
Correction of acidosis and alkalosis
Thermoregulation, care of patient with hyper/hypothermia
Management of hyper and hypothermia
Glycemic control, care of patient with glycemic imbalances
Insulin therapy (sliding scale and infusion)
Management of hyperglycemia
Management of hypoglycemia
Pharmacological management of pain, sedation, agitation, and delirium
Calculation, loading and infusion
Creating public awareness on organ and tissue donation
Counseling - individual and family
Individual and family education
| I | 6 | Organ transplant immunology General concepts of human immune system and transplant immunology Immunologic risk assessment Donor selection, matching - HLA and histocompatibility Organ or graft rejection and types |
| II | 5 | Drugs used in transplant Drugs and solutions used during harvesting, storage and transportation of organs Supplements Immunosuppressants and preparation and prevention of its toxicity and complications Antibiotics Blood and blood components Prophylactic and adjuvant medications used in transplant Nursing responsibility |
| III | 5 | Psycho-social issues in transplantation Psychological impact of transplant in donor and recipient Psycho-social assessment of donor and recipient Prevention: Multidisciplinary care Role of nurse Role of support groups |
| IV | 10 | Organ donation Brain death evaluation and organ donation process Organ donation pledge - advocacy Types of donors - Donation after Cardiac Death (DCD), Donation after Brain Death (DBD), Live related donor, Live unrelated donor (altruistic donor) Eligibility criteria for transplant donor Contraindications to organ donation High risk donor and potential impact if organs used Management of potential donor Allocation of organs for both local and national offering Types of grafts - split, marginal, domino Cold Ischemic Time (CIT), Warm Ischemic Time (WIT) and its impact on the donor organ survival Donor and recipient factors involved in the calculation of the Transplant Benefit Score (TBS) Organ allocation Multi-organ retrieval Family approach for organ donation and family care |
| V | 5 | Care of the donor and the organ Donor assessment Care of the donor Organ procurement, preservation, storage, and transportation Organ perfusion and tissue preservation |
| | | Family communication/counseling Role of transplant coordinator/NP in Transplant Nursing - donor and recipient Waitlist management |
| VI | 5 | Operative Room Management Physical preparation - physical set up, operation trolley preparation OR team Organ perfusion - UW and HTK solutions Therapeutic environment in OT Assisting with organ transplantation Intra-operative management and monitoring of donor and recipient |
| VII | 15 | Heart and Valves Transplantation Review of anatomy and physiology of cardiovascular system Indication and contraindications for heart and valve transplant Eligibility criteria for transplant recipient Evaluation of transplant recipient Selection of donor and matching Pre-transplant assessment - history, physical examination, investigation and diagnostic procedures Pre- and post-transplant care of the recipient Treatment modalities - CPR, ACLS, defibrillation, cardioversion, IABP Transplant procedure and intraoperative care of the donor organ and the recipient Monitoring and evaluation for potential surgical complications, infections, or rejection and their management Complications after heart transplant and management Nurse’s role in caring for patients undergoing heart transplantation Drugs used after heart transplant Post-transplant cardiac rehabilitation and follow up |
| VIII | 15 | Lung Transplantation Review of anatomy and physiology of lung Indication and contraindications for lung transplant Eligibility criteria for transplant recipient Evaluation of transplant recipient Selection of donor and matching Pre-transplant assessment - history, physical examination, investigation, and diagnostic procedures Pre- and post-transplant care of the recipient Treatment modalities - ECMO Organ retrieval and transplant procedure and intraoperative care Monitoring and evaluation for potential surgical complications, infections, or rejection and their |
| | | management Nurses’ role in lung transplantation Drugs used in lung transplantation Rehabilitation and follow-up |
| IX | 15 | Renal Transplantation Review of anatomy and physiology of kidney Donor and Recipient assessment - history, physical examination, investigation and diagnostic procedures Indications and contraindication for renal transplant Eligibility criteria for transplant recipient Evaluation of transplant recipient Selection of donor and matching ABO incompatible transplant, Swap transplantation Pre-transplant care of the recipient Treatment modalities - hemodialysis, peritoneal dialysis and therapeutic plasma exchange Fluid management protocol following transplant Post-operative care of donor and recipient Transplant procedure and intra-operative care Monitoring and evaluation for potential surgical complications, infections, or rejection and their management Nurse’s role in renal transplantation Drugs used in renal transplantation - therapeutic drug monitoring Rehabilitation and follow-up |
