BACHELOR OF SCIENCE IN NURSING

PROGRAMME
BACKGROUND AND GOAL

PY
Revolution in modern information technology and science has made the
world a smaller place with all countries within easy reach. The western
developed countries have massively capitalized on the new advances
of science and technology and have improved the socio-economic and
the quality of life of their people to a great extent that is inconceivable
in the developing countries. Access to quality education, health care
services, quality food, shelter and social security with the provision of

CO
all the necessary services, have become the essential needs of the
common people in the developed countries whereas the very essential
need have become the exclusive privileges of the wealthy and affluent
class in most of the developing countries. Access to quality health
education and services as more than any other factor, significantly
improved the quality of life in the western world. The improvement in
the quality of life has stemmed from a substantial public and private
sectors investment on health education and services over a long period
of time. It is universally recognized that until and unless a country can
T
produce the high quality and adequate human health manpower at
various levels needed by the country, it is inconceivable to bring the
intended qualitative improvement in the health sector. The production
of high quality human resources in health sector at various levels must
AF

be based on the need and priority of the country.

The Government of Nepal, Ministry of Health and Population has

committed itself to raise the health status of the people of Nepal by
pursuing the strategy of Primary Health Care in order to realize the
objectives of Health for All which call for inter sectorial coordination as
well as active community participation. It is in this context that effective
DR

dissemination of relevant, sound and feasible nursing and public health

measures are necessary in order to increase individual and community
capabilities for active involvement and self reliance in health sectors
that will promote healthy behavior in regard to disease prevention
and control. Thus it has become essential through understanding of
all relevant branches of health science with special emphasis on the
most appropriate nursing health measures which are necessary for
promoting individual, institutional and community involvement.

Nepal faces a major challenge in providing even the basic health

care services to its population. The main limiting factor in meeting this

-1-
challenge is the severe lack of health workers at various levels i.e.
junior, medium and higher levels. A large number of junior and medium
level nursing and public health workers are needed to deliver the basic
health services to the people at various levels (community, district,
regional and national). The present rate of the production of nursing

PY
bachelors relating to the need of the country is so small that it may take
many decades to meet the present demand of the country.

The country’s health situation and indicators of health reveals that the
production of professional nursing graduates at various levels need to
be carefully planned and accelerated in regard to the needs of such
manpower to provide essential promotive, preventive, curative and
rehabilitative quality care services that will ensure every body’s access

CO
to health and realize Alma Ata Declaration of which Nepal is a signatory.
Purbanchal University envisages contributing towards the noble goal of
providing quality health services and improving people’s health through
the production of nursing professionals and graduates required by the
country through its several affiliated colleges.

PURPOSES

The bachelor in nursing program (B.Sc.) aims to prepare competent

T
professional nurses in education, administration and services
in respective level of health programs, which includes problem
identification, planning, implementing and evaluating. Such graduates
can serve in various types of positions at national, regional, zonal,
AF

district and local levels. Such graduates will be needed in various kinds
of governmental or nongovernmental health agencies, communities,
hospitals, schools, campuses and institutions. Other areas may involve
special responsibilities e.g. working directly with local communities
and individuals, working primarily with school teachers, administrative,
health education services and preparing health workers in nursing
fields. In general, B.Sc. nursing graduates will be able to carry out the
DR

responsibilities of various health institutions as a nursing officer/faculty/

basic level researcher and care provider.

PHILOSOPHY

The graduate in nurses will be thoroughly acquainted with the

present trends, advanced technology in health care system,
changing concepts of life style pattern and the expanding role
and responsibilities of nurse midwife in providing health services.
Each individual is unique bio-psychological and spiritual being with
capacity to think and adopt towards wholeness/comprehensive
-2-
 approach.
Environment conducive to learning can be adopted
The prevention of illness, promotion of health, care of sick and
rehabilitation are the responsibilities of individual, group, family,
community and nation.

PY
Nursing is a dynamic process, which focuses on need based,
problem solving and decision making in all nursing care activities
by emphasizing on nursing process.
Each learner has the capacity to change if encouraged and
guided towards positive health practices and the self directed
learning.
Leadership in nursing is to have a clear vision of institutional and

CO
national goal which demonstrate problem solving and decision
making at all levels of health care system.

OBJECTIVES OF THE PROGRAM

General objectives
The general objective of the B.Sc. nursing program is to produce
competent graduates basic with advanced knowledge and practical
skills necessary to deliver high quality health services needed for the
T
country. Especially, the program entails the following general objectives:

Provide basic and advanced knowledge and practical skills in

nursing science covering Primary Health Care.
AF

Develop skills in health system research and management

Equip nursing professionals with communication and group
organization skills for promoting community participation in health
and development activities ultimately leading to the individual
and community self reliance in obtaining health services and
improvement in health status.
DR

Management issues, concerns and problems.

Enable nursing health professionals to deal with the existing
realities in health Foster positive attitude of health professionals
to encourage them for providing accessible and equitable nursing
services for disadvantaged groups and communities.
Develop the leadership capabilities of nursing professionals in the
management of nursing services at various levels of health programs.
Enhance the vocational competence of nursing professionals
through advanced education in health strategies, health
promotion and health programming.

-3-
 Prepare professionals to be creative innovative in preventive,
promotive, curative and rehabilitative aspect of care according to
scientific advancement and the trend of the day.
Enhance competence in teaching learning process as self
directed learner.

PY
Specific Objectives
Upon the completion of four years Bachelor of Science in Nursing
course, the graduates will be able to achieve the following objectives:

Communicate effectively with individual, group, family, community

and society.

CO
Apply the knowledge of nursing process for providing quality
nursing care and service using the principle of basic science and
concepts of social and behavior sciences.
Identify the socio cultural and economical status, which affects
the health and development of the clients and the society.
Apply the knowledge and principles of Family Reproductive
Health (FRH) and Comprehensive Primary Health Care (CPHC)
in planning, programming, supervision, monitoring and evaluating
process for promotion and maintenance of the client’s health.
T
Make appropriate decision in all activities by critical analysis to
bring suitable changes in their work environment.
Demonstrate effective teaching learning skill in formal and
AF

nonformal educational activities in different settings.

Mobilize the necessary and available resources in appropriate manner.
Identify need based simple researchable problems and conduct
research on it.
Recognize the importance of personal and professional goal,
growth and development.
DR

Apply the epidemiological concept and principles in order to

solve individual, family and community health problems.
Utilize the principles and concepts of nursing foundations theories
and models in providing nursing and midwifery services.
Recognize mental health conditions and provide holistic care to
the clients.
Provide effective care and services to the client in preventive,
promotive, curative and rehabilitative aspect of care throughout
the life span.
Perform the care competency of SBA.

-4-
Conceptual Framework

The conceptual framework provides the structure in the curriculum

and is based on theory to guide the B.Sc. nursing program to prepare
competent nurse midwife with advanced knowledge, competent skill

PY
and positive attitude in the areas of hospital, midwifery, nursing and
community health nursing.

At the B.Sc. level the major focus is placed on family, reproductive

health, midwifery, hospital and community health nursing, which
prepares competent nurse midwives who will be capable leaders in
different capacities as educator, manager, researcher, care provider
and change agent in the society to promote healthy life style throughout

CO
the life span of a person. Throughout the curriculum the nursing process
is integrated for the provision of quality nursing care/management of an
individual, group, family and community.
T
AF
DR

-5-
Duration of the course

This course has been designed for four academic years Bachelor in
Nursing Science.

PY
Admission Criteria:

Candidate must have completed intermediate science or 10+2

or equivalent with biology, chemistry, physic, math and English
as main subjects and should have secured minimum of 50% of
mark in aggregate.
Physically and mentally fit

CO
Must have completed 17 years of age

Entrance Examination

There will be entrance examination of one paper (English 50 mark

and hundred mark of nursing science related/health science related
major subject area). The question will be of multiple choice. Duration
of examination will be 3 hours. Candidates must obtain at least 50%
marks to pass entrance examination. Candidates will be selected from
obtained mark within descending order.
T
Commencement of the course
AF

According to Purbanchal University operation calendar (tentatively

from Mangsir)

TEACHING LEARNING METHODS

Various methods of teaching learning will be used in participatory

approach. Lecture, discussion, group discussion, demonstration,
DR

self directed learning, problem based learning observation, practical,

written assignments, project work, term paper, group presentation as
per need of the subject taught.

Formative Evaluation

Theory subjects
Internal assessment 20%
a) Class test
b) Project work
c) Written assignment/presentation

-6-
Clinical subject practicum
Internal assessment 50%
a) Performance evaluation
b) Case study/presentation
c) Client teaching/classroom teaching

PY
d) Project work presentation
e) Report presentation

Summative evaluation (Final evaluation)

Final written examination
Short answer and essay questions final evaluation weightage 80%
OSPE/EVALUATION/ PRACTICUM/OSCE Viva 50%
20 20 10 =50

CO
OVERVIEW OF BACHELOR SCIENCE IN NURSING (BSN)
PROGRAMME

BSN: First Year Subject and Hours/Cr Distribution

Course Hours
S.N. Course Title Marks
Code Theory Practical
1 BSN101 Anatomy and physiology 120 80 100
2 BSN102 Biochemistry 50 30 50
T
3 BSN 103 Microbiology/Parasitology 50 30 50
4 BSN104 Pathophysiology 50 30 50
5 BSN105 Pharmacology 50 30 50
AF

6 BSN 106 Nutrition and Dietetics 60 60 50

7 BSN107 Foundation of nursing 150 420 100+100
Community health
8 BSN108 100 200 100+100
nursing I
Total 630 880 750

Note: Practicum 6 hours/day, theory 7 hours/day/12 hrs/night

DR

-7-
BSN: Second Year
Course Hours
S.N. Course Title Marks
Code Theory Practical
Nursing concepts and
1 BSN 201 100 - 100
theory

PY
Medical Surgical
2 BSN 202 150 300 100+100
Nursing I
Medical Surgical
Nursing II (EENT, OT,
3 BSN 203 100 300 100+100
Oncho, Emergency
Nursing)

CO
4 BSN204 Mental health nursing 100 200 100+100
Community health
5 BSN205 100 200 100+100
nursing II
Medical sociology/
6 BSN 206 100 - 100
Anthropology
Total 650 1000 1000

Note: theory 7 hours/day, practicum 6 hours/day/12 hrs/night

BSN: Third Year

T
Course Hours
S.N. Course Title Marks
Code Theory Practical
1 BSN301 Child health nursing 100 180 100+100
AF

Obstetric nursing I
2 BSN302 100 200 100+100
( Midwifery)
Obstetric nursing II
3 BSN 303 100 200 100+100
(Midwifery)
Obstetric nursing III
4 BSN304 100 200 100+100
(Postnatal & Gynae)
DR

Community health
5 BSN305 100 200 100+100
nursing III
6 BSN 306 Basic Epidemiology 60 - 50
Total 560 980 1050

Note: Theory 7 hours/day, practicum 6 hours/day -M E, 12 hour/day -

Night

-8-
BSN: Fourth Year
Code Hours
S.N. Course Title Marks
No. Theory Practical
Nursing research &
1 BSN 401 120 300 100+100
Biostatistics

PY
2 BSN 402 Educational Science 100 300 100+100
Leadership &
3 BSN 403 100 300 100+100
management
Medical Surgical Nursing
4 BSN 404 300 100
(Advance practice)
Total 320 1200 700

CO
T
AF
DR

-9-
 Course Title: Anatomy and
Physiology
Placement : First Year
Total Hour: 120 Full Mark: 100

PY
Course Code: BSN 101 Pass Mark: 50

COURSE DESCRIPTION

This course has been designed to acquire basic concept and knowledge
on human anatomy and physiology of different systems of human body,
which will enable them to apply the knowledge while providing nursing

CO
care to the clients.

COURSE OBJECTIVES

Upon successful completion of this course, the students will be able to:

Distinguish between anatomy and physiology, explain the body

as a whole and different system of human body.
Explain anatomical position of the body, organs, and cavities.
T
Describe the structure and functions of the cells, its characteristic,
reproductive cellular genetics, and differences between normal
cell and cancer cells.
Discuss the various types of tissues their characteristics and
AF

functions.
Explain the anatomy and physiology of skeletal system including
joints, cartilage, ligaments tendon and age related changes.
Describe muscular system, its types, and principles of muscular
system its anatomy and physiology.
Explain the structure, location, and function of spleen.
DR

Discuss the structure of upper respiratory tract, bronchial tree,

lungs and alveoli and function of respiration including pulmonary
ventilation.
Explain structure and function of digestion in the mouth, stomach,
small intestine and large intestine.
Explain structure, location, and function of female and male
reproductive organs
Discuss embryology.
Explain anatomy and physiology of central nervous system and
peripheral nervous system.
- 10 -
 State internal and external structure location and function of
vision, hearing and taste.
Discuss circulatory system including blood, structure of the
heart, blood supply, blood vessels, conduction system and their
functions including blood pressure.

PY
Describe the organs related to the lymphatic system their
structure functions, and immune response.
Discuss the structure location and function of kidney, nephron,
ureter, bladder and urethra.
Explain fluid and electrolyte balance in the body and acid base
balance.
Discuss structure and function of endocrine system.

COURSE CONTENTS CO
Discuss structure and function of integumentary (skin) system.

UNIT I: Body as whole: organization of the human body cell. 6hrs

Chemical constituent of cells,
Structure of the cell
Physiology of the cell
T
Cell reproduction (Mitosis/Miosis)
Cellular genetics
AF

UNIT II: Human tissues, and its types: 8hrs

Epithelial tissue, connective tissues
Muscle, and nervous tissue, and its types
Transplant
Characteristics, location, function and formation of tissues
DR

Tissue repair, membranes gland

Classification and structures

UNIT II: Skeletal system 12hrs

Composition of bone, bone cells
Organization of skeletal system
Bone types, structure, formation and growth, axial skeleton,
appendicular
Skeleton membranes of bone

- 11 -
 Description and function of bone
Joints classification
Regulation of bone formation and growth by vitamins and
hormones

PY
UNIT III: The muscular system: 12hrs
Skeletal muscle: anatomy of muscle and mechanism of
contraction
Transmission of the electrical impulses to the sarcoplasmic
reticulum
Energy sources for skeletal muscle contraction

CO
Muscle tone/physiology of muscle contraction, lever, and
maintenance of posture
Smooth muscle/cardiac muscle

UNIT IV: Respiratory system 12hrs

Structure and function of organs of respiration (alveoli)
Physiology of respiration, vital capacity, tidal volume FEC, FIC, RV.
Mechanism of respiration, exchange of gases in the lungs,
T
pulmonary ventilation
Respiratory problems
AF

UNIT V: Digestive System 10hrs

Structure and movements of alimentary tract.
Function of different glands involved in digestion i.e. liver, spleen
and pancreas,
Composition of food, digestion in the mouth, stomach, small
intestine large intestine, absorption of food.
DR

Metabolism of protein, carbohydrate, and fat.

