TOPIC FOR NURSING MANAGEMENT FOR B.SC NURSING, M.SC NURSING. HELPFUL TOPIC FOR NURSING CURRICULUM

2. INTRODUCTION
Every organization require the service of a large number of
personal placed at different positions staffing basically involves
matching job and individuals. This may require a number of
functions like man power planning, recruitment, selection,
placement, training and development, performance appraisal,
promotion transfer, employee welfare and reward system etc.
Nursing staffing is a constant challenge for health care facilities.
Before the selection of the employees one has to make analysis of
the particulars job, which is required in the organization, then
comes the selection of personal.

3. DEFINITION OF STAFFING:
Staffing is a systematic approach to the problem of
selecting, training, motivating and retraining
professional and non-professional is any organization.
It involves manpower planning to have a right person
at right place.

4. Functions of Staffing:
 Identifying the type and amount of service needed by
agency client.
 Determining the personal categories that have the
knowledge and skills to perform service measures.
 Predicting the member of personal in each job category
that will be needed to meet anticipated service demands.
 Obtaining budgeted positions for the member of each job
category need for service for the expected types and
number of clients.

5.  Recruiting personal to fill available positions.
 Selecting and appointing personal from the suitable
applications.
 Combining personnel into desired configurations by
unit and shift.
 Orienting personal to fulfill assigned responsibilities.
 Assigning responsibilities for client services to
available personal.

6. STEPS OF STAFFING:
 Determine the number and type of personal needed to fulfill the
philosophy, meet fiscal planning responsibilities and carryout the
chosen patient care management organization.
 Recruit interview, select and assign personal based on established job
description performance standards.
 Use organizational resources for induction and orientation.
 Ascertain that each employee is adequately socialized to
organizational values and unit norms.
 Use creative and flexible scheduling based on patient care needs to
increase productivity & retention.
 Develop a program of staff education that will assist employees the
goals of the organization.

7. PHILOSOPHY OF STAFFING:
 Philosophy is a statement encompassing ontologic
claims about the phenomena of central interest to a
discipline, epistemic claims about how the phenomena
came to be known and what members of the discipline
value.
 There are three general philosophies of personal
management. The first is based on organizational
theory, second on industrial engineering and the third
on behavioural science.

8. 1. The organizational the first believes that:-
 Human needs are either so irrational and so varied and
adjustable to specific situations that the major function of the
personal management is to be pragmatic as the occasion
demands.
 If the job are organized in a proper manner he reasons, the
result will be most efficient job structure and the most
favourable job attitude will follow as a matter of course.

9. 2. The industrial engineer believes that:-
 The man is mechanistically oriented and economically motivated and
his needs are best met by attuning the individual to the most efficient
work forces.
 The goal of personal management should be to concoct the most
appropriate incentive system and to design the specific working
condition in a way that facilitates the most efficient use of human
machine.
 By strutting the jobs is a manner that leads to most efficient
operation the engineer believes that he can obtain the optimal
organization of work and proper work attitude.

10. 3. The behavioural scientist believe that.
 The behavioural scientist forces on group sentiments, attitude of
individual employees and the organizations social and psychological
climate.
 Personal management generally employees some form of human
relations educations in the hope instilling healthy employee attitudes
and an organizational attitudes and an organizational climate which
he considers to be felicitous to human values. He believes that the
proper attitude will lead to efficient job and organizational structure.

11. PHILOSOPHY OF STAFFING IN NURSING.
 Nurse administrators believe that it is possible to match employee’s
knowledge and skills to patient care needs in a manner that
optimizes job satisfaction and care quality.
 Nurse administrators believe that the technical and humanistic care
of critically ill patient are so complex that all aspects of that care
should be provided by professional nurse.
 Nurse administrators believe that healthy teaching and
rehabilitations needs of chronically ill patient are so complex direct
care of chaotically ill patients should be provided by professional
and technical nurse.

12.  Nurse administrators believe that patient assessment, work
quantification and job analysis should be used to determine the
number of personal in each categories to be assigned to care for the
patient of each types (such as coronary care, renal failure , chronic
arthritis paraplegia, cancer etc.)
 Nurse administrators believed that master staffing plan and policies
implement that plan in all units should be developed centrally by the
nursing heads and staff of the hospital.
 Nurse administrators believe that the staffing plan details such as
shift start time, numbers of staff assigned on holiday and numbers of
employees assigned to each shift can be modified to accommodate the
units work load and work flow.