| X | 15 | Liver Transplantation Review of anatomy and physiology of liver Indication and contraindications for liver transplant Eligibility criteria for liver transplant recipient Evaluation of transplant recipient Types of liver transplant - live donor/cadaveric donor Selection of donor and matching Pre-transplant assessment - history, physical examination, investigation and diagnostic procedures Pre-transplant care of the recipient Organ retrieval and preservation Monitoring and management of post-operative liver function of donor and recipient Monitoring and management of renal function including Hemodialysis Transplant procedure and intraoperative care Monitoring and evaluation for potential surgical complications, infections, or rejection and their management |
| | | Nutrition management Nurse’s role in liver transplantation Drugs used in liver transplantation Rehabilitation and follow-up |
List of skills to be practiced in the skill lab (48 hours include demonstration by the faculty and practice by the
Evaluation of brain death
Counselling for organ donation
Safe retrieval, storage and transport of the organ
Assisting with organ harvesting
Assisting with transplant surgeries
Care of donor
Care of recipient - pre- and post-transplant
| II | 16 | Bone marrow Transplantation Review of anatomy and physiology of blood, bone marrow, spleen and lymphatics Clinical assessment and diagnostic procedures of the hematological system Indications and contraindications for bone marrow transplant Eligibility criteria for transplant recipient Evaluation of transplant recipient Selection of donor and matching Peripheral blood stem cell transplantation Bone marrow stem cell transplantation Autologous vs. Allogenic stem cell transplantation Stem cell harvesting Preparing a patient for transplantation - conditioning Treatment modalities - transfusion of blood and blood products Genetic counselling and role of a nurse |
| | | Care of patient after bone marrow transplantation Monitoring and evaluation for potential surgical complications, infections, or rejection and their management Nurse’s role in caring for patients undergoing bone marrow transplantation Drugs used in and after the bone marrow transplantation Rehabilitation and follow-up |
| III | 12 | Pancreas Transplantation Review of anatomy and physiology of the pancreas Donor and recipient health assessment - history, physical examination, investigation, and diagnostic procedures Indications and contraindications for pancreatic transplant Eligibility criteria for transplant recipient Evaluation of transplant recipient Selection of donor and matching Pre- and post-operative care of recipient Transplant procedure and intraoperative care Monitoring and evaluation for potential surgical complications, infections, or rejection and their management Nutrition and management of blood glucose levels Nursing management after pancreatic transplantation Drugs used in pancreatic transplantation Rehabilitation and follow-up |
| IV | 12 | Intestine Transplantation Review of anatomy and physiology of GI system Donor and recipient health assessment - history, physical examination, investigation, and diagnostic procedures Indications, and contraindications for intestinal transplant Eligibility criteria for transplant recipient Evaluation of transplant recipient Selection of donor and matching Pre-operative care of recipient Post-operative care of donor and recipient Transplant procedure and intraoperative care Monitoring and evaluation for potential surgical complications, infections, or rejection and their management Nutritional considerations Nurse’s role in intestinal transplantation Drugs used in intestinal transplantation Rehabilitation and follow-up |
| V | 10 | Eye Transplantation Review of anatomy and physiology of the eye Health assessment - history, physical examination, investigation and diagnostic procedures Indications, and contraindications for eye/corneal transplant Donor care and organ retrieval Evaluation of transplant recipient Pre- and post-operative care of the recipient Transplant procedure and intraoperative care Monitoring and evaluation for potential complications after transplant and their management Nurse’s role in transplantation Drugs used in transplantation Rehabilitation and follow-up |
| VI | 8 | Thymus and uterus Transplantation Review of anatomy and physiology of thymus and uterus Donor and recipient health assessment - history, physical examination, investigation, and diagnostic procedures Indications, and contraindications for thymus and uterus transplantation Evaluation of transplant recipient Primary immune deficiency and thymus anomaly Monitoring and evaluation for potential complications after transplant and their management Pre- and post-operative care of donor and recipient Nurse’s role in transplantation Rehabilitation and follow-up |
