The Union health ministry has launched a postgraduate programme for nurses titled ‘Nurse Practitioner in Critical Care’ which will prepare registered BSc nurses for advanced practice roles as clinical experts, managers, educators and consultants leading to MSc degree in Critical Care. The ministry has now issued the draft curriculum for the course.
After the completion of the course, the ‘Nurse Practitioners’ (NPs) will be able to provide cost effective, competent, safe and quality driven specialized nursing care to patients in a variety of settings in tertiary care centres.
The NP programme is a nursing residency programme 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.
The special feature of this programme is that it is a clinical residency programme emphasizing a strong clinical component with 20 per cent of theoretical instruction including skill lab and 80 per cent of clinical experience. Competency based training is the major approach and NP education is based on competencies adapted from International Council of Nurses (ICN, 2005), and NONPF competencies (2012).
The programme is intended to prepare registered BSc nurses to provide advanced nursing care to adults who are critically ill. The nursing care is focused on stabilising patients’ condition, minimising acute complications and maximising restoration of health. These NPs are required to practice in tertiary care centers. The programme consists of various courses 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 bachelor’s programme in nursing.
When authorised by the nursing regulatory council/s, state or national laws, they may prescribe drugs, medical equipment and therapies. The NPs in CC when exercising prescriptive authority or drug administration as per institutional protocols, they are accountable for the competency in patient selection/admission into ICU and discharge; problem identification through appropriate assessment; selection/administration of medication or devices or therapies; patients’ education for use of therapeutics; knowledge of interactions of therapeutics, if any; evaluation of outcomes; and recognition and management of complications and untoward reactions.
The health ministry’s initiative in this regard is significant as in India, reshaping health systems in all dimensions of health have been recognised as an important need in the National Health Policy, 2015. It emphasises human resource development in the areas of education and training alongside regulation and legislation. The government recognises significant expansion in tertiary care services both in public and private health sectors. In building their capacity, it is highly significant that the healthcare professionals require advanced educational preparation in specialty and super-specialty services.
To support specialized and super-specialized healthcare services, specialist nurses with advanced preparation are essential.
On completion of the programme, the NP will be able to assume responsibility and accountability to provide competent care to critically ill patients and appropriate family care in tertiary care centres; demonstrate clinical competence/expertise in providing critical care which includes diagnostic reasoning, complex monitoring and therapies; apply theoretical, patho-physiological and pharmacological principles and evidence base in implementing therapies/interventions in critical care; identify the critical conditions and carry out interventions to stabilise and restore patient’s health and minimise or manage complications; and collaborate with other health care professionals in the critical care team, across the continuum of critical care.