tamilnadu nurses and midwives council-cum-principal 1 professor-cum-vice principal 2 3 principal...

TAMILNADU NURSES AND MIDWIVES COUNCIL(Constituted Under Tamilnadu Nurses and Midwives ACT III of 1926)

Jayaprakash Narayanan Maligai,

Old No.140, New No.56, Santhome High Road, Chennai - 600 004.

Tel. No.044-24934792, Fax : 044-24620547

Email : [email protected]

Web : www.tamilnadunursingcouncil.com

INSPECTION PROFORMA

FOR ALL NURSING PROGRAMMES

FOR THE GRANT OF RECOGNITION

RHODIUM JUBILEE1926-2013

Inspector's Information

2. Name of the Member with Designation and address

3. Tamil Nadu Nursing Council Letter No. & Datein which the Inspection Commission Constituted.

4. Date of Inspection

5. Academic Year

Phone No. Office

Residence

Mobile No.

Is the institution willing to submit itself for the inspection under

Rule No.37 of Tamil Nadu Nurses & Midwives Act.

(Please Tick the Appropriate Boxes)

NoYes

Types of Inspection :

Sl.No.

Type of Inspection

1. Primary Inspection

2. Annual Inspection

3. Re-Inspection

4. Enhancement of Seats

5. Surprise Inspection

H.V. ANM GNMBasic

B.Sc.(N)PBB.Sc.(N) M.Sc.(N)

P.B. DiplomaProgram

TAMILNADU NURSES AND MIDWIVES COUNCIL(Constituted Under Tamilnadu Nurses and Midwives ACT III of 1926)

INSPECTION PROFORMA

1

1. Name of the facilitator Designation and AddressPhone No. Office

Residence

Mobile No.

:

:

:

:

:

6. Bi-annual inspection

I. GENERAL INFORMATION

1. Name of the Institution : __________________________________

__________________________________

2. Full Address with Pin Code : __________________________________

(as given in G.O) __________________________________

__________________________________

District __________________________________

3. If there is any address change, specify the : __________________________________

new Address (enclosed the Govt. Order for __________________________________

change of Address) __________________________________

__________________________________

4. Name of the Principal : __________________________________

a) Telephone Number of the Principal (O) ______________ (R) ______________

(M) _______________________________

5. Name of the Vice Principal : __________________________________

a) Telephone Number of the Principal (O) ______________ (R) ______________

(M) _______________________________

6. Telephone Number of the Institution : ______________ Fax No._____________

7. E-Mail of the Institution : __________________________________

8. Name of the Trust/Society/Missionary/ : __________________________________

Company (enclosed a copy of the Registered __________________________________

Trust Deed only if any name change of the __________________________________

trust or trust members, trust address) __________________________________

Encl. : __________

9. __________________________________

a) Telephone Number (O) _______________ (R) _____________

(M) _______________________________

10. Administrative Control : 1. Government 2. University

3. Corporation 4. Private

5. Autonomous 6. Voluntary

7. Missionary/Trust/Society 8. Company

11. Does the institution has Minority status : Yes / No

(If yes, enclose the minority status G.O Encl. : __________

issued in recent years)

Name of the Managing Trustee / Chairperson :

2

12. First Batch admitted for School / College:

ProgrammeG.O

No. &Date

Year ofProgramme

Started

No. of Seats Sanctioned in Original G.O. No&

DateRemarks

Enhancement of Seats(No. of seats Sanctioned)

G.O G.OINC INCTNC TNCUniversity UniversityBoard Board

M.Sc.,(N)a. Med. Surg. Nsg.b. Com. Health Nsg.c. Paediatric Nsg.d. Psychiatrict Nsg.e. OBG Nsg.

H.V.

ANM

GNMBasic B.Sc(N)

Post Basic B.Sc(N)

M.Phil (N)

Ph.D

Post Basic

Diploma

Programmes

* G.O, INC, TNC, University & Board Orders to be enclosed; * If G.O is exempted, kindly mentioned those courses (Both for New / Enhancement) Encl : ______________

13.a) Do you have parent Medical College : 1. Yes 2. No

b) Do you have own Hospital : 1. Yes 2. No.

If Yes, Name & Address of the Medical College Hospital (Proof of the same to be enclosed): Encl: _________

14. Is the INC/TNC/University affiliation Orders for the Previous

academic year is available for each program : 1. Yes 2. No

If Yes, Mention the date of last inspection for each programme (Latest orders to be enclosed) Encl: _________

Council / University H.V. ANM GNMBasic

B.Sc.(N)PBBSc(N) M.Sc.(N)

Post BasicDiploma Programmes Remarks

3

Tamilnadu Nursing Council

Indian Nursing Council

University

Board (Govt. / CMAI)

II. TEACHING FACULTY

STAFFING PATTERN AS PER INC NORMSSchool of Nursing

For School of nursing with 60 students (i.e., an annual intake of 20 students):

Teaching Faculty No.

Principal

Vice-Principal

Tutor

Additional Tutor for interns

Total

Required Available

1

1

4

1

7

Note : Teacher students ratio should be 1:10 for students sanctioned strength.

