NURSING

REGULATORY
MECHANISMS
BY
M.SENTHIL KUMAR
MSC NURSING II YEAR
CHRI
INTRODUCTION
 REGULATION

 Regulation is "controlling human or

societal behavior by rules or restrictions.“
forms of Regulation :
 legal regulation: promulgated by a
government authority
 self-regulation : by an industry, institution
such as through a trade association, social
regulation e.g. norms
REGULATION INFLUENCES:

 Educational programmes and institutions

(approval, accreditation)

 Practitioners (registration, licensure,

certification)

 Practice (scope of practice)

 Health care agencies (accreditation,

approval)
PROFESSIONAL REGULATION
DEFINED
All of those legitimate and appropriate means –
governmental, professional and individual – where
by order, identity, consistency and control are
brought to a profession and its practice.
Styles & Affara for ICN. 1997
 OUTCOMES OF REGULATION

 Define the profession and its members.

 Determine the scope of practice.

 Set standards of education and for ethical,

competent practice.

 Establish some system of accountability.

 TYPES OF SYSTEMS

1. Regulation by the Government

Its focus tends to be on registering and licensing

nurses.

2. Regulation by the statutory bodies

 TYPES OF THE CREDENTIALING
MECHANISMS

Regulatory Mechanisms
 Licensure
 Accreditation
 Certification
 Education
 Registration
 REGULATORY MODEL
Regulation includes:
 Licensure
 The granting of authority to practice
 Accreditation
 Formal review and approval by a recognized agency of educational
degree or certification programs in nursing or nursing related
programs
 Certification
 The formal recognition of knowledge, skills and experience
demonstrated by the achievement of standards identified by the
profession
’
 Education

 The formal preparation in graduate or post-

graduate programs

 Registration

 Registration is the listing of an individual

name and other information on the official
roster of a governmental or non governmental
agency
 Nurse who are registered are permitted to
use the title “ registered nurse”
LICENSURE

The process by which an agency of

state government grants permission to
an individual to engage in a given
profession , upon finding that the
applicant has attained the essential
degree of competency necessary to
perform a unique scope of practice
TYPES

 Mandatory
 Anyone who practices nursing must
be licensed
 Permissive
 The title RN is reserved for licensed
but the practice of nursing is not
prohibited to others who are not
licensed or registered[canada]
MECHANISMS

 Two mechanisms
 Mutual recognition model
 Nurses can practice electronically
or in person across state lines
with one license
 Inter state compact
 Agreement between 2 or more
states to create mutual recognition
among the states
 ACCREDITATION

It refers to a voluntary review process of

educational programs by a professional
organization.

The organization is called an accrediting

agency which compares the educational
quality of the program with established
standard and criteria
NLNAC [National League for Nursing
Accrediting Commission]
Accreditation
PURPOSE
 to provide specialized accreditation for
programs of nursing education, both
postsecondary and higher degree,
which offer either a certificate, a
diploma, or a recognized professional
degree (clinical doctorate, master’s,
baccalaureate, associate, diploma,
and practical).
GOALS

 Promulgate a common core of standards

and criteria for the accreditation of
nursing programs.
 Strengthen educational quality
 Advocate self-regulation in nursing
education.
 Promote peer review.
 Foster educational equity, access,
opportunity, mobility
 BENEFITS OF ACCREDITATION

 enhance quality improvement in nursing

education.
 Provides recognition
 Assures professional development
opportunity and validation for faculty.
 Is a gateway to licensure, certification, and
eligibility for entitlement programs.
 Identifies areas needing development.
 Fosters ongoing self-examination, re-
evaluation, and focus on the future.
 Aids in student recruitment and
retention.
 Assists employers seeking graduates
who are competent nurses.
 Facilitates career and education
decision-making.
 Promotes professional and educational
mobility of program graduates.
CERTIFICATION

 The formal recognition of knowledge,

skills and experience demonstrated by
the achievement of standards
identified by the profession

 Certification programmes are

conducted by the American nurses
credentialing center and by specialty
nursing organizations
CERTIFICATION
Certification programs will:
 Follow established testing and psychometrically
sound, legally defensible standards
 Assess APRN core and role competencies across
at least one population focus
 Assess specialty competencies separately, if
appropriate
 Be accredited by a national certification
accreditation body
CERTIFICATION CONT.
Certification programs will:
 Enforce congruence between the education
program and the type of certification.
 Provide a mechanism to ensure ongoing
competence and certification maintenance.
 Participate in a mutually agreeable
mechanism
CERTIFICATION
PROGRAMME
EDUCATION

 Education
 The formal preparation in
graduate or post-graduate
programs
Education programs will:

 Follow established educational standards

 ensure attainment of core, role and population competencies.

 Be accredited.

 Be pre-approved, pre-accredited, or accredited prior to

accepting students.

 Ensure that graduates are eligible for national certification and

state licensure.

 Ensure that the transcript specifies the role and population focus.
REGISTRATION

 Registration is the listing of an

individual name and other information
on the official roster of a
governmental or non governmental
agency
 Nurse who are registered are
permitted to use the title “ registered
nurse’
 REGISTRATION IN INDIA
 REGISTRATION IN USA

 Eligibility criterion
 Registered general nurse
 Minimum one year of experience

 Eligibility exams
 CGFNS[centre for graduate foreign nursing school]
 NCLEX RN[National Council Licensure
Examination]
56
 English language
 The Test of English as a Foreign Language
(TOEFL),
 the Test of English for International
Communications (TOEIC)
 the International English Language Testing System
(IELTS)
 REGISTRATION IN CANADA

 Eligibility criterion
 B.sc nursing degree
 With at least 1 year of clinical experience

 Eligibility exams
 CRNE exam[twice a year=feb, june, oct]
 CRNE conducted by CNA
 IELTS
 REGISTRATION IN NEWZEALAND

 Eligibility criterion
 International nursing qualification
equivalent to that prescribed in
newzealand

 English language test

 IELTS
 OET
 REGISTRATION IN AUSTRALIA

 Eligibility criterion
 Certificate, diploma or degree
 Registration certificate from the
native country

 Eligibility exams
 OET=> over all pass must be
achieved
 REGISTRATION IN IRELAND

 Eligibility criterion
 Graduate nursing programme/
graduate midwife programme
 2 year of clinical experience

 English exam
 IELTS : 7 score
 REGISTRATION IN MALAYSIA

 Eligibility criterion
 Certificate in nursing
 Minimum 2 years of clinical experience
 Registered with nursing board in
respective countries

 English language
 IELTS: 6.5
 REGISTRATION IN SINGAPORE
RENEWAL / REPEAT
REGISTRATION
 In INDIA: recommended to renewal every 5 years

 Practiced in most of the developed countries

 Renewal of one’s license about every 2 years
with payment of fee each time
 Other places: granting renewal only when the
applicant has
 Worked for certain hours in last year
 Taken no of hours continuing education
 Passed in exam conducted by nursing
board
 BCLS certificate latest
21st century professional regulation

 Self-regulation (self governance)

 Public involvement in professional self-
regulation
 Mechanisms for international
communication
 Collaboration and coordinating
 Increased congruence and coherence
among regulatory systems
ICN & WHO 2005
INTERNATIONAL REGULATORY
CHALLENGES

 Agreeing on acceptable and feasible

criteria for mutual recognition
 Portability of qualifications
 Providing evidence about
competence, qualifications and the
fitness of nurses
SUMMARY &
CONCLUSION
THANK YOU