13. Objective of staffing in Nursing:
 Provide an all professional nurse staff in critical units operating norms
labor and emergency room.
 Provide sufficient staff to permit a 1:1 nurse patient ratio for each shift
in critical care unit.
 Staff the general medical, surgical, obstetrics and gynecology ward
pediatric and psychiatric units to achieve a 2:1 professional- practical
nurse ratio.

14.  Provide sufficient nursing staff in general medical surgical
obstetrics and gynaecology pediatric and psychiatric units
to permit 1:5 nurse patients ration on a day and afternoon
shift and 1:10 nurse patient ratio on night shift.
 Involve the head of the nursing staff and all nursing
personal in designing the departments overall staffing
programme.

15.  Design a staffing plan that specific how many nursing personal
in each classification will be assigned to each nursing unit for
each shift and how vacation and holiday time will be requested
and scheduled.
 Hold each head nurse responsible for translating the
departments master staffing plan to sequential eight weeks
time schedule for personal at least eight weeks in advance.
 Post schedule for all personal atleast eight weeks in advance.

16.  Empower the head nurse to adjust work schedule for unit
nursing persona; to remedy any staff excess or deficiency
caused by census fluctuation or employees absence.
 Inform each nursing employee that requested for specific
vacation or holiday time will be honoured within the limits
imposed by patients care and labour contract requirements.
 Reward employees for long service by granting individuals
special time request on the basis of seniority.

17. Introduction:
Norm is a standard, model, or pattern. It a standard of
achievement or behaviour that is required, desired, or designated
as normal. These are standards that guide, control, and regulate
individuals and communities. For estimating the requirement of
nursing manpower, various committees, nursing council,
associations have been recommended staffing norms for
hospitals, community both rural and urban, nursing institution in
India.

18. The norm has been put forward taking into consideration the workload projected
in the wards and the other areas of the hospital. The nursing norms are
recommended by various committees, such as; the Nursing Man Power
Committee, the High-power Committee, Dr. Bajaj Committee, and the staff
inspection committee, TNAI and INC. The norms has been recommended taking
into account the workload projected in the wards and the other areas of the
hospital. All the above committees and the staff inspection unit recommended
the norms for optimum nurse-patient ratio, such as 1:3for NonTeaching
Hospital and 1:5 for the Teaching Hospital.

19. NORMS
DEFINE: agreed upon and often
informed rules that guide group
members behavior.
Formal norms: more important to
continuity of organization, written
codes of conduct.
Informal: implicit but unwritten.
Agreed upon: continuing consensus
among group members.

20. Characteristics of norms
 Range of tolerated behaviors- approved behavior is actually over a range that
deviates from the prototype of norms.
 Intensity- strength of approval- disapproval, some norms have sharp
approval, others are mild.
 Crystallization- group consensus

21. STAFF INSPECTION UNIT( S.I.U)
The Staff Inspection Unit (SIU) was set up in 1964 with the objective of securing
economy in the staffing of Government organizations consistent with
administrative efficiency and evolving performance standards and work norms in
Government offices and institutions wholly or substantially dependent on
Government Grants. The Scientific and Technical Organizations are not within the
purview of the SIU but a Committee constituted by the ‘Head’ of the respective
Department, with a representative from SIU as ‘Core Member’, conducts a study
of such organizations.

29. The Assistant Nursing Superintendent and the Deputy Nursing Superintendent have to do
the duty of one category below of their rank:
Out of the entitlement worked out on the basis of norms, 30% posts may be sanctioned as
nursing sister. This would further improve the existing ratio of 1 nursing sister to 3.6 staff nurses
fixed by the government in settlement with Delhi Nurse union in May 1990. The Assistant
Nursing Superintendent are recommended in the ratio of 1 ANS to every 4.5 nursing sisters. The
ANS will perform duty in shift also. The posts of Deputy Nursing Superintendent may continue
at level of 1DNS per every 7.5 ANS. There will be a post of Nursing Superintendent for every
hospital having 250 or more beds. There will be a post of 1 Chief Nursing Officer for every
hospital having 500 or more beds. It is recommended that 45% posts added for the area of 365
days working including 10% leave reserve.