UNIT VI: The Excretory system: 8hrs

The structure and function of kidneys, nephron, ureters, urinary
bladder and urethra composition of urine, and mechanism of
urine formation

UNIT VII: The reproductive system: 12hrs

Spermatogenesis

- 12 -
 Ogenesis, structure, and function of female reproductive organs,
Structure and function of breast
Female sexual cycles - Physiology of menstruation
Introduction of embryology

PY
Structure and function of male reproductive organs
Male reproductive organs, function in reproduction, and fertility

UNIT VIII: Nervous system: 15hrs

Structure and function of
o Central nervous system

CO
o Peripheral nervous system
o Neuralgia and neurons, brain and spinal cord.
o Nerve fiber and nerves.
o Cranial and spinal nerve, location and function
o Stimulus and nerve impulse
o Definition and mechanism
o Reflex arc, reflex action and reflexes
o The autonomic nervous system
o Structure, location autonomic function
T
UNIT IX: Sense organ: -Eye 6hrs
Somatic, visceral and referred pain
AF

External and internal structure of the eye

Accommodation, physiology of vision
Binocular vision

UNIT X: Auditory sense: 6hrs

DR

Structure of the ear, external, middle, inner, physiology of hearing

and equilibrium
Olfactory sense organs, gustatory sense

UNIT XI: Skins: 6hrs

Hair, nail, glands,
Function of skin
Temperature regulation

- 13 -
UNIT XII: Circulatory system: 18hrs
Blood microscopic structure, formation, composition, and
function (Haematopoiesis, RBC, WBC, Platelets) blood grouping
ABO, RH factor
Clotting factors, Mechanism of coagulation

PY
Systemic and pulmonary circulation
Heart structure, conduction system and functions. Cardiac cycle,
cardiac out put
Pericardium, wall, chamber, valves, blood supply)
Heart beat, ECG,
Structure of blood vessels, arteries, veins, circulation principles,

CO
control, factors influencing, blood pressure and pulse

UNIT XIII: Lymphatic system and spleen:

Component of lymphatic system and lymph flow
Function of lymphatic system
6hrs

Immune response

UNIT XIV: Endocrine System 10hrs

T
Structure and functions
o Pituitary gland
o Hypothalamus
AF

o Parathyroid
o Thyroid
o Adrenal gland
o Pancreatic islets
o Pineal gland
o Thymus gland
DR

UNIT XV: Fluid and Electrolytes: 5hrs

Intracellular, extra cellular, interstitial
Fluid loss, fluid gain,

TEACHING LEARNING ACTIVITIES

METHODS: Faculty and students in participation

Lectures

- 14 -
 Discussion
Demonstration
Project work
Presentation

PY
MEDIA
White board
OHP
Posters, charts and models
Skeleton

CO
CD, video cassettes
LCD system
Organ Specimen

EVALUATION
Class test
Assignment
T
REFERENCES

1. Stanley W. Jacob.
AF

2. Clarice AF Walter J. Lossow, Pl + D, structure and function in man,

latest Ed. 1978 Ed, WB Saunders Company Philadelphia, London
Toronto latest edition.
3. JH. Green, Basic clinical physiology, 3rd Ed., Oxford University
Press, New York.
4. Arnold Edward, Sears Anatomy and Physiology for Nurses, 1998,
6th Edition, Jaypee Brothers.
DR

5. Wilson and Ross, Anatomy and Physiology, 2000. 8th Edition,

Churchill Livingstone
6. Ross and Wilson, Anatomy and Physiology in Health and Illness,
2001, 9th Edition, London.
7. Chatterjee C.C., Human Physiology, Vol. I, II, 1997, 10th Edition,
Calcutta, India.
8. Guyton A.C., Text Book of Medical Physiology, 2000. 10th Edition,
W.B., Saunders.
9. Pearce E.C., Anatomy and Physiology for Nurse, 1997, 1st Edition
- 15 -
 J.P., New Delhi.
10. Gupta, Anatomy and Physiology for Nurses, 2004, 1st AITBS
Publication.
11. Thomas Mc Cracker Richard Walker, New Atlas of Human

PY
Anatomy, 1999, 1st Edition, Lustree Press, Roli Books.
12. Wilson, K. Ross and Wilson Foundations of Anatomy and
Physiology, English Language Book Society.
13. Winwood, R.S. Sera's Anatomy and Physiology for Nurses English
Language Book Society.
14. Latest Edition

CO
15. Recent Edition to be used
T
AF
DR

- 16 -
 Anatomy and Physiology Practicum
Placement : First Year
Total Hour: 80 Full Mark:
Course Code: BSN 101 Pass Mark:

PY
COURSE DESCRIPTION

Lab experiences will take place during exposure in the laboratory

practical demonstration will be carried out during study block according
to assigned practicum hour of each courses i.e. Anatomy and Physiology

CO
Anatomy

Gross anatomy practical – demonstration of specimen, organs,

models or charts according to the human system approach.
Histology practical – demonstration of specimen according to the
human system approach.
Introduction and uses of laboratory specimens.

Physiology
T
Introduction and uses of laboratory specimens
Collection of blood and study of haemocytometer
Haemoglobinometry, determination of specific gravity of blood
AF

RBC, WBC (total and differential) and platelet counts, ESR, PCV
Osmotic fragility test, haemin crystals
Determination of blood groups
Calculation of blood indices
Determination of bleeding time and clotting time
DR

Semen analysis
Spirometry lung function test
Blood pressure measurement, CPR, ECG
Physiological examination of sensory system, moter system,
reflexes
Examination of cranial nerves
Visual activity, field of vision, colour vision
Test of hearing – Rinne's test, Weber's test, Reaction time.

- 17 -
 Course Title: Biochemistry
Placement: First Year
Hour: 50 Full marks: 50
Course Code: BSN 102 Pass mark: 25

PY
COURSE DESCRIPTION

This biochemistry course gives the knowledge, concept and its

application in the human body system.

COURSE OBJECTIVES

CO
Explain the basic concept of biochemistry
Describe the types and properties of solution, physiological
application of osmosis and difusion.
Explain the theory of electrolyte the human and buffer system in
body, pH and their clinical importance (use), acid base balance
in the body.
Explain the importance and properties of gases (02, C02) and
their effect
T
Discuss the uses and properties of anesthetic gases etc
List the characteristics classification and uses of organic
compounds.
AF

Discuss the composition, classification, Occurrence, and

metabolism of carbohydrate, lipid, protein, enzyme and mineral
Discuss the metabolism of carbohydrates, fats, and proteins.
Explain about the chemistry of nucleic acid and their biological
role.
Explain classification, sources, and action of the hormones in the
body.
DR

Explain vitamins & minerals their classification daily requirements

and their clinical significance.

COURSE CONTENTS

UNIT I: Introduction 2 hours

Definition, Scope and importance of biochemistry in health
sciences.
Types of solution

- 18 -
 o Normal solution
o Molar solution
o Percentage solution
o Osmosis
Diffusion

PY
o

Components of biochemical system

Concepts of acid/ base/ salt, Acid Base indicator
Buffer solution, Types of buffer present in body fluids.

Unit II: Biomolecules 12hrs

occurrence

Protein:- definition,
occurrence
CO
Carbohydrate:- definition, Classification, composition, Function and

Classification, composition, Function and

Essential & Non-essential amino acids and their significance.

Lipid:- definition, Classification, composition, Function and occurrence

T
Nucleic Acid:- Definition, Composition, types and importance

Unit III: Enzymes 6hrs

AF

Definition, Classification, Factors affecting enzymatic activity, Co-

enzymes, Iosenzymes, Clinical significance of Enzymes (AST, ALT,
CPK, CPK-MB, Amylase, Lipase, ALP, GGT, LDH)

Unit IV: Vitamins and Minerals 5hrs

Vitamins:- Definition, Classification, Daily requirements in Diet, Clinical
significance
DR

Mineral:- Micro and Macro mineral, Essential and Nonessential

minerals, Trace elements

Unit V: Hormones 5hrs

Definition, Classifications, Source, Mode of action,
Clinical significance of Thyroid Hormones,
Hormones of Adrenal cortex,
Hormones of reproductive system
Hormones involved in Calcium Phosphate Homeostasis
- 19 -
Unit VI: Intermediary Metabolism of Carbohydrate, Protein and
Lipid. 4 hours
Carbohydrate: - General concept of Metabolism, Glycolysis, TCA cycle,
Glycogenolysis , Glycogenesis, HMP Shunt, Blood sugar Homeostasis,
Diabetes Mellitus

PY
Lipid: - Oxidation of fatty acid(β-oxidation),and Ketone bodies

Protein:- Transamination, Deamination, Decarboxylation and Urea cycle.

UNIT VII: Gases in biochemical system 2 hours

Oxygen:- Importance and properties; oxidation and reduction.
Transportation of oxygen.

CO
Unit VIII: Blood Coagulation mechanism (Coagulation Factors,
Intrinsic and Extrinsic pathways)
Unit-IX Organ Function Test
2hrs
4hrs
Liver function test (Bilirubin, ALT, AST, ALP, and GGT).
Renal function tests (Urea, Creatinine, Na+ and K+)
Pancreas function test (Amylase and Lipase)
T
Cardiac Profile (Troponin, CPK, CPK-MB, LDH, AST)

B. Practical Credit- I
AF

1. Preparation of Normal solution, Molar solution, Percentage

solution 2hrs
2. Introduction of Biochemical Instruments and its application
(Colorimeter, Centrifuge, Water bath, pH meter) 2hrs
3. Estimation of serum glucose by enzymatic method and its
DR

clinical significance 2hrs

4. Estimation of serum Urea and its clinical significance 2hrs
5. Estimation of serum Bilirubin and its clinical significance 2hrs
6. Estimation of serum Cholesterol and its clinical
significance 2hrs
7. Estimation of serum Triglyceride and its clinical
significance 2hrs
8. Estimation of serum amylase by Iodometric method and its
clinical significance 2hrs
- 20 -
TEACHING LEARNING ACTIVITIES

METHODS
Lectures
Discussion

PY
Demonstration
Project work
Presentation

MEDIAS
White board
OHP
Slide
CD ROM CO
Real objects in laboratory setting

EVALUATION
Class test
Assignment
T
REFERENCES
AF

1. Satyanarayan V. Biochemistry, 2002, 1st Edition, Calcutta.

2. Siddigre, M.A., Handbook of Biochemistry, 2001, 10th, Patna, India
3. K.R. Reddy, Medical Biochemistry for Nurses, 2001, 1st Edition,
Jaypee New Delhi.
4. Satyanarayan V. Essential of Biochemistry, 2003, 1st, Books and
Allied P. Ltd.
5. Dandekar, Medical Biochemistry, 2002, 2nd Edition, BI, Churchill,
DR

Livingstone.
6. Varun Kumar Malhotra, Biochemistry, 1994, 8th, Jaypee Brothers.
7. Campbell, Smith, Biochemistry Illustrated, 2000, 4th Edition, Churchill.
8. Shivananda Nayak B., Manipal Manual of Clinical Biochemistry,
2002, 1st Edition, Jaypee.
9. Shanmugam A, Fundamentals of Biochemistry for Medical
Students, Madras, Novabharat Printers, 1997.
10. Recent edition of the mention books and journals.
11. Internet
12. Research reports
- 21 -
 Course Title: Microbiology/
Parasitology
Placement: First Year
Course Code: BSN- 103 Full Mark: 50

PY
Total Hour: 50 (Theory) Pass Mark: 25

COURSE DESCRIPTION

This course is intended to impart the basic concept in general

microbiology, parasitology, bacteriology, virology, mycology, and
immunology. This course aim to provide basic, practical laboratory,

CO
concepts in identifying and diagnosing the fungal, bacterial, and viral,
and parasites related causal organism in diseases.

COURSE OBJECTIVES

Upon completion of this course, students will be able to:

Describe microbial diseases (fungal, parasitic, bacterial and viral)

Explain morphology, physiology and growth requirement of
bacteria
T
Describe the normal opportunistic, and pathogenic bacteria
Explain the mechanism of infection and development of immunity
AF

Describe different methods of sterilization

Explain the collection and transport of bacterial specimen for the
identification of bacterial disease
Describe antigen, antibody, hypersensitive reaction, and defense
mechanism of the body
Explain the collection transport and preservation of specimen
Describe classification of disease
DR

Explain the life cycle, mode of infection, prevention, control, and

treatment of intestinal and blood parasites.
Describe replication virus / fungi, gram staining &AFB stains

COURSE CONTENTS

UNIT I: Microbiology 6 hrs.

1. An introduction to microbiology
Introduction to microbial world

- 22 -
 o Microbes (Bacterias, Virus, Parasites, Fungi, Ricketsiae etc.)
o Classification of microbial diseases
o Introduction to community acquired microbial infection

UNIT II: Parasitology 9 hrs.

PY
Classification of human parasite
Introduction to parasitic diseases associated with poor personal
and public hygiene.
Blood parasites (Malaria parasite, Kala-zar, microfilaria)
Life cycle and mode of infection.
Collection of sample, processing and identification.

Cryptosporia) CO
Treatment, prevention and control.
Intestinal protozoa (Entamoeba hystolytica, Giardia lamblia and

o Life cycle and mode of infection.

o Collection of sample, processing and identification.
o Treatment, prevention and control.
Intestinal worms (Roundworm, hookworm, pinworm, and
whipworm)
T
Tapeworm: T. saginata, T. solium, Echinocococus granulosus. H.
nana
o Life cycle and mode of infection.
AF

o Collection of sample, processing, and identification.

o Treatment, prevention, and control.

UNIT III: Bacteriology 9 hrs.

Introduction and Classification of bacteria.
Normal bacterial flora on or in the body.
DR

Concept of opportunistic and pathogenic organisms.

Bacterial structure physiology and its growth factors.
Mechanism of infection.
Resistance to infection and immunity.
Spread of diseases, pandemic, endemic, epidemic and laboratory
infection.
Methods of sterilization - Physical sterilization, chemical
disinfectants and radiation.
Collection and transport of specimen for identification of common

- 23 -
 bacterial communicable diseases (Respiratory, genital and
gastrointestinal diseases)
Culture and staining
Gram staining and AFB staining in identifying bacteria.

PY
UNIT IV: Virology 10 hrs.
Introduction
Classification of virus
Replication of virus
Introduction to viral diseases of community concern
Collection and preservation of viral specimen for laboratory study

UNIT V: Immunology CO
Prevention and control of viral diseases

Introduction to immunology
10 hrs.

Defense mechanism of the body

Antigen and antibody - types
Hypersensitivity reaction –types
T
Immunoassay - Mention agglutination, precipitation, ELISA,
Western blot, RIA, etc
Basic concept of immunology in diagnosis of viral diseases.
AF

UNIT VI: Mycology "Fungi" 4 hrs.