STAFFING PATTERN AS PER INC NORMSCollegiate Programme

Sl.No

DesignationB.Sc.(N)

40-60(Students Intake)

B.Sc.(N)61-100

(Students Intake)Available

3.

4.

5.

6.

Professor

Associate Professor

Assistant Professor

Tutor

0

2

3

10-18

1. Professor cumPRINCIPAL

1 1

2. Professor cumVICE-PRINCIPAL

1 1

1

4

6

19-28

Principal is excluded for 1:10 teacher student ratio norms.

Tutor student ratio will be 1:10

(For 40 students intake minimum teacher required is 17 (including Principal).

The strength of tutors will be 10, and 6 will be as per Sl. No.1 to 4.

Sl.No

DesignationB.Sc.(N)

40-60(Students Intake)

P.B.B.Sc.(N)20-60


3.

4.

5.

6.

Professor

Associate Professor

Assistant Professor

Tutor

0

2

3

10-18


1


1 1

2

2-10

4

B.Sc.(N)40-60

(Students Intake)

P.B.B.Sc.(N)20-60

(Students Intake)

M.Sc.(N)10-25


0

2

3

10-18

1

DesignationSl.No

3.

4.

5.

6.

Professor

Associate Professor

Assistant Professor

Tutor



1

1

1

2 3*

2-10

B.Sc.(N)40-60

PBBSC(N)20-60

M.Sc.(N)10-25

AvailableGNM20-60

6-18

Designation

Professor

Associate Professor

Assistant Professor

Tutor

Sl.No

3.

4.

5.

6.

Professor cumPRINCIPAL

1.

Professor cumVICE-PRINCIPAL

2.

0

2

3

10-18

1

1

1*

1*

3*2

2-10

* 1:10 teacher student ratio for M.Sc.(N)

B.Sc.(N)40-60

PBBSC(N)20-60

M.Sc.(N)10-25

AvailableGNM20-60

ANM20-60

6-184-12

Designation

Professor

Associate Professor

Assistant Professor

Tutor

0

2

3

10-18

1

1

1*

1*

3*2

2-10

Sl.No

3.

4.

5.

6.

Professor cumPRINCIPAL

1.

Professor cumVICE-PRINCIPAL

2.

* 1:10 teacher student ratio for M.Sc.(N)

5

Follow as per Latest INC Norms.

1. Prof-Cum-Principal

2. Prof-Cum-Vice-Principal

3. Reader / Associate Professor

4. Lecturer / Assistant Professor

5. Clinical Instructor

II. FACULTY DETAILS

A. Teaching Faculty Profile (Full - Time) of all the Nursing programme offered by this institution (H.V., GNM, Basic B.Sc.,(N)Post Basic B.Sc.,(N), M.Sc.,(N) & any other (Nursing Faculty of all the nursing programme details to be given irrespective of the program being inspected)

SlNo

NameRNRMNo.

PayScale

BasicB.Sc.(N)

PostBasic

B.Sc.(N)

M.Sc.(N)

M.Phil., PhD., Clinical BeforePG

AfterPG

Teaching

Date ofJoining Remarks

Total

Experience in years & months*

Speciality

Name of the institution Year of passing fromwhere and when qualified. (Enclose Photos with

self-attestation of all teaching facultyindividually in the affidavit - Form II)Age

Date ofLeavingPrevious

Employment**&

InstitutionName

Designation

Professor-cum-Principal

1

Professor-cum-VicePrincipal

2

Principal3

Reader/Asso.Professor

4

Lecturer5

Tutor /ClinicalInstructor

6

Enclosed the colour photograph duly signed by the faculty, copies of appointment order, a copy of relieving order of Last institution, UG & PG

Certification, RN, RM & Addl. Qualn. Registration Certificates & Experience Certificates. Encl : _____________

** Check the Relieving order & enclose the same; if joined within 6 months.

6

B. External Teachers Details (Part Time) (whichever subject applicable for the programme)

Sl.No.

Subject Name QualificationNumber of Hrs / Year

RemarksAs per normsprescribed

Allotted

1. Anatomy

2. Physiology

3. Bio-Chemistry

4. Nutrition

5. Micro-Biology

6. English

7. Computer Science

8. Psychology

9. Sociology

10. Pharmacology

11. Pathology

12. Genetics

13. Bio-Statistics

14. Bio-Physics

15. Community Medicine

16. Others

**The above teachers should have post graduate qualification with teaching experience in respective area.

C. COLLEGE OFFICE STAFF

Sl.No.

DesignationNo.

RequiredNo. in

PositionVacant Since

WhenRemarks

1. P.A. to Principal

Sr. Assistant

Jr. Assistant

Accountant-cum-Cashier

Librarian

Computer Programmer

Peon / Office Attendant

Security

Driver (As per the No. of Vehicles)

Cleaner (Bus) (As per the No. of Vehicles)

House Keeping Staff

Maintenance Staff

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

1

1

1

1

2

1

2

2

4

2

7

D. HOSTEL STAFF

Sl.No.

DesignationNo.

RequiredNo. in

PositionVacant Since

WhenRemarks

1. Warden

Asst. Warden2.

Cooks (1:20)3.

Bearer4.