| VII | 10 | Transplantation of the skin, muscle nerve, vein, bone, and tendon Bone banking Review of anatomy and physiology of neuromusculoskeletal system Donor and recipient health assessment - history, physical examination, investigation, and diagnostic procedures Indications, and contraindications for nerve, vein, bone and tendon transplantation Evaluation of transplant recipient Skin malignancy, muscle and musculocutaneous flaps, brachial plexus injury, tendon and nerve transfers/implants, bone graft Pre- and post-operative care of donor and recipient Transplant procedure and intraoperative care Monitoring and evaluation for potential complications after transplant and their management Nurse’s role in transplantation Drugs used in transplantation and immunosuppression Rehabilitation and follow-up |
| VIII | 10 | Transplant in children Donor Recipient Clinical concerns following organ transplantation in children |
List of skills to be practiced in the skill lab (48 hours include demonstration by the faculty and practice by the
Handing over of transplant patient
Documentation and verification
Monitoring signs of rejection
Administration of immunosuppressant
Diet planning for post-transplant patients
Monitoring of immunosuppressive client
The skills listed under the Specialty courses such as Foundations of Transplant Nursing Practice, Transplant Nursing I
and Transplant Nursing II are taught by the faculty in skill lab. The students after practicing them in the lab, will
continue to practice in the Transplant unit. The log book specifies all the requirements to be completed and the list of
skills that are to be signed by the preceptor once the students develop proficiency in doing the skills independently.
Wolters and Kluwer Publisher
Kenyan M. & Babic A. (2003) The European Blood and Marrow Transplantation (1st ed.) Text book for Nurses,
and Wilkins: Philadelphia
Recommended Courses to Complete
Equipment List for a Transplant Unit (Other equipment may be added as per institutional need)
1. ICU adjustable electronic cot with mattress - 10
19. Blood warmer and fluid warmer - 1
29. Suction port with jar - 10
38. Ambu bag with different sizes - 10 sets
41. Trays with sterile sets/disposable sets for various procedures (e.g. insertion of central venous catheter,
INTERNAL ASSESSMENT (Theory and Practical)
1. Theoretical Basis for Advanced Nursing Practice
College examination of theory only: 50 marks
Test paper and Quiz: 10 marks
Written assignment/term paper: 10 marks (Global and national healthcare trends and policies)
2. Research Application and Evidence Based Practice in Transplant Nursing
Journal club: 5 marks (Analysis of research evidence for Transplant Nursing competencies)
3. Advanced Skills in Leadership, Management and Teaching Skills
4. Advanced Pathophysiology and Advanced Pharmacology applied to Transplant Nursing
Written assignment: 10 marks (Diagnostic/Investigatory reports - interpretation and analysis of findings)
End of posting exam (OSCE): 10 marks
End of posting exam can be conducted in Transplant unit
1. Foundations of Transplant Nursing Practice
Test papers and Quiz: 20
End of posting exam (OSCE): 10 marks
Test papers and Quiz: 20 marks
Clinical seminar and Journal club: 10 marks
End of posting exam (OSCE): 10 marks
End of posting exam (OSCE): 10 marks
End of posting exam can be conducted in Transplant ICU/Step down unit
EXTERNAL (FINAL) EXAMINATION (As per schedule in syllabus)
Theory: Short answer and essay type questions (Weightage can be decided by the University) {Essay 2 × 15
OSCE GUIDELINES FOR INTERNAL AND EXTERNAL PRACTICAL EXAMINATION
1. Focused history taking of adult patient
2. Focused physical examination of adult patient
3. Focused history taking of pediatric patient
4. Focused physical examination of pediatric patient
5. Interpretation of history and physical examination findings
6. Interpretation of results of lab and diagnostic tests
Number of stations: 5 (4 + 1 Rest station)
Time for each station: 10 minutes
Marks for each station: 5 marks (As per competency check list and allotted marks)
1. Focused history taking of adult patient
2. Focused physical examination of adult patient
3. Focused history taking of pediatric patient
4. Focused physical examination of pediatric patient
5. Interpretation of history and physical examination findings
6. Interpretation of results of lab and diagnostic tests
Number of stations: 10 (8 + 2 Rest stations)
Time for each station: 10 minutes
Marks for each station: 5 marks (As per competency check list and allotted marks)
On completion of procedural competencies in log book and clinical requirements, the NP student is
qualified to appear for final practical examination.
