TAMILNADU NURSES AND MIDWIVES COUNCIL ... Rule No: 37 of Tamil Nadu
Nurses & Midwives Act. : Yes /No. Please Tick ..... Approved by CMDA / DTCP /.
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 No:044-24620547 (to be filled by the Principal) Academic Year: ……………………… Date of Inspection …………………….. INSPECTION PROFORMA 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 Type of Inspection : Sl H.V. Type of Inspection No 1 Primary Inspection 2 Annual Inspection 3 Re-Inspection 4 Enhancement of Seats 5 Surprise Inspection 6 Bi-annual Inspection I.
ANM
GNM
Basic B.Sc(N)
: Yes /No
PBB.Sc (N)
M.Sc (N)
P.B Diploma Program
GENERAL INFORMATION
1.
Name of the Institution
:
2.
Full Address with Pin Code (as given in G.O)
:
4.
Name of the Principal a)Telephone Number of the Principal
:
5.
Name of the Vice Principal a)Telephone Number of the Vice- Principal
:
6.
Telephone Number of the Institution
:
…………………………………………….. ……………………………………………. ……………………………………………. ……………………………………………. ……………………………………………. ……………………………………………. ……………………………………………. ……………………………………………. ……………………………………………. ……………………………………………. ……………………………………………. (O)…………………….(R)………………… (M)……………………………………. …………………………………… (O)…………………….(R)………………… (M)……………………………………. ………………………. Fax No:……………
7.
E-Mail of the Institution
:
…………………………………………….
8.
Name of the Trust/Society/Missionary/ : Company (enclose a copy of the Registered trust Deed only if any name change of the trust or trust members,trust address)
9.
Administrative Control
3.
District If there is any address change, specify the new Address (enclose the Govt. Order for change of Address)
10. Does the institution has Minority status (If yes, enclose the minority status G.O. issued in recent years)
:
:
:
……………………………………………. ……………………………………………. ……………………………………………. …………………………………………… Encl:……….. 1.Government 2.University 3.Corporation 4.Private 5.Autonomous 6.Voluntary 7.Missionary/Trust/Society 8.Company Yes / No
Encl:………..
-211. First Batch admitted for School/College : G.O Year of No. of Seats Sanctioned in Original G.O No. Enhancement of Seats Remarks Programme No & Programme & Date (No.of seats sanctioned) Date Started G.O INC TNC University Board GO INC TNC University Board H.V. ANM GNM Basic B.Sc(N) Post Basic B.Sc (N) M.Sc.,(N) a. Med.Surg,Nsg b.Com. Health Nsg c. Paediatric Nsg d. Psychiatric Nsg e. OBG Nsg M.Phil (N) Ph.D Post Basic Diploma Programmess * G.O, INC, TNC , University & Board Orders to be enclosed; *If G.O is exempted, kindly mention those courses (Both for New / Enhancement) Encl:……… 12. 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:……... 13) 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 Tamilnadu Nursing Council Indian Nursing Council University Board (Govt/CMAI)
H.V.