36. 0PD DEPARTMENT
Blood bank
Paediatric
Immunization work
Eye
ENT
Pre anaesthatic
Cardiac lab
Burns
Vaccination Anti Rabies
Family planning
Medical
Surgical
Dental
Central sample collection centre
Orthopaedic
Gynae
Obstetric
Skin
V.D. centre
NO. OF STAFF NURSE/NURSING SISTER
1
2
2
1
1
1
1
2
1
2
1
1
1
1
2
2
3
2
2

37.  10% leave reserve ( maternity leave, earned leave, and days off as nurses are entitled for 8 days
off per month and 3 national holidays per year when doing 3 shift duties), and 45% posts
reserve where services are provided for 365 days in a year/ 24 hours.
 The post of Nursing Sister and Staff nurses are clubbed together. Both will perform nursing
care work.
 30% posts may be sanctioned as Nursing Sister. The Nursing Sister to Staff nurse ratio will be
1:3.6
 The ratio of Assistant Nursing Superintendent to Nursing Sisters is recommended as 1:4.5.
They will work in shift duty.
 The ratio of Deputy Nursing Superintendent to Assistant Nursing Superintendent is
recommended as 1:7.
 Nursing Superintendent: 1 for 250 beds or more.
 Chief Nursing Officer: 1 for 500 beds or more

39. JOINT COMMISSION ACCREDITATION OF
HEALTH CARE ORGANIZATION
 The joint commission on Accreditation of Health Care
Organization is a nonprofit organization based in the United
States that accredits over 20,000 health care organizations and
programs in the country. The JCAHO commonly is referred to
as the Joint Commission in the health care industry and
among governmental industry on the federal and state levels.
The Joint Commission is the successor of an organization
established in 1951.

40. JCA can be earned by many types of health care organization including hospitals, doctor’s
office, nursing homes, office-based surgery centers, behavioral health treatment facilities, and
providers of home care services.
Accreditation is awarded upon successful completion of an on-site evaluation by the Joint
Commission. The on- site survey is conducted by a specially trained Joint Commission survey
or team of surveyers who assess organization’s compliance to JCA standards. After earning
accreditation , health care organization receive “the Gold Seal of Approval” from Joint
Commission.

41. Goals and objectives of JCAHO
The JCAHO has an explicitly stated mission:
“To continuously improve health care for the public, in
collaboration with other stakeholders, by evaluating
health care organization and inspiring them to excel in
providing safe and effective care of the highest quality
and value.

42. A major objective of the Joint Commission is to continually improve and enhance the quality
and safety of health care delivery in the United States. Towards this end, makes a concerted,
consistent effort to engage patients in issues associated with improving the quality and safety
of health care delivery across the country. For example, JCAHO has focused intensity on the
matter of infections that arise in healthcare settings, including surgical site infections and
multidrug- resistant.

43. STANDARDS
Joint Commission Standards help to develop strategies to
address the most complex issues and identify key
vulnerabilities in the patient care experience. The standards
review various aspects of patient care process- such as
infection prevention, medication management and environment
of care- ensuring a comprehensive based on status, the need to
meet their continuing care needs, and the ability of the
receiving organization to meet patients needs.

44. PATIENT FOCUSED FUNCTION
 Infection prevention and control.
 Medication management
 Provision of care, treatment and services
 Rights and responsibilities of the individual

45. ORGANIZATION FUNCTION
 Management of the environment of care.
 Emergency management
 Human resources
 Management of information
 Leadership
 Life safety
 Medical staff
 Nursing
 Performance improvement
 Records of care, treatment and services

46. ACCREDITATION
 The Joint Commission premier accreditation
product has earned industry recognition as
the “gold standard” for quality and safety.
EARLY SURVEY OPTION FOR HOSPITAL
ACCREDITATION
 Some organization requesting a traditional
hospital survey may not be quite ready for
full evaluation. These organizations may
prefer early survey option.

47. FIRST SURVEY
The first survey can be conducted announced as early as two months before the
organization begins operations, provided the organization meets the following
criteria:
 It is licensed or has a provisional licence.
 The building in which patient care services will be provided in identified,
constructed, and equipped to support such services.
 It has identified its chief executive officer or administrator, its director of
clinical or medical affairs, and its nurse executive , if applicable.

48. Cont….
The Joint Commission requires written evidence of these criteria within 30 days
before conduction the first survey. The first survey is a limited survey, addressing
physical plant, policies, and procedures, plans, and related structural consideration
for patient care. Following this initial survey, assuming that the organization can
demonstrate compliance with the abbreviated set of standards, the organization
receives limited Temporary Accreditation.

