Nursing regulatory mechanisms

Nursing Management-Nursing regulatory mechanisms
Accreditation, Licensure and Renewal

1. NURSING REGULATORY
MECHANISMS
JORRY POULOSE
2
ND
YEAR MSc NURSING
JIPMER, PONDICHERRY

2. REGULATION
Regulationreferstotheprocessesusedtodesignate
thatanindividual,programme,institutionorproduct
havemetestablishedstandardssetbyanagent
(governmentalornon-governmental)recognisedas
qualifiedtocarryoutthistask.-Styles&Affara,1997,

3. GOALSOFREGULATION
Define the profession and its members
Determine the scope of practice
Set standards of education
Set standards of ethical and competent practice
Establish systems of accountability
Establish credentialing processes

4. REGULATORY BODY
Public authority or Government agency

5. DEFINITION
“Regulatorybodyistheformalorganization
designatedbyastatuteoranauthorized
governmentalagencytoimplementtheregulatory
formsandprocesswherebyorder,consistencyand
controlarebroughttotheprofessionanditspractice.”
-ICN,1997

6. IMPORTANCE OFREGULATORY BODIES
To provide quality health care service to the public.
To support and assist professional members.
Set and enforce standards of nursing practice.

7. Monitor and enforce standards for nursing education.
Set the requirements for registration of nursing
professionals.
To exercise legal control over institution within their
respective area.

8. NURSING REGULATORY
MECHANISMS
Main functions
To protect patient or society
To define the scope of nursing practice
To identify the minimum level of nursing care that must
be provided to clients

9. Theregulatorybodiesthatdefinethelaws
andregulationsinnursingpracticebythe
nursingcouncilsattheinternational,national
andstatelevels
Internationalcouncilofnurses
Indiannursingcouncil
Statenursingcouncil

10. ACCREDITATION
“Accreditationistheprocesswherebyanorganization
oragencyrecognizesacollegeofuniversityof
programmeofstudyashavingmetcertain
predeterminedqualificationsofstandards”
-Selden,1962

11. Aprocessofreviewandapprovalbywhich
aninstitution,programme orspecific
service isgranted atime-limited
recognition ofhaving met certain
establishedstandardsbeyondthosethatare
minimallyacceptable.
-ICN

12. Organizationoragencyrecognizesacollegeor
universityoraprogramofstudyashavingmetcertain
predeterminedqualificationsandstandard
voluntaryreviewprocessofeducationalprogramsbya
professionalorganization

13. PURPOSES OF ACCREDITATION
Forthemaintenanceofadequateadministration
requirement.
Maintainingauniformstandardfornursingeducation
andnursingservice.
Stimulationofinstitutionalself-improvementby
evaluationandinspection.

14. Itsafeguardstheinstitutionfromsocialeducationand
politicalpressures.
Ithelpsintheregistrationofnurses.
Itprescribesthesyllabus.
Itgrantsrecognitiontoschoolandcolleges.
Itguidestheschool/collegeofnursing,accordingto
recommendationandcriteria.
Italsoservicestopreparethecompetenttoservethe
public.

15. FUNCTIONS OF ACCREDITATION
It aims to protect the autonomy of various health
service programmes.
It preserves the quality of nursing education.
It protects the public from ill prepared nurses.
It protects the institutions unsound and unsafe political
pressure.
It helps the practitioner for the broad scope of nursing
practice.

16. TYPES OF ACCREDITATION
AGENCIES
i. National accrediting agency
ii. National professional accrediting agency
iii. State accrediting bodies

17. NATIONALAGENCIES
Concernedwithappraisingthetotalactivitiesofthe
institutionsofhigherlearning,andwithsafeguarding
thequalityofliberaleducation,thefoundationof
professionalprogramsincollegesanduniversities.
Eachagencyestablishescriteriafortheevaluationof
institutionsinitsregionitreviewsthoseinstitutions
periodically,anditpublishesfromtimetotimealistof
thoseagencieswhichithasaccredited.

18. Central advisory board of education
All India council for Elementary education
All India council for secondary education
University grants commission
All India council for technical education
National assessment and Accreditation council

19. NATIONALPROFESSIONAL ACCREDITING
AGENCY
Aimtofosterresearch,toimproveservicetothe
publicandthenumberofindividualsadmittedtothe
profession.

20. Medical Council of India
Indian Nursing Council
Dental council of India
Pharmacy council of India
Central council of Indian system of Medicine
Indian nursing council, (INC) is the official accrediting
agency for all programs of nursing, which include
Diploma (GNM), BscNursing (both basic and post
basic), MscN /M.phil(Masters) and PhD (Doctoral
programs in Nursing)

21. INDIAN NURSING COUNCIL
AIMS
Toestablishuniformstandardoftraining
throughoutthestate
Prohibittrainingcentre,whichareinadequate
Prohibitpracticeofnursingbynon–qualified
nurses.