House Keeping Staff5.

Security6.

1

1

4

4

4

2

* Hostel should be under the control of the Principal. * Separate Hostel for Nursing Students is a mandate.

III. PHYSICAL INFRASTRUCTURE DETAILS

A) ACADEMIC BLOCK : Own / Leased / Rented

1. Total Land Area : __________________ Acres

2. Ready Built Area : __________________ Sq.ft.

3. Details about ownership of the Building : 1. Own / 2.Leased / 3. Rented

If own, proof to be enclosed with building completion Encl: _____________Certificate & Latest E.C. If leased, copy of theRegistered lease deed to be enclosed.*If leased building make sure it is registered for 5 yrslease, if not mention the same in the report. Make aspecial note in the report if the building is rented

4. Building Completion :

a) Building Stability Certificate from : ______________________________Collector / Panel Engineer(Should be renewed in 3 years)

b) Sanitation Certificate : : ______________________________(Should be renewed every year)

c) Fire Safety : ______________________________(Should be renewed every year)

d) Building License (Thasildhar) : ______________________________

i) Does all the courses are imparted in the : Yes / Nosame building

ii) If no, where the other courses are imparted : ______________________________

5. Number of Toilets in the College for allNursing programs

Total No. of Students : ______________________________Total No. of Toilets : ______________________________Student Toilet Ratio : ______________________________

Facilities Minimum requirements as per INC norms Available Remarks

A. Teaching Block:a. Lecturer Halls No.

2 for ANM, 4 for GNM, P.B.B.Sc.,(N), 2 forM.Sc.,(N), 4 for B.Sc.,(N) & Extra / Batch

Area Size 1080 sq.ft. (720 sq.ft. - ANM)

No. of TablesNo. of Chairs

Should adequate for Intake

B. Multipurpose Hall/ Auditorium

1. Area2. Seating Capacity3. Confidential Room4. CCTV Facility5. Furniture & Settings

3000 sq.ft. (ANM-1200 sq.ft.)

Exam. purpose

Adequate for capacity.

}

8

Facilities Minimum requirements as per INC norms Available Ramarks

C. Laboratoriesa) Nursing Foundation Lab

1500 sq.ft.

1. No. of beds 1:6 students

2. No. of articles 10-12 sets in each item

3. Equipment & supplies Adequate for lab practice

4. No. of dummies Adult manikin - 3

Child / Neonate - 1

CPR manikin - 1

I.V. Arm Simulator - 1

5. Hand washing facilities Elbow / Leg operated system

b. Nutrition Lab - Area 900 sq.ft.

1. Equipment & Supplies Adequate for practice

2. Charts / Models Adequate for practice

c. MCH Lab - AreaSimulators / charts /model / playmaterials / specimens /charts / models / specimens

900 sq.ft.Adequate for practiceDelivery Manikin - 1Neonatal Manikin - 1

d) CHN Lab - AreaCharts / models etc.Community Health Bags

900 sq.ft.

1:2 students.

e) Pre-Clinical Science labs(Anatomy, Physiology etc.)

900 sq.ft.

f) Computer Lab-AreaNo. of computerInternet facilities

1500 sq.ft.

1:5 students.

D. A.V. Aids Rooms - AreaOHP

900 sq.ft.1 for each class room

LCD 2 (minimum)

Slider Projector 1

TV / Video 1

Charts / Models / Specimen Other T.L. Aids Specify

Adequate for each student

* Enclose the list of articles for all the labs Enclosures : ____________Enclose copy of latest purchase bills : ____________

* Proportionately the size of the built up area will increase according to the number of students admitted(10 sq.ft. for each student to be calculated for every additional seats)

* Apart from 2 additional Class room's for Post Graduate Programme, as per the no. of Specialities, theSeminar Rooms should be available.

* The nursing institution can have all the nursing programmes in the same building but with requisite infrastructure.Labs can be shared.

9

E. LIBRARY Minimum Required Available Remarks

Library AreaSeatingCapacity

Staff reading room

2400 sq.ft.Min. 60

10 persons

Room for librarianFurniture

Should be Adequate

No. of cupboards Should be Adequate

No. of racks Should be Adequate

Total No. of Books(For DGNM programtotal books = 1000)

For Collegiate Programme 3000

YearMin.

Books

Professional Journals

NationalInter

NationalTotal

I

II

III

IV

1000

1500

2500

3000

3

5

2

10

2

2

1

5

5

7

3

15

* For PG programme Departmental library with additional 1000 books and journals(National & International) speciality wise should be available.

(i) General Books / Fictions : _____________________

(ii) No. of latest edition Nursing books (since 2000) : _____________________

(iii) Photocopying facility : Yes No o o

(iv) Internet facility : Yes No o o

(v) Separate section for Staff / PG : Yes No o o

(vi) Ventilation : Yes No o o

(vii) Lighting : Yes No o o

(viii) Registers maintained

Accession Register : Yes No o o

Journal Register : Yes No o o

Issue Register : Yes No o o

10

Available Remarks

* Principal & Vice-Principal office should be attached with toilet.

AdministrativeFacilities

Size (Sq.ft.)

As perNormsSq.ft.