49. SECOND SURVEY
The second survey under the Early Survey Policy is an unannounced full
accreditation survey. The Joint Commission conducts this survey at the following
times:
 Approximately 6 months after first survey or
 At a time frame selected by organization within 4 months of the acceptance of its
first Evidence of Standards Compliance( ESC) for organizations seeking to meet
CMS deemed status requirements.
Based on survey results, organization’s accreditation decision then changes to one
of the following:
 Accreditation
 Accreditation with follow up survey
 Denial of accreditation

50. Cont….
The effective date of the accreditation is the day after the second survey, if the
organization does not receive any Requirements of for Improvement(RFIs).the
organization accreditation cycle begins the day after the second survey was
conducted, unless the Joint Commission reached a decision to deny accreditation.
SURVEY RESULTS AND ACCREDITATION DECISSION
Shortly after the survey, an organizations report of survey findings is posted.
The final accreditation decision, which is valid for three years, is based on
organization’s compliance with Joint Commission standards and will be awarded a
decision of these categories of accreditation.

51. Limited temporary accreditation
 The organization demonstrates compliance with selected standards on the first
survey conducted under the Early Survey Policy.
Accredited
The organization is in compliance with all standards at the time of the on-site
survey or has successfully addressed all Requirements for Improvement in an
Evidence of Standards Compliance (ESC) within 45 or 60 days following the
posting of the Accreditation Survey Findings Report and does not meet any other
rules for other accreditation decisions.

52. Accreditation with Follow-up Survey
The organization is not a compliance specific standards that require a
follow-up recovery within 30 days to 6 months. The health care
organization also must successfully address the identified problem aras
(S) in a ESC submission.

53. Intracycle Monitoring/ Focused Standards Assessment:
Every accredited organization has access to an Intracycle Monitoring (ICM)
Profile on their secure Joint Commission Connect external site. The profile
provides access to overview information regarding the organizations current
accreditation status, major risk areas related to the accredited program, and
numerous helpful tools, solutions, and resources available to available to the
organization’s continuous standards compliance activities.

54.  TYPES OF ACCREDITATION
Broadly speaking, there exists two types of hospital accreditation:
1. Hospital and healthcare accreditation which takes place within national
borders.
2. international healthcare accreditation.

56. BAJAJ COMMITTEE
The Ministry of Health and Family Welfare, Government of India following the adoption
of the National Policy of Education, 1986, which for the first time took cognisance of the
essential linkages between health and education, set up a committee on Health Manpower,
Planning, Production and management in 1986 under the Chairmanship of professor
Dr.J.S.Bajaj, Professor of Medicine, AIIMS, New Delhi with major emphasis on the
creation of additional facilities for vocational training.

57. Recommendation of Bajaj Committee:
1. A national policy on education in health science must be enunciated and the
major focus should be on policy guidelines for health manpower development.

68. Department Staff
nurse
Sister per shift Departmental Sisters/Assistant Nursing
Superintendent
Medical wards 1:3 1:25 1 for 3-4 wards
Surgical wards 1:3 1:25 1 for 3-4 wards
Orthopaedic
ward
1:3 1:25 1 for 3-4 wards
Paediatric ward 1:3 1:25 1 for 3-4 wards
Gynaecology
ward
1:3 1:25 1 for 3-4 wards
Maternity ward
(including
newborns)
1:3 1:25 1 for 3-4 wards

69.  Intensive care unit (24 hours)
 Coronary care unit (24 hours)
 Nephrology (24 hours)
 Neurology and Neurosurgery (24
hours)
 Special wards: Eye, ENT, etc. (24hours
hours)
 Operation theatre (24 hours)
 Casualty and Emergency unit
 1:1 1 each shift, 1department sister/ANS for 3-4
units
1:1
1:1 ,1 each shift Clubbing together
1:1 1 each shift Departmental sisters/ ANS
1:1 1 each shift
1:1 1 each shift
3 for each 24 hours 1 departmental sister/ ANS 4-5
OT
2-3 1 each shift 1 departmental sister/ ANS

71.  The High Power Committee on Nursing was appointed by Government of
India, Ministry of Health on 29th July, 1987 (under chairmanship of
Smt.Sarojini Vardappan) to review the roles, functions, status, preparation of
nursing personnel, nursing services and other issues related to the development
of the profession and to make suitable recommendations to the government.
The committee report was released at the end of March, 1990.