22. FUNCTIONS AND ROLE OF INC
Prescribing Syllabus
Inspection

23. NATURE OF INSPECTION BY INC
First Inspections
Re Inspection
Periodic Inspections

24. STATE ACCREDITING BODIES
Astatenursingcouncils,whichiscalledreciprocity,
waspossibleonlyifuniformstandardsofnursing
educationweremaintained.
Providingtheregistrationtothenurses
Maintainsaregisterofnamesofprofessionalnurses
Alldegreeholdingnursesalsohavetogetthe
registrationinstatecouncil.

25. LICENSURE/REGISTRATION
Licensureisdefinedasthe“processbywhichan
agencyofstategovernmentgrantpermissiontoan
individualtoengageinagivenprofessionupon
findingthattheapplicanthasattained the
essentialdegreeofcompetency necessaryto
performauniquescopeofpractice”(NCSBN,2004).

26. Adocumentissuedbyabodychargedwiththe
exclusiverighttodetermineeligibilityforpracticeina
specifiedprofession,orfieldintheprofession.Itis
generallyusedwithinaregulatorysystemthatprohibits
practicewithoutalicense.
-ICN

27. PURPOSE:-
Licensure offers protection to the public
It ensure minimum competency among
professional.
It ensures minimum standard among the
professionals.
It help to prevent malpractice.
It helps to regulate the professional conduct.

28. Licensing permits a person to offer special skills and
knowledge to the public in a particular jurisdiction
when such practice would otherwise be unlawful. A
particular jurisdiction or area is covered by the
license.

29. InIndiaallnursesarerequiredtobelicensedto
workinanypartofthecountry,forthattheyhave
toberegisteredinanyofthestatenursing
council.AlloverIndiaeachstaterunningtheir
ownnursingcouncil.
Registrationcouncilsarefunctioninginallstates
ofIndiaandtheyareaffiliatedtoINC.

30. NURSING LICENSURE
Theprocess,sanctionedbythelaw,ofgranting
exclusivepowerorprivilegetopersonsmeeting
establishedstandards,whichallowsthemto
engageinagivenoccupationorprofession,andto
useaspecifictitle.-ICN

31. CURRENT LICENSURE
ACTIVITIES
Nurses are required to apply for licensure in
each state in which they practice
Nurses will be responsible for following the laws
and regulations of those states

32. COMPONENTS OF NURSING
PRACTICE ACTS
Twoessentialcomponents
1.Toprotectingthehealthandsafetyofthepublic
2.ProtectionofthetitleofRN
Nursingpracticeactdescribestherequirements
forlicensure
Registerednurse,isreservedforthosemeeting
therequirementstopracticenursinginthestate.

33. PROCESS OF REGISTRATION
It is the process by which individuals are assessed
and given status on a registry attesting to
individual’s ability and current competency. Its
purpose is to keep a continuous record of the past
and current achievements of an individual.

34. TNMC REGISTRATION
ProcessofProvidingAuthoritytousean
ExclusiveTitletothosepersonstoenterinthe
"StateRegister"MaintainedundertheLawofthe
State.

35. TAMILNADU CANDIDATES(PRIMARY)
RegistertheQualificationintheconcernState.
PrimaryRegistrationmeansthecandidateswho
obtainRecognizedQualificationwithinTamil
NaduandRegisteringthesameQualificationin
TamilNaduNursesandMidwivesCouncilasper
theAct.

36. 1) Candidates may apply in person or by Postal
with the required documents to this Council for
Registration
2) Bulk Registration may be done through the
Head of the Institution for all the Candidates

37. TAMILNADU CANDIDATE’S(PRIMARY)
ADDITIONALQUALIFICATION
RegistrationofAdditionalQualificationdoneby
thisCouncilfortheCandidates whohas
ObtainedNursingQualificationafterRegistering
theirBasicQualificationinTamilnaduNursing
Council.

38. OTHERSTATECANDIDATES(SECONDARY)
RegistertheQualificationintheconcernState
whereyouhavetrained.SubsequentlyRegistering
thesameQualificationonceagaininOtherState
withinIndiawhereyouwouldliketopractice
nursing/do highereducation isSecondary
Registration.

39. AftersurrenderingyourparentalRegistration
CertificateatyourCouncilandshouldobtaina
NOCfromtheParentalCounciltoRegistration
inTamilnadutopractisetheprofessionwithin
Tamilndau.

40. GENERAL INSTRUCTIONS
(1)ForBulkRegistration,alongwiththeabove
procedure,Candidate'sColourPhoto(Passport
Size)tobesubmitted&writetheCandidateName
behindthephoto.Onephototobefixedinthe
ApplicationformandDoNotStaple.AndalsoCD
tobesubmittedwithScanedPhotoandithasbeen
SavedinfilenameasCandidateName(Photofile
size20to40kbin.JPGformatonly).

41. (2) Other State Trained Candidates should
surrender their Concerned State Nursing
Council´s Registered Nurse & Midwife Certificates
to the parent Council where ever they have
Registered.
(3) Two Xerox copies of parent Council's RN and
RM Certificates should be enclosed.

42. (4)OtherStateCandidatesaftersurrenderingtheir
parentCouncil'sRN,RMcertificatestheyshould
obtainNOCfromtheparentCounciltoRegisterin
TNNMC.
(5)ForDispatching theBulkRegistration
Certificate,SelfaddressedEnvelopealongwith
NecessaryStamptobesent.

