PAKISTAN NURSING COUNCIL ISLAMABAD

ANNUAL RETURN FORM

FOR PUBLIC HEALTH NURSING SCHOOL
1. Name of Institution: 2. Full Postal Address 3. Telephone No ______________ 4. Date of Establishment: __________
Pro. Govt. q Autonomous q Armed Forces q Private q

5. Type of institution: Fed Govt. q

6. Type of programme offered 7

_________

Others (Specify) _________

Infrastructure of Institute as prescribed by PNC rules and regulations Number 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 7.10 7.11 7.12 7.13 7.14 7.15 Office of Principal Office of Vice-Principal Offices of the faculty members Office of the Ministerial Staff Lecture Hall Demonstration Room / skill lab Audio-Visual Room Auditorium Science Laboratory Computer lab English language lab Library Tuck shop/cafeteria Lavatory Faculty meeting room Capacity to accommodate Furniture /Fixtures

(Attach the list of furniture) 8. There is a separate budget for PHNS 8.1 Attach last year budget (and expenditure) 8.2 Name of Drawing and disbursing Officer q Yes q No

9. Transportation 9.1 Is vehicle available for Principal and teaching staff for official use 9.2 Is vehicle available for students qVehicles are from central pool q Vehicles belong to School 10. Components of Curriculum 10.1Philosophy/mission 10.2Program goals 10.3Learning Outcome - Level and terminal objectives 11. Programme overview

q Yes q No q Yes q No q other source

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11.1Course sequence: list courses taught in each year 11.2 Course descriptions, objectives, outlines (make available at time of inspection) 11.3 Teaching learning strategies: (course plans, class schedules, lesson plans, and assignments) 11.4 Formative and summative assessments of students. 12. Quantity and quality of faculty members. Please fill the attached Performa of teaching staff. Faculty development plan: provide list of faculty on study leave Continuing education session provide list of faculty and session taught Teaching Staff S.No Designation 12.1 12.2 12.3 12.4 12.5 12.6 12.7 12.8 12.9 12.10 Principal Vice Principals WMO Nursing Instructors Clinical Instructor Public health Nurse Supervisor Midwifery Supervisor Lady Health Visitors Dais English Teacher ( M A Eng) Part Time Monthly 13.1 13.2 How are the lecturers paid? How much they are paid? Rs._________ Rs.________ Per Lecture BPS Sanction Post Filled Vacant Reg No Remarks

13. Remuneration of lecturers (Part timer)

14. Ministerial staff required for the school: S.# 14.1 14.2 14.3 14.4 14.5 Designation Office Supdt. Assistant Computer operator Senior clerk Junior clerk BPS Sanctioned Post Filled Vacant Remarks

15. Learning Resources, please provide the list of the following: e.g. library, text books, relevant books, reference books, and journals, audio visual aids such as models charts, equipment and mannequins , Internet Facilities available

16. Academic calendar

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17.1 17.2

Term and or semester systems? Class schedule copy Allocated hours for each course and classes taught.

17. Academic policies 17.1 Provide examination record of the current year of students

18. Evaluation criteria for programme, courses, faculty and clinical facilities
18.1 Provide examples of filled evaluation forms. 19. Information management System Record keeping of incoming students, analysis of trends and statistics Examinations and progress of students transcripts 19.1 19.2 19.3 19.4 Attendance Register Academic Record Clinical Record Health Record q Yes q No q Yes q No q Yes q No q Yes q No

20. Statistical Data of students for last 3 years: Statistics Yr. 200 P 20.1 20.2 20.3 Admitted in last 3 years Passed in PTS First year Examination (NEB) Final Year Examination(NEB 21. Selection of the Students: 21.1 21.2 21.3 21.4 21.5 21.6 Age of entry in years: Minimum Maximum Number of sanctioned seats Number of students in training Annual Intake _____________ F D Number of students Yr. 200 P F D Yr. 200 P F D

_____________ _____________

(a) (b) (c) (d) (e)

22. Selection Committee: 22.1 Composition of selection Committee _________________________________ _________________________________ _________________________________ _________________________________ _________________________________ 22.2 Mode of Selection: a. Merit b. Written Test c. Interview q Yes q No q Yes q No q Yes q No ______________

22.3 Which month does the introductory (P.T.S.) period begin? 22.4 Length of introductory (PTS) training period?

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23. Existence of Committees: 23.1 23.2 23.3 23.4 23.5 23.6 Academic Committee Selection Committee Discipline Committee Mess Committee Social/Recreation Committee Others, please specify q Yes q Yes q Yes q Yes q Yes q Yes q No q No q No q No q No q No