ANM
GNM
Basic B.Sc. (N)
PBBSc(N)
M.Sc. (N)
Post Basic Diploma Programmes
Remarks
-3II.TEACHING FACULTY STAFFING PATTERN AS PER INC NORMS School 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 1 1 4 1 7
Note: Teacher student ratio should be 1:10 for student sanctioned strength. STAFFING PATTERN AS PER INC NORMS Collegiate Programme B.Sc.(N) Sl.No. Designation 40-60 (Students Intake) 1 Professor cum PRINCIPAL 1 2 Professor cum 1 VICE- PRINCIPAL 3 Professor 0 4 Associate Professor 2 5 Assistant Professor 3 6 Tutor 10-18
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. Designation 1 2 3 4 5 6
Professor cum PRINCIPAL Professor cum VICE- PRINCIPAL Professor Associate Professor Assistant Professor Tutor
B.Sc.(N) 40-60 (Students Intake) 1
P.B.B.Sc.(N) 20-60 (Students Intake)
1 0 2 3 10-18
2 2- 10
B.Sc.(N) 61-100 (Students Intake)
Sl.No. Designation
1 2 3 4 5 6
Professor cum PRINCIPAL Professor cum VICE- PRINCIPAL Professor Associate Professor Assistant Professor Tutor
-4B.Sc.(N) 40-60) (Students Intake) 1
P.B.B.Sc.(N) 20-60 (Students intake)
M.Sc.(N) 10-25 (Students intake)
1 0 2 3 10-18
2 2-10
GNM 20-60
Sl.No. Designation
1 1 3*
B.Sc.(N) 40-60) 1
P.B.B.Sc.(N) 20-60
M.Sc.(N) 10-25
1
Professor cum PRINCIPAL
2
Professor cum VICE- PRINCIPAL
1
3
Professor
0
1*
4
Associate Professor /Reader Assistant Professor /Lecturer Tutor
2
1*
5 6
6-18
3
2
10-18
2-10
3*
*1:10 teacher student ratio for M.Sc.(N) Sl.No. Designation 1 2 3 4 5 6
Professor cum PRINCIPAL Professor cum VICE- PRINCIPAL Professor Associate Professor Assistant Professor Tutor
ANM 20-60
GNM 20-60
B.Sc.(N) 40-60) 1
P.B.B.Sc.(N) M.Sc.(N) 20-60 10-25
1
4-12
6-18
0 2 3 10-18
2 2-10
*1:10 teacher student ratio for M.Sc(N) 1. Prof-Cum-Principal 2.Prof.-Cum Vice-Principal
:
5 years after M.Sc.,(N) with Total experience of 10 years after U.G.
3.Reader/Associate Professor
: 3 years after M.Sc.,(N) with a total experience of 7 years after U.G.
4.Lecturer/Asst.Professor
: M.Sc.,(N) with a total experience of 3 years after B.Sc.,(N)
5.Clinical Instructor
: Basic B.Sc.,(N)/Post Basic B.Sc.,(N) with one year experience
1* 1* 3*
-5II. FACULTY DETAILS A).Teaching Faculty Profile ( Full – Time) of all the Nursing programme offered by this institution( H.V., M, 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) Sl No
1. 2.
3.
Designation
Professor -cumPrincipal Professor -cumVice Principal Professor
4.
Reader/ Asso. Professor
5.
Lecturer
6.
Tutor/ CIinical Instructor
Name
Age
RN RM No
Pay scale
Name of the institution Year of passing from where and when qualified.(Enclose Photos with self-attestation of all teaching faculty individually in the affidavit –Form II) Post Basic Basic M.Sc M Phil PhD BSc (N) BSc (N) (N)
Experience in years & months* Specialty
Teaching Clinical
Before PG`
After PG
Date of Joining
Date of Leaving Previous Employment** & Institution Name
Total
Enclose the colour photograph duly signed by the faculty,copies of appointment order, a copy of relieving order of Last institution, UG & PG Certificate, RN, RM & Addl. Qualn. Registration Certificates & Experience Certificates Encl ------------** Check the Relieving order & enclose the same; if joined within 6 months
Remarks
-6B) External Teachers Details (Part Time) (whichever subject applicable for the programme) Sl. Subject Name Qualification Number of Hrs/ Year Remarks No As per norms Allotted prescribed 1. Anatomy 2.
Physiology
3.
Bio –Chemistry
4.
Nutrition
5.
Micro – Biology
6.
English
7. 8
Computer Science 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. Designation No. No. in Vacant Since Remarks No Required Position When 1. P.A to Principal 1 2. Sr.Assistant 1 3.
Jr.Assistant
1
4.
Accountant-cumCashier Librarian Computer Programmer Peon/Office Attendant Security Driver( As per the No. of Vehicles)
1
5. 6. 7. 8. 9. 10. 11. 12.
Cleaner(Bus) ( As per the No. of Vehicles) House Keeping Staff Maintenance Staff
2 1 2 2
4 2
-7D )HOSTEL STAFF: S.No 1. 2. 3. 4. 5. 6.
Designation
Warden Asst.Warden Cooks (1:20) Bearer House Keeping staff Security
No. Required
No.in Position
Vacant Since When
Remarks
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 /
1. 1.Total Land Area
: ………….……….Acres
2.Ready Built Area
: ………………….Sq.ft.