Introduction
Structure and classification of fungi
Types of mycosis
Prevention and control of fungal disease.
DR

TEACHING LEARNING ACTIVITIES

METHODS
Lectures
Discussion
Demonstration
Project work
Presentation

- 24 -
MEDIAS
White board
OHP
Slide

PY
CD Rom

EVALUATION
Class test
Assignment

CO
REFERENCES

1. Maclcie and Mc Cartney, Practical Medical Microbiology, 2001, 9th

Edition, Churchill Livingstone, London.
2. Chatterjee K.D, Parasitology, Protozoology and Helminthology,
2001, 12th Edition, Calcutta.
3. Mukherjee K.L., Medical Lab Technology, Vol. I, II, III, 1998, 3rd
Edition, New Delhi.
4. Lewis S.M., Dacio and Lewis, Practical Hematology, 2001, 9th
T
Edition, Churchill Livingstone, London.
5. Cheesbrough M., District Laboratory Practice in Tropical Countries
Vol. 3, 1999, 1st Edition, Cambridge University.
AF

6. Dey N.C., Medical Bacteriology Including Medical Mycology and

AIDS, Calcutta.
7. Cappuccino J. G., Microbiology A Laboratory Manual, 1999, 4th
Edition, AWL Tokyo.
8. Seema Sood, Microbiology for Nursing Students and Nurses,
2002, 1st Edition, B.J. Churchill, Livingstone Pvt. Ltd. New Delhi.
DR

9. Paniker C.K., Jayaram, Text Book of Medical Parasitology, 2002,

5th, Jaypee.
10. Ichtipujani, RL, Microbiology for Nurses, 1999, 1st Edition, Jaypee.
11. Pelczar Michael, Microbiology, 2003, Tata, Mc. Graw Hill.
12. Ichhpujani R.L., Medical Parasitology, 2002, 3rd, Jaypee.
13. Ichhpujani RL, Microbiology for Nurses, 2001, 1st Edition, Jaypee
Brothers.
14. R. Anantnanarayan, CKJ Paniker, Text Book of Microbiology,
2001, 6th Edition, Orient Longman.
- 25 -
15. RN Iyer, Sample Collection in Clinical Microbiology, 2002, 1st
Edition, Jaypee.
16. Parker M. Microbiology for nurses, London: Bailliere Tindall.
17. Simplified Microbiology, New Delhi: The Trained Nurses

PY
Association of India.
18. Recent edition of the mention books and journals.
19. Internet
20. Research reports

CO
T
AF
DR

- 26 -
 Microbiology/Parasitology
Practicum
Placement: First Year
Course Code: BSN- 103 Full Mark:

PY
Total Hour: 30 Pass Mark:

COURSE DESCRIPTION

This course aims to provide basic, practical laboratory, concepts in

identifying and diagnosing the fungal, bacterial, and viral and parasites
related causal organism's diseases.

COURSE OBJECTIVES

CO
Upon completion of this course, students will be familiarized in following
skills during laboratory practices:

1. Handling, cleaning, uses and precaution of microbial

laboratory instruments. 2 hrs.
2. Specimen collection for microbial test: 2 hrs.
o Blood, pus, sputum, urine, throat swab.
T
o Demonstration of collection of CSF, Bone marrow and Body
fluid.
3. Study of Compound Microscope. 2 hrs.
AF

4. Study of morphology of bacteria by:

o Gram's Staining Technique. 2 hrs.
o Ziehl Neelsen Staining Technique for AFB. 2 hrs.
5. Urine routine and microscopic test. 2 hrs.
6. Study of intestinal parasite by Stool Routine and Microscopic
test, (Protozoa and helminthes-OPC). 4 hrs.
DR

7. Study of blood and tissue parasite using Giemsa staining

technique. (Malaria, Kalaazar, and Microfilaria) 4 hrs.
8. Sample collection and KOH preparation for fungus test 2 hrs.
9. Demonstration of culture and antimicrobial susceptibility
test. 2 hrs.
10. Demonstration of sterilization techniques (using dry and moist
heat- Hot air oven, boiling and chemical sterilization, autoclave,
radiation and filtration) 2 hrs.
11. Selection of patient and perform Tuberculin test (Mountux
test) 2 hrs.
12. Serological test (Widal and ASO titer). 2 hrs.
- 27 -
 Course Title: Pathophysiology
Placement: Second semester (First Year)
Course Code: BSN- 104 Full Mark: 50
Total Hour: 50 (Theory), Pass Mark: 25

PY
COURSE DESCRIPTION

This course will provide students the knowledge regarding pathological

changes during diseases process/infection/trauma/neoplastic and
degenerative changes.

COURSE OBJECTIVES

CO
At the end of this course students will be able to:

Explain the pathological changes during infection/trauma/

neoplastic and degenerative.

COURSE CONTENTS

UNIT I: Introduction 6 hrs.

T
Define basic terminologies
Explain the general concepts of Necrosis, inflammation,
Thrombosis, Embolism, Fracture healing, wound healing, shock,
AF

Oedema, Neoplasia, Antigen and Antibody Reaction, common

auto immune disorders, basic genetic disorders.

UNIT II: Human Systems

Musculo Skeletal System 4 hours

Explain the basic concepts of fractures Arthritics, Oesteomyelitis/
DR

osteoporosis, leprosy, gout, muscular dystrophy, and myasthenia

gravis.
Cardiovascular System 5 hours
Explain the basic concepts of Rheumatic heart diseases,
myocardial infarction, hypertension, atherosclerosis, heart failure,
anemia, leukemia, hemophilia, idiopathic thrombocytopenic
purpura (ITP)
Explain immune deficiency disorders
Define hypersensitivity reactions
- 28 -
Respiratory System 5 hours
Explain the basic concepts of bronchitis, bronchial asthma,
tuberculosis, COPD, Pneumonia, carcinoma lung
Gastrointestinal System 4 hours

PY
Explain the basic concepts of gastritis, peptic ulcer, intestinal
TB, appendicitis carcinoma of stomach, hepatitis, cirrhosis,
cholecystitis and cholelithiasis
Neurosensary System and special senses 4 hours
Explain the basic concept of meningitis, epilepsy, encephalitis,
conjunctivitis, Trachoma, Retinoblastoma, Xerophthalmia, otitis

CO
media and CSOM, deafness, cataract, and refraction error.
Renal and electrolyte System 4 hours
Explain renal failure, Nephritis, Nephrotic syndrome, Renal
stones, UTI, renal cell carcinoma, acidosis, alkalosis
Reproductive System 4 hours
(Explain DUB, Abortions, Ectopic pregnancy) benign prostatic
Hyperplasia (BEP), Carcinoma cervix.
List different cause of breast lump
T
Endocrine System: 4 hours
Nodular goitre, Diabetes mellitus, phnechromocytoma, thyroids
AF

disorder, parathyroid disorder, Cushing syndrome.

Integumentary System: 4 hours
Basal cell carcinoma, squamous cell carcinoma, dermatitis,
dermatophytes, warts
Reticulo-Endothelial System: Lymphomas 4 hours
DR

TEACHING LEARNING ACTIVITIES

METHODS
Lectures
Discussion
Demonstration
Project work
Presentation

- 29 -
MEDIAS
White board
OHP
LCD

PY
EVALUATION
Class test
Assignment

REFERENCES

1.

2.
CO
Stephen J. Mc Phee et. al, Patho-physiology of disease.
International Ed. Mc Graw Hill, Lange Medical Books, Health
Professional Div. Auckland, Tokyo.
Catherine Paradiso, Lippincott Review series, Pathophysiology
2nd Ed. Lippincott Com., New York, Balimore.
3. Latest/Recent Education Pathophysiology books for nurses.
4. Recent edition of the mention books and journals.
5. Internet
T
6. Research reports
AF
DR

- 30 -
 Pathophysiology Practicum
Placement: First Year
Course Code: BSN- 104 Full Mark:
Total Hour: 30 Pass Mark:

PY
Specimen or pictures needed for practical demonstration.

Malignancy

1. Squamous cell carcinoma.

2. Adeno carcinoma

CO
3. Rabdomyo sarcoma
4. Osteosarcoma
5. Leiomyosarcoma
6. Melanoma
7. Undifferenc tated Ca. of lung
8. Leukaemia slides
T
AF
DR

- 31 -
Brain

1. Brain hemispheres specimen

2. Meninges layers

PY
Chest

1. Lung cancer specimen

2. Pneumonia specimen of lung
3. Broncheactasis

Abdomen

1.
2.
3.
4.
5.
Ca-stomach

CO
Liver specimen/cirrhosis
Biliary stones-biliaryduct stones specimen.
Pancreas
Intestines – appendix

Genito Urinary
T
1. Kidney specimen and stones
2. Bladder stones
3. Kidney malignancies
AF

4. Congenital anomaliles of kidney (Polycystic kidney disease)

5. Dermoid cyst of ovary
6. Fibroid uterus
7. Ectopic pregnancy
8. Placenta
9. Ca cervix
DR

10. Congenital amomalies of uterus

11. Bicornuate

Endocrine

1. Thyroid goiter
2. Testis/ovary
3. Pituitary gand
4. Thymus gland

- 32 -
 Course Title: Pharmacology

Placement: First Year

Total Hour: 50 Full Mark: 50

PY
Course Code: BSN- 105 Pass Mark: 25

COURSE DESCRIPTION

This course offers the basic knowledge on pharmacology in relation

to the fundamental concepts of different drugs and to their effects on
different body systems.

COURSE OBJECTIVES

CO
Upon completion of this course, students will be able to:

Explain the basic pharmacological concepts.

Describe antimicrobial agents and anti-neoplastic drugs, their
effects, mechanisms of action and adverse effects.
Explain the actions and effects of drugs in different body systems.
T
Store, maintain and use of life saving drugs
Manage poisoning cases and use effective anti-dotes
Describe the mechanism, action of drugs, indications,
contraindication, pharmacokinetics and doses and common
AF

nursing implications.

COURSE CONTENTS

UNIT I: Introduction 6 hours

Common Terminology used in pharmacy and pharmacology.
DR

Sources of drugs and routes of drug administration

Pharmacokinetics and pharmacodynamics
o Factors affecting response to drugs
o Adverse drug reactions
o Drug interactions

UNIT II: Introduction to Chemotherapy 2 hours

Antimicrobial agents

- 33 -
 Antineoplastic drugs
Anti- neoplastic drugs

UNIT III: Drugs acting on the Gastrointestinal System 6 hours

PY
Drugs used in the treatment of peptic ulcer
Drugs used in vomiting, constipation
Antispasmodics
Antidiarrheal drugs and ORS
Drugs used in the treatment of intestinal worm infestation

CO
UNIT IV: Drugs acting on the Musculoskeletal System 4 hours
NSAIDs
Drugs used in the treatment of gout and rheumatic arthritis
Neuromuscular blocking agents
Treatment of myasthenia gravis

UNIT V: Drugs acting on Respiratory System 4 hours

Antitussives and expectorants
T
Drugs used in the treatment of asthma
Drugs used in the treatment of tuberculosis
AF

UNIT VI: Drugs acting on Cardiovascular System 5 hours

Antihypertensive drugs
Drugs used in the treatment of ischemic heart disease (IHD),
cardiac arrhythmias, shock

UNIT VII: Drug acting on Blood and Reticuloendothelial

DR

System 4 hours
Anticoagulants, fibrinolytics, coagulants, and hematinics
Immunosuppressant and immunostimulants.

UNIT VIII: Drugs acting on the Nervous System 4 hours

General anesthetics and pre-anesthetic medication, local anesthetics
Anti epileptic drugs
Sedatives, hypnotics and tranquilizers
Morphine and related analgesics
- 34 -
UNIT IX: Drugs affecting the Endocrine System 2 hours
Drugs used in the treatment of diabetes
Drugs used in the treatment of thyroid disorders
Pituitary hormones

PY
Adrenal steroids

UNIT X: Drugs acting on the Urinary System 2 hours

Urinary alkalinizers and acidifiers
Diuretics

CO
UNIT XI: Pharmacology of the Special Senses 2 hours
Miotic and mydriatic agents
Drugs used in the treatment of glaucoma
Commonly used eye/ear medications

UNIT XII: Miscellaneous topics 2 hours

Management of poisoning
Emergency and life saving drugs
T
UNIT XIII: Review of pharmacokinetic principles with special
focus on its application of different pharmacokinetic parameters
AF

in nursing practice 2 hours

Absorption
Distribution
Metabolism
Excretion
DR

UNIT XIV: Nursing consideration in drugs administration 2 hours

Basic mechanism and action of following drugs and nursing role.
o Adrenaline
o Atropin
o Digoxin
o Potassium chloride
o Sodium nitroprusside
o Verapamil
o Streptokinase

- 35 -
TEACHING LEARNING ACTIVITIES

METHODS
Lectures
Discussion

PY
Demonstration
Project work
Presentation

MEDIAS
White board
OHP
Slide
CD Rom
LCD, Real Objects
CO
EVALUATION
Class test
T
Assignment

REFERENCES
AF

1. "Clinical Pharmacology for Nurses", Trounce J.

2. "Pharmacology and Pharmacotherapeutics", Satoskar R. S.,
Bhandarkar S. D.
3. "Pharmacology", Rang H. P., Dale M. M., Ritter J. M.
4. Seth, U.K. Problem Oriented Pharmacology and Therapeutics,
Katmandu, Nepal, IOM
DR

5. Trounce, I.R. Pharmacology for Nurses New Delhi, English

Language Book Society.
6. Recent edition of the mention books and journals.
7. Internet
8. Research reports

- 36 -
 PHARMACOLOGY PRACTICUM
Placement: First Year
Total Hour: 30 Full Mark:
Course Code: BSN- 105 Pass Mark:

PY
Case studies on one drug each from the following therapeutic classes
of drugs:

Antimicrobial agents
Respiratory drug
Cardiovascular drug

Recommended format for study.

Therapeutic class:
CO
Prepare and submit reports on all three case studies.

PATIENT INFORMATION
T
Name: Address:
Age:
Sex:
AF

Diagnosis:
Drug history:

Other conditions relating to the patient (other diseases, allergies etc):

Drug name:
DR

Brand name:
Dose:
Duration of therapy:
Side effect profile:

Precautions:

Contraindications:

- 37 -
 Course Title: Nutrition and
Dietetics
Placement: First Year (theory)
Total Hour:60 (Theory) Full Mark: 50

PY
Course Code: BSN- 106 Pass Mark: 25

COURSE DESCRIPTION

This course is designed to provide comprehensive knowledge and

develop specific skill in nutrition and dietetics.

CO
COURSE OBJECTIVES

On completion of this course, student will be able to:

Describe the nutrition and nutrition lab.
Recognize the various methods for assessing the nutritional
status.
Explain the daily requirement of nutrition for different age groups
Explain therapeutic diet and different types of therapeutic diet
Discuss the need based balance diet.
T
Demonstrate the source of nutrient, daily requirements, balance
diet
Identify the national nutritional problem, strategy, and programs
AF

Describe the nutritional deficiency diseases and their management

COURSE CONTENTS

UNIT I: Introduction 4 hrs.

Definition: Nutrition, Nutrients
DR

Types of nutrients and chemical composition

Main sources of nutrients in different foodstuffs and metabolic
process
Digestion, absorption, and metabolism of carbohydrate, protein
and fat

UNIT II: Daily Requirement of Nutrition for: 8 hrs.

Neonate/LBW
Infant

- 38 -
 Toddler
School children
Adolescent
Middle age

PY
Old age

UNIT III: Balance Diet 5 hrs.