StorageFacility

No. ofTables

No. ofChairs/ Stools

RemarksTel.

Facility

Venti-lation

LightingComputer

FacilityActuallyAvailable

1. V.Good2. Good3. Fair4. Poor

1. V.Good2. Good3. Fair4. Poor

Principal Office 300

Vice-Principal Office 200

Professor Offices 100 x 5

Lecturer's Office 600 x 3Tutor's /Clinical Instr. Offices 600 x 2

Office ofAdministrative, Clericalstaff and PA(s)

300

Accountant Office 100

Store Room 100

Record Room 100Room forMaintenance Staff 100

Duplicating / XeroxingRoom 75

Common Room forBoys, Girls separately 300

Guidance /Counseling room

B) Hostel Facilities

1. Whether the School/College is having a : 1. Yes 2. No o oSeparate Hostel?

2. Built-up area of the Hostel : ____________________ Sq.ft.

3. Is the Hostel : 1. Own 2. Leased 3. Rented o o oIf owned, proof of ownership to be enclosed;(sale deed / Building completion certificate and latestE.C.). Building Stability Certificate from Collector/ Encl: _____________Panel Engineer (Should be renewed in 3 years)If leased, Registered Lease Deed for 5 yrs to beattached. If rented mention in the report

4. Is there a separate provision of Hostel for : Yes Noo oMale and Female Students

a. Total number of Day Scholars : Girls Boyso ob. Total number Students in the hostel : Girls Boyso oc. Number of Rooms : Girls Boyso od. No. of students living in each room : Girls Boyso oe. Size of each Rooms : Girls Boyso o

(Single room 100 sq.ft. & Double Room - 150 sq.ft.)

f. Total number of Toilets : Girls Boyso og. Total number of Bathrooms : Girls Boyso oh. Furniture allotted to each student : Bed Tableo o

Chair Cupboardo oRemarks ___________________________________________________________________________

11

5. Whether the Hostel has provision for

a. Water Supply : Yes Noo ob. Electricity : Yes Noo oc. Safe Disposal of Wastes : Yes Noo od. Laundry : Yes Noo oe. Hot water supply : Yes Noo o

6. Is there a Recreation room available with T.V./Radio : Yes No If yes area ___ sq.fto o7. i) Is there facilities available for outdoor and : Yes Noo o

indoor games? Play ground area ___ sq.ft

ii) If play ground is not available within thecampus specify the address : _________________________________

iii) Distance from the college campus : ___________ kms.

iv) List of the sports articles available : _________________________________

8. Is there a Reading Room available : Yes No If yes area ___ sq.fto o(It should accommodate 25% of the Total intake)

9. Is there a Sick Room available : Yes No If yes area ___ sq.fto o10. Whether the hostel mess is available : Yes No If yes area ___ sq.fto o

(seating capacity 50% of the total intake)

11. Dining Facilities:

a) Dining room well maintained : Yes Noo ob) Size : _________ Seating Capacity _________

c) Hand Washing facility : Yes Noo od) Safe Drinking water facility : Yes Noo oe) Hygienic Kitchen : Yes Noo o

12. Whether Sanitation certificate & Fire Safety : Yes Noo ocertificate obtained from competent authorities

IV. TRANSPORT DETAILS

a) Vehicles available are : Own / contract / If both ______________

b) Vehicles available arei) Number of Vehicles available : ________________________________

ii) No. of own vehicles available : ________________________________

iii) No. of vehicles available on contract basis : ________________________________ (vehicles should be allotted exclusively for Nursing College)

Sl.No. Vehicle Capacity Registration No.

c) Who is the controlling authority of the vehicle : _______________________________________

12

d) Enclose the copy of Vehicle Registration :Certificate in the Name of the InstitutionInsurance copy, Drivers' License & latest FC(FC should be checked for yearly renewal) Encl : ______________

e) Mention the availability for Enhancementof seats : Adequate / Inadequate

V. BUDGET

1. a. Is there a separate budget for the

school / college : Yes Noo o o1. Amount per annum : _________________________________

2. What was the last year's budget Allocation : _________________________________

Furnish the following details:

S.No. PARTICULARS

1. CAPITAL EXPENDITURE

Land

Building

Furniture

Transport

Equipment

AV Aids, Computer

Library Books & Journals

2. SALARY

Nursing Staff

Non Nursing Staff

Part Time

Stipend

MAINTENANCE

Electricity

Building : Lease / Rental

Furniture

AV Aids, Computer

Lab Equipments

Sports Articles

Transport

Stationeries

Postal

Telephone

Contingencies

Books & Journals

House Keeping

INC

BOARD

UNIVERSITY

TOTAL

EXPENDITURE (Rs.)

3.

4.

INSPECTION & ANNUAL FEES : TNNMC5.

MISCELLANEOUS6.

* Enclose the Balance Sheet & Previous year audited income and expenditure statement of theInstitution / Trust / Society. Encl: ___________

13

VI. CLINICAL FACILITIES

a. Hospital Details :

1. Is the Institution has parent Hospital : Yes Noo oIf Yes, No. of Beds : __________________

2. Is the Institution having parent : Yes Noo oMedical College Hospital

If Yes, No of Colleges affiliated

3. No. of Affiliated Hospitals

(Inspectors should visit, verify and enclose the

consent letters, bills and payment receipts)

S.No.