72. Nursing Superintendent 1:200 beds (hospitals with 200 or more beds
Deputy Nursing Superintendent 1:300 beds (wherever beds are over 200)
Assistant Nursing Superintendent 1:150 beds (wherever beds are over 150) (7:1000
beds)
Ward Sister/Ward Supervisor
Staff Nurse for wards
1:25 beds+30% leave reserve
1:3 (or 1:9 for each shift) +30% leave reserve
Staff Nurses for OPD and Emergency, etc 1:100 patients (1bed:5 out patients) +30% leave
reserve
For ICU 1:1(or 1:3 for each shift) +30% leave reserve
For specialized depts. Such as Operation
theatre, labour room etc.
1:25 + 30% leave reserve
Norms recommended for nursing service in hospital setting by High Power
Committee, 1987 are

73. Working conditions of nursing personnel
1.Employment:
 Uniformity in employment procedures to be made.
 Recruitment rules are made for all categories of nursing posts. The qualifications and
experience required or these be made through out the country.
 There should not be a bond for nursing students as some of the states do not give them
employment during the stipulated period. Keeping in view of the shortage of nurses in hospitals
and community health field states should create posts and appointment these nurses in the
appropriate positions.

74. Cont…….
2. Job description:
Job description of all categories of nursing personnel is prepared by central
government to provide guidelines.
3. Working hours:
The weekly working hours should be reduced to 40 hours per week. Straight shift
should be implemented in all states, extra working hours to be compensated either
by leave or by extra emoluments depending on the state policy. Nurses to be given
weekly day off and all the gazetted holidays as per government rules

75. Cont…..
4. Work load/ working facilities:
 Nursing norms for patient care and community care to be adopted as
recommended by the committee.
 Hospitals to develop central sterile supply departments, central line services,
and central drug supply system. Group D employees are responsible for
housekeeping department.
 Policies for breakage and losses to be developed and nurses not are made
responsible for breakage and losses

76. 5. Pay and allowances
Uniformity of pay scales of all categories of nursing personnel, i.e. uniform
allowance, washing, mess allowance etc should be uniform through out the
country.

77. Cont…..
6. Promotional opportunities
For promotion to the post of ward sister, post basic BSc Nursing is made an essential
qualification. The principle of possessing higher qualification than the category to be
supervised, should apply for all levels and categories of nursing personnel in the rural and urban
areas. The committee recommends that along with education and experience, there is a need to
increase the number of posts in the supervisory cadre, and for making provision of guidance and
supervision during evening and night shifts in the hospital. Each nurse must have 3 promotions
during the service period. Promotion is based on merit cum seniority. Promotion to be senior
most administrative teaching posts is made only by open selection. In case of stagnation,
selection grade and running scales to be given.

78. Cont…..
7. Career development
Provision of deputation for higher studies after 5 years of regular services be made by all states.
The policy of giving deputation to 5-10% of each category be worked by each state. Every
nursing personnel must have an opportunity to attend at least one refresher course every 2
years.
8. Accommodation
As far as possible, the nursing staff should be considered for priority allotment of
accommodation near to work place. Hospitals should not build nurse’s hostel for trained nurses.
Apartment type of accommodation is built where married / unmarried nurses can be allowed to
live. Housing colonies for hospitals must be considered in long run

79. Cont…..
9. Transport
During odd hours, calamities etc. arrangements for transport must be
made for safety and security of nursing personnel.
10. Special incentives
Scheme of special incentives in terms of awards, special increment
for meritorious work for nurses working in each state/ district/ PHC
to be worked out.

80. Cont…..
11. Occupational hazards
Medical facilities as provided by the central government by extended by the state government
to nursing personnel till such time medical services are provided free to all the nursing
personnel. Risk allowance to be paid to nursing personnel working in the rural and urban area.
12. Other welfare services
Hospitals should provide welfare measures like creche facilities for children of working staff,
children education allowance, as granted to other employees, be paid to nursing personnel.

81. Additional Facilities For Nurses Working In The Rural Areas
 Family accommodation at sub centre is a must for safety and security of
ANM's /LHV.
 Women attendant, selected from the village must accompany the ANM for
visits to other villages.
 The district public health nurse is provided with a vehicle for field supervision.
 Fixed travel allowance with provision of enhancement from time to time.
 Rural allowance as granted to other employees is paid to nursing personnel

83. NURSING EDUCATION
Nursing education to be fitted into national stream of education to bring about
uniformity, recognition and standards of nursing education. The committee
recommends that;
1. There should be 2 levels of nursing personnel - professional nurse (degree level)
and auxiliary nurse (vocational nurse). Admission to professional nursing should be
with 12 yrs of schooling with science. The duration of course should be 4 yrs at the
university level. admission to vocational /auxiliary nursing should be with 10 yrs of
schooling .The duration of course should be 2 yrs in health related vocational stream.
.