3.Details about ownership of the Building
: 1.Own
2.Leased
If own, proof to be enclosed If leased, copy of the Registered lease deed to be enclosed *If leased building make sure it is registered for 5 yrs lease, if not mention the same in the report. Make a special note in the report if the building is rented 4. Building Completion Certificate by the State Authority (proof to be enclosed) i)Does all the courses are imparted in the same building ii)If no, where the other courses are imparted 5.Number of Toilets in the College for all Nursing programs Total No. of students Total No. of Toilets Student Toilet Ratio Facilities A. Teaching Block: a. Lecturer Halls No. Area /Size No. of Tables No. of Chairs B. Multipurpose Hall/ Auditorium 1.Area 2.Seating capacity 3.Confidential Room 4.CCTV facility 5.Furniture settings
Rented
Encl:………………..
: 1.Date of Completion ------------------2.Approved by CMDA / DTCP / Municipality / Panchayat Encl:……………….. : Yes/No ………………………………………….. :
…………………………………………..
: : :
………………………………………….. ………………………………………….. …………………………………………..
Minimum requirement as per INC norms 4 for B.Sc.,(N) & extra/batch 1080 Sq.ft. Should be adequate for Intake 3000 sq.ft. }Exam purpose } Adequate for capacity
3.Rented
Available
Remarks
Facilities C. Laboratories a)Nursing Foundation Lab 1.No. of beds 2.No. of articles 3.Equipment & supplies 4.No. of dummies
-8Minimum requirement as per INC norms 1500 sq.ft.
Available
Remarks
1:6 students 10-12 sets in each item Adequate for lab practice
5.Hand washing facilities
Adult manikin -3 Child/Neonate - 1 CPR manikin - 1 I.V.Arm Simulator - 1 Elbow/Leg operated system
b)Nutrition Lab – Area
900 sq.ft
1.Equipment & supplies 2.Charts/Models
Adequate for practice Adequate for practice
c.MCH Lab – Area Simulators/charts/models/play materials/specimens/ charts/models/specimens
900 Sq.ft Adequate for practice Delivery Manikin -1 Neonatal Manikin -1
d.CHN Lab - Area. Charts/models etc Community Health Bags
900 sq.ft.
e. Computer Lab –Area No. of computer } Internet facilities }
1500 sq.ft
D.A.V.Aids Room - Area. OHP LCD Slide projector TV/Video Charts/models/specimen Other T.L.aids specify
900 sq.ft. 1 for each class room 2 (minimum) 1 1 Adequate for each student
1:2 students
1:5
* 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 ( 10sq.ft for each student to be calculated for every additional seats)
-9E.LIBRARY Library Area Seating capacity Staff reading room Room for librarian Furniture No. of cupboards No. of racks Total No. of Books (For DGNM program total books=1500)
Minimum Required 2400 sq.ft. Min. 60
Available
Remarks
10 persons Should be Adequate Should be Adequate
Year I II III IV
For Collegiate Programme 3000 Min. Professional Journals Books 1000 National Inter Total National 1500 3 2 5 2500 5 2 7 3000 2 1 3 10 5 15
* For PG programme Departmental library with additional 1000 books and journals (National & international)specialitywise should be available (i) General Books/Fictions
:
(ii) No of latest edition Nursing books (since 2000)
:
……………………………….
