Nursing Standards/ development and maintenance of nursing standards

1. Development and
maintenance of
standards
By-
Amit Newton
Lecturer Psychiatric
Nursing
Era University

2. Introduction
 Standards are helping to plan implement
and assess the quality of services and to
show that nursing is accountable to
society, to consumers of nursing
services and to governments as well as
to the profession of nursing itself.

3. Definition
 It is an established rule or basis judging
capacity, quality and value of objects in
the same category, selected standards
are reliable and relevant for the category
being compared e.g. Standard of ideal
height and weight.

4. Purposes of standards
 It is descriptive standard of desired
quality against which to evaluate nursing
education programs.
 It improves quality of nursing education
programmes like GNM, B.Sc etc.
 Standards provide professional
accountability.
 Standards help to achieve objectives,
aims and goals of programme.

5. Contd...
 Standards give direction and provide
guidelines for performance of nursing
tutors.
 Standards provide a baseline for
evaluating quality of education provided
from excellent to unsafe care.
 Standards help principal and
supervisors to guide teachers to improve
performance.

6. Basic principles
 Standards should be designed to
achieve a stated purpose.
 Standards should be based on clear
definition of professional scope and
accountability.
 Standard should promote the fullest
development of profession.
 Standards should be broad and flexible
to achieve their objectives.

7. Contd...
 Standards should promote universal
levels of performance.
 Standards should recognise the equality
and interdependence of professions
offering essential services.
 Standards should be formulated
according to requirements.

8. Sources of standards
Professional organisations e.g. TNAI
Licensing bodies e.g. INC
Universities and nursing institutions.
Government units at national, state and
local government units.
Individual e.g. Personal standards.

9. Types of standards
1) Normative standards
2) Experienced standards

10. Classification of standards
1) structure standards
2) Process standards
3) Outcome standards

11. Standards for nursing education
programs
Section1 : statement of purpose
 serve as a guide
 provide criteria for evaluation and
approval of new/established nsg
education program.
Foster continued improvement of
established nsg education proghram.
Ensure that graduates are prepared for
safe nsg practise.

12. Section 2: approval of nsg
education programs
a) Provisional approval
Proposal which involves the following:
 Documentation of the present & future
needs for the nsg education program.
 Rationale for the establishment of nsg
education program.

13. Contd...
 Availability of qualified administrator &
faculty.
 Evidence of financial resources.

14. b) Criteria before making
application for provisional
approval
 A qualified nurse administrator &
sufficient qualified faculty.
 A written nursing education program
plan, developed in accordance with
standards of nsg.
 A site visit has been conducted by the
board if necessasry.

15. Contd..
c) Following board review of the proposed
nursing education program, the board
may grant or deny the provision.
d) Administrative head of the proposed
nursing education program may be
present at the meeting to clarify
information in reports.
e) If provisional approval is denied, the
institution may requeat a hearing before
the board.

16. Contd....
f) Following provisional approval, progress
reports shall be made to the board as
requested.
g) Following graduation of the first class,
a self-evaluation report of compliance
with the standards for nsg education
shall be submitted by the nsg education

17. B) Full approval/Conditional
approval
 Full approval
It is granted to a nsg education program
after the first graduating class has taken
the board approval licensing
examination and the program has
demonstarated compliance with the
standards of nursing.

18. Conditional approval
 Conditional approval may be granted foe
a limited time to a nsg education
program that has had provisional or full
approval has now failed to meet the
standards. The board will determine the
length of time and determine the
deficiencies.

19. c) Continued full approval
 All nsg education program shall be re-
evaluated at least every 8 year to
ensure continuous compliance with
standards for nsg education.
 It involves submission of self-evaluation
report by nursing education program 30
days prior to scheduled site visit.

20. Section 3: Board review of nsg
education program
A) Annual review
B) Site visits
C) Non compliance
 The administartor of the nsg education
program shall, within 10 days from
reciept of deficiencies, file a plan of
correction with the board.

21. Contd...
 Administrator after recepit of notice
submit a written request for hearing
before the board to appeal the board’s
determination of deficiencies.
 At any time during correction period, the
nursing education program may request
restoration to full approval if the nursing
education program demonstrates
correction of the deficiencies.

22. Section 4 : Denial or withdrawal of
approval
 The board may deny full approval when
it determines that a nursing education
program fails to meet the standards for
nursing education.
 If the board determines that an
approved nsg education program is not
meeting the criteria set forth in these
regulations, the parent institutions is
given reasonable to correct deficiencies,
if it fails, approval can be withdrawn.

23. Contd...
After hearing the board may take the
following actions:
Grant provisional approval if standards
are met by parent institution.
Deny provisional approval if standards
are not met by parent institution.

24. Contd...
 Grant conditional approval if the board
identifies in nursing education program
that has been failed to meet the criteria
as stated in the board’s standards for
nursing education.
 Grant full approval if the board finds that
the nursing education program meets
the criteria as stated in the board’s
standards for nursing education.

25. Section 5 : Appeal and
reinstatement
 A parent institution may appeal the
board’s decision to withdraw approval of
a nursing education program and may
request a hearing to review the board’s
decision. The hearing and all actions
related to the appeal shall be affected in
accordance with the due process rights,
administrative rules of the board.

26. Section 6: closure of nursing
education program and storage of
records
a) Voluntary closing
 When the parent institution decides to
close a nursing education program, it
shall notify the board in writing, stating
the reason for closure, the plan for
discontinuation and the intended date
of closing.
 Parent institution can choose any of
the following reason for closure:

27. Contd...
 Continue the nsg education program
until the last class enrolled is graduated.
 Assist in the transfer of students to other
approved nsg education programs.