Definition, concept, purpose
Pregnant and lactating mother
Growing children and adolescence

CO
Sedentary people and laborers
Elderly people

UNIT IV: Therapeutic Diet 5 hrs.

Meaning and purpose
Types according to diseases

UNIT V: Nutritional Status 4 hrs.

T
Purpose of growth monitoring
Method of growth monitoring
Breast feeding (exclusive)
AF

o Importance and purpose

Weaning
o Meaning, purpose, types and methods
Role of parents and family in growth monitoring, breast feeding
and weaning
IYCP (infant and young child feeding counseling skill)
DR

UNIT VI: Nutritional Deficiency Diseases (Micro and Macro) 8 hrs.

Protein energy malnutrition, kwashiorkor and marasmus
Night blindness, betot spot
Iodine deficiency disease
Iron deficiency disease (anaemias)
Rickets
Beri-beri
Nutritional assessment:
- 39 -
 o Diet survey
Anthropometric measurement
Clinical assessment
Biochemical test

PY
UNIT VII: National Nutritional Problem/Programme 4 hrs.
Iodine deficiency disease
Iron deficiency disease
Vitamin A deficiency
Protein energy malnutrition

CO
Nutrition policy

UNIT VIII: National Strategic and Programme 4 hrs.

Introduction
Purpose
Target
Training
Monitoring/nutrition indicators
T
Evaluation

UNIT IX: Methods and Preservation of Food: 4 hrs.

AF

Drying, salting- canning and freezing

Selection, storage and preparation of food
Different methods
o boiling, steaming and frying
o simmering, stewing
o backing and pressure cooking
DR

UNIT X: Nutritional Lab- Demonstration 4 hrs.

Display- sources of nutrients
Preparation of daily requirements chart
Project work on balance diet
Preparation, cooking and serving of therapeutic diet
Observation/practice of rehabilitative nutritional center

- 40 -
TEACHING LEARNING ACTIVITIES

METHODS
Lectures
Discussion

PY
Demonstration
Project work
Presentation

MEDIAS
Field practice nutritional assessment and management (Hospital/
community) Practicum

EVALUATION
Class test
Assignment
CO
REFERENCES
T
1. Molly Sam & N. Geetha, A Text Book of Nutrition of Nurses, First
Edition; Jaypee, 2000.
2. M. Maltese, Introductory Nutritional and Diet Therapy, First Edition;
AF

J.B. Lippincott, 1990

3. Angela Dare & Margaret D, A Practical Guide to Child Nutrition,
First Edition; Stanly Thornes; 1997.
4. H.A. Lee & G. Venkat R. A Handbook of Parenteral Nutrition,
(Hospital and Home Application), Chapman & Hall; First Edition,
1990.
5. Recent edition of the mention books and journals.
DR

6. Internet
7. Research reports

- 41 -
 Course Title: Nutrition and
Dietetics (Practicum)
Placement: First Year
Course code: BSN – 106 Full marks:

PY
Total hour: 60 Pass mark:

COURSE DESCRIPTION

I. Nutritional assessment
o Diet survey
o Anthropometric measurement of under five

o Hemoglobin test
CO
o Clinical nutritional assessment of 5 children

o Urine test, sugar, albumin

o Growth monitoring/plotting on the chart

II. Project work and demonstration

o Balance diet for different age group

o Pre-school
T
o School
o Adolescent - Male/Female
o Adult - Male/Female
AF

o Pregnant
o Lactating mothers
o Elderly adult

III. Observation visit of hospital and nutritional rehabilitation center

DR

a. Hospitals
- During Hospital visits orientation about therapeutic
diets (Cardiac problem, GI problem, Renal problem &
Diabetic diet)
b. Nutritional rehabilitation centre
c. Report preparation and presentation after visits

- 42 -
i. Nutritional Assessment

Direction: Each student will be responsible to perform following activities

during clinical and community setting.

PY
Performed Practice
S.N. Activities Means of Verification
Yes No Area
1 Diet Survey
Anthropometric
Maintain Road to
Measurement of <5
Health Card for under
1.1 children and Growth
3 years children in
monitoring/plotting on
SHP
the chart

1.2

1.3
Clinical Nutritional
Assessment of under
5 children

Hemoglobin test
CO Maintain

Hemoglobin
Road to
Health Card in Clinic
test of
pregnant and lactating
women during physical
examination
Urine test for sugar Demonstration in the
1.4
and albumin lab /community
T
ii. Project Work and Demonstration (Balance diet for different
age group)
Group Performed
Activities Means of Verification
AF

No Yes No
Prepare Chart with key messages on-
Exclusive Breast Feeding up to
6 months children
Complementary Food for 7 to
Infants and
1 12 months children
Toddler
Demonstration of locally
DR

available food items for

complementary food ( 7 to 36
months children )
Table of 24 hours Dietary Recall
(3 to 5 years child)
Chart on Recommended Dietary
2 Pre-School
Allowance
Demonstration of food items /
serving size

- 43 -
 Table of 24 hours Dietary Recall
(6 to 12 years child)
Table of Recommended Dietary
2 School
Allowance
Demonstration of food items/

PY
serving size
Table of 24 hours Dietary Recall
(15 to 12 years child)
Chart on Recommended Dietary
Adolescents-
3 Allowance
Male/Female)
Demonstration of locally
available food items /serving
size

3
Adults-Male/
Female
CO Table of 24 hours Dietary Recall
(6 years to 12 years child)
Chart on Recommended Dietary
Allowance
Demonstration of locally
available food items /serving
size

Table of 24 hours Dietary Recall

T
Chart on Recommended Dietary
Allowance
4 Pregnant Demonstration of locally
available food items/serving
AF

size

Table of 24 hours Dietary Recall

Chart on Recommended Dietary
Allowance
Lactating
4 Demonstration of locally
mothers
available food items/serving
DR

size.

Table of 24 hours Dietary Recall

Chart on Recommended Dietary
Allowance
3 Elderly Adult
Demonstration of locally
available food items/serving
size.

- 44 -
iii. Observation visit of hospital and nutritional rehabilitation
center

S.N. Health Institution Objectives Means of Verification

Orient/Familiarize with

PY
Report preparation
therapeutic diet for Cardiac,
including chart of
1 Hospital GI ,Renal and Diabetic
therapeutic diet and
problems)
presentation
Orient/Familiarize with
management of mal
Report preparation
Nutritional nutrition cases ,such as
including chart of
2 Rehabilitation Protein Energy Malnutrition

CO
therapeutic diet and
Centre (PEM), Anaemia, Iodine
presentation
and Vitamin “A” deficiency
etc.
T
AF
DR

- 45 -
Course Title: Foundation of Nursing
(Theory)
Placement: First Year
Course code: BSN – 107 Full marks: 150

PY
Total hour: 150 Pass mark: 50

COURSE DESCRIPTION

This course focuses on the foundation of nursing regarding basic

nursing concepts skills and attitudes, professional history within and
outside the country, its scope; trends, theoretical propositions and need

CO
based safety, comfort and therapeutic measures for individual family
and community.

COURSE OBJECTIVE

At the end of the course the learners will be able to;

Define nursing profession; its scope, history, trends, ethical
values and legal aspects.
Decide and make different types of beds based on needs of the
patients following nursing principles.
T
Position the patient on the basis of need identified.
Provide comfort devices based on the need of the patients.
AF

Transfer patients from and to bed, wheel chair, and stretcher.

Lift patient with various condition, apply nursing principles and
technique.
Collect equipment needed for the nursing procedure and use
economically and with care.
Maintain the audit, report, and record.
Discuss the care of the unconscious, acute, and chronic and
DR

terminally ill patient.

Explain the purpose of NAN, NNC, and ICN code of ethics.
Discuss Maslow’S hierarchy needs and comprehensives need of
the individual.
Discuss the pre and post operative nursing care of the patient.
Discuss the methods of communication.
Discuss the methods of administering oral medication.
Discuss the care of acute. chronic/terminally ill dying and death
patients
- 46 -
 Explain the process of helping clients to meet their various needs.
that is nutrition. elimination etc.
Perform different types of bandaging and using principle and process.
Perform dressing procedure.
Diagnose the need of the client and perform emergency first aid

PY
intervention using appropriate material in any situation
Describe infection control measures.
Describe the care of dying patient.
Explain the care of client after death.
Administer injection of a medication through correct route,
Describe nursing process its component and use of care plan.

Unit I: Introduction
CO
Definition of nurse and nursing.
12 hours

History of nursing and nursing in Nepal before and after 1972

Objective and philosophy of nursing.
Qualities and function of the nurse.
Role and function of nurse/primary health care nurse.
T
Scope and trend of nursing.
Factors influencing in nursing.
Standard in nursing/advocacy in nursing.
AF

Ethics and values health professionals.

ICN code of ethics
Legal responsibility of nursing
Hospital organization and their functions in Nepal.
Nursing assignment and its types
Professional growth and development; NNC/NAN
DR

Unit II: Introduction to huspital nursing 4 hours

Definition
Purposes
Types and functions

Unit III: Comfort measures

A. Bed making; 12hours
o Unoccupied bed
- 47 -
 o Occupied bed
o Orthopedic bed
o Cardiac bed
o Burns bed
o Water/air bed

PY
o Divided bed
o Striker bed

B. Positions; 4 hours
o Types of position.
o Lateral/left and right
o
o
o
o
o
Prone/lateral
Dorsal/recumbent
CO
Fowlers/semi-fowlers
Lithotomy, kneechest
Trendelenburg/kneeling

Changing position of the helpless patient from and to;

Bed and wheel chair
T
Bed and stretcher
Wheel chair to bed
AF

C. Use of comfort devices; 4 hours

o Definition of devices.
o Different devices used for patient
- Bed cradle, foot board, side rails, bed lifter, cardiac
table, back rest, air cushion, and extra pillow.

D. Personal hygiene; 10 hours

DR

o Oral care
o Care of skin(sponge and bed bath)
o Care of hair
o Care of eye/ear
o Care of back
o Back care; care of pressure point and giving massage.

E. Body mechanics; 10 hours

o Lifting
- 48 -
 o Moving
o Exercise;
o Range of motion/exercise
o Deep breathing exercise
Posture exercise

PY
o
o Postural drainage

Unit IV: Basic need of the patient 4 hours

Definition
Ways of meeting basic needs.
Maslow’s hierarchy of needs
Safety in environment
Physical need
Psychological needs
Spiritual needs
Survival needs
CO
Self actualization
T
Unit V: Assessment of the client’s health needs 10 hours
Vital signs:Temperature-oral, pedal, Axillary and rectal
Pulse –carotid, radial, pedal, apical
AF

Respiration
Blood pressure
Height/weight
Collection of specimen-urine, stool, blood, sputum, pus and
throat swab
Importance of assessment
DR

Unit VI: Admission and discharge 4 hours

Procedure for admission of patient
Orientation of ward/hospital rules, policy, payment system.
Discharge preparation.
Discharge teaching.
o Treatment effect
o Side effect of drug
o Follow-up

- 49 -
 o Diet regimen
Report and record
Nurse clients interaction.

PY
Unit VII: Meeting sefty measures 4 hours
Safty measures
Body mechanism
Helping the clients ambulation
Range of motion : mobility
Exercise

CO
Common devices to support protect with impaired mobility
Cleaning the air passage

Unit VIII: Drugs Administrations 12 hours

Definition
Different routes of medication
Rights of drug administration
Types, principles, purposes, procedures of administration of oral
T
medication
Nurses role in drug administration.
AF

Injection
Types
Site of injection
Precution while giving injection
Procedures
Insertion of i/v cannula
DR

Indication of administered drip

Types of i/v cannula
Care of i/v cannula
Nurses role and responsibility while giving injection and drip
Blood transfusion

Unit VIII: Record and reports 2 hours

Definition of report and record

- 50 -
 Purpose and principles
Types of report and records
Audit

PY
Unit IX: Communication 3 hours
Definition
Types
Purpose
Methods
Barriers

CO
Nurses role in effective communication

Unit X: Definition of nursing process 12 hours

Definition
Purposes
Component of nursing process/elements
o Assessment
o Nursing diagnosis, according to NANDA
T
o Planning
o Implementation
o Evaluation
AF

Required blended skills

o Cognitive skills
o Technical skills
o Interpersonal skills
o Legal skills
DR

Unit XI: Nutritional needs of client 8 hours

Helping client to meet nutritional need.
Serving food in time
Helping suprervising clients meal serving/feeding
General diet/modified diet
Plan and provide dieatory teaching as per need
Feed helpless patient through
Ryles tube insertion and feeding

- 51 -
 Gastrostomy feeding
Gastric aspiration
Definition
Management of aspiration

PY
Maintain intake and outpurt chart

Unit XII: Elimination needs 8 hours

Enema : Defination, Types,and Methods
Suppository
Bowel wash

CO
Insertion of flatus tubes
Giving removing bed pans to strict bed rest operated patients
Catheterization on model then on patient
Care and removal of catheter and drainage tubes using
appropriate technique.
Stomach wash

Unit XIII: Hot and cold application 4 hours

T
Introducation
Effect of heat on the body
Hot water bag, application, principles
AF

Hot packs
Hot compress
Sitz Bath
Hot fomentation
Effect of cold on the body
DR

Cold compress
Cold packs
Ice packs
Tapid sponge

Unit XIV: Infection control measures 10 hours

Definition
Infection control measures
o Sanitation

- 52 -
 o Hygienic condition
o Cleanliness
Adequate lightening
Ventilation

PY
Environment
Control of noise
Hand washing
o Purpose
o Techniques
o Procedures
Medical asepsis/surgical asepsis

Sterilization:
CO
Use of gloves, masks. gown, apron, goggles, shoes, overshoes.

Definition; Purpose, methods

Barriers of nursing
Isolation technique/Reverse isolation
Hospital acquired infection and measures to control them.
T
Unit XV: Dressing and Bandaging 6 hours
Wound
Types of wound, care of wound
AF

Dressing(minor and major)

Definition,types,purpose,technique of dressing
Removal of sutures
Types of suture
Different types of drainage tubes
DR

Bandage 4 hours
Definition
Types
Purpose
Principle
Procedure

Unit XVI: Therapeutic measures: 6 hours

Oxygen inhalation
- 53 -
 Indication
Administration of oxygen
Types of masks
Precaution

PY
Procedures
O2 monitoring
Nurses role towards patient receiving oxygen
Steam Inhalation
Nebulization

CO
Unit XVII: Care of ill patient; 6 hours
Care of unconscious patient
Care of bed ridden patient
Care of chronic ill patient
Care of terminally ill patient
Care of elderly patient
Role of the nurse in the care of such patient
T
Unit XVIII: Frist aid treatment:- 6hours
Definition
Emergency conditions and their management: drawning, chocking,
AF

burn, frost bite, wound, fracture, epistaxis, haemorrhage, shock,

poisoning, forenbody, snake bite, dog bite, insect bite.