II. FOUNDATIONS OF TRANSPLANT NURSING PRACTICE
1. Focused history taking, physical examination and interpretation of results of adult patient
2. Focused history taking, physical examination and interpretation of results of pediatric patient
3. Monitoring competencies (invasive and non-invasive)
4. Development of care plan
5. Family education and counseling
Number of stations: 5 (4 + 1 Rest station)
Time for each station: 10 minutes
Marks for each station: 10 marks (As per competency check list and allotted marks)
1. Focused history taking, physical examination and interpretation of results of adult patient
2. Focused history taking, physical examination and interpretation of results of pediatric patient
3. Monitoring competencies (Invasive and noninvasive)
4. Development of care plan
5. Family education and counseling
Number of stations: 10 (8 + 2 Rest stations)
Time for each station: 10 minutes
Marks for each station: 10 marks (As per competency check list and allotted marks)
TRANSPLANT NURSING I and II
1. Focused history taking, physical examination and interpretation of findings of adult and pediatric patient
2. Monitoring competencies (Invasive and noninvasive)
3. Evaluation of brainstem functioning
4. Family education and counseling for organ donation
5. Counseling of the transplant recipient
6. Development of plan of care/care pathway
7. Preparation of operating room for transplant surgery
Number of stations: 5 (4 + 1 Rest station)
Time for each station: 10 minutes
Marks for each station: 10 marks (As per competency check list and allotted marks)
1. Focused history taking, physical examination and interpretation of findings of adult and pediatric patient
2. Monitoring competencies (Invasive and noninvasive)
3. Evaluation of brainstem functioning
4. Family education and counseling for organ donation
5. Counseling of the transplant recipient
6. Development of plan of care/care pathway
7. Preparation of operation room for transplant surgery
Number of stations: 10 (8 + 2 Rest stations)
Time for each station: 10 minutes
Marks for each station: 10 marks (As per competency check list and allotted marks)
On completion of procedural competencies in log book and clinical requirements, the NP student is
qualified to appear for final practical examination.
CLINICAL LOG BOOK FOR NURSE PRACTITIONER IN TRANSPLANT NURSING PROGRAM
| S.No. | Specific Competencies/Skills | Number Performed | Date | Signature of the Preceptor*/Faculty |
| 1 | Preparation of research instrument | | | |
| 2 | Preparation of a manuscript for publication (Ist year/IInd year) | | | |
| II | ADVANCED SKILLS IN LEADERSHIP, MANAGEMENT AND TEACHING | | | |
| 1 | Preparation of staff patient assignment | | | |
| 2 | Preparation of unit budget | | | |
| 3 | Preparation of staff duty roster | | | |
| 5 | Preparation of nursing care standards/protocols | | | |
| 6 | Management of equipment and supplies | | | |
| 7 | Monitoring, evaluation, and writing report related to infection control | | | |
| 9 | Preparation of teaching plan and media for patients and staff | | | |
| 10 | Planning and conducting OSCE/OSPE | | | |
| 11 | Construction of tests | | | |
| S.No. | Specific Competencies/Skills | Number Performed | Date | Signature of the Preceptor*/Faculty |
| 5 | Age specific history and physical examination | | | |
| S.No. | Specific Competencies/Skills | Number Performed | Date | Signature of the Preceptor*/Faculty |
| 6. | Setting up, use and maintenance of transplant care equipment | | | |
| 7 | Monitoring and Interpretation of Critical Parameters | | | |
| 8.2 | Fluid management in renal transplant | | | |
| 8.6 | Management of graft rejection | | | |
| S.No. | Specific Competencies/Skills | Number Performed | Date | Signature of the Preceptor*/Faculty |
| 10 | Creating Public Awareness on Organ Donation | | | |
*When the student is found competent to perform the skill, it will be signed by the preceptor.
Students: Students are expected to perform the listed skills/competencies many times until they reach level 3
competency, after which the preceptor signs against each competency.
Preceptors/Faculty: Must ensure that the signature is given for each competency only after they reach level 3.