(iii)Photocopying facility
:
Yes
No
(iv)Internet facility
:
Yes
No
(v)Separate section for staff/PG
:
Yes
No
(vi) Ventilation
:
Yes
No
(vii) Lighting
:
Yes
No
(viii) Registers maintained Accession Register
:
Yes
No
Journal Register
: Yes
No
Issue Register
:
No
Yes
Administrative Facilities
Principal Office Vice Principal Office Professor Offices Lecturer’s Offices Tutors/ Clinical Instr. Offices Offices of Administrative , Clerical staff and PA(s) Accountants Office Store Room Record Room Room for maintenance staff Duplicating/Xeroxing Room Common Room for Boys, Girls separately Guidance/ Counselling room
Size (Sq. ft) As per Norms sq.ft
Storage Facility
No. of Tables
Actually Available
-10-
No. of Chairs / Stools
Tel. Facility
Computer Facility
Venti -lation
1.V.Good 2.Good 3.Fair 4.Poor
Lighting
Remarks
1.V.Good 2.Good 3.Fair 4.Poor
300. 200 . 100x5 600x3 600 x2 300
100 100 100 100 75 300
Principal & Vice –Principal office should be attached with toilet. B] Hostel Facilities 1.Whether the College is having a Separate Hostel? : 1. Yes
2.No
2.Built- up area of the Hostel
: ……………………Sq.ft.
3.Is the Hostel
: 1.Own
2.Leased
:
Yes
No
:
Girls
Boys
b. Total number Students in the hostel
:
Girls
Boys
c. Number of Rooms
:
Girls
Boys
d. No. of students living in each room
:
Girls
Boys
e. Size of each Rooms
:
Girls
Boys
f. Total number of Toilets
:
Girls
Boys
g. Total number of Bathrooms
: Girls
Boys
h. Furniture allotted to each student
: Bed
Table
: Chair
Cupboard
If owned, proof of ownership to be enclosed; (sale deed/Building completion certificate) If leased, Registered Lease Deed for 5yrs to be attached. If rented mention in the report 4. Is there a separate provision of Hostel for Male and Female Students a. Total number of Day Scholars
Remarks----------------------------------------------------------------------------------------------------------------
3.Rented
Encl: -----------
-11-
5. Whether the Hostel has provision for a. Water Supply b. Electricity c. Safe Disposal of Wastes
: Yes
No
: Yes
No
: Yes
No
: Yes
d. Laundry
No
: Yes
e. Hot water supply
No
6. Is there a Recreation room available with : Yes T.V./Radio
No
7. i) Is there facilities available for outdoor and : Yes indoor games?
No
ii)If play ground is not available within the campus specify the address
: ………………………………………..
iii) Distance from the college campus
: ………………………………..kms
iv) List of the sports articles available 8. Is there a Sick Room available
: ……………………………………. : Yes
9. Whether the hostel mess is available
: Yes
10. Dining Facilities: a. Dining room well maintained
: Yes
No No
If yes area ……….sq.ft
Play ground area …..…. sq.ft.
If yes area .……….sq.ft If yes area .……….sq.ft
No
b Size
: ……………….. Seating Capacity ………
c. Hand washing facility
: Yes : Yes
d. Safe Drinking water facility
No
: Yes
e Hygienic kitchen
a)Vehicles available are
No
No
IV TRANSPORT DETAILS. :
Own/ contract/ If both ……………….
b)Vehicles available are i)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 Institution, : Insurance copy, Drivers’ License & Latest FC (FC should be checked for yearly renewal)
Encl:……………………….
(e)Mention the availability for Enhancement of seats : Adequate/Inadequate V.BUDGET 1. a) Is there a separate budget for the school/college : Yes No 1.Amount per annum : ………………………………………. 2.What was the last year’s budget Allocation : ………………………………………. Furnish the following details: S.NO PARTICULARS EXPENDITURE (Rs.,) 1. CAPITAL EXPENDITURE Land Building Furniture Transport Equipment AV Aids, computer Library books & journals 2. SALARY Nursing Staff Non Nursing Staff Part Time 3. Stipend 4. MAINTENANCE Electricity Building : Lease/Rental Furniture AV Aids, Computer Lab Equipments Sports Articles Transport Stationeries Postal Telephone Contingencies Books & Journals House Keeping 5. INSPECTION & ANNUAL FEES: TNNMC INC BOARD UNIVERSITY MISCELLANEOUS 6. TOTAL * Enclose the Balance Sheet & Previous year audited income and expenditure statement of the Institution / Trust / Society Encl:………………..
-13VI. CLINICAL FACILITIES
a) Hospital Details: 1.Is the Institution has parent Hospital If Yes, No. of Beds
: :
2.Is the Institution having parent Medical 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)
Sl. No
Name of the Hospitals
Distance
No. of Beds
2 3 4 5 6 7
No
Yes
No
:
……………………………….