Unit XIV: Pre and post operative nursing care of surgical

patient. 2hours
DR

Unit XV: Care of the dead body:- 2hours

Cleaning, packing, clearance, psychological support to family

- 54 -
 Course Title: FOUNDATION OF
NURSING (CLINICAL)
Placement: Second Semester (First year)
Total Hour : 7 Full Marks: 100

PY
Course Code: BSN 107 Pass Marks: 60

COURSE DESCRIPTION

Clinical experience will be total 420 hours, on medical and surgical

unit. The students will be supervised at all time. They will develop
competency in providing basic nursing care. Students will do morning

CO
and evening and night duty in different wards.

COURSE OBJECTIVE

Uses nursing process for the care of there clients.

Demonstrate skill in history taking and physical assessment
Demonstrate skill in basic nursing procedures.
Apply the principles of infection prevention by using universal
precaution, medical asepsis and surgical asepsis.
T
Performs simple wound care and bandaging
Apply safe measures and ethical practice in injection and
medication.
AF

LEARNING ACTIVITIES

Use the nursing process to care clients. For evaluation submit 4

nursing care plans and perform 2 history taking and 2 physical
examination.
Develop competency in basic nursing skill according to client’s
DR

need in the following areas

Oxygen therapy
Care of i/v fluid and site
Insertion of nasogastric tube, NG tube feeding.
Catheterization, enema, active and passive exercise
Practice hand washing technique properly
Practice different methods of sterilization
Develop competency in doing dressing and performs at least 5
simple dressing and bandaging

- 55 -
 Each student will develop knowledge and skill of safe and ethical
practice drugs and administration.
Students practice CPR in human model

Evaluation

PY
Internal evaluation

Clinical performance evaluation - 20

Procedure logbook - 10
Nursing care plan - 5

CO
Health teaching - 5
History taking and physical examination - 5
Simple dressing - 5
Total marks - 50

Final examination
OSCE-Patient care - 25
OSPE-VIVA - 25
T
Total - 50

REFERENCES
AF

1. Berger and Williams (1999), Fundamentals of Nursing:

Collaborating for Optim Health. Volume 1 and 2. Stamford CT,
Appleton and Lange
2. Chevalking, H., Tuladhar, K., and Shrestha, U. (2001). Integrated
sciences 1st HLMC, TUIOM
3. Craven, R.F. and Hirnle, C.J. (2000) Fundamentals of nursing:
DR

human health function (3rd edition). J.B. Lippincot, Sydney.

4. Crisp and Taylor (2001). Potter and Perry Fundamentals of nursing
St. Missouri: Mosby.
5. Galbraith, A. Bullock, S. and Manias, E. (2001). Fundamentals of
pharmacology edition) Prentice Hall, Sydney.
6. Gatford, J.D. and Phillips, N. (2002). Nursing calculations (5th
edition). Churchill Livingstone, Edinburgh.
7. Kozier, B. and Erb, G. (2000). Fundamentals of nursing: Concepts
and practice (6th edition). Prentice Hall USA.

- 56 -
8. Leddy, S. and Pepper, J.M. (1998). Conceptual bases of
professional nursing (4th edition). Philadelphia, Lippincott.
9. Potter, P and Perry, A. (2000). Fundamentals of nursing: Concepts,
Process and practice (4th edition). C.V. Mosby, Missouri.

PY
10. Reed, P.G., Shearer, N.C. and Nicoll, L.H. (2004). Perspective on
nursing theory (4th edition). Philadelphia, Lippincot Williams and
Wilkins.
11. Tiziani, A. (2002). Harvards nursing guide to drugs (6th edition).
Churchill Livingstone, Sydney.
12. Verghese A., Shrestha, N.M., Singh, S., Shrestha, S., Thapa, S.,
And Bantawa, S. (2002). Fundamental of nursing (2nd edition)

CO
health learning material centre, TUIOM.
13. Weller, B.F. (2000). Bailliere's nurses dictionary (23rd edition).
Royal College of Nursing Bailliere Tindall.
14. Recent edition of the mention books and journals.
15. Internet
16. Research reports
17. Recent Procedure Manuals
T
AF
DR

- 57 -
 Course Title: Community Health
Nursing – I
Placement: First Year(theory)
Course Code: BSN- 108 Full Mark: 100

PY
Total Hour: 100 (Theory) Pass Mark: 50

COURSE DESCRIPTION

This course is designed to prepare the B.Sc. Nursing students to

become a competent basic level community health nurse. These
students will be equipped with comprehensive knowledge, skill and

CO
attitude in relation to the concept, principles and process of Community
Health Nursing.

Basically this course is focused on providing care to individual, family,

group and community regarding disease prevention , health promotion,
protection and rehabilitative aspects of holistic health care in home and
community settings. Students will utilize the concept of Primary Health
Care, environmental sanitation as well as community resources by
considering the socio/cultural background of the clients.
T
COURSE OBJECTIVES

After completion of this course students will be able to:-

AF

Describe the concept and developmental process of community

health and community health nursing globally as well as of Nepal.
Explain the concept of health and disease in relation to disease
prevention, health promotion, health protection and rehabilitative
aspect of positive health.
Explain the various determinants and indicators of health and
DR

illness.
Describe the components of environmental sanitation in
community health.
Explain the concept, types of services, advantages and disadvantages
of integrated and non-integrated type of health services.
Recognize the importance of Primary Health Care (PHC) concept
to provide effective community health services to the community.
Explain the importance of community resources and process of
its mobilization.
Discuss the importance of socio/economic and cultural
- 58 -
 background of the family and community in relation to providing
care and services.
Describe the importance of holistic health care for family and
community services, utilizing the nursing process.

PY
COURSE CONTENTS

UNIT I: Historical development of community health and

community health nursing 10 hours
1. Basic terms used in community health nursing
o Community
o Community Health

2.
o Public health

CO
o Community Health Nursing
o Public health nursing
Changing concepts in public health.
o Disease control phase(1880-1920)
o Health promotional phase(1920-1960)
o Social engineering phase(1960-1980)
o Health for all phase(1981-2000AD)
T
o International Conference for Population and Development
(ICPD)
o Millennium Development Goals (MDG)
AF

3. Community Health Nursing in Nepal.

o Before 1972 AD
o After 1972 AD

UNIT II: Concept of Health: 10 hours

1. Changing concept of health
o Biomedical concept
DR

o Ecological concept
o Psychological concept
o Holistic concept
o Spectrum of health
2. Determinants of Health
o Hereditary
o Environment
o Lifestyle
o Socio-economic condition

- 59 -
 o Health services
o Aging factors
o Psychological factors
3. Responsibility for Health
o Individual / family responsibility

PY
o Community responsibility
o State / National responsibility
o International responsibility
4. Concept of Disease
o Germs theory of disease
o Epidemiological triad

CO
o Multi- factorial causation
o Web of causation

UNIT IV: Environmental Sanitation and Health 15 hours

1. Introduction and component of environment.
2. Elements of environment
o Physical
o Biological
T
o Social
3. Effects of environmental pollution
o Global warming
o Green house effects
AF

o Ozone layer
o Nuclear accidents
o Toxic hazards
o Noise pollution
4. Solid waste Management
o Introduction
DR

o Sources
o Methods of solid waste disposal
5. Liquid waste Management
o Introduction
o Sources
o Method
6. Hospital waste management
o Definitions, purpose
o Disposing of sharps

- 60 -
 o Disposing contaminated solid and liquid waste of hospital
7. Excreta disposal
o Introduction
o Types of latrine
o Disposal method

PY
o Open field defecation and its hazards
8. Housing
o Types of housing.
o Standard of housing
o Effects of poor housing
9. Water

o Water requirement.
CO
o Definition of safe and wholesome water.
o Uses of water

o Sources of water supply.

o Purification of water.
o Water related disease.
10. Air pollution and noise/ Sound pollution
o Sources
T
o Indicators
o Health effects
o Preventive and control measures
AF

Unit V: Communication 10 hrs

Introduction and concept
o Component of communication.
o Interview Techniques
Report writing
DR

Components of report writing

Consideration on report writing
Process of conducting successful meeting
Presentation
o Introduction
o Tips for better presentation

Unit VII: Community Based Rehabilitation 10 hrs

1. Introduction and concept

- 61 -
2. Types of disabilities
o Physical
o Mental
o Socio/economic
3. Types of rehabilitation

PY
o Medical base
o Education/training
- Individual
- Family
- Community
o Sociological support

1.
o

CO
Economical support

Unit VIII: Health Education

Concept of Health Education
o Definition
14 hours

o Aims of Health education

o Objectives of Health Education
o Principles of Health Education
T
2. New Health Practices
o Motivation
o Communication
AF

o Decision Making
3. Various Approaches to Health Education
o Individual approach
o Group approach
o Mass Approach
4. Steps of carrying out health education programme in community
DR

o Responsibility of Community Health Nurse

o Developing lesson plan
5. Methods and medias of Health Education
6. Information Education and Communication (IEC) and Behaviour
Change Communication (BCC)
o Background
o Objectives
o Strategies
o Difference between IEC and BCC

- 62 -
Unit IX: Home Visiting 5 hrs
1. Definition
2. Purpose
3. Principle
4. Steps of home visiting

PY
Unit X: Health Indicators 18 hrs
1. Terms used in Demography
o Demography
o Population pyramid
o Sex ratio

CO
o Dependency ratio
o Rate
o Ratio
o Proportion
o Numerator
o Denominator
2. Vital and health statistics
o Measurement of mortality
- Crude death rate
T
- Neonatal mortality rate
- Perinatal mortality rate
- Infant mortality rate
AF

- Under five mortality rate

- Maternal mortality rate
- Case fatality rate
o Measurement of morbidity
- Incidence
◊ Attack rate
DR

◊ Secondary attack rate

- Prevalence
◊ Point prevalence
◊ Period prevalence
- Measurement of fertility
◊ Crude birth rate
◊ Total fertility rate
◊ Growth rate
◊ Pregnancy rate
◊ Abortion rate

- 63 -
 o Others
- Contraception prevalence rate
- Life expectancy
o Quality of life measurement
Disability Adjusted Life Years (DALY)

PY
o
o Quality Adjusted Life Years (QALY)
o YPLL

Unit XI: Level of prevention 10 hrs

1. Concept of prevention
2. Level of prevention

3.
o Primordial
o Primary
o Secondary
o Tertiary
Stage of prevention
CO
o General health promotion
o Special prophylaxis
o Early diagnosis and treatment
T
o Limiting damage
o Rehabilitation
4. Health promotions
AF

o Concept and Definition

o Models and approach
o Ethical issues in health promotion
o Planning health promotion intervention
o Evaluation in health promotion
5. Modes of intervention
o Health promotion
DR

o Specific protection
o Early diagnosis and treatment
o Disability limitation

TEACHING LEARNING ACTIVITIES

METHODS
Lecture/Discussion
Interactive presentation
Group discussion Role play
- 64 -
 Demonstration
Small project activities

MEDIAS

PY
White board
OHP
AV/Aids
Video cassettes/CD cassettes
Slide Projection
LCD

EVALUATION
Final Examination
Class Test CO
Class interaction, presentation
Class project etc.

REFERENCES
T
1. Basavanthapa B.T, Community Health Nursing, Jaypee Brothers, 2003.
2. Prabhakar G.N, Textbook of Community Health for Nurses,
peepee, 1st Ed, 2004.
AF

3. Park .K, Preventive and Social Medicine, M/S Banarasdas Bhanot,

Latest Edition.
4. Annual Report, Dept of Health survives, HMG Nepal MOH, Dept
of Health survives KTM, Latest Ed.
5. Sapkota Shiv. Prasad, A Handbook of Health Education and
Communication, Vidyarthi Pustak Bandar, 1st Ed, 2004.
DR

6. Shavema. S.R, Koushik Vijay, Nursing and Health Education,

Anmol Publication PVT. LTD. New Delhi; 2002.
7. Health Care Management, National open college.
8. Community as Partner, Elizabeth T Analysis Judith MC Far lance
Theory of practice in Nursing, Lippincott, 3rd edition.
9. Annual Report DHS 2057/58(2000/2001). Recent/Latest
10. Recent edition of the mention books and journals.
11. Internet
12. Research reports
- 65 -
 Community Health Nursing I
Practicum
Placement: First Year
Course Code: BSN- 108 Full Mark: 100

PY
Total Hour: 200 Pass Mark: 60

COURSE DESCRIPTION

Basically this course is focused on providing care to individual, family,

group and community regarding disease prevention, health promotion,
protection and rehabilitative aspects of holistic health care in home

CO
and community settings. Students will utilize the concept of primary
health care, environmental sanitation as well as community resources
by considering the socio/cultural background of the community people
(clients).

COURSE OBJECTIVES

At the end of the course, students will be able to:

Assess the services provided by the selected health related
institutions through observation visit.
T
Prepare a list of the existing facilities in the community concerning
environmental sanitation.
Measure the health status of community people by using various
AF

health indicators.
Provide individual and family health care by using the nursing
process.
Mobilize the community resources to raise the health status of
family and community people by utilizing PHC principles.
DR

TEACHING/LEARNING ACTIVITIES

This practicum experiences include 200 hrs. In an assigned community,

the students will do concurrent field visit 5 days/week and have
opportunity to develop competency as a care giver to individual/family
at community setting. Students will be supervised regularly during the
community placement.

Student will spend two weeks visiting different local institutions

and write group report about the activities of each institution.

- 66 -
 o Water treatment plant
o Factory: (brick/cement/iron/metal)
o Municipality office/dumping site
o Sewage disposal plant
Milk pasteurization centre

PY
o
o Rehabilitation centre
o SOS village
o Geriatric homes
Student will be posted to concurrent field practice for four weeks
in a community for community/family visit and each student will
be assigned two families and evaluated on completing two family

CO
folders including the complete health assessment of two adult
clients in the family.
Once a week seminar will be organized during clinical field
practice to discuss the problems faced by the students as well
as their learning.
Assess the health problem/s in the family for giving health
teaching, including nutritional teaching.
Learn to plan, organize and perform a health action plan/
exhibition by using group dynamics.
T
EVALUATION SCHEME
AF

Internal Assessment: (50)

Observation visit report – 5

Log book – 3
Performance – 12
Health teaching – 5
Family Folder – 10
DR

Health action presentation – 5

Nutrition exhibition – 10

Final examination viva: (50)

- 67 -
 Course Title: Nursing Concept and
Theories
Placement: Second Year
Course Code: BSN- 201 Full Mark: 100

PY
Total Hour: 100 Pass Mark: 50

COURSE DESCRIPTION

This course focuses on modern concepts and different theories of

nursing to be applied in health and illness. This course is designed to
facilitate in depth knowledge on pain, crisis and stress management;

CO
and the concept of rehabilitation in providing holistic health care to the
client and the families in the hospital and community situation.

COURSE OBJECTIVES

Upon the completion of the course, students will be able to:

Discuss the concepts of health, illness, and wellness.
Explain human systems, environment; and its effects on health.
Describe the selected nursing theories and its application in
T
relevant situation.
Explain the physical and psycho-socio-cultural responses of the
body to stress and crisis and their management.
AF

Describe pain and the factors which influence pain perception

and pain responses (assessment), and its nursing management.
Discuss creativity and its implication in nursing.
Explain the concept of disability and rehabilitation process.
Discuss holistic health care trends in medicine and nursing
Acquire knowledge on legal and ethical aspects in nursing.
DR

Apply the concept of therapeutic relationship with the client in

various situation

COURSE CONTENTS

UNIT I: Health and Illness 6 hrs.