84. 2. All school of nursing attached to medical college hospitals is upgraded to
degree level in a phased manner
3. All ANM schools and school of nursing attached to district hospitals be
affiliated with senior secondary boards.
4. Post certificate BSc Nursing degree to be continued to give opportunities to
the existing diploma nurses to continue higher education.

85. 5. Master in nursing programme to be increased and strengthened.
6. Doctoral programmes in nursing have to be started in selected universities.
7. Central assistance be provided for all levels of nursing education institutions in
terms of budget( capital and recurring)
8. Up gradation of degree level institutions be made in a phased manner as
suggested in report.

86. 9.Each school should have separate budget till such time is phased to
degree/vocational programme. The principal of the school be the drawing and the
disbursing officer.
10. Nursing personnel should have a complete say in matters of selection of
students. Selection is based completely on merit. Aptitude test is introduced for
selection of candidates.

87. 11. All schools to have adequate budget for libraries and teaching equipements.
12.All schools to have independent teaching block called as School Of Nursing
with adequate class room facilities, library room, common room etc as per the
requirements of INC.
13.Adequate accommodations are provided to students. A maximum of 3
students to share a room. Rooms to be furnished with light, study table , chair
etc. Adequate dining room, toilets and bathrooms facilities to be provided in each
hostel as per norms recommended.

88. 14. Students should learn under supervision in the wards. Tutors/clinical
instructors must go to the ward with students. Students should not be used for the
service of the hospital.
15.Community nursing experience should be as per INC requirements. Necessary
transport and accommodation at PHC be made available for safety, security and
meaningful learning of students.

89. 16.INC requirements for staffing the schools and meeting the minimum
requirements are followed by all schools as these are statutory requirements.
17.Speciality courses at post-graduate level be developed at certain special
centres of excellence eg; AIIMS.

90. 18.Institutes like National Institute of Health and Family welfare, RAK
College of Nursing and several others may develop courses on nursing
administration for senior nursing leading to doctorate level.
19.Provision for higher training abroad and exchange programmes is made

91. Continuing Education And Staff Development
 Definite policies of deputing 5-10% of staff for higher studies are made by
each state. Provision for training reserve is made in each institution.
 Deputation for higher study is made compulsory after 5 yrs.
 Each nursing personnel must attend 1 or 2 refresher course every year.
 Necessary budgetary provision be made,
 A National Institute for Nursing Education Research and Training needs to be
established like NCERT, for development of educational technology,
preparation of textbooks, media, / manuals f.or nursing

92. NURSING SERVICES: HOSPITALS/INSTITUTIONS
(URBAN AREAS)
Definite nursing policies regarding nursing practice be available in each
institution .These policies include:
1. a) Qualification/recruitment rules
b) Job description/job specifications
c) Organisational chart of the institutions
d) Nursing care standards for different categories of patients.

93. 2. Staffing of the hospitals should be as per norms recommended.
3. District hospitals /non teaching hospitals may appoint professional teaching
nurses in the ratio of 1; 3 as soon as nurses start qualifying from these
institutions.
Students not to be counted for staffing in the hospitals

94. 4. Adequate supplies and equipements, drugs etc be made available for practice of
nursing. The committee strongly recommends that minimum standards of basic
equipment needed for each patient be studied , norms laid down and provided to
enable nurses to perform some of the basic nursing functions . Also there should
be a separate budget head for nursing equipment and supplies in each hospitals/
PHC. The NS and PHN should be a member of the purchase and condemnation
committee.

95. 5. Nurses to be relieved from non -nursing duties.
6. Duty station for nurses is provided in each ward.
7. Necessary facilities like central sterile supplies, linen, drugs are considered
for all major hospitals to improve patient care. Also nurses should not be
made to pay for breakage and losses. All hospitals should have some systems
for regular assessment of losses.