Name of theHospitals

Distancefrom

institution

No. ofBeds

Bed Occupancy Rate onthe day of Inspection

Last MonthOn the day

of inspection

No. ofSchoolsaffiliated(Mention

the name)

No. ofCollegesAffiliated(Mention

the name)

No. ofRegistered

Nurses

14

4. Bed Distribution: (IP - No. of beds and OP - No. of Patients per day)

ParentHospital

Speciality(Minimum Required Beds)

Medical - Surgical - 40

Affiliated Hospital TotalBeds

TotalOP/day

IP IP

1 2 3 4 5 6

IP IP IP IP IPOP OP OP OP OP OPOP IP OP

Cardio Thoracis

Respiratory

Orthopedic - 10

Neurology

Nephro & Urology - 10

Dermatology 5-10

Communicable & STD

ENT - 5

Eye - 5

Burns & Reconstructive 5-10

Oncology 5 - 10

Gynecolgy

ICU / CCU - 10

Geriatrics

Any other - Emergency - 10

Pediatric Nursing - 50 beds

Medical

Surgical

Communicable

NICU

PICU

Nursery

Any Other

OBG & Gynaec - 40 beds

Antenatal

Postnatal

High Risk & Emergency

No. of Deliveries

No. of Caesarians

Any other

Psychiatric Nursing - 60 beds

Acute Ward

Chronic Ward

De-adiction

Intensive Ward

Family Therapy Ward

Halfway Home

Any Other

15

5. Statistics of Operation / Deliveries performed in the last month : MA - Major Surgeries & MI - Minor Surgeries

ParticularsMA MI

Parent Hospital Affiliated Hospital - 1 Affiliated Hospital - 2 Affiliated Hospital - 3

Total MA MI TotalTotalTotal MI MIMA MAGeneral Surgery

Ortho

ENTOphthalmic

Gynec

Obstetrics

PediatricsSuper Specialities

Bed Occupancy Rate (BOR) at Parent Hospital : _________________________________

on the day of INSPECTION

Bed Occupancy Rate (BOR) at Affiliated Hospital : 1. ______________ 2. ______________

on the day of inspection 3. ______________

Average BOR for the last 6 months (Own Hospital) : _________________________________

Average BOR for the last 6 months (Affiliated Hospital) : 1. ________ 2. ________ 3. ________

6. Staffing Pattern of the Hospitals:

S.No.

1

2

3

4

Designation Qualification ParentAffiliated Hospital

21 3 4 5 6 7

Nursing Superintendent

Ast. Nursing Superintendent

Ward Sisters / Ward In-charges

Staff Nurses 1. ANM

2. Hospital Trained

3. GNM

4. B.Sc.,(N)

5. M.Sc.,(N)

* Furnish the detailed list of Nurses with RN *RM Nos. working in the parent & affiliated Hospitals.* Encl: ________

7. Brief description of the hospital : _________________________________

8. Hospitals Records & Registers

IP Register : Yes / No

OP Register : Yes / No

Day / Night Register : Yes / No

Discharge Register : Yes / No

Census Register : Yes / No

Any other (Specify) :

9. Clinical Supervision of students by

a) Hospital Nursing Staff : Yes Noo o

b) College Teaching Faculty : Yes Noo oc) On the day of Inspection, was College teaching

faculty supervising the Students : Yes Noo od) Teacher students ratio in Clinical Area : ________________________________

16

b) Community Health Facilities

(1) Type Name & Address DistancePopulation

CoveredArea

CoverageNo. of Villages

Covered

2. Service Rendered a) Health & Family Welfare Programme : Yes / No

b) National Health Programme : Yes / No

Supervision of Students : 1) Field Staff only 2. College Teaching Faculty 3. Both o o o

c) Community Health Nursing Experience

I. ACTIVITIES AT COMMUNITY HEALTH DEPARTMENT

(Verify the following activities at the College / Community Centre / Primary Health Centre)

1. Home Visits - Family Health Care :

2. MCH Clinic :

a) Antenatal

b) Postnatal

c) Well baby

3. Immunization :

4. School Health :

5. Family Planning and Welfare :

6. Health Education :

7. Nutrition Education :

8. Community Nutrition :

II. RECORDS & REGISTERS

1. Family Folder :

2. EC Register :

3. Survey :

4. Organization of subcentres :

5. Treatment of minor ailments :

6. School Health Programme :

7. First aid and Emergency Care :

8. ILR Register :

17

II. Specific Practical Experience Requirements - Check Students Records:

18

Performed /Not Performed

RemarksSl.No.

