Amendments for Auxiliary Nurses and Midwives syllabus and regulation

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Amendments for Auxiliary Nurses and Midwives syllabus and regulation Duration of the course : The total duration of the course is 2 year (18 months + 6 months internship) First Year : i. Total weeks - 52 weeks ii. Vacation - 4 weeks iii. Gazetted holiday - 2 weeks iv. Preparatory holidays and examination - 3 weeks v. Teaching hours in weeks - 43 weeks Total teaching hours - 43 weeks x 40 hours/week = 1720 hrs Second year (including internship) i. Total weeks - 52 weeks ii. Vacation - 4 weeks iii. Gazetted holiday - 2 weeks iv. Preparatory holidays and examination - 2 weeks v. Teaching hours in weeks - 44 weeks Total teaching hours - 44 weeks x 40 hours/week = 1760 hrs Admission terms and Conditions : 1. The minimum age for admission shall be 17 years on or before 31 st December of the year in which the admission is sought. 2. The maximum age for admission shall be 35 years. 3. The minimum educational requirement shall be the passing of 12 years of schooling (10+2 year course) recognized by CBSE/ICSE/SSSCE/HSCE or a recognized equivalent examination.

COURSE OF STUDY FIRST YEAR : NURSING COURSE CLASSROOM HOURS EXPERIENCE S.No Course title and Demonstration Total Hospital Community Total description i. Community health 120 50 170 10 100 110 nursing ii. Health Promotion 120 75 195 20 180 200 A. Nutrition 35 20 55 B. Human Body & 35 20 55 Hygiene. C. Environmental 20 15 35 Sanitation D. Mental Health 30 10 40 iii. Primary Health care 130 150 280 90 300 390 nursing I A. Infection and 25 20 45 immunization B. Communicable 40 25 65 Diseases. C. Community 30 50 80 health problems. D. Primary 20 20 40 medical care E. First aid and 25 35 60 referral. iv. Child Health Nursing 75 110 185 80 100 180 Total Hours 455 385 835 200 680 880 TOTAL = 1720 Hours

SECOND YEAR (First 6 months) NURSING COURSE CLASSROOM HOURS EXPERIENCE S.No. Course title and Demonstration Total Hospital Community Total description v. Midwifery 200 160 360 220 160 380 vi. Health Center 40 40 80 60 60 Management Total Hours 240 200 440 220 220 440 Total 880 Hours SECOND YEAR (Internship period) NURSING COURSE EXPERIENCE S.No. Course title and description Hospital Community Total i. Midwifery 240 240 480 Antenatal ward 40 Intranatal/labour 120 room Post natal ward 40 Neonatal care unit 40 II. Child Health 80 160 240 III. Community Health and 160 160 Health center management Total Hours 880 Total = 880 hours in the internship period Grand Total = 1760 hrs. Guidelines for internship : a. The ANM students (in a group of 4-5) should be posted in the sub center/primary health center with a regular ANM for one month/4 weeks for supervised independent practice in the community which should be residential. b. The students should participate in all the National Health and Family Welfare programs during their clinical experience. c. At least 80% of all the clinical requirements should be completed before appearing for the final (Second year) examination. d. The principal of the ANM school should certify for each student that she has undergone successfully the internship program, 100% clinical requirements and acquired the requisite competencies as listed in the syllabus before the award of the certificate/diploma by the state nursing councils/examination boards. e. The casebook and competency record book should be completed and signed by the competent authority of the school.

Scheme of Examination and practical examinations at the end of the first year Paper Course External Internal Duration Assessment Assessment Community Health 75 25 3 hrs Paper I Nursing Paper II Health Promotion 75 25 3 hrs Paper III Paper IV Practical I Primary Health Care 75 25 3 hrs Nursing Child Health Nursing 75 25 3 hrs Community Health Nursing and health promotion 100 100 Practical II Child health Nursing 100 100 Total 500 300 Grand total for first year 800 marks and practical examinations at the end of the Second year Paper Course External Internal Duration Assessment Assessment Midwifery 75 25 3 hrs Paper V Health Centre 75 25 3 hrs Paper VI Management Practical III Midwifery 100 100 Practical IV Primary health care and 100 100 health center management Total 350 250 Grand total for second year 600 marks Venue for Practical Examination : 1. Govt. District only (if the District Hospital is not having School or College of Nursing attached to the District Hospital) even then practical examination of 2 nd year ANM students should be conduct at District Hospital. 2. All the ANM Schools run by Government or Private Schools in the District, their examination should be conducted in district hospital. 3. If large number of private Schools exist in the District, proper planning and phasing to be done by examination board to cover all students.