96. 8. Provision of part time jobs for married nurses to be considered. (min 16-
20hrs/week)
9. Re-entry by married nurses at the age of 35 or above may also be considered
and such nurse be given induction courses for updating their knowledge and skills
before employment.
10. Nurses in senior positions like ward sisters, Asst. nursing superintendents,
Deputy NS; N.S must have courses in management and administration before
promotions

97. Community nursing services
 Appointment of ANM/LHV to be recommended.
 ANM/LHV promoted to supervisory posts must undergo courses in
administration and management.
 Specific standing orders are made available for each ANM/LHV to function
effectively in the field.
 Adequate provision of supplies, drugs etc are made.
 Recording system be simplified.
 Posts of public health nurses and above are given gazetted status.

100. IINTRODUCTION
The Indian Nursing Council is an Autonomous Body under the
Government of India and was constituted by the Central
Government under the Indian Nursing Council Act, 1947 of
parliament. It was established in 1949 for the purpose of providing
uniform standards in nursing education and reciprocity in nursing
registration throughout the country. Nurses registered in one state
were not registered in another state before this time. The condition
of mutual recognition by the state nurses registration councils,
called reciprocity was possibly only if uniform standards of
nursing education were maintained.

101. The main functions of INC
1 To establish and monitor a uniform standard of nursing education for nurses
midwife, Auxiliary Nurse Midwives and health visitors by doing inspection of the
institution.
2.To recognize the qualification under section 10 (2) (4) of the Indian Nursing
Council Act, 1947 for the purpose of registration and employment in India and
abroad.
3. To give approval for registration of India and Foreign nurses possessing
foreign qualification under 11 (2) (a) of Indian Nursing Council Act,1947.

102. Cont…
4. to prescribe the syllabus and regulations for nursing programs.
5. power to withdraw the recognition of qualification under section 14 of the Act
in case the institution fails to maintain its standards under section 14(1) (b) that an
institution recognized by a State Council for the training of nurses, midwives,
auxiliary nurse midwives or health visitors does not satisfy the requirements of the
council.

103. 6. To advise the State Nursing Councils, Examining Boards, State Governments
and Central Government in various important items regarding Nursing Education
in the country.
COMMITTEES OF INC
1.Executive Committee of the Council deliberate on the issues related to
maintenance of standards of nursing programs.
2. The Nursing Education Committee- The committee is constituted mainly with
nursing education and policy matters concerning the nursing education.

104. 3. Equivalence Committee- To deliberate on the issues of recognition of foreign
qualifications which is essential for the purpose of registration under section 11(2)
(a) o(b) of Indian Nursing Council Act 1947, as amended.
4. Finance Committee- This is another important Sub- Committee of the Council
which decides upon the matters pertaining of finance of the Council in terms of
Central Government orders with respect to service condition.

105. ORGANIZATIONAL STRUCTURE
PRESIDENT
VICE PRESIDENT
SECRETORY
ASSISTANT SECRETORY
OFFICE STAFF

106. 1.Inspection for enhancement of seat:
INC conduct inspection of the institution once the
institution is found suitable by INC and on receipt of
the fees and the proposal for enhancement of seat.
2. Periodic Inspection:
INC conduct periodical (after 3 years) inspection of the
institution once the institution is found suitable by INC
to monitor the standard of nursing education and the
adherence of the norms prescribed by INC,

107. Cont…
3. Re- inspection:
Re-inspection are conducted for those institutions, which are found unsuitable by
INC. once the institution takes necessary steps to rectify the deficiencies,
institution should submit the compliance report with documentary proof of the
deficiencies pointed out and re-inspection fees.
4. First Inspection:
First inspection is conducted on receipt of the proposal received from the institute
to start nursing program prescribed by INC.

108. Indian Nursing Council has recommended nurse patient ratio in 1965, 1975 for
hospitals and the revised recommended staffing norms for teaching hospitals
(1986) are:
 Nursing Superintendent 1 for every hospital with 150 beds.
 Deputy Nursing Superintendent 1 for every hospital with 150 beds.
 Assistant Nursing Superintendent 2 for every hospital with 150 beds.
For every 50 additional beds.
1 Assistant Nursing Superintendent.


109. Staffing pattern according to INC
COLLEGIATE PROGRAMME –A
Qualifications and experience of teachers of college of nursing-
1.Professor cum Principal- Master Degree in Nursing, total 15 years experience
with minimum of 12 years teaching experience with minimum 5 years in
collegiate programme. Ph. D (N) is desirable.
2. Vice- Principal cum Professor: 12 years experience with M.Sc(N) out of
which 10 years should be teaching experience with minimum 5 years in collegiate
programme. Ph. D (N) is desirable.