Definition: Health, Illness and Wellness
Level of wellness
Health illness continuum
Concept of health promotion and maintenance
- 68 -
 Stages of illness.
o Transition from health to illness
o Acceptance of illness
o Convalescence
Tasks of convalescence

PY
o Reassessment of life's meaning
o Reintegration of life's image
o Resolution of role change

Unit II: Philosophy of Nursing 3 hours

Review value, profession, Nursing philosophy, criteria of
profession

CO
Four basic philosophies influencing nursing value, Ascetism,
Romanticism, Pragmatism and humanistic existentialism.

Unit: III Communication 10hrs

1. Concept Definition
2. Elements
3. Tools
T
4. Barriers of communication
5. Principle of effective communication
6. IEC/BCC: review
AF

7. Non violence communication

o Concept
o Process
- Observations
- Feelings
- Needs
DR

- Request
o Communication skill

Unit IV: Human system and environment 6 hrs.

1. Health, ecology and human system
2. Interaction of human population in biosphere
3. Effects of imbalance in: Atmosphere, Air, and Land
4. Impact of imbalance environmental on human health.

- 69 -
Unit VI: Environmental factors that influence human health 6 hrs.
1. Internal environmental factor:
o Personal characteristic
o Physiologic processes

PY
o Physical growth and development
o Human behaviors
2. External environmental factors:
o Physical variable
o Biologic variables
o Social variables
o Cultural variables

Unit VII: Nursing theories:

1.
2.
3.
CO
Introduction to nursing
The paradigm of nursing
Purposes of nursing theories
20 hrs.

4. Selected nursing theories: theoretical concept and practical

application of:
o 1 Nightingale's environmental theory
T
o 2 Henderson's theory of nursing
o Orem's self care theory of nursing
o Abdullah's problem solving theory
AF

o Roy's adaptation model

o Paplu’s theory (IPR)
5. Applications of nursing theories in education, and research.

Unit VIII: Stress and crisis 14 hrs.

Stress
DR

1. Definition: Stress, stressors, coping and adaptation.

2. Physiological and psychological responses to stress
3. Burnout syndrome
4. Modes of coping with stress.
5. Nurse's role in stress management

Crisis
1. Concept of crisis
2. Types and characteristics of crisis
3. Crisis of separation and loss; stages of dying, loss, mourning and

- 70 -
 grieving
4. Factors influencing the outcome of crisis
o The individual's perception of the problem or event
o Available situational support
o Coping mechanisms

PY
5. Nursing intervention in crisis resolution

Unit IX: Pain 8 hrs.

1. The nature of pain
2. Types of pain
3. Physiological process of pain transmission and pain perception.
4.

5. Pain assessment:
o Subjective data
o Objective data
CO
Psychological and socio-cultural factors affecting perception of
pain and reaction to pain

6. Nursing management in pain relief.

o Pharmacological pain management
o Non-pharmacologic pain management
T
- Cutaneous stimulation (Massage, heat and cold
application, acupressure,and TENS)
- Distraction (Visual, auditory, tactile and intellectual)
AF

- Imagery
- Relaxation techniques
- (Slow rhythmic breathing, progressive muscle
relaxation, and meditation)
- Hypnosis

Unit X: Creativity 5 hrs.

DR

1. Definition: Creativity
2. Personality conditions related to creativity
o Capacity to be puzzled
o Ability to concentrate
o Experiencing 'T'
o Ability to adjust during conflict or tension
o Willingness to be born everyday
3. Stages of creative problem solving
o Preparation

- 71 -
 o Incubation
o Illumination
o Verification
4. Creative problem solving process
o Fact finding

PY
o Problem finding
o Idea finding
o Solution finding
o Acceptance finding
5. Importance of creativity in nursing

1.
2. CO
Unit XI: Rehabilitation (review)
Concept of rehabilitation
Goals of rehabilitation
o Resolving potential functions
o Maximizing existing capabilities
2 hrs.

o Preventing deterioration
3. Process of rehabilitation
o Providing psychological support
T
o Maintaining integrity
o Preventing secondary disability
o Promoting equilibrium
AF

o Evaluating progress
o Initiating referral as needed
4. Nursing approaches to clients with mobility problems,
communication problems, elimination problem andthreat to body
image.
5. Discharge plan of disable client.
DR

Unit XII: Holism and holistic nursing 8 hrs.

1. Introduction to holism, holistic health, holistic health care, and
holistic nursing
2. Holistic health practice modalities
o Touch therapy:
- Foot Reflexology
- Acupressure
- Reiki
o Mind-body therapies:

- 72 -
 - Progressive relaxation
- Bio feed back
- Guided imagery
- Meditation
- Prayer

PY
- Humour and laughter
- Hypnosis
o Alternative medical therapies
- Ayurved
- Herbal medicines
- Naturopathy

1.
-
-
Homeopathy
Acupuncture
CO
Unit XIII: Legal and ethical aspects in nursing 10 hrs
General legal concepts: Law, types of law, function of the law in
nursing, Nurse as witness
2. Regulation of nursing practice
o Standards of Nursing Practice
T
o Nurse practice act
o Monitoring, Accreditation and Credentialing
3. Legal role, right and responsibility of nurse
AF

4. Collective bargaining
5. Legal aspects of nursing practice
o Informed consent
o Delegation
o Violence, abuse and neglect
o Sexual harassment at workplace
DR

o Abortion
o Death and Related issue
6. Areas of potential liability in nursing
o Crimes and torts
o Unintentional torts
- Negligence
- Malpractice
o Loss of client property
o Nonprofessional conduct

- 73 -
7. Legal protection in nursing practice
o Good Samaritan act
o Carrying out a physician's order
o Providing competent nursing care
o Record keeping

PY
o The incident report
8. Reporting crime, tort and unsafe practice.
9. Legal responsibility of student
10. Legal aspect of nursing practice in Nepal
o NAN
o NNC
11.
12.
13.
Consumer Right
Ethics CO
Laws related to health in Nepal (Health Act)

o Principles of ethics
o Major ethical issues in nursing
- Care of HIV
- Abortion
- Care of dying patient and death body
T
- Euthanasia
- Surrogated mother
o Nursing responsibilities in dealing the ethical issues
AF

Unit XIV: Therapeutic relationship 2 hrs

Nurse patient relation
Phases of relationship
Anti-therapeutic relationship
DR

TEACHING LEARNING ACTIVITIES

METHODS
Classroom teaching/Lecture
Discussion
Presentation (Group/Individual)
Self directed learning
Case study

- 74 -
MEDIA
OHP
Whiteboard, different AV/Aids (used for Health Educational
activities.)

PY
Real objects

EVALUATION
Class Test (Written examination)
Student presentation
Class interaction

REFERENCES

1.

2.
CO
Brush, Lynaugh et al, Nurses for All Nations: A history of the
International Council for Nurses, 1999.
Blattner, Barbara, Holistic Nursing, New Jersey, Prentice-Hall, Inc.
1981.
3. George Jule B., Nursing Theories: A Base for Professional Nursing
Practice- Prentice-Hall Inc. 1980.
T
4. Homes, Carolyn Cooper, Hunt, Joseph Dayle, Basic Concepts of
Helping: A Holistic Approach,New York, Appleton Century Crofts,
1980.
AF

5. Koizer, B et al, Fundamentals of Nursing (Concepts, Process and

Practice) 7th Edition, 2004.
6. Mc Kenna, H., Nursing Theories and Models, Rontledge
Publication, 11 New Fetter Lane, London EC4P4EF, 2000.
7. Murry R., Zentar, et al, Nursing Concepts for Health Promotion,
New Jessey, Prentice-Hall Inc. 1985.
DR

8. Leddy, S and Pepper JM, Conceptual Base of Professional

Nursing, 4th Edition, Philadelphia, Lippincott-Raven, 1998.
9. Mc Caffy, Margo. Nursing Management of the patient with pain, JB
Lippincott Co. Philadelphia, 1979.
10. Potter P, Perry et al, Fundamental of Nursing: Concepts, Process
and Practice CV Mosky Co., 4th Edition Missouric, 2000.
11. Reed, PG, Sheare N.C., et al, Perspective on Nursing Theory, 4th
Edition, Philadelphia, Lippincott William's and Welkin's 2004.
12. Sorensen and Luck Man's Basic Nursing: Psychological Approach,
3rd Edition W.B. Saunders Co. 1994.
- 75 -
13. Smeltzer S.C. and Bare, B.G., Brunner and Suddarth's Medical
Surgical Nursing. Gopsons Papers Ltd., Noida (India), 9th Edition,
2001.
14. Wilma J and Phipps, et al, Medical Surgical Nursing, St. Louis, CV
Mosby Co. 1979.

PY
15. Wesley, Ruby L., Nursing Theories and Models Prentice – Hall
Inc. Englewood Cliffs, NJ 07632, 1980.
16. NNC Act, Journal and Brochure
17. WHO Beyond 2000 in Nursing
18. ICN, NAN Constitutions, Journals and Brochures.
19. Atkinson, Leslie D., and Many Ellen Murray, (1982) Understanding
the Nursing Process.

Jersey. CO
20. Blatter, Barbara, (1981) Holistic Nursing, Prentice Hall, Inc. New

21. Bond. Meg (1986) Stress and Self-Awareness. A Guide for Nurses,
Willan
22. Chinn, Peggy L., (1979) Child Health Maintenance. The C.V.
Mosby Company, St. Conis.
23. Henderson. Virgima (1977) Basic Principles of Nursing Care, ICN,
T
Geneva.
24. Heinemam Medical Books, London.
25. McCaffry, Margo, (1979) Nursing Management of the Patient with
AF

Pain. JB Lippincoitt Co, Philadelphia.

26. Murray, Ruth. Zentner, Judith and Others, Nursing Concepts for
Health Promotion, Prentice – Hall, Inc., New Jersey.
27. Murray Ruth and Judith Zentner () Nursing Assessment and
Health Promotion Through the Life Span, Prentice – Hall Inc., New
Jersery.
DR

28. Potter P.A., (1985) Fundamentals of Nursing Concepts Process

and Practice C.V.S. Mosby Company St. Lovis Missatsi.
29. Phipps, Long Woods (1972) Medical Surgical Nursing (Concepts
and Clinical Practice). The C.V. Mosby Company, London.
30. Whaley and Wong, (1983) Nursing Care of Infants and Children,
the CV Mosby Company, St. Louise.
31. Recent edition of the mention books and journals.
32. Internet
33. Research reports

- 76 -
 Course Title: Medical Surgical
Nursing I
Placement: Second Year
Course Code: BSN-202 Full Mark: 100

PY
Total Hour:150 (Theory) Pass Mark: 50

COURSE DESCRIPTION

This course offers students an opportunity to apply the nursing

process/problem solving approach in the care of adult patients with
common medical-surgical conditions in a verity of settings, with special

CO
emphasis on promotive, preventive, curative and rehabilitative aspects
of nursing care.

COURSE OBJECTIVES

Upon completion of this course, the students will be able to:

Discuss the developmental needs and tasks of adult patients/
clients and role and responsibility of the nursing professionals.
Explain the etiology, patho-physiology clinical manifestations,
modifiable and non modifiable risk factors and complications of
T
different medical and surgical conditions of body system.
Describe the different laboratory and invasive and non invasive
diagnostic investigations for different body system
AF

Explain preventive measures and therapeutic approaches of

problems and disorders of different body system.
Apply nursing process/problem solving approach in the care of
the patient with specific medical surgical conditions in preventive,
promotive, curative and rehabilitative aspect.
Provide comprehensive care to the client as per need.
DR

COURSE CONTENTS

Unit I: Nursing process (review) 4 hrs.

1. Assessment
o History taking
o Complete physical examinations
o Observation/questionnaire/interview
2. Nursing Diagnosis
3. Planning
- 77 -
4. Implementations
5. Evaluation

Unit II: Pre and post operative nursing care: 4hours

1. Preoperative nursing care

PY
o Preparation
o Nutrition therapy
o Reduce anxiety
o Breathing exercise
o Preparation of the room for postoperative care.
2. Postoperative nursing care

CO
o Immediate post operative care
o Assessment of patient’s condition
o Monitoring: drainage, wound I.V
o Maintain comfort measure
o Discharge planning and instruction to patient.

Unit III: Developmental task and need of adulthood 6hours

1. Definition of terms: adulthood, young adult, middle adult.
T
2. Developmental process/physiological and psychological needs
at different stagesses.
3. Developmental task of young and middle aged adult.
AF

4. Health promotion and maintenance

5. Nursing implications.

Unit IV: Common Health Problems during Different Stages of

Life 2 hrs.
Young adulthood
DR

Middle adulthood
Late adulthood
Nursing implications of above stages

Unit V: Disorder related to different body system

1. Pulmonary disorders 16 hours

o Review of structure and function of respiratory system from
Anatomy and Physiology course
o Laboratory and diagnostic investigations: CT scanning, Pul-

- 78 -
 function test, Laryngoscopy, Bronchioscopy, Sputum test,
Cytological studies, Thoracocentesis, ABG analysis, Pulse
Oximmetry and Spirometry
o Etiology / Risk factors pathophysiology, preventive measure,
medical, surgical management nursing interventions using
nursing process for the following conditions:

PY
- Respiratory infections: Acute Chronic tracheobronchitis,
pneumonia, pulmonary tuberculosis, lung abscess,
histoplasmosis, atelectasis
- Pleural conditions: Pleural effusion, empyema and
Pneumothorax
- Chronic obstructive pulmonary disease (Emphysemia

CO
and Bronchitis), Asthma
- Respiratory distress syndrome, pulmonary
hypertension, pulmonary heart disease (Corpulmonale),
pulmonary embolism, sarcoidosis
- Occupational lung disease: Pneumoconiosis, silicosis,
asbestosis, coal workers' pneumoconiosis
- Chest tumors: Lung cancer (bronchogenic carcinoma),
Tumors of mediastinum
- Blunt chest trauma: Rib fractures, pulmonary contusion
T
- Penetrating chest trauma: Gunshot and stab wounds,
subcutaneous emphysema
- Other lung disease: Cystic fibrosis, respiratory
AF

insufficiency, Lungs Cancer

o Special medical and surgical management: Oxygen
therapy, neubulizer therapy, chest physiotherapy, airway
management, endotrachial intubation, tracheostomy care.
o Special nursing management of client in the following
condition
o Care of the patient with close chest drainage system.
DR

o Care of the patient undergoing Thoracic surgery.

o Care of the patient in mechanical ventilation.