:
……………………………….
Bed Occupancy Rate on the day of Inspection
Last month 1
Yes
On the day of inspection
No. of Schools affiliated (Mention the name)
No. of Colleges Affiliated (Mention the name)
No. of Registered Nurses
-144.Bed Distribution: (IP – No. of beds and OP – No. of patients per day) Specialty Parent Affiliated Hospital (Minimum Required Beds) Hospital 1 Medical–Surgical – 40 Cardio Thoracic Respiratory
IP
Orthopedic -10 Neurology Nephro & Urology – 10 Dermatology 5-10 Communicable&STD ENT- 5 Eye – 5 Burns & Reconstructive 5-10 Oncology 5-10 Gynecology 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-addiction Intensive Ward Family Therapy Ward Halfway Home Any Other
OP
IP
2 OP
IP
3 OP
IP
Total Beds
4 OP
IP
5 OP
IP
6 OP
IP
OP
IP
Total OP/ day OP
-155. Statistics of Operation/Deliveries performed in the last month: MA - Major Surgeries & MI -Minor surgeries Particulars Parent Hospital Affiliated Hospital - 1 Affiliated Hospital - 2 Affiliated Hospital - 3 MA MI Total MA MI Total MA MI Total MA MI Total General Surgery Ortho ENT Ophthalmic Gynec Obstetrics Pediatrics Super Specialties Bed Occupancy Rate (BOR) at Parent Hospital : …………… on the day OF INSPECTION Bed Occupancy Rate (BOR) at Affiliated Hospital on the day : 1.…………………2. ……………3……………. of inspection Average BOR for the last 6 months(own Hospital) : ……………………………………………… Average BOR for the last 6 months(Affiliated Hospitals) : 1………………2 …………3………………. 6. Staffing Pattern of the Hospitals: S. Designation Qualification Parent Affiliated Hospital No 1 2 3 4 5 6 7 1 Nursing Superintendent 2 Asst. Nursing Superintendent 3 Ward Sisters/ Ward In charges 4. 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 OP Register Day / Night Report Discharge Register Census Register Any other (Specify)
: : : : : :
Yes / No Yes / No Yes / No Yes / No Yes / No
9. Clinical Supervision of students by (a) Hospital Nursing Staff
:
Yes
No
b) College Teaching Faculty
:
Yes
No
c) On the day of Inspection, was College teaching faculty supervising the Students d) Teacher student ratio in Clinical Area
:
Yes
No
:
_________________
-16(b) Community Health Facilities (1) Type Name & Address
Distance
Urban
Population Covered
Area Coverage
No. of Villages covered
Rural (PHC) Own / Adopted (2) Service Rendered
a) Health & Family Welfare Programme : Yes / No b) National Health Programme
Supervision of Students: 1. Field Staff only
: Yes / No
2.College Teaching Faculty
3.Both
(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 Health Field and record their observation) Encl:…………………..
VII ADMISSION DETAILS. (i) Admission of students in current session (ii) Percentage of Admission
:
INC Norms / University Norms
: Management / Government
(Attach the copy of admission criteria)
Encl:…………………….
Total No. of Students under Training in the current Programme: Programme ANM
I year
II year
III Year
IV year
Male Female
GNM
Male
B.Sc(N)
Female Male Female
Post Basic B.Sc (N)*
Male Female
M.Sc (N)*
Male Female
M.Phil (N)
Male Female
Post Basic Diploma Programme
Male Female
Any other
Male Female
Total * 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.
Total
-17Sl. No.