Midwifery Expected competency Hospital Experiences Community Experiences Assessment Detecting pregnancy using Registration and and care of pregnancy testing kit. management of normal Registration of antenatal vital events pregnant mothers. registers. woman Pre conception counseling Conduct antenatal Measuring the blood examinations at pressure, pulse and fetal home heart rate, checking for Participate in pallor and edema and antenatal clinics determining the fundal in the sub center height, fetal lie and Malaria testing for presentation accurately. pregnant mothers. Hemoglobin estimation and testing urine for protein and sugar Conduct normal delivery Recognize different degrees of tears give emergency care and refer. Assessment and care of postnatal mothers and newborns Examine 20 antenatal women (in the hospital and Provide IFA supplements and administer TT injection to 10 women. Maintain midwifery case book Conduction pelvic assessment to determine pelvic adequacy. PV examination 5 Plotting the partograph and deciding when to refer the women. Conduction 10 safe deliveries (in the hospital and, with active management of the third stage of labour, using infection prevention practices, Assist in the suturing of 5 episiotomies and tears Provide essential care of the newborn 10 Basic resuscitation of the newborn 5 Managing/counseling on post-partum care and Counseling on birth preparedness, complication readiness, diet and rest, infant feeding, sex during pregnancy, domestic violence and contraception. Conduct deliveries in the community (health centers preferably and home) Follow up of 10 postnatal mothers for 10 days with at least 3 home visits. Care of newborns

Assessing and referring mothers at risk nutrition Counseling/supporting of mothers for breast feeding and preventing/managing breast feeding problems Counseling for kangaroo mother care Care of postnatal mothers 10 (in the hospital and Conduct health education for groups of mothers and individuals 3 each Follow infection prevention and biomedical waste management in the labour room and sub center Identify high-risk mothers and give care Prepare for caesarean sections -2 Observe caesarean section - 2 Observe abnormal deliveries 5 Prepare for MTP and observe procedure -2 Take care of women with abortion -2 Insert an intravenous line. Insert a urinary catheter in women Preparation and administration of magnesium sulphate injection. Preparation and administration of oxytocin drip. Bimanual compression of the uterus for the management of PPH Care of mother with HIV. Digital removal of retained products of conception for incomplete abortion. Provide post abortion care. at home -10 Conduct health education for groups of mothers and individuals -2 each Integrate the accepted practices of AYUSH Do a case study of complicated childbirth in the village Conduct a village meeting for emergency transport of women at risk Identify and refer women with unwanted pregnancy for MTP Interview any 10 women and list reasons for unsafe motherhood and abortion Identify high risk mothers 5 and newborns 5 and refer them to the higher center

Counsel eligible couples about different methods of contraception Prepare acceptors for sterilization and IUCDs Direction of cervical cancer Counseling of mother/couples for family planning. Prepare and assist for sterilization of 5 female and 2 male cases (in the hospital or Insertion of intra uterine devices and prescription of contraception of contraceptives. Perform 2 IUCD insertions (in the hospital or Distribute oral pills -5 Demonstrate the use of condoms and distribute condoms -5 Visual inspection of the cervix and taking a pap smear test -2 Counsel eligible couples on different methods of contraception Perform 2 IUCD insertions (in the hospital or Community) Distribute oral pills -5 Demonstrate the use of condoms and distribute condoms -5 Visual inspection of the cervix and taking a pap smear test -2

Clinical requirements to be completed during the internship period :- In addition to practicing and gaining competency in the above mentioned skills, the students are expected to complete the following requirements during the internship period : Expected competency Assessment and care of normal pregnant woman Conduct normal delivery Recognize different degrees of tears give emergency care and refer. Assessment and care of postnatal mothers and newborns Assessing and referring mother at risk Counsel eligible couples about different methods of contraception Prepare acceptors for sterilization and IUCDs Detection of cervical cancer Management of sick neonates and children (IMNCI) Hospital and community experiences Examine 15 antenatal women (in the hospital and Conducting pelvic assessment to determine pelvic adequacy. PV examination 5 Conducting 10 safe deliveries (in the hospital and, with active management of the third stage of labour, using infection prevention practices. Assist in the suturing of 5 episiotomies and tears Provide essential care of the newborn -10 Basic Resuscitation of the newborn -5 Care of postnatal mothers 10 (in the hospital and Take care of women with abortion -2 Prepare and assist for sterilization of 5 female and 2 male cases (in the hospital or Perform 3 IUCD insertions (in the hospital or Distribute oral pills -5 Demonstrate the use of condoms and distribute condoms -5 Assessment and care of 5 sick neonates and 5 sick children as per the IMNCI protocols.

Clinical requirements to be completed during the 2 nd year :- Competency 1 st 6 months of 2 nd Internship Total during 2 nd year year ANC 20 (hospital + 15 (Hospital + 35 (hospital + Community) Conducting normal 10 (Hospital + 10 (Hospital + 20 (Hospital + deliveries with community*) Community) AMTSL Assist suturing of 5 5 10 Episiotomy/tears Care of new born 10 10 20 Basic resusc. Of 5 5 10 normal new born P/V Examination 5 5 10 Postnatal cases 10 (hospital + 10 20 (hospital + Community) community ) Management of sick - 5+5 5+5 neonates and children (INCI) IUCD insertion 2 3 5