2. Cardiovascular, circulatory and hematological disorder 16 hrs

o Review structure and function of cardiovascular, circulatory
system and blood
o Laboratory and diagnostic investigation: Diagnostic
imaging, cardiac catheterization and angiography/PTCA,
electrocardiography, cardiac monitoring, stress test, holter,
CVP monitoring, ECG, chest X-ray and fluoroscopy,

- 79 -
 echocardiography
- Definition: Etiology/risk factors, Patho-physiology,
clinical manifestation, preventive measures medical/
surgical management and nursing interventions using
the nursing process for the following conditions:

PY
◊ Coronary artery disease: Angina pectoris,
myocardial infarction,
- Conduction disorders: Heart block, Arrhythemia
◊ Cardiac pulmonary resucitation
◊ Defibrilator / cardioversion
◊ Cronary artry by pass graft (CABG)
◊ Care of patient with pacemaker implantation

CO
◊ Cardiac rehabilitation
- Valvular disorders
◊ Valvular Stenlosis
◊ Valvular Prolapse
◊ Valvular Regorgitation
- Congestive heart failure: Pulmonary edema,
cardiogenic shock/thromboembolism, pericardial
effusion and cardiac temponade, myocardial rupture,
cardiac arrest
- Inflammatory cardiac disease: Mitral valve prolapse,
T
mitral stenosis, mitral regurgitation, aortic regurgitation,
cardiomyopathy, rheumatic endocarditis, infective
endocarditis, myocarditis, pericarditis
AF

◊ Complications from heart disease: Acute pulmonary

edema, congestive heart failure, cardiogenic
shock
- Vascular disorders: Arterial sclerosis, atherosclerosis,
hypertension, arterial embolism, aneurysm,
raynaud's disease, thrombophlebitis, varicose veins
venous thrombosis, buerger's disease.
DR

- Hematologic disorders: Purpura, anemia, thalassemia,

polycythemaia, leucopenia and neutropenia,
leukaemia's, Hodgkin's disease, thrombocytopenia,
haemophilia
- Specific nursing management of the patient
3. Digestive disorder 12 hours
o Review structure and function of the digestive system
o Laboratory and diagnostic investigations: Gastric analysis,
duodenoscopy, endoscopy, gastroscopy, barium swallow,
barium meal, barium emema, examination of stool for occult
- 80 -
 blood, proctoscopy, sigmoidoscopy, colonoscopy, stool
culture, plain X-ray of abdomen, ultrasonogram, CT scan,
ERCP.
o Etiology, pathophysiology, preventive measures, medical,
surgical and nursing intervention using nursing process of
the following conditions:

PY
- Disorders of mouth: Dental plaque and caries, cancer
of oral cavities, infection of oral cavities.
- Esophagus disorder: Hiatal hernia, diverticulum,
foreign bodies, tumours, reflex disorder (GERD)
- Gastric and duodenal disorders: Gastritis, peptic ulcer,
gastric cancer

CO
- Intestinal and rectal disorders: Constipation, diarrhoea,
dysentery, vomiting, fecal incontinence, irritable bowel
syndrome, malabsorptions, appendicitis, diverticular
disease, peritonitis, crohn's disease, ulcerative colitis,
intestinal obstruction, colorectal cancer, anorectal
abscess, anal fistula, anal fissure, hemorrhoids,
pilonidal sinus/cyst
- Special nursing management of the patient with
gastrointestinal disorder and problem
Meeting the nutritional needs by tube feeding / Gastrostomy
T
o
care
o Colostomy care
AF

4. Hepatic and biliary disorders 8 hrs

o Review of structure and functions of hepatic and biliary
system
o Laboratory and diagnostic investigations: Serum bilirubin
test, liver enzyme test, serum protein test, serum amylase
and serum lipase test, oral cholecystography, IVP, IVC, USG
of liver, pancreas, gall bladder and biliary system, hepato-
biliary system, liver biopsy, hepatitis virus studies, CT scan,
DR

urine analysis etc.

o Etiology / risk factors, patho-physiology, preventive, medical
/surgical management, and nursing intervention using
nursing process for the following conditions:
- Hepatic dysfunction: Hepatitis
- Hepatic disorder: Hepatic cirrhosis, cancer of liver, liver
abscess, liver trauma
- Billary disorders: Cholecystitis, cholelithiasis
- Special nursing management for the patient with the
following procedures
- 81 -
 - Care of drainage tube and removed.
- Nursing management with related procedure
5. Musculoskeletal disorders 12 hours
o Review the structure and function of musculoskeletal system

PY
o Laboratory and diagnostic investigation: Radiographic
studies, electrographic procedure, fine needle aspiration for
cytology (FNAC), MRI, CT scan etc.
o Etiology, patho-physiology, medical / surgical management
and preventive measures, nursing interventions using
nursing process for the following conditions:
- Common musculoskeletal problems: Back pain

CO
- Common problems of the upper extremity: Bursitis and
tendonitis, carpel tendon syndrome, ganglion
- Metabolic bone disorders: Osteoporosis, osteomalacia,
paget's disease,
- Musculoskeletal infections: Osteomyelitis, septic
arthritis
- Neoplasm of bone
- Musculoskeletal trauma: Contusions, strains, and
sprains, fractures, dislocation and amputation.
T
- Rheumatic disorders: Rheumatoid arthritis, pyogenic
arthritis osteoarthritis, spondylitis, gout, other disorders
- Fracture – Types, complications and surgical/ medical
AF

management and nursing management using nursing

process
- Treatment modalities of fractures immobilization, open
and closed reduction, plaster cast, traction,
other fixation devices effects of immobilization on other
body systems
- Care of the patient in a cast, splints an braces, joint
DR

replacement, hip and knee replacement.

6. Urinary disorders 8 hrs
o Review structure and function of urinary system.
o Laboratory investigation and analysis: Urine analysis; renal
function tests, X-ray (KUB), ultrasonography, CT scan,
MRI, nuclear scans, intravenous urography, cystoscopy,
retrograde pyelography, biopsy, renal angiography etc.
o Etiology / risk factors, pathophysiology, preventive measures,
medical/surgical management, and nursing intervention
using nursing process of the following conditions:

- 82 -
 - Urinary and renal dysfunction: Fluid and electrolyte
imbalance, urinary retention, urinary incontinence,
neurogenic bladder.
- Urinary and renal disorders: Urinary tract infections,
pyelonephritis, glomerulonephritis, nephritic syndrome,

PY
urolithiesis, renal cancer, renal failure (Acute and
cronic).
- Other renal and urinary tract disorders: Nephrosclerosis,
hydronephrosis, urethritis
- Other urinary disorders: Polycystic disease, vascular
disorders, trauma of urinary tract.
- Special nursing management for the following

CO
procedures
◊ Paritoneal and hemodialysis
◊ Catheterization and continuous urinary drainage
◊ Care of patient with renal Transplantation.
7. Endocrinel disorders 14 hrs
o Review the structure and function of endocrine systems.
o Laboratory investigation and analysis: Basal metabolic
rate, flourescent test, urine testing for random blood sugar
and oral glucose tolerance T3, T4 tests, serum amylase
T
hemoglycoside etc.
o Etiology / risk factor, patho-physiology, preventive measures,
medical / surgical management, and nursing intervention
using nursing process for the following conditions including
AF

management of complications:
- Pituitary gland disorders: Abnormal pituitary function,
hypopituitarism, pituitary tumors, diabetes insipidus.
- Thyroid dysfunction: Abnormalities of thyroid functions,
hypothyroidism and hyperthyroidism, thyroiditis,
thyroid tumor.
DR

- Parathyroid dysfunction: Hyperparathyroidism,

hypoparathyroidism
- Adrenal glands disorders: Adrenocortical insufficiency
(Addison's disease), Cushing's Syndrome
- Pancreatic disorders: Pancreatitis, pancreatic cysts,
pancreatic tumors,]
- Diabetes mellitus: Types, complication
- Special nursing procedures
◊ Administration of insuline
◊ Administration of cortioson therapy

- 83 -
8. Neurological disorder 10 hrs
o Review the structure and function of nervous system
o Laboratory investigation and analysis: CT scan, MRI,
myelography, electroencephalography, electromyography
neurologic assessment, and Glasgow coma scale etc.

PY
o Etiology / risk factors, patho-physiology, preventive measures,
medical / surgical management, and nursing interventions
using nursing process for the following conditions:
- Cerobrovascular disease: Transient ischemic attack,
stroke
- Neurologic trauma: Head injury, spinal cord injury
- Neurologic disorders: Headache, brain tumors,

-
migraine

CO
Intracranial infections: Meningitis, encephalitis brain
abscess, intracranial aneurism.
Degenerative neurologic disorders: Multiple sclerosis,
parkinson's disease, huntington's disease, alzheimer's
disease, muscular dystrophies, seizure disorders,
myasthenia gravius
- Disorders of the spinal cord: Tumours, herniation
(PIVD)
T
- Cranial nerve disorders: Neuralgia, Bell's palsy
- Disorders of the peripheral nervous system: Guillain
Barre syndrome (GB syndrome)
AF

- Special nursing management if the client on the

following
◊ Care of Unconscious patient
◊ Care of increased intracranial pressure
◊ Care of patient undergoing craniotomy surgery
9. Breast disorders 4 hrs
DR

o Review structure and functions of breast

o Laboratory investigation and analysis: CT scan,
MRI, angiography myelegraphy, venography,
echoencephalography, electroencephalography,
electromyography, neurologic assessment, Glasgow coma
scale etc.
o Etiology, patho-physiology, modifiable non modifiable
risk factor, laboratory investigation and analysis medical,
surgical measures (Breast self examinations, periodic breast
checkup) or the following conditions/complications:
- Health problem on breast in Nepal: Benign breast

- 84 -
 disorders, breast reconstruction, cancer of breast,
metastatic disease.
10. Male reproductive disorders 4 hrs
o Review structure and functions of male reproductive systems

PY
o Laboratory and diagnostic investigation: Prostate-specific
antigen test, ultrasonography, prostate fluid or tissue analysis,
tests of male sexual function semen analysis, infertility test,
TSE, Digital rectal examination.
o Etiology / risk factors, pathophysiology, preventive measures,
medical / surgical management, and nursing intervention
using nursing process preventive measures for the following
conditions including management of complications:
-
-

-
CO
Disorders of male sexual function - impotence
The prostate disorders: Prostatitis, benign prostatic
hyperplasia (enlarged prostate), cancer of the prostate,
Balanitis
Conditions affecting the testes and adjacent structures:
Undescended testis (Cryptorchidism), orchitis,
epididymitis, testicular cancer, hydrocele, varicocele,
vasectomy (sterilization reversal)
- Penis disorders: Hypospadias and epispadias,
T
phimosis, cancer of the penis, priapism, urethral
strincture
11. Gerontological Problems 30 hrs
AF

o Theories of aging
o Psychological and cognitive aspects of aging
o Needs and developmental task of elderly people.
o Social attitude towards elderly.
o Ethical aspect that affect older adults
o Health promotion and maintenance of elderly people
DR

- Nutrition
- Physical activities and rest
- Stress management
- Safety measures
- Health checkup
- Religious actvities
o Physiological changes according to a body system approach
in the aging process and their nursing management:
- Sensory system,

- 85 -
 - Integument system,
- Musculoskeletal system, inability , activity intolerance
and prevention of fall
- Neurological system, dizziness
- Pulmonary system, C.O.P.D, cor-pulmonell

PY
- Endocrine system,
- Renal and urinary system, urinary incontinence
- Gastrointestinal system with nutritional considerations,
- Female reproductive system
- Cancer in old age
o Pain and pain management,
o
-
-
-
CO
Aging and infection,
HIV disease in older adults,
Medications and the elderly (altered pharmacokinetics)
Alterations in mental processing and the nursing
management of the following condition:
o Sleep disturbances,
o Acute confusion,
o Alzheimer's disease and other dementia in older adults,
T
- Special behavioural problems: Demanding, wandering
repetitious, annoying, persistent behaviour, paranoid
and suspicious behaviour, assaultive behaviour,
inappropriate sexual behavior.
AF

TEACHING LEARNING ACTIVITIES

METHODS
Lectures
Discussion
DR

Seminars and case presentation

Self directed problem based approach
Role play
Demonstration
Supplement reading in professional journal

MEDIA
White board
OHP
- 86 -
 Posters, charts and models
Skeleton
CD, video cassettes
LCD system

PY
EVALUATION
Internal assessment 20%
o Class presentation
o Project work
University examination
o Written examination 80%

REFERENCES

1.
CO
Brush, Lynaugh et al, Nurses for All Nations: A history of the
International Council for Nurses, 1999.
2. Blattner, Barbara, Holistic Nursing, New Jersey, Prentice-Hall, Inc.
1981.
3. George Jule B., Nursing Theories: A Base for Professional Nursing
T
Practice- Prentice-Hall Inc. 1980.
4. Homes, Carolyn Cooper, Hunt, Joseph Dayle, Basic Concepts of
Helping: A Holistic Approach,New York, Appleton Century Crofts,
AF

1980.
5. Koizer, B et al, Fundamentals of Nursing (Concepts, Process and
Practice) 7th Edition, 2004.
6. Mc Kenna, H., Nursing Theories and Models, Rontledge
Publication, 11 New Fetter Lane, London EC4P4EF, 2000.
7. Murry R., Zentar, et al, Nursing Concepts for Health Promotion,
DR

New Jessey, Prentice-Hall Inc. 1985.

8. Leddy, S and Pepper JM, Conceptual Base of Professional
Nursing, 4th Edition, Philadelphia, Lippincott-Raven, 1998.
9. Mc Caffy, Margo. Nursing Management of the patient with pain, JB
Lippincott Co. Philadelphia, 1979.
10. Potter P, Perry et al, Fundamental of Nursing: Concepts, Process
and Practice CV Mosky Co., 4th Edition Missouric, 2000.
11. Reed, PG, Sheare N.C., et al, Perspective on Nursing Theory, 4th
Edition, Philadelphia, Lippincott William's and Welkin's 2004.
12. Sorensen and Luck Man's Basic Nursing: Psychological Approach,
- 87 -
 3rd Edition W.B. Saunders Co. 1994.
13. Smeltzer S.C. and Bare, B.G., Brunner and Suddarth's Medical
Surgical Nursing. Gopsons Papers Ltd., Noida (India), 9th Edition,
2001.

PY
14. Wilma J and Phipps, et al, Medical Surgical Nursing, St. Louis, CV
Mosby Co. 1979.
15. Wesley, Ruby L., Nursing Theories and Models Prentice – Hall
Inc. Englewood Cliffs, NJ 07632, 1980.
16. NNC Act, Journal and Brochure
17. WHO Beyond 2000 in Nursing

CO
18. ICN, NAN Constitutions, Journals and Brochure
19. Recent edition of the mention books and journals.
20. Internet
21. Research reports
T
AF
DR

- 88 -
 Cource Title: MEDICAL SURGICAL
NURSING PRACTICUM
Placement: Second year
Total hours: 300 Full marks: 100

PY
Course code no: BSN - 202 Pass marks: 60

COURSE DESCRIPTION

This course offers students an opportunity to apply the nursing process/

problem solving approach in the care of adult's patient with common
medical and surgical conditions in a variety of setting with special

CO
emphasis on preventive, promotive, curatie and rehabilitative aspect of
nursing care. Students will spend 4 weeks in medical and 4 weeks in
surgical units during hte period of practicum.