Level 3 Competency denotes that the NP student can perform that competency without supervision.
Level 2 Competency denotes that the student can perform each competency with supervision.
Level 1 Competency denotes that the student is not able to perform that competency/skill even with supervision.
Note: 5-10% of procedures that are rare can be practiced in skill lab and attained level 3 competency.
Signature of the Program Coordinator/Faculty
Signature of the HOD/Principal
| S.No. | Specific Competencies/Skills | Number Performed | Date | Signature of the Preceptor*/Faculty |
| 1 | Setting-up, Use and Maintenance of Transplant Care Equipment | | | |
| 2 | End of life care | | | |
| 9 | Monitoring and Interpretation of Critical Parameters | | | |
| 10 | Administration of Medication | | | |
| S.No. | Specific Competencies/Skills | Number Performed | Date | Signature of the Preceptor*/Faculty |
| 10.7 | Administration of IgG/ATG | | | |
| 11 | Management of Cardiovascular Alterations | | | |
| 11.2 | Blood and blood product administration | | | |
| 11.3 | Insertion and care of CVP line | | | |
| 11.4 | Removal of CVP line | | | |
| 11.5 | Assisting with insertion of arterial line | | | |
| 11.6 | Care of arterial line | | | |
| 11.7 | Removal of arterial line | | | |
| 11.8 | Assisting with insertion of pulmonary artery catheter | | | |
| 11.9 | Blood collection from arterial line | | | |
| 12 | Management of Pulmonary Alterations | | | |
| 12.3 | Assisting with intubation | | | |
| 12.4 | Care of ET tube | | | |
| 12.6 | Assisting for tracheostomy insertion | | | |
| 12.7 | Tracheostomy care and suctioning | | | |
| 12.12 | Care of patient on mechanical ventilator | | | |
| 12.14 | Connecting to ventilator | | | |
| 12.15 | Weaning from ventilator | | | |
| 12.16 | Use of T-tube and venturi devices | | | |
| 12.17 | Weaning from tracheostomy | | | |
| S.No. | Specific Competencies/Skills | Number Performed | Date | Signature of the Preceptor*/Faculty |
| 13.1 | Care of potential donor | | | |
| 13.2 | Identification of potential donor | | | |
| 13.3 | Screening of potential donor | | | |
| 13.5 | Family counseling for organ donation | | | |
| 13.6 | Authorizing and consenting process | | | |
| 14 | Management of Renal Alterations | | | |
| 14.1 | Assisting with cannulation for hemodialysis | | | |
| 14.2 | Starting and closing of hemodialysis | | | |
| 14.3 | Care of patient on hemodialysis | | | |
| 14.5 | Care of patient on peritoneal dialysis | | | |
| 15 | Management of Gastrointestinal Alterations | | | |
| 16 | Management of Endocrine Alterations | | | |
| 16.2 | Calculation of steroid administration | | | |
| 17 | Ordering Procedures and Investigations | | | |
| 18.4 | Insertion and removal of urinary catheter | | | |
| S.No. | Specific Competencies/Skills | Number Performed | Date | Signature of the Preceptor*/Faculty |
| 18.10 | Application of Ichthammol Glycerin/Magnesium Sulphate dressing for Thrombophlebitis/extravasation | | | |
| 18.11 | Hot and cold applications | | | |
| 19 | Operation Room Competencies for Organ Retrieval and Transplant | | | |
| 19.2 | Handing over of patient to immediate post-operative ICU | | | |
| 19.3 | Maintaining Nurses’ documentation in OT | | | |
| 19.4 | Setting up of Operation Trolley | | | |
| 19.5 | Assisting in OT as Scrub Nurse - organ donation | | | |
| 19.6 | Assisting in OT as Scrub Nurse - transplantation | | | |
| 19.7 | Assisting in OT as Circulatory Nurse | | | |
| 19.8 | Assist with Organ Perfusion | | | |
| 19.11 | Assist in Organ Harvesting | | | |
| 20 | Care of Recipient | | | |
| 20.1 | Counselling - individual/family for transplant | | | |
| 20.2 | Care of recipient - pre- and post-operative | | | |
| 20.3 | Monitoring of immediate transplant patients | | | |
| 20.4 | Administration and monitoring of immunosuppressants | | | |
*When the student is found competent to perform the skill, it will be signed by the preceptor.