1. Conducting Antenatal Examination

2. Conducting Deliveries

3. Nursing lying in women and babies

4. Conducting Child care clinics

5. Motivating eligible couples

and mothers to adopt F.P. Methods

6. Conducting Health talks /

Health Education Activities

7. Training Community

Level Voluntary Health Workers

8. Carrying out Immunization

Programme in

1) Clinic

2) Community

3) School

(Enclose copy of the letter of agreement for affiliation & bills paid to the Hospital and Health Centers to

be attached. Inspectors to Visit the Hospital and Community Field and Record their Observation)

Encl : ______________

VII. ADMISSION DETAILS

(i) Admission of students in current session : INC Norms / University Norms

(ii) Percentage of Admission : Management / Government(Attach the copy of admission criteria) Encl : ______________

(iii) Total No. of Students under Training in the current Programme:

Programme I year II year III year IV year Total

Male

Male

Male

Male

Male

Male

Male

Male

Female

Female

Female

Female

Female

Female

Female

Female

Total

ANM

GNM

B.Sc.(N)

Post BasicB.Sc.(N)*

M.Sc.(N)*

M.Phil(N)

Post Basic DiplomaProgramme

Any other

(iv) *I & II Year Post Basic B.Sc.(N) & M.Sc.(N) Students details to be ENCLOSED as per table given below &the inspectors should verify whether these students are present in the institute on the day of inspection

Sl.No.

Name ofthe Student

State Nursing CouncilRegistration No.

ResidenceAddress

Place & Addressof Work at the

time ofadmission

Board / Universityfrom where lastexam qualified

Duration ofCourse with

DatesFrom _____

To _____

Does thisdetails updatedin the nurses

data bankGNM B.Sc.(N)

(v) Year of passing out of first batch of Students:

ANM GNM Basic B.Sc.(N) Post Basic B.Sc.(N) M.Sc.(N) P.B. Diploma Programmes

(vi) No. of Students graduated previous year.

ANM GNM Basic B.Sc.(N) Post Basic B.Sc.(N) M.Sc.(N) P.B. Diploma Programmes

19

VII. ACADEMIC / CURRICULUM PLANNING

a) COURSES OF INSTRUCTION & SUPERVISED PRACTICE(Kindly attach the enclosure as per the column given below for each program conducted at your institution)

b) Academic system of the course (ü) : Annual / Semester

No. of working days per year / semester (programmeswise) : ANM : GNM : B.Sc.(N) : PBBSc.(N) : M.Sc.(N) : P.B Diploma

:

c) Teaching system adopted (ü) : 1) Block : 2) Partial Block : 3) Study Day

d) Experience gained by student according to syllabus :

through instruction (Verify overall adequacy subject wise by

verifying the Attendance Register) and comment

e) Experience performed by the student in the clinical area :

(verify clinical attendance) and comment

Na

me

of

the

Pro

gra

mm

e

Ye

ar

- w

ise

pa

pe

r

No. ofHoursTheory

No. ofHours

Practical

TheoryMarks

PracticalMarks

Eligibility for admission to Examination

Pre

sc

rib

ed

Pre

sc

rib

ed

Allo

tte

d

Allo

tte

d

Ex

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al

Inte

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l

To

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To

tal

Att

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da

nc

e %

Int.

As

s. M

ark

s

Co

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on

of

Pra

cti

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lR

ec

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s

Co

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Re

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the

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Inte

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l

Ex

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Du

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20

b) Teaching Plan (S - Satisfactory, I - Irregular, NA - Not Applicable)

Sl.No.

Program

MasterPlan

S / I / NA S / I / NA S / I / NA S / I / NA S / I / NA S / I / NA S / I / NA

LessonPlan

LearningObjectives

LearningExperiences

Plan ofEvaluation

UnitPlan

TimeTable

1 H.V.

2 ANM

3 GNM

4 Basic B.Sc.(N)

5 P.B.B.Sc.(N)

6 M.Sc.(N)

7 P.B. Diploma

Programmes

a.

b.

c.

d.

e.

f.

g.

h.

i.

j.

k.

c) Does Clinical Teaching takes place? : Yes Noo o(N.B. : Inspectors should make an observation on plan of different clinical experiences)

d) Teaching Plan:

i) Which syllabus is followed by the teachers in the college?

a) University Syllabus b) Indian Nursing Council Syllabus

ii) Whether University syllabus fulfills the requirement of

Indian Nursing Council Syllabus : Yes Noo o

If No, what is the gap : __________________________

21

1. a) Is Rotation based on the needs of clinical : Yes Noo olearning experience (Rotation plan to be enclosed) Encl : ______________

b) Clinical Rotation is (ü) : _________ Regular / Inconsistence with syllabus / Not available.

e) Clinical Plan:

H.V.

I Year

i. Number and size of student Groups

ii. Number of Rotation

iii. Duration of each Rotation

iv. Graphic rotation plan (attach copy) 1. Yes Appendix No. 2. No

II Year

ANM

I Year





II Year

GNM

I Year III Year





II Year IV Year

Basic B.Sc.(N)

I Year III Year





II Year IV Year

P.B.B.Sc.(N)

I Year





II Year

22

M.Sc.(N)

I Year





II Year

P.B. Diploma in:

I Year





(N.B. : Inspector to make observation of the rotation plan discuss the adequacy and inadequacy and record

their observation)

2. Planning of Specific Clinical Experience

a. Who prepares the Clinical Rotation Plan?

1. School / College Faculty 2. Hospital Nursing Service Personnel 3. Both o o o

b. Who are all involved in planning the Clinical Rotation Plan?

