RGUHS releases Revised ordinance for MSc Nurse Practitioner in Critical Care

BENGALURU: The Rajiv Gandhi University of Health Sciences (RGUHS) has released the revised ordinance for MSc Nurse Practitioner in Critical Care.

Healthcare system Landscape in India is changing rapidly to meet the growing health needs and demand of the population. Nurses in India are expected to extend and expand their scope of practice beyond general nursing practice. The need is a significant expansion in public and private health sector is recognized by the government. Specialist nurses with advanced skills are required to support specialized and super-specialized healthcare services. Recognizing this need, RGUHS has decided to implement M.Sc., Nurse Practitioner in Critical Care, an Academicresidency program to meet the challenges and demands of tertiary care services in order to provide quality care to critically ill patients of all age groups and families. 

Nurse Practitioner in critical care/acute care oncology, emergency care, neurology, cardiovascular care, anaesthesia and other specialities can be prepared to function in a tertiary care setting. Rigorous educational training will enable them to collaboratively manage critical illnesses both for prevention and promotion of health.A curricular structure/framework is proposed by INC towards preparation of nurse Practitioner in critical care (NPCC) at Masters Level. The Special feature of this Program is that it is a clinical residency program emphasizing a strong clinical component with 15% of theoretical instruction and 85% of practicum. Competency-based training is the major approach and Nurse Practitioner education is based on competencies adapted from the International Council of Nurses (ICN, 2005), and NONPF competencies (2012).

Revised ordinance for MSc Nurse Practitioner in Critical Care.

Critical Care Nurse Practitioner Program is intended to prepare registered BSc Nursing Graduates, to provide advanced nursing care to the patients, who are critically ill. The nursing care is focused on stabilizing patient's condition, minimizing acute complications and maximizing restoration of health. These Nursing Practitioners are required to practice in critical care units of

Tertiary Health care centers. The program consists of various subjects of study that are based on strong scientific foundations including evidenced based practice and the management of complex health systems. These are built upon the theoretical and practice competencies of BSc trained nurses. On completion of the program and registration with respective state council they are permitted to assess and, participate and work under the supervision of the doctors. They can practice in ICUs of Tertiary Care Hospitals based on institutional protocols. The Nurse Practitioners in Critical Care when exercising this authority, they are accountable for the competencies in 

a) Patient selection/admission into ICU

b) Problem identification through appropriate assessment

c) Administration of medication or Non invasive devices or therapies

d) Patients' education for use of therapeutics

e) Knowledge of interactions of therapeutics, if any

f) Evaluation of outcomes

g) Recognition of complications and untoward reactions.

The Nurse Practitioner in critical care is prepared and qualified to assume responsibility and accountability for the care of critically ill patients under his/ her care.

The said post graduate degree will be registered as an additional qualification by the State Nursing Council.

I. PROGRAM DESCRIPTION 

The M.Sc in Nurse Practitioner in Critical Care is a Nursing Academic Residency program with a main focus on Competency based training. The duration is of two years with the curriculum consisting of theory that includes core courses, advanced practice courses and clinical courses besides clinical practicum which is a major component.

II. AIM

The critical care NP program prepares registered BSc nurses for advanced practice roles as clinical experts, managers, educators and consultants leading to M.Sc degree in Nurse Practitioner in critical care.

III. OBJECTIVES 

On completion of the program, the NP will be able to

1. Assume responsibility and accountability to provide competent care to critically ill patients and appropriate family care in tertiary care centers.

2. Demonstrate clinical competence / expertise in providing critical care which includes diagnostic reasoning, complex monitoring and therapies.

3. Apply theoretical, patho-physiological and pharmacological principles and evidence base in implementing therapies / interventions in critical care.

4. Identify the critical conditions using differential diagnosis and carry out treatment/interventions to stabilize as per the Institutional protocol and restore patient's health and minimize or manage complications collaboratively as a part of critical care team.

5. Collaborate with other health care professionals in the critical care team, across the continuum of critical care.

6. On completion of the programme, they are registered with State Nursing Council as additional qualification and practice critical care nursing in ICU settings of tertiary hospitals only.

IIV. MINIMUM REQUIREMENTS TO START THE NP CRITICAL CARE PROGRAM 

The institution must accept the accountability for the Nursing Practitioner program and its students and offer the program in congruence with the Rajiv Gandhi University of Health Science standards. It must fulfill the following requirements.

1. Hospital 

The hospital should be a own tertiary care center, with a minimum of 200 beds. Hospitals on MOU/Agreement /lease are not considered for granting this course affiliation. Hospital should be under the registered name of the trust and it should have gotten all the statutory permission from the Government of Karnataka.

2. ICU Beds

The hospital should have a minimum of 4 ICUs namely Medical ICU, Surgical ICU, Cardio/cardiothoracic ICU & NICU or PICU. Each ICU shall have at least 5 beds and Emergency care unit with at least 20 beds, thus constituting a total of 40 beds.

3. ICU staffing

a. Every ICU should have a charge nurse with BSc or MSc qualification

b. The nurse patient ratio should be 1:1 for every shift for ventilated patients

c. For the rest of ICU beds the nurse patient ratio should be 1:2 for every shift

d. Provision of additional 45% staff towards leave reserve

e. Doctor patient ratio can be 1:5

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4.Faculty

a. Teaching faculty:

• Professor/Associate professor OR Faculty with 8 years of PG Teaching Experience after M.Sc - 1 (shall be the Guide)

• Assistant Professor - 1 (Teaching experience- 3 years post BSc)

• Ratio for Guide : Student - 1:5 

Note: Faculty who is a Guide for NPCC cannot be guide for another PG Programme.

Faculty involved in NPCC should have a dual role

b. Nursing Preceptors : The Nursing preceptors must be a full time qualified GNM with 6 years of experience in critical care nursing OR BSc with 2 years of experience in critical care nursing OR MSc(Specialty-Medical Surgical Nursing/Pediatric Nursing) with one year critical care nursing experience.

• Ratio for Nursing Preceptor : Student - 1:10

c. Medical Preceptors : The Medical Preceptors must be MD/MS/Qualified Intensivist.

d. The Co-Guide for NPCC programme can be a Medical preceptor.

e. Ratio for Medical Preceptor : Student - 1:10 

5. Physical and learning resources at hospital/college

a. One classroom/conference room at the Hospital.

b. Skill lab for simulated learning (hospital/college).

c. Library and computer facilities with access to online journals.

d. E-Learning facilities.

6. List of equipment for ICU (enclosed) Appendix-1

7. Latest edition of critical care books and international journals and Helinet must be available. 

8. Student Recruitment/Admission Requirements

a. Applicants must possess a Registered B.Sc nursing Degree with a minimum of one year clinical experience in ICU prior to enrollment.

b. Must have undergone the BSc-Nursing in an institution recognized by the Indian Nursing Council and Karnataka Nursing Council.

c. Must have scored not less than 55% aggregate marks in the BSc- Nursing Course.

d. Selection must be based on the order of merit of an entrance examination and interview held by the competent authority or University

Number of candidates: 1 candidate for 5 ICU beds,