(NOTE: Evidence of activities and minutes of the meeting of above mentioned committees to be attached) 24. Teaching Program of institute: 24.1 Are conferences /meetings held regularly between? 24.1.1 Teaching staff and students (Pre & Post) q Yes 24.1.2 Nursing staff and students q yes 24.1.3 Nursing Staff and Teaching Staff q Yes 24.2 Medical Staff give clinical teaching to students q Yes 24.3 How many hours per week students spend time in learning in the hospital? NOTE: Schedule of Instructors for clinical supervision/Teaching (Attach Copy) 25. Field Visits: Students are taken for field visits according to prescribed curriculum (Attach the list of sites) 26. Clinical Experience for midwifery: 26.1. Does the hospital meet the required basic criteria as prescribed by PNC? 26.2. Is the school affiliated with one or more hospitals? If so: 26.2.1 Name of hospital 26.2.2Clinical area utilized for learning experience by the students 26.2.3 Size of the unit 26.2.4 Are any of the units of the hospital/institution under inspection being used by other hospitals/institutions for gaining experience? If so, please give brief details: 27. Number of beds: Total No. of Non-paying beds 28 Beds Allocation: Sanctioned Beds Average occupancy last month Female Children No. of Paying beds q Yes q No

q No q No q No q No

28.1 28.2 28.3 28.4 28.5 28.6 28.7

Pre-natal Labour Post Natal Gynae Isolation Eclampsia Nursery a. Normal b. Sick babies c. Isolation babies

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28.8 a b 28.9

Deliveries Last month Last year Out-Patients Dept. 28.9.1. Pre-Natal 28.9.2. Post Natal 28.9.3. Gynae 28.9.4 Obs 28.9.5. Immunization 28.9.6. Infertility 28.9.7. Family Planning

Normal

Forceps/Vacu um

Caesarian

Daily average

Monthly average

Yearly

29.

Operation Theatres
29.1 29.2 General Theatres for (Obstetric Surgery General Theatres for (Gynae Surgery)

Daily Number

No. of operations performed during last year __________________ __________________

30. Arrangement for domiciliary services/training (attach annexure) 30.1 # domiciliary case in community 30.2 visit report by Midwife. 30.3 Antenatal cases 30.4 Primigravida cases. 30.5 Multigravida 30.6 Hospital confinement 30.7 Home deliveries Postnatal visit Record New born EPI status Broken Shift Straight
31.1 31.2 Trained Staff Nurse patient ratio

30.8 30.9
31.

Present hours of duty

32. Clinical experience available: with attached MCH centre A) Physical facilities of MCH Offices Doctor office (WMO) Nursing Supth LHVs Domiciliary Mid-supervisor Dispensary Sitting area for mother & children Well baby clinic, Labour/examination room Vaccination room, Lab, Dai training room yes no

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Family planning Record room Lavatory for staff /patient Optional day care nursery with lavatory for infant, toddles
Each MCH centre should Target population 25000 to 30000

b) Function of MCH center MCH Normal deliveries Community Health Services Schedule of post natal visits Activities of LHV during post natal cases Observation within 72 hours bleeding Management of breast feeding Follow up postnatal visit Immunization (campaign) Feeding/ cord care teaching Advise for diet of mother Advise on birth spacing Family planning Early ambulation and Post Natal exercises Record of Maternal, Neonatal, infant, mortality cases 33. Transport for community services available for student and staff for 24hrs
qYes q No

Community

34.

Student residence:
34.1 Accommodation: In hostel 34.1.1 34.1.2 34.1.3 34.1.4 34.1.5 34.1.6 34.1.7 34.1.8 34.1.9 34.1.10 Total number of students living How many share a room? (Approx. size How many share a bath room? Is there a student common room Is there a student dinning room is there a students visitors room What are the visiting days Are there adequate recreational facilities available Are there adequate recreational equipment facilities Are the living conditions Out of hostel

yes yes

no no

satisfactory

poor

34.2 what is the distance between the hospital and the hostel 35.

Accommodation for Single female teaching staff:

35.1 Is there hostel accommodation available? 35.2 Is it furnished according to the list furnished by PNC? q Yes q Yes q No q No

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36.

Accommodation for the married Nursing staff

36.1 36.2 36.3 36.4 How many houses are allocated for Nursing Faculty? How many actually living? Is official transport available? Is accommodation provided according to the grades?

q Yes

q No

37.

Furnished Accommodation & Services:

Is free furnished accommodation with free electricity, gas and water as well as free services of servants being provided to the Student who is living in the hostel?

38.

Annexure required to be attached: 1. List of Nursing Personnel in clinical area

2. 3. 4. 5. Rules & Regulations for the hostel Sample Menu for a week. Blank student health record card. Weekly class schedules of students of all classes. Formal teaching hours. schedule

6.

Name of the Principal:

Signature

of Principal

OFFICIAL STAMP

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Performa of Nursing Faculty Members

S. # Name Designation Reg No Qualification

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