110. 3. Professor: 10 years experience with M.Sc(N) out of which 7 years should be
teaching experience. Ph.D. is desirable.
4. Associate professor: M. Sc(N) with 8 years experience including 5 years
teaching experience. Ph.D. is desirable.
5. Assistant professor: M. Sc (N) with 8 years experience.
Ph.D. is desirable.
6. Tutor: M. Sc (N) or B, Sc (N) / P.B.B.Sc (N) with 1 year experience.
Principal is excluded for 1:10 teacher student ratio norms (teacher).
Tutor student ratio will be 1:10.

111. Part time teachers/ External Teachers
1.Microbiology
2. Bio- chemistry
3. Sociology
4. Bio-physics
5. Psychology
6. Nutrition
7. English
8.Computer
9.Hindi / any other language.
10. Any other clinical disciplines
11. Physical education

112. NOTE
 No part time nursing faculty will be counted for calculating total number of
faculty required for a college.
 Irrespective of number of admissions, all faculty positions ( Professor or
Lecturer) must be filled.
 For M.Sc(N) programme appropriate number of M.Sc.(N) faculty in each
speciality be appointed subject to the condition that total number of teaching
faculty ceiling is maintained.

113.  All nursing teachers must possess a basic university or equivalent
qualification as laid down in the schedules of the Indian Nursing Council
Act,1947. they shall be registered under the State Nursing Registration Act.
 Nursing faculty in nursing college except tutor/ clinical instructors must
possess the requisite recognized postgraduate qualification in nursing subjects.
 All teachers of nursing other than Principal and Vice- Principal should spend
at least 4 hours in the clinical area for clinical teaching or supervision of care
every day

114. Programmes under INC are:
 ANM
 GNM
 Post Basic B. Sc. Nursing
 B.Sc. Nursing
 M. Sc. Nursing
 M. Phil.
 Doctorate in nursing

116.  Maximum period for students to complete revised ANM and GNM course in 3
and 6 years respectively.
 INC resolved that maximum age for teaching faculty is 70 years subject to the
condition that he/she should be physically and mentally ill.
 Admission to married candidate for the entire nursing programmes allowed
subject to the conditions that they should produce medical fitness certificate.

117.  Relaxation of norms to establish M.Sc (N) programme: As per INC norm, only
those institution can start M. Sc. Programme where at least one batch of
students has qualified B. Sc. (N) programme. INC resolved apart from there
institutions the super specialty hospital can also open the M.Sc (N)
programmes, even though the institutions are not having B. Sc(N) programme.
 Relaxation of students patient ratio for clinical practice 1:3 student patient
ratios instead of 1:5 student patient ratio.

118.  Relaxation of teaching faculty qualification to start a B. Sc (N) programme at
least 2 M.Sc(N) qualified teaching faculty to be available to start B. Sc (N)
programme for next 4 years in order to combat acute shortage of nursing and
teachers till position of M. Sc (N) qualified teaching faculty improves.
 to maintain quality of post graduate in nursing INC resolved not to have M.
Sc(N) programme through distance education.
 Institution should have its own building within 3 years of establishment.
 Maximum number of 60 seats can be sanctioned to those institutions which are
having less than 500 bedded hospitals. And 100 seats can be sanctioned to
those having 500 bedded hospitals

119. RESEARCH ABSTRACT
Optimum nurse-patient ratio is, the concern of most of the nurse leaders globally.
It has benefits both for nurses and patients, which is essential for patient safety
and quality care. Some parts of the world such as California, USA, and
Queensland, Australia has passed the law for the minimum nurse – to- patient
ratio, which has scientifically found to be beneficial for the patient and health care
system. Indian nurse staffing norms given by the Staff Inspection Unit, Indian
Nursing Council and Medical Council of India developed through professional
judgement models and are not updated. Five electronic databases were considered
for literature search; in addition, gray literature and books were also searched.

120. The primary outcome was to summaries existing national nurse- to- patient ratio
and nurse staffing norms as per Indian resources. It is concluded that nurse
staffing norms must be international norms and research evidence available in
this regards. Further , their is need for work load analysis based research
evidence to have true nurse- to –patient ratio estimation for hospitals in India.

121. CONCLUSION
The key to success of any hospital primarily depends upon its human resource
than any other single factor. The core determinants of staffing in the hospital
organization are quality, quantity and utilization of its personnel keeping in view
the structure and process. The staffing norms should aim at matching the
individual aspiration to the aims and objectives of the organization.