28. Contd...
 The nsg education program shall
continue to meet the board’s standards
for nsg education until all the enrolled
students are graduated or until the last
student is transferred
The date of closure is the date on the
degree, diploma or certificate of the last
graduate or the date on which the last
student was transferred.

29. b) Closing because of withdrawal
of approval
 When the board withdraws approval of a
nsg education program, the parent
institution shall comply or prepare a
written plan for and shall submit the plan
to the board within 30 days of recepit of
the notice of withdrawl of approval.

30. Accreditation in nursing education
program

31. Introduction
All professionals have one thing in
common, that is concern for the quality
of their service, which is ensured by
developing and enforcing the standards.
2 important ways of setting standards
are accreditation of the education
program and the professional licensure.

32. Definition
 Accreditation is the process whereby an
organization or agency recognizes a
college or university or program of study
as having met certain predetermined
qualifications or standards. ( Selden,
1962)

33. 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.
 It safeguards the institution from social
education and political pressures.

34. Contd...
 It helps in registration of nurses.
 It prescribes the syllbus.
 It grants recognition to schools and
colleges.
 It guides the school/ college of nursing,
according to recommendation and
criteria.
 It also provide services to prepare the
competent to serve the public.

35. Functions of accreditation
 It aims to protect the autonomy of
various health service program e.g. Nsg
education & medical education.
 It preserves the quality of nursing
education.
 It protects the public from ill prepared
nurses.

36. Contd...
 It protects the institution’s unsound and
unsafe political pressure.
 It helps the practitioner for the broad
scope of nursing practise.

37. Types of accreditation
agencies
1) Regional accreditation agencies
2) Professional accreditation agencies
 State accreditation agencies
National accreditation agencies

38. Important features of accreditation
program
 Institutional accreditation is a means for
the self-regulation of the academic
institution.
 Institutional accreditation is done in 2
parts:
The first part starts with self-study by
the institution, involving in this activity all
of its major constitutes including facility,
students & the institutional
management.
2nd involves outside evaluation by

39. Contd...
3) The institutional accreditation process
involves the judgement of the
responsible members of the profession
to see weather the institutional goals are
fulfilled.
4) The institution will be assessed as
follows:
 institutional mission & objectives
Evaluation & planning
Organization & governance

40. Contd...
Program of instruction
Special activities
Library & learning resources
Physical resources
Financial resources
Advertising & publication
5) Accreditation agency encourages
institutional improvement through self-
study & evaluation.

41. Contd...
6) Before an institution is accredited, a
provisional 1 year candidate status is
given to the institutions after certain
criteria & can be extended to 3 years.
7) Accreditation bodies have the right to
review the member instiutions at any
time.
8) Though the accrediting agency are
non-governmental, their accreditation
has come to be recognized as a
necessary qualification.

42. Purpose of accreditaion
 To ensure safe practise of nursing
 To encourage self-study & self-
evaluation
 To ensure maximum benefits for the
students
 To ensure graduates of the accredited
schools the eligibility for admission to
the licensing examination.
 It acts as monitoring & controlling
agency.

43. Accreditation in nursing education
program
Policies for accreditation
a)Board approval of the initial
development
Letter of intention should be submitted
to the board describing the reason for
establishing the school.
Qualification forms to be submitted to
the board by the full time person
responsible for the program.

44. Contd...
 The nurse director or chairman of the
department nursing be employed on full
time basis for 1 academic year before
admission of the students. This period is
known as “planning year”

45. B) Board approval for admission
of students
 A statement describing the philosophy,
objectives, nature of organization &
administration should be submitted to
the board, at least 3 weeks prior to
board meeting.
 The statement should contain
description of following:
 student body
faculty

46. Contd....
 Curriculum, educational & clinical
facilities.
Projected budget for a 5 year plan.
Plans for evaluation.

47. Further procedures regarding
board approval
An application for accreditation should
be filled with concerned activity.
Request will be reviewed at regular
board meeting & institution advised of
board actions.
Initial accreditation is granted for a
period of 1 year after which time
evaluation visit is made.
Renewal accreditation is based on
survey visits & correspondence during

48. Process of accreditation
 Applying for institution to be accredited.
 Preparing a report by the institutional
head according to the criteria & format
sent by the accrediting agency known as
self-study.
 Visit to the site by the inspectors
apponited by the accrediting agency.
 preparing the reports by the visitors.

49. Contd...
 Visitors report & insitutional report is
sent to review by board of council.
 The board review reports & make
decision to give accreditation or not.

50. Criteria for accreditation
Report of the inspection of the college is
held on :
Type of training given.
Date of previous inspection
Recognition of the college by the
government order no., date & number of
seats sanctioned for the year.
Registration number, registration valid,
non-nursing teachers, other staff
members, physical facilities available in

51. Contd...
Number of classrooms
Demonstration room
Library
Office of principal, tutors
laboratory

52. Services rendered by
accredited
 Registration & admission of students.
 Distribution of study materials.
 Organization of personal contact
program.
 Registering students for external
examination.
 Distribution of marks sheets &

53. Colleges/schools of nursing are
expected to keep the following
ready
 General information
 Philosophy
 Organization & administration
 Teaching staff
 Administration & physical set-up
 Finance
 Committees

54. Contd...
 Staff teaching
 Construction& institution facilities
 Health facilities for students & staff
 Clinical set-up

55. Thanx