Name of the Student
State Nursing Council Registration No. GNM
Residence Address
B.Sc(N)
Place & Address of Work at the time of admission
Board/University from where last exam qualified
Duration of Course With Dates From…… …….To
Does this details updated In the nurses data bank
c) 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
-18-
VIII. CURRICULAM PLANNING & EXAMINATION
a) COURSES OF INSTRUCTION & SUPERVISED PRACTICE
Report from the principal
Conduct
Completion of Practical Records
Attendance % Practical
Theory
Freq
Int. Ass. Marks
Eligibility for admission to Examination
System of supple. exam Yes/No
Duration
Total
External
Internal
Practical Marks
Total
External
Theory Marks Internal
Allotted
No. of Hours Practical Prescribed
Allotted
No. of Hours Theory Prescribed
Year –wise Paper
Name of the Programme
(Kindly attach the enclosure as per the column given below for each program conducted at your institution)
-19b] I Teaching Plan Sl. Program No
1 2 3 4 5 6 7
Master Plan
Unit Plan
Lesson Plan
Learning Objectives
Learning Experiences
Plan of Evaluation
Yes/ No
Yes/ No
Yes/ No
Yes/No
Yes/ No
Yes/ No
H.V. ANM GNM Basic B.Sc N P.B.B.Sc N M.Sc N P.B. Diploma Programmes a. b. c. d. e. f. g. h. i. j. k.
c) .Does Clinical Teaching takes place?
: Yes
No
(N.B : Inspector to make observation of 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 requirements of Indian Nursing Council syllabus a) If yes, what is the gap
; Yes
No
____________________________________________
Time Table Yes/ No
-20e) CLINICAL PLAN : 1. Is Rotation based on the needs of clinical learning experience (Rotation plan to be enclosed) Encl …………………….. 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
Yes
No
II Year
ANM i. Number and size of student Groups ii. Number of Rotation iii. Duration of each Rotation iv. Graphic rotation plan (attach copy) Appendix no. GNM i. Number and size of student Groups ii. Number of Rotation iii. Duration of each Rotation iv. Graphic rotation plan (attach copy) Appendix no. Basic B.Sc.(N) i. Number and size of student Groups ii. Number of Rotation iii. Duration of each Rotation iv. Graphic rotation plan (attach copy) Appendix no.
I Year
II Year
I Year
II Year
I Year
II Year
I Year
II Year
1.Yes 2.No IV Year
1.Yes 2.No
1.Yes 2.No
P.B. B.Sc.(N) i. Number and size of student Groups ii. Number of Rotation iii. Duration of each Rotation iv. Graphic rotation plan (attach copy) Appendix no.
III Year
1.Yes 2.No
III Year
IV Year
-21M.Sc.(N) I Year i. Number and size of student Groups ii. Number of Rotation iii. Duration of each Rotation iv. Graphic rotation plan (attach copy) Appendix no.
II Year
1.Yes 2.No
P. B. Diploma in: I Year i. Number and size of student Groups ii. Number of Rotation iii. Duration of each Rotation iv. Graphic rotation plan (attach copy) Appendix no.
1.Yes 2.No
(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? School /college Faculty 2.Hospital nursing service personnel 3.Both b. Who are all involved in planning the Clinical Rotation Plan? ( Please indicate designation) ………………………………………………………………………………….. f) System of Examination: 1. Name and Address of Affiliated Examining Body / Board ………………………………………………………………………………….. Tel…………………………………Fax…………………………………..... E Mail ID ………………………………………………………………………………….. Website …………………………………………………………………………........
……………………………………………………………………………….
-222. 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 assignments & 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 on achievments
-23-
IX RECORDS & REGISTERS 1. Are the following Registers maintained well? (Check depending on programme implemented)
S.No 1 2 3
4
5
6 7 8 9 10 11 12 13
Registers *
Yes
No
Admission Register Cumulative Register Attendance Registers a) Daily b) Subject c) Clinical d) Faculty e) Ministerial Staff Leave Record a) Student’s b) Faculty c) Ministerial Staff Practical Records a)Nursing Foundation b)Medical Surgical Nursing c)Midwifery Case Book d)Log Book e)Drug Files Daily Diary Health Record Clinical and Field Experience Record Clinical Evaluation Internal Assessment – Practical & Theory Curricular & Co – Curricular Record Family Folders Any Other
Which type of Records used? TNC Records / other 2. Maintenance of Records: Course planning of each subject
: Yes
No
Rotation Plans (Master & Clinical)
: Yes
No
Mark Register
: Yes
No
Minutes of Committee Meetings
: Yes
No
College Development Committee
: Yes
Curriculum
: Yes
Anti-ragging
: Yes
Selection Committee
: Yes
Library Committee
: Yes
No No No No No
-24-
Any other – specify ……………………………………………………………………………….