(Please indicate designation)

___________________________________________________________________________

c. Experience gained by students on rotation (verify overall adequacy areawise / programewise

from the rotation and make your remarks)

d. Supervision and Guidance given by teaching staff / clinical staff (ü) :

Adequate & Effective / Inadequate and Needs Improvement

e. Clinical field experience gained by each students - Satisfactory / Fair / Poor

f. System of Examination:

1. Name and Address of Affiliated Examining Body / Board

________________________________________________________________________

________________________________________________________________________

Tel __________________________________ Fax ______________________________

E-mail ID _______________________________________________________________

Website _________________________________________________________________

23

2. Name and Address of affiliated University to

______________________________________________________________________________

Which affiliated / Deemed _________________________________________________________

Telephone and Fax Number Tel ___________________________ Fax _____________________

E-mail ID ______________________________________________________________________

Website ______________________________________________________________________

g) 1) Eligibility for admission in Examination:

a) Attendance percentage : 1. Theory ___________________ 2. Clinical Practice

b) Internal Assessment Marks : Minimum requirement _____________________________

c) Completion of assignment & practical record : Yes / No

2) Practical Examination conducted in : Parent Hospital / Affiliated Hospital

3) Faculty eligible to be appointed as examiner is available in each speciality : Yes / No

4) No. of students examined per day _____________________________________________

5) University / Board publishes results in time : Yes / No (If No kindly state the reason)

6) Weak points on examination : ________________________________________________

7) Strong points on Examination : ______________________________________________

8) Pass percentage of students in University Examination (Current Academic Year)

Sl.No.

Programme I year II year III year IV Year Remarks onachievements

24

IX RECORDS & REGISTERS:

1. Are the following Registers maintained well? (Check depending on programme implemented)

2. Maintenance of Records :

l Course Planning of each subject : Yes Noo o

l Rotation Plans (Master & Clinical) : Yes Noo o

l Mark Register : Yes Noo o

l Minutes of Committee Meetings : Yes Noo o

College Development Committee : Yes Noo o

Curriculum : Yes Noo o

Anti-ragging : Yes Noo o

Selection Committee : Yes Noo o

Library Committee : Yes Noo ol Teaching Load : Satisfactory / Fair / Unsatisfactory (Over Load)

1. Admission Register

3. Attendance Registersa) Daily

b) Subject

c) Clinical

d) Faculty

e) Ministerial Staff

S. No. Registers* Yes No

4. Leave Record

a) Student's

b) Faculty

c) Ministerial Staff

5. Practical Records

a) Nursing Foundation

b) Medical Surgical Nursing

c) Midwifery Case Book

d) Log Book

e) Drug Files

2. Cumulative Register

6. Daily Diary

7. Health Record

8. Clinical and Field Experience Record

9. Clinical Evaluation

10. Internal Assessment - Practical & Theory

11. Curricular & Co - Curricular Record

12. Family Folders

13. Any Other

25

l Any other - specify : ______________________________

l Affiliation records : Yes Noo ol Stocks Register : Yes Noo ol Inventory Register : Yes Noo ol Budget Plan : Yes Noo ol Annual report of activities and achievements : Yes Noo ol Staff Development Program : Yes Noo ol Records signed by Teachers with dates : Yes Noo o

[Note : verify Physically (a) & (b)]

X WELFARE ACTIVITIES

A. STUDENT

1. Professional Association / ActivitiesN.S.S. / SNA / any other - specify : ______________________________

2. Is the students of all basic nursing programmes : Yes Noo obeen enrolled in SNA

3. Health services are provided when students are sick : Yes Noo oIf Yes name of the hospital : ______________________________

Address : ______________________________Pin : ______________________________Tel : ______________________________Fax : ______________________________E-mial : ______________________________Website : ______________________________

a) Do students have Health Insurance : Yes No o o

If yes, is the Health Insurance : Group Individual o ob) Name of the Health Insurance Company

Address : ______________________________Pin : ______________________________Tel : ______________________________Fax : ______________________________E-mial : ______________________________Website : ______________________________

3. Counseling Guidance : Available / Not available

4. Eligible leave for students(*should adhere to INC Norms) :

1. As per INC :2. As per University :

If not Remarks :

5. Is the Alumni for Graduates available : Yes / No

6. Students Committee (List) : 1.2.3.4.

26

B. FACULTY

1. Is there any Professional Organization for Faculty? :If yes, name the Organization.

2. Establish Faculty Committee,If yes, name of the Committees.

3. Any other welfare activities

4. Eligible leave for faculty

Nature of LeaveSl.No. As per norms (Days)

No. of Days / Year

1. Casual Leave 12

2. Sick / Medical Leave 10

3. Vacation / Annual Leave 30

4. Public Holidays All Govt. gazette holidays

5. Maternity Leave As per policy of institution

6. On Duty 15

No. of days given by the instituion

S.No.

1.

2.

3.

4.

Name of the Organization

S.No.

1.

2.

3.

4.

Name of the Committees

S.No.

1.

2.

3.

4.