43. REQUIREMENT FORREGISTRATION BASIC
B.SC., NURSINGREGISTRATION PARTICULARS OF B.SC(N) - ORIGINAL CERTIFICATE
1 Filled Application form (Application can be downloaded from Council Website
“www.tamilnadunursingcouncil.com”)
2 Xerox copy of 12th Mark sheet (1 No.) or its Equivalent
3 Xerox copy of Transfer of Certificate (1 No.)
4 B.Sc(N) Provisional / Original Certificate
5 Xerox copy B.Sc(N) Provisional / Original Certificate (1 No.)
6 Original Certificate of Course Completion Certificate
7 Xerox copy of Course Completion Certificate (1 No.)
8 Final year Mark Sheet - Original (1 no.) Xerox Copy
9 Rs.2000/- Demand Draft Drawn in favour of “The Registrar, Tamilnadu Nurses and Midwives
Council, Chennai” payable at Chennai Branch and also.
10 CD to be Submitted with Scanned Photo to be Saved the file name as Candidate name (Photo
file size 20 to 40 kb in jpg format only).

44. REQUIREMENT FORREGISTRATION M.SC.,
NURSING
REGISTRATION PARTICULARS OF M.SC(N) - ORIGINAL CERTIFICATE
1 Filled Application form (Application can be downloaded from Council Website
“www.tamilnadunursingcouncil.com”)
2 Xerox copy of 12th Mark Sheet (1 No.) or its Equivalent
3 Xerox copy of Transfer of Certificate (1 No.)
4 M.Sc(N) Provisional / Original Certificate
5 Xerox copy M.Sc(N) Provisional / Original Certificate (1 No.)
6 Original Certificate of Course Completion Certificate
7 Xerox Copy of Course Completion Certificate (1 No.)
8 Final year Mark Sheet - Original (1 no.) Xerox Copy
9 Xerox Copy of Registered Nurse & Midwife of this Council (Each 1 No.)
10 Rs.1000/- Demand Draft Drawn in favour of “The Registrar, Tamilnadu Nurses and
Midwives Council, Chennai” Payable at Chennai Branch and also.
11 CD to be Submitted with Scanned Photo to be saved the file name as Candidate
Name (Photo file size 20 to 40 kb in jpg format only).

45. RENEWAL OF LICENSURE
The process for periodic reissuing of the legal
authority to practice.
Renewal system in a proper way it will help to
improve the professional competencies in nursing.
In TNMC instructed that all the nurses renew
their registration every 5 years for that they need
a specific(150) credit hours.

46. JOURNALREVIEW
The attitude of health care professionals towards
accreditation: A systematic review of the
literature
Done by:-Abdullah Alkhenizanand Charles Shaw1
Retrieved from Journal of Family Community
Med. 2012 May-Aug; 19(2): 74–80.
Aim:-To systematically review the literature of the
attitude of health care professionals towards
professional accreditation.

47. Studydesign:-Thiswasasystematic
qualitativereviewoftheliteratureofthe
attitudeofhealthcareprofessionalstowards
accreditation.Acomprehensive updated
searchoffourelectronicbibliographic
databasesincludingMedlinefrom1996-
January2011,Cinhal,from1982-January
2011,Embasefrom1980-January2011,and
HealthStarfrom1980-January2011was
done.Hereincludedthephysicians,nurses
andalliedhealthpersonnel.

48. ATTITUDEOFPHYSICIANS
InaqualitativeAustralianstudy(n=72)
doctorsweregenerallyunawareofaccreditationand
skepticalofit.Theirconcernwasonhowqualityof
carewastobemeasured.Doctorsfeltaccountable
withinaprofessionalframework,tothemselves,the
patientandfamily,theirpeersandtotheir
profession;butnottoaccreditationbodies.Inacross-
sectionalquestionnaireofconsultantradiologists,
87%ofradiologistsfavoredaccreditationforvirtual
colonoscopy.

49. ATTITUDEOFNURSES
 Inthelargerandomizedcontrolledtrial,
the(QAP)nurses’overallperceptionsofcare
(n=1048),attheaccreditedhospitals
increased significantly(59%to61%),
comparedtothecontrolhospitals(declined
from61%to57.Inalargerigoroussurvey
conductedinLebanon(n=1048),nurses
perceivedasignificantimprovement of
resultsinqualityinhospitalsasanoutcome
ofaccreditation.

50. CONCLUSION
Severalstudieshaveshownthathealthcare
professionalswereskepticalaboutaccreditation
becauseofconcernsaboutitsimpactonthe
qualityofhealthcareservices.Concernsraised
aboutthecostofaccreditationprogramsby
healthcareprofessionalsespeciallyindeveloping
countries were consistent. Healthcare
professionals(especiallyphysicians)havetobe
educated onthepotentialbenefitsof
accreditation.Itisalsonecessarytoconducta
rigorous,independentevaluationofthecost-
benefitanalysisofaccreditationofhealth
services.

51. THEORYAPPLICATION