Affiliation records
Stocks Register
: Yes
No
Inventory Register
: Yes
No
Budget plan
Annual report of activities and achievements
: Yes
No
Staff development Program
: Yes
No
Records signed by Teachers with dates
: Yes
No
: Yes
No
: Yes
No
[Note: verify
Physically (a) & (b) ]
X WELFARE ACTIVITIES A.STUDENT: 1.Professional Association / Activities N.S.S. / SNA/ TNAI/any other – specify 2.Is the students of all basic nursing programmes been enrolled in SNA 3. Health services are provided when students are sick: If yes name of the hospital Address :
.
: Yes
: Yes
Pin Tel fax Email Web site
:
:
:
: Yes
If yes, is the Health Insurance b) Name of the Health Insurance Company
: Group :
Pin Tel Email Web site
4.Eligible leave for students (*should adhere to INC norms) : 1. As per INC : 2. As per University : 3.As per Institutional Policy
No
: : :
a). Do students have Health Insurance
Address
No
No Individual
: : : : : : :
fax ___________
:
-25B] FACULTY 1. Is there any Professional Organization for Faculty? If yes, name the Organization S.No 1. 2. 3. 4.
:
Yes
No
NAME OF THE ORGANIZATION
2. Establish Faculty Committee, If yes , Name of the Committees S.No 1. 2. 3. 4.
NAME OF THE COMMITTEES
3. Any other welfare activities S.No 1. 2. 3. 4. 4.
ACTIVITIES
Eligible leave for faculty
S.No
2. 3. 4. 5. 6.
1.
NATURE OF LEAVE
Casual leave Sick/medical leave Vacation/annual leave Public holidays Maternity leave On duty
NO.OF.DAYS / year As per norms No. of days (Days) given by the institution 12 10 30 All govt.gazette holidays As per policy of institution 15
-265.Provides health services for the faculty when sick If yes, name the Hospital
: a) Will the faculty have Health Insurance If yes, is the Health Insurance b) Name of the Health Insurance Company
: Address
Yes
: : : :
Tel Email Web site :
: Yes Group
Address
:
Pin Tel
: :
Email Web site 6. Are the faculty eligible for Provident Fund
No
No Individual
_____________ Fax _________________
: :
7..Are the faculy deputed for the conference/workshops/seminars : If yes list the criteria
: Yes
Yes
No No
XI. LAST TNNMC INSPECTION DETAILS a) Is there any Deficiencies notified in the previous/ recent Inspection Date of last inspection:----------------
: Yes /No
b) If Yes, enclose Rectification/ Compliance Report sent to the Council
: Yes/No
c) Inspectors to verify the rectification of the past deficiencies & write the report …………….. ……………………………………………………………………………………………………………………………………………………………………………………… ……………………………………………
-27-
XII CHECK LIST I have received the inspection Performa & have filled the same Yes Whether the Inspection report is completely filled after verification Yes Enclosures 1. Certified copy of the Registered Trust Deed : Yes No
2. G.O – Each Program
: Yes
3. INC – Each Program
: Yes
3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16.
17. 18. 19. 20. 21. 22. 23. 24. 25. 26.