Students: Students are expected to perform the listed skills/competencies many times until they reach level 3
competency, after which the preceptor signs against each competency.
Preceptors/Faculty: Must ensure that the signature is given for each competency only after they reach level 3.
Level 3 Competency denotes that the NP student can perform that competency without supervision.
Level 2 Competency denotes that the student can perform each competency with supervision.
Level 1 Competency denotes that the student is not able to perform that competency/skill even with supervision.
NOTE: 5-10% of procedures that are rare can be practiced in skill lab and attained level 3 competency.
Signature of the Program Coordinator/Faculty
Signature of the HOD/Principal
CLINICAL REQUIREMENTS FOR NURSE PRACTITIONER IN TRANSPLANT NURSING (NPTN)
| S.No. | Clinical Requirement | Date | Signature of the Preceptor/Faculty |
| 1.1 | Foundations of Transplant Nursing Practice (Clinical Conference) Title of the topic: | | |
| 1.2 | Transplant Nursing I (Clinical Seminar) Title of the topic: | | |
| 1.3 | Transplant Nursing I (Journal Club) Title of the topic: | | |
| 1.4 | Transplant Nursing II (Clinical Seminar) Title of the topic: | | |
| 1.5 | Transplant Nursing II (Journal Club) Title of the topic: | | |
| 2 | Clinical Rounds (With Nursing Staff, Faculty, Students) -Clinical/Case Presentation (Written reports are for submission) | | |
| 2.1 | Foundations of Transplant Nursing Practice (Family Education/ Counseling) Written Report Title of the topic: | | |
| 2.2 | Foundations of Transplant Nursing Practice (Transplant Care Pathway) Title of the topic: | | |
| 2.3 | Transplant Nursing I (Clinical Presentation) Name of the clinical condition: | | |
| 2.4 | Transplant Nursing I (Case Study Report) Name of the clinical condition: | | |
| 2.5 | Transplant Nursing II (Clinical Presentation) Name of the clinical condition: | | |
| 2.6 | Transplant Nursing II (Case Study Report) Name of the clinical condition: | | |
| 2.7 | Name of the drug: | | |
| 2.8 | Name of the drug: | | |
| S.No. | Clinical Requirement | Date | Signature of the Preceptor/Faculty |
| | Name of the clinical condition: | | |
Note: Clinical presentation can be written for case study report.
Signature of the Program Coordinator/Faculty
Signature of the HOD/Principal
| Transplant Unit | Clinical Condition | Number of days care given | Signature of Faculty/Preceptor |
Signature of the Program Coordinator/Faculty
Signature of the HOD/Principal
NURSE PRACTITIONER IN TRANSPLANT NURSING (NPTN)
Nurse practitioners are prepared and qualified to assume responsibility and accountability for the care of
transplant patients. They collaborate with Intensivists, physicians, surgeons, and specialists to ensure accurate therapy
for patients with high acuity needs. On completion of the program, the NPs will be permitted to administer drugs
listed in standing orders as per the institutional protocols/standing orders. They will also be permitted to order/perform
diagnostic tests/procedures and therapies.
The following intravenous injections or infusions may be administered by the Nurse Practitioner in the transplant
Sedatives and relaxants
Electrolytes and acid base correction agents
Antibiotics and antifungal
The following investigations and therapies may be ordered by the Nurse Practitioner
| for culture, urine samples for random, micro and culture | Isometric and isotonic exercises Hot and cold applications Prescribing supplements |
INSTITUTIONAL STANDING ORDERS AND PROTOCOLS
In every hospital, the standing orders for drug administration with specific dosage to be administered during
emergency situations and specific therapeutic procedures/activities permitted to be performed by the NP after
competency certification can be made available as guidelines for NPTN graduates. The NPTN students will be trained
to administer these drugs and perform therapeutic procedures under supervision by preceptors/NP faculty and the
competency to be certified by NP faculty. The protocols for ordering selected investigations and carrying out specific
therapeutic procedures can also be available in every hospital that trains NPTN students.
and Published by the Controller of Publications, Delhi-110054. SARVESH KUMAR
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