Activities

27

5. Provides health services for the faculty when sick : Yes Noo oIf yes, name the Hospital : ______________________________

Address : ______________________________

Pin : ______________________________

Tel : ______________________________

Fax : ______________________________

E-mial : ______________________________

Website : ______________________________

a) Will the faculty have Health Insurance : Yes No o o

If yes, is the Health Insurance : Group Individual o o

b) Name of the Health Insurance Company

Address : ______________________________

Pin : ______________________________

Tel : ______________________________

Fax : ______________________________

E-mial : ______________________________

Website : ______________________________

6. Are the faculty eligible for Provident Fund : Yes Noo o

7. No. of faculty meeting conducted in a year : ______________________________

8. No. of Workshops / Seminar / Conference conducted

by the Institution in a year : ______________________________

9. No. of faculty deputed for Conference / Workshop /

Seminar in a year : ______________________________

XI. LAST TNNMC INSPECTION DETAILS

a) Is there any Deficiencies notified in the previous / recent Inspection : Yes / No

Date of last inspection : ________________

b) If Yes, enclose Rectification / Compliance Report sent to the Council : Yes / No

c) Inspector to verify the rectification of the past deficiencies & write the report

___________________________________________________________________________

___________________________________________________________________________

28

XII. CHECK LIST

l I have received the inspection Performa & have filed same : Yes No o ol Whether the Inspection report is completely filled after verification : Yes No o oEnclosures:

1. Certified copy of the Register Trust Deed : Yes No o o2. G.O. - Each Program : Yes No o o3. INC - Each Program : Yes No o o4. TNC - Each Program : Yes No o o5. University / Board Orders - Each Program

6. Proof of documents for change of Address & Trust

7. Proof of the Own & Affiliated Hospitals and Health Centres.

8. Admission Criteria - Each Program.

9. List of Post Basic B.Sc.(N) & M.Sc.(N) Students.

10. Latest orders of TNC, INC, Board / University & Also for enhancement of seats if any.

11. Nursing faculty Details - UG, PG Certificates, RN, RM, Addl. Qualification, Experience Certificate, relievingorder Last institution if DOJ within 3 months, Appointment Order & Self Attested Color Photo.

12. Land Deed of the College & Hostel with Building Completion certificate.

13. If Leased, Registered Lease Deeds of College & Hostel.

14. Vehicle Registration Certificate in the Name of the Institution, Insurance, Drivers' License & Latest FC.

15. The Balance Sheet & Previous Year Audited Income and Expenditure Statement of the Institution / Trust/ Society.

16. The list of Articles for all the Labs. (Enclose the recent / Last year purchase Bills)

17. Lis of Library Books & Journals. (Enclose the recent / Last year purchase Bills)

18. List of Nurses with RN & RM No. working in the Parent & Affiliated Hospitals.

19. Master & Clinical Rotation plan for respective years - Each Program.

20. Eligibility for admission to examination : for all Nursing Programmes.

21. List of Sports Articles.

22. Report from the principal on course of instruction etc.

23. Whether the institution has uploaded details in the Institution Management Software (IMS)

24. Furnish the evidences for the Latest inspection and annual recognition fees paid.

25. Minority status GO

26. Past Rectification report.

XIII. INSTRUCTION1. Inspection should be conducted confirming to the norms prescribed by Indian Nursing Council Curriculum

and Syllabi.

2. Counseling session should be held with the faculty members and students. Inspector to plan it for collectiveor individual meeting.

3. Wherever necessary, separate papers have to be attached.

4. The practical clinical experience records, progress and cumulative records may be perused and guidancegiven wherever necessary.

5. The clinical staff and faculty member's registration status to be verified and reported.

6. Inspectors, may take into account the remarks and recommendation of the previous inspection.

7. Inspectors are required to meet the Head of the institution and discuss the result of inspection.

8. The institution should provide the necessary facilities for carrying out the inspection properly.

9. The inspectors may specifically indicate the deficiencies in clinical and teaching staff strength.

10. Documents produced by Institute must be signed by the authorized signatory.

29

XIV. REMARKS OF THE INSPECTORS

b. Hostel

(Land, Building, Furniture, etc.)

S. No. Particulars Remarks

a. Institution

(Land, Building, Library, Lab,

Equipments, Furniture, etc.)

Physical Infrastructure (School / College1.

30

Clinical Experience2.

a. Hospital

b. Community

3. Transport

31


Faculty

5. Admission Procedure (Criteria)

6. (a) Curriculum Planning and

Implementation

(i) Theory

(ii) Practical

(iii) Supervision

(iv) Evaluation

(b) Examination

Adequacy of Teaching Staff4.

32


7. Records & Registers

8. Welfare Activities for Students

9. Welfare Activities for Faculty

10. Miscellaneous

EXECUTIVE SUMMARYPlease tick the appropriate:

DEFICIENT / TIME BOUND RECTIFICATION / SUITABLE / UNSUITABLE.If Deficient or Unsuitable, a separate handwritten letter stating the reasons with both inspector's signature should be submitted.

___________________________________________________________________________________Name and Signature of the Inspectors

1)

2)

3)

Date :

N.B. : Suggest proposal for further developments of the institution to make good of deficiencies to be calledfor from the Management.

33


XV. REGISTRAR REMARKS:

34