Nursing Management-Nursing regulatory mechanisms Accreditation, Licensure and Renewal

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

2. REGULATION
 Regulation refers to the processes used to designate
that an individual, programme, institution or product
have met established standards set by an agent
(governmental or non-governmental) recognised as
qualified to carry out this task.- Styles & Affara, 1997,

3. GOALS OF REGULATION
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
 “Regulatory body is the formal organization
designated by a statute or an authorized
governmental agency to implement the regulatory
forms and process whereby order, consistency and
control are brought to the profession and its practice.”
- ICN,1997

6. IMPORTANCE OF REGULATORY 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. The regulatory bodies that define the laws
and regulations in nursing practice by the
nursing councils at the international, national
and state levels
 International council of nurses
 Indian nursing council
 State nursing council

10. ACCREDITATION
 “Accreditation is the process whereby an organization
or agency recognizes a college of university of
programme of study as having met certain
predetermined qualifications of standards”
- Selden, 1962

11.  A process of review and approval by which
an institution, programme or specific
service is granted a time-limited
recognition of having met certain
established standards beyond those that are
minimally acceptable.
-ICN

12.  Organization or agency recognizes a college or
university or a program of study as having met certain
predetermined qualifications and standard
 voluntary review process of educational programs by a
professional organization

13. PURPOSES OF ACCREDITATION
 For the maintenance of adequate administration
requirement.
 Maintaining a uniform standard for nursing education
and nursing service.
 Stimulation of institutional self-improvement by
evaluation and inspection.

14.  It safeguards the institution from social education and
political pressures.
 It helps in the registration of nurses.
 It prescribes the syllabus.
 It grants recognition to school and colleges.
 It guides the school/college of nursing, according to
recommendation and criteria.
 It also services to prepare the competent to serve the
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. NATIONAL AGENCIES
 Concerned with appraising the total activities of the
institutions of higher learning, and with safe guarding
the quality of liberal education, the foundation of
professional programs in colleges and universities.
 Each agency establishes criteria for the evaluation of
institutions in its region it reviews those institutions
periodically, and it publishes from time to time a list of
those agencies which it has accredited.

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. NATIONAL PROFESSIONAL ACCREDITING
AGENCY
 Aim to foster research, to improve service to the
public and the number of individuals admitted to the
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), Bsc Nursing (both basic and post
basic), Msc N /M.phil (Masters) and PhD (Doctoral
programs in Nursing)

21. INDIAN NURSING COUNCIL
AIMS
 To establish uniform standard of training
throughout the state
 Prohibit training centre, which are inadequate
 Prohibit practice of nursing by non –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
 A state nursing councils, which is called reciprocity,
was possible only if uniform standards of nursing
education were maintained.
 Providing the registration to the nurses
 Maintains a register of names of professional nurses
 All degree holding nurses also have to get the
registration in state council.

25. LICENSURE/REGISTRATION
 Licensure is defined as the “process by which an
agency of state government grant permission to an
individual to engage in a given profession upon
finding that the applicant has attained the
essential degree of competency necessary to
perform a unique scope of practice”(NCSBN,2004).

26. A document issued by a body charged with the
exclusive right to determine eligibility for practice in a
specified profession, or field in the profession. It is
generally used within a regulatory system that prohibits
practice without a license.
-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.  In India all nurses are required to be licensed to
work in any part of the country, for that they have
to be registered in any of the state nursing
council. All over India each state running their
own nursing council.
 Registration councils are functioning in all states
of India and they are affiliated to INC.

30. NURSING LICENSURE
 The process, sanctioned by the law, of granting
exclusive power or privilege to persons meeting
established standards, which allows them to
engage in a given occupation or profession, and to
use a specific title.-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
 Two essential components
1. To protecting the health and safety of the public
2. Protection of the title of RN
 Nursing practice act describes the requirements
for licensure
 Registered nurse, is reserved for those meeting
the requirements to practice nursing in the state.

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
 Process of Providing Authority to use an
Exclusive Title to those persons to enter in the
"State Register" Maintained under the Law of the
State.

35. TAMILNADU CANDIDATES (PRIMARY)
 Register the Qualification in the concern State.
Primary Registration means the candidates who
obtain Recognized Qualification within Tamil
Nadu and Registering the same Qualification in
Tamil Nadu Nurses and Midwives Council as per
the Act.

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)
ADDITIONAL QUALIFICATION
 Registration of Additional Qualification done by
this Council for the Candidates who has
Obtained Nursing Qualification after Registering
their Basic Qualification in Tamilnadu Nursing
Council.

38. OTHER STATE CANDIDATES (SECONDARY)
 Register the Qualification in the concern State
where you have trained. Subsequently Registering
the same Qualification once again in Other State
within India where you would like to practice
nursing/do higher education is Secondary
Registration.

39.  After surrendering your parental Registration
Certificate at your Council and should obtain a
NOC from the Parental Council to Registration
in Tamilnadu to practise the profession within
Tamilndau.

40. GENERAL INSTRUCTIONS
 (1) For Bulk Registration, along with the above
procedure, Candidate's Colour Photo (Passport
Size) to be submitted & write the Candidate Name
behind the photo. One photo to be fixed in the
Application form and Do Not Staple. And also CD
to be submitted with Scaned Photo and it has been
Saved in file name as Candidate Name (Photo file
size 20 to 40 kb in .JPG format only).

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) Other State Candidates after surrendering their
parent Council's RN, RM certificates they should
obtain NOC from the parent Council to Register in
TNNMC.
 (5) For Dispatching the Bulk Registration
Certificate, Self addressed Envelope along with
Necessary Stamp to be sent.

43. REQUIREMENT FOR REGISTRATION BASIC
B.SC., NURSING
REGISTRATION 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 FOR REGISTRATION 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. JOURNAL REVIEW
 The attitude of health care professionals towards
accreditation: A systematic review of the
literature
 Done by:- Abdullah Alkhenizan and 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.  Study design:- This was a systematic
qualitative review of the literature of the
attitude of health care professionals towards
accreditation. A comprehensive updated
search of four electronic bibliographic
databases including Medline from 1996-
January 2011, Cinhal, from 1982-January
2011, Embase from 1980-January 2011, and
Health Star from 1980-January 2011 was
done. Here included the physicians, nurses
and allied health personnel.

48. ATTITUDE OF PHYSICIANS
In a qualitative Australian study (n = 72)
doctors were generally unaware of accreditation and
skeptical of it. Their concern was on how quality of
care was to be measured. Doctors felt accountable
within a professional framework, to themselves, the
patient and family, their peers and to their
profession; but not to accreditation bodies.In a cross-
sectional questionnaire of consultant radiologists,
87% of radiologists favored accreditation for virtual
colonoscopy.

49. ATTITUDE OF NURSES
 In the large randomized controlled trial,
the (QAP) nurses’ overall perceptions of care
(n = 1048), at the accredited hospitals
increased significantly (59% to 61%),
compared to the control hospitals (declined
from 61% to 57.In a large rigorous survey
conducted in Lebanon (n = 1048), nurses
perceived a significant improvement of
results in quality in hospitals as an outcome
of accreditation.

50. CONCLUSION
 Several studies have shown that health care
professionals were skeptical about accreditation
because of concerns about its impact on the
quality of health care services. Concerns raised
about the cost of accreditation programs by
health care professionals especially in developing
countries were consistent. Healthcare
professionals (especially physicians) have to be
educated on the potential benefits of
accreditation. It is also necessary to conduct a
rigorous, independent evaluation of the cost-
benefit analysis of accreditation of health
services.

51. THEORY APPLICATION