No No
No No
TNC – Each Program : Yes No University/Board Orders – Each Program Proof of documents for change of address & trust Proof of the Own & Affiliated Hospitals &Health Centres Admission Criteria – Each Program List of Post Basic B.Sc (N) & M.Sc (N) Students Latest orders of TNC,INC, Board/ University & Also for enhancement of seats if any. Nursing faculty Details – UG,PG Certificates, RN, RM, Addl. Qualification, Experience Certificates, relieving order of Last institution if DOJ within 3 months, Appointment Order & Self Attested Color Photo Land Deed of the college & Hostel with Building completion certificate If Leased, Registered Lease Deeds of College & Hostel Vehicle Registration Certificate in the Name of the Institution ,Insurance, Drivers’ License & Latest FC The balance Sheet & Previous year audited income and expenditure statement of the institution / Trust / Society The list of Articles for all the Labs (Enclose the recent/ Last year purchase Bills) List of Library Books & Journals (Enclose the recent/ Last year purchase Bills List of Nurses with RN & RM No. working in the Parent & Affiliated Hospitals Master & Clinical Rotation plan for respective years – Each Program Eligibility for admission to examination : for all Nursing Programmes List of Sports Articles Report from the principal on course of instruction etc Whether the institution has submitted details for the Website Updation; If not, CD containing details to be enclosed Furnish all the above mentioned annexure in the CD in the jpg and Word format accordingly. Furnish the evidences for the Latest annual recognition fees & web page renewal fees paid. Minority status GO Past Rectification report
-28-
TAMILNADU NURSES AND MIDWIVES COUNCIL, CHENNAI-4
AFFIDAVIT FORM - II Particulars of the Faculty 1. Name (as in Degree Certificate
:
2. S/o./D/o./W/o
:
3. Date of Birth and Age
: ------/ -------- / ------- --------- Years
As on Date 4.
(a) Year of UG Qualification (b) Year of PG Qualification (c) Specialty in M.Sc (Nursing) 5. Council Registration No
Photowith Signature
Date / Month / Year : -----------------------------------( attach Certificate ) : ----------------------------------- (attach Certificate) :-----------------------------------:------------------------------------
6. Additional Qualification Registration :------------------------------------( attach Certificate) 7. Teaching Experience: (Teaching Experience in various Institutions must be filled up& Copies should be enclosed) S.No Name of the Institution Designation From To Experience From To
Total Experience
8. Residential Address
-29-
Phone No
: _____________________________________ _____________________________________ _____________________________________ _____________________________________ : _____________ Mobile No.------------------
Office Phone No
: _____________
9. Voter card Number
: _____________ Place of issue ___________ Date of issue ____________
10. Driving License Number
: ______________________ Place of issue _____________
(Enclose photocopy of the relevant page) 11. PAN Card Number
Date of issue _____________
:__________________________
12. T.D.S for the last three years &Place of filing income, Tax Return (attach photocopy) :___________________________________________________________________ I declare that (i) the above information provided by me is true and correct to the best of my knowledge. (ii) I also understand that if any information given by me, is found incorrect, I will be debarred from teaching; (iii) if any information found incorrect, my case will be given over to the law authorities for furtherance in the matter. Place : Date : Signature of the Teacher Signature of the Inspection Team 1. 2. 3. Signature of the principal of the college With seal & date
-30XV. REMARKS OF THE INSPECTORS S.NO 1.
PARTICULARS a. Institution (Land, Building, Library, Lab, Equipments, Furniture, etc,)
Physical Infrastructure
b.Hostel (Land, Building, Furniture, etc,)
2.
Transport
3.
Clinical Facilities a. Hospital
b. Community
4.
a. Nursing
Staffing
REMARKS
-315.
Admission of Students
6. (a)
Curriculum Planning and Implementation
(b)
Examination
7
Records & Registers
8
Welfare Activities for Students
9.
Welfare Activities for Faculty
10
Performance indictors
11
Miscellaneous
EXECUTIVE SUMMARY
Please tick the appropriate: DEFICIENT (time bound) /SUITABLE/ UNSUITABLE Name of the Inspectors (in Capital Letters)with Designation and Address Signature 1) 2) 3) Date:
-32XVI. REGISTRAR’S REMARKS S.NO PARTICULARS 1. a.Institution (Land, Building, Library Lab, Equipments, Furniture, etc,)
REMARKS Physical Infrastructure
b. Hostel (Land, Building, Furniture, etc,)
2.
Transport
3.
Clinical Facilities a. Hospital
b. Community
4.
5
a.Nursing
Admission of Students
Staffing
-336
a. Curriculum Planning and Implementation b. Examination
7
Records & Registers
8.
Welfare Activities for Students
9
Welfare Activities for Fsaculty
10
Performance indicators
11
Miscellaneous
REGISTRAR i/c, TAMILNADU NURSES AND MIDWIVES COUNCIL, CHENNAI