COURSE CONTENTS

A. During the four weeks clinical placement in Medical unit, the

students will be able to:
o Identify physical, physiological and psychological problems
of the adult clients.
T
o Provide total nursing care to the client with different medical
disease conditions by applying nursing process.
o Perform blood transfusion, IV canulation, IM injection,
AF

catheterization, enema, oral suction, measure and record

vital signs, ROM exercise for bedridden patient, ECG, CVP
line care, medication, oxygen therapy, nebulization therapy,
chest physiotherapy, airway management, admission/
discharge procedure, etc competently.
o Prepare and assist the patient for diagnostic and therapeutic
procedures; lumber puncture, chest tube insertion,
paracenthesis, pleural fluid aspiration, liver biopsy, kidney
DR

biopsy, bone marrow aspiration, FNAC etc

o Prepare the patient for USG, EEG, Echo-cardiography, CT
scan, and Cardiac catheterization, Angiography including
pre and post procedure care.
o Collect the different types of specimens like blood, stool,
urine, sputum and send to the Lab.
o Differentiate abnormal investigation findings while providing
nursing care to the patient.
o Monitor the patient's condition through using different medical
devices like; pulse oxymeter, ECG monitor, peak flow meter,

- 89 -
 CVP line etc.
o Co-relate theoretical knowledge (etiology, patho-physiology,
risk factors, clinical features, investigations and medical/
surgical management) of different disease while providing
care to the patient.

PY
o Co-relate pharmacological knowledge used in different
disease condition while providing care to the patient.
o Prepare pocket drug book which are commonly used in
medical and surgical units.
o Demonstrate skills in history taking and physical examination
competently.
o Perform detail case study of a patient with medical problem
by applying one of the relevant nursing theory then prepare

B.
accordingly. CO
a report and present in the group.
o Identify patients health needs and provide health teaching

During the four weeks clinical placement in surgical unit, the

students will be able to:
o Identify physical, physiological and psychological problems
of the adult clients.
o Provide total nursing care to the client with different surgical
disease conditions by applying nursing process.
T
o Perform dressing by maintaining aseptic technique,
catheterization, catheter care, blood transfusion, IV canulation,
IM injection, enema, oral suction, measure and record vital
signs, ROM exercise for bedridden patient, ECG, CVP line
AF

care, medication, oxygen therapy, nebulization therapy, chest

physiotherapy, airway management, admission/discharge
procedure, accurate record and report etc.
o Perform pre and post operative nursing management of the
patient with different surgical conditions.
o Prepare and assist the patient for diagnostic and therapeutic
procedures; lumber puncture, chest tube insertion,
DR

paracenthesis, pleural fluid aspiration, liver biopsy, kidney

biopsy, bone marrow aspiration, FNAC, incision & drainage etc.
o Prepare the patient for USG, EEG, Echo-cardiography, CT
scan and Cardiac catheterization, Angiography including pre
and post procedure care.
o Collect the different types of specimens like blood, stool,
urine, sputum and send to the Lab.
o Differentiate abnormal investigation findings while providing
nursing care to the patient.
o Monitor the patient's condition through different medical
devices like; pulse oxymeter, ECG monitor, peak flow meter,
- 90 -
 CVP line etc.
o Co-relate theoretical knowledge (etiology, patho-physiology,
risk factors, clinical features, investigations and medical/
surgical management) of different disease while providing
care to the patient.

PY
o Co-relate pharmacological knowledge used in different
disease condition while providing care to the patient.
o Prepare pocket drug book which are commonly used in the
medical and surgical units.
o Demonstrate skills in history taking and physical examination
competently.
o Perform detail case study of a patient with surgical problem
by applying one of the relevant nursing theory then prepare

o
CO
a report and present in the group.
Identify patients health needs and provide health teaching accordingly.

Evaluation Scheme:

Internal Assessment: 50
Final Examination: 50
T
Internal assessment:
1. Performance evaluation: 20
o Medical ward 10
AF

o Surgical ward 10
2. Case study and presentation 7.5+7.5=15
o Medical ward – 1 5+2.5 =7
o Surgical ward – 1 5+2.5=7
3. Physical examination: 5
DR

o Medical ward – 2 2.5

o Surgical ward – 2 2.5
4. Formal Health teaching: 2.5
(Either in medical ward or surgical ward)
5. Procedure log book: 2.5
(Same procedure log book used in first year)
6. Preparation of pocket drug book: 5
(Commonly used in medical and surgical ward)
Total 50

- 91 -
 Course Title: Medical Surgical
Nursing II
Placement: Second year
Total hours:150 (theory) Full marks: 100

PY
Course code no: BSN - 203 Pass marks: 50

COURSE DESCRIPTION

This course is focused on care of Adult client with skin, eye, ENT
disorders and skill and knowledge regarding operating room nursing,
peri-operative nursing care.

COURSE OBJECTIVES

CO
Upon completion of this course students will be able to:
Explain etiology, pathophysiology, clinical manifestations,
diagnostic (invasive/non invasive) therapeutic and nursing
intervention of the client with disorders/problems of special
senses skin, eye, ENT
Provide pre-operative nursing care/management as per need of
the client.
T
Carryout the role and responsibilities of scrub nurse, circulating,
anesthetic and recovery nurse.
Describe complete process of preparation of patient, equipment
AF

or instrument package.
Maintain principle of surgical asepsis.
State routine policy/procedure of OR
Explain types of anesthesia, their uses, advantages,
disadvantages and role and responsibilities of nurse
Demonstrate ability to perform skills which provide comfort and
DR

healing to the client.

Upon completion of this course students will be able to:

Explain etiology, path physiology, risk factors clinical manifestation
types of malignancies, diagnostic, (invasive noninvasive),
preventive, promotive therapeutic, curative, and rehabilitative
nursing intervention of the client with cancer
Describe different treatment modalities of the patient with cancer
Explain complete process of the preparation of the patient
for diagnostic investigation, chemotherapy, immunotherapy,

- 92 -
 radiotherapy, and surgery
Discuss the need of palliative care in cancerous and non
cancerous disease problems
Identify effective ways of communication with patient and their
families

PY
Discuss effective ways of pain assessment and its management
Explain effective ways of management of the common symptoms
among patients/client requiring palliative care

CONTENTS

CO
Disorders of sensory organs 10 hours
Unit I: Integument conditions
Review anatomy and physiology of skin
Assessment/Diagnostic procedures
Trauma/Burn
Allergies
Infections
Medical/Surgical Nursing Care Management
T
Unit II: Ophthalmic Disorder 16 hours
Review the Anatomy and Physiology of the Eye
AF

Examination and assessment of vision

Diagnostic teast
Assessment of eye disorders
Medical/surgical nursing management of the following condition.
o Disorder of the eye lids,
o Lachrymal drainage disorder
DR

o Conjunctival disorder
o Corneal disorder
o Refraction Error
o Epidural and scleral disorder
o Lens disorder and blindness/catract
o Glaucoma , Retinal detachment
o Intraocular Tumors, Retinal vascular disorders, Strabismus
o Occular trauma and foreign body eye
Nursing management on special investigations ,diagnostic
- 93 -
 procedures, like slit lamp,
Tonometry, Snellens Chart, visual acuity test, IOP (Intra Occular
Pressure).
Eye irrigation
Instillation of medication, care of the patient undergoing eye

PY
surgery (Perioperative care)

Unit III: Disorder of the Ear 6 hours

Review anatomy and physiology of the ear.
Disorder of the External, middle and internal ear
Trauma, infection, degenerative conditions, external middle and
inner ear.
Hearing loss.
CO
Foreign body in the ear.
Nursing management of the client with the following conditions
Meniere’s Disease
Otalgia, Tinnitus
Tympanoplasty
Hearing aids.
T
Nursing management of the patients in diagnostic, preventive,
curative, and rehabilitative aspect of care utilizing nursing
process.
AF

Pre and postoperative nursing care of ear surgery.

Unit IV: Disorder of the Nose and Throat 8 hours

Review anatomy and physiology of the nose
Assessment of the client with nose and throat disorders
Diagnostic test and investigations
DR

o Nasal septal disorder

o Rhinitis (Acute Chronic ,Allergic)
o Sinusitis (Acute ,Chronic, Allergic)
o Epistaxis, Foreign body in the nose.
o Nasal Polyp and tumors.
o Neoplasm of the nasal cavity,
o Review anatomy and physiology of the pharynx, Larynx,
o Disorder of the pharynx, Larynx,
o Speech disorder and problem

- 94 -
 o Foreign body throat,
o Tonsillitis, Tracheostomy
Nursing management of the client with above problems in the
area of preventive, promotive, curative and rehabilitative aspect
of care utilizing nursing process

PY
Unit V: Trauma and Emergency Nursing 10 hours
Overview of the emergency nursing
Priorities and principle of emergency care (triage)
Basic Life support(CPR)
Pre-hospital care/ First Aid

CO
Medical/Surgical emergencies, behavioral emergencies
Trauma care, Surgical care and fracture
Disaster (political riots, landslides, earthquake, floods,
communicable diseases)its preparation and management of
mass casualty
Anaphylaxis , snake bite, stings, dog bite, frost bite
Poisoning, (OPP, Kerosene, Acids)
Death in emergency/ Care of dead body
T
Handling of Medico legal Case in Emergency

Unit VI: Oncology and Palliative Care 30 hours

AF

Cancer 5 Hours
Introduction ( Prevalence- Global and National)
Risk Factors/Warning signs and Etiology
Types, stages
Path physiology of Tumor, Carcinogens
DR

Primary, secondary and tertiary prevention and control

Different Diagnostic Investigation and Patient Preparation
o Biopsy( Histopathology)
o X-Ray
o Pap Smear
o Mammogram/ BSE
Cancer Treatment Modalities with Nursing Management 5 Hours
Chemotherapy
Radiotherapy
- 95 -
 Immunotherapy
Hormonal Therapy
Surgery
Combined Therapy

PY
Rehabilitation and Occupational Therapy
Palliative Care 2 Hours
Introduction/ Definition
o History- Global/National
Challenges of Palliative Care in Developing Country
Need of Palliative Care in Cancerous and Non-Cancerous Patient
Non Cancerous
o Diabetes
o Renal Failure
o Respiratory Problems
o Cardiac Problems
CO
o HIV/ AIDS
Management of common Symptoms in Palliative Care Setting 2 Hours
Nausea and Vomiting
T
Oral Problems
Diarrhea/ Constipation
Anorexia/ Cachexia
AF

Pressure Sore/ Wound

Pain
Lymphoedema
Nutritional problems
Pain Management 4 Hours
DR

Definition of Pain
Type of Pain
Nursing Management in Pain Relief
o Pain Assessment Tool
o Pharmacologic Pain Management (WHO Ladder)
o No Pharmacological Pain Management ( Covene by Cancer
Patient)
Common Drugs Used in Cancer Patient 4 Hours
Indications and Side Effects
- 96 -
 Mechanism of Action
Nursing Consideration
o Anti Cancer Drugs
o Steroid
o Analgesics/ NSAID

PY
o Anti emetics
o Laxative
o Others
Psycho social Aspect in Palliative Care 7 Hours
Communication

CO
o Definition
o Barrier
o Ways to Make Effective Communication
o Breaking Bad News ( Steps of Breaking Bad News)
Psychological Problems and Its Management
o Delirium
o Dementia
o Depression
o Anxiety
T
Psychosocial Aspects of Terminally Ill Patient
o Patient
o Family
AF

Spiritual Care
Grieve and Bereavement
End of Life Care/ Hospice 3 Hours
Introduction of End of Life care
Signs and Symptoms
DR

Care and Management of Patient at the End Stage of Life

Including Last 48 Hours
Ethical Issues in End Stage Life Care

Unit VII: Operation Theatre Nursing 25 hours

I. Introduction to Intraoperative nursing

o Overview of OT and CSSD layout/setup
o Qualities of the OT nurse

- 97 -
II. Operation Theatre Technique
o Maintenance of aseptic technique ( universal precaution)
o Sterilization of equipment and supplies
o Techniques of scrubbing, gowning and gloving
o Responsibilities of the scrub nurse, circulating nurse and

PY
recovery room nurse
III. Administration of anesthesia
o Types of anesthesia
o Stages of anesthesia
o Complications of anesthesia
o Role and responsibilities of anesthesia nurse

CO
IV. Perioperative Nursing Care
o Preoperative
o Intraoperative
o Post operative
V. Safety Precaution
o Prevention of accident and fire hazards
o Position and draping of patient
o Care of equipment and supplies
T
AF
DR

- 98 -
 Medical Surgical NURSING II
(PRACTICUM)
Placement : Second year
Hours: 200 Full marks: 100

PY
Course Code : BSN 203 Pass marks: 60

OBJECTIVES

Utilize of nursing process in providing holistic care to adult clients.

Providing health education to the clients according to needs.
Assist/perform different diagnostic procedures and investigation

CO
Provide nursing care to the patients with eye , skin , ENT , cancer
disease.
Provide appropriate pre and postoperative nursing care for
patient under going surgery.
Carryout the scrub and circulting nurse responsibility in operation
theatre.
Demonstrate understanding of health hazard in OT and take
necessary precaution for the safty of the OT staffs and patients.
T
CLINICAL EXPERENCE

Students will be posted to various units for clinical practice under the
AF

guidance of clinical supervisor for a total period of 200 hours. Students

will have experiences in various areas such as EENT, OT, Emergency,
and cancer hospital unit.

Clinical activites are:

Provide comprehensive nursing care.

DR

Assist in special investigation and procedures

Case study and presentation
Health education according to needs of client’s
Carryout the role of scrub and circulating nurse
Assisting in anesthesia
Taking care of the patient in recovery room.
Preparing nursing care plan and implementation of care plan
Maintain log book.

- 99 -
Evaluations

Internal evaluation: 50%

o Clinical performance ( each area) 20
o Nursing care plan in each area 5

PY
o Performance evaluation in OT 15
o Health teaching 5
o Case study and presentation 5

Final examination:50%
o Practical exam

REFERENCE

1.

2.
CO
Brush, Lynaugh et al, Nurses for All Nations: A history of the
International Council for Nurses, 1999.
Blattner, Barbara, Holistic Nursing, New Jersey, Prentice-Hall,
Inc.1981.
3. George Jule B., Nursing Theories: A Base for Professional Nursing
Practice- Prentice-Hall Inc. 1980.
T
4. Homes, Carolyn Cooper, Hunt, Joseph Dayle, Basic Concepts of
Helping: A Holistic Approach,New York, Appleton Century Crofts,
1980.
AF

5. Koizer, B et al, Fundamentals of Nursing (Concepts, Process and

Practice) 7th Edition, 2004.
6. Mc Kenna, H., Nursing Theories and Models, Rontledge
Publication, 11 New Fetter Lane, London EC4P4EF, 2000.
7. Murry R., Zentar, et al, Nursing Concepts for Health Promotion,
New Jessey, Prentice-Hall Inc. 1985.
DR

8. Leddy, S and Pepper JM, Conceptual Base of Professional

Nursing, 4th Edition, Philadelphia, Lippincott-Raven, 1998.
9. Mc Caffy, Margo. Nursing Management of the patient with pain, JB
Lippincott Co. Philadelphia, 1979.
10. Potter P, Perry et al, Fundamental of Nursing: Concepts, Process
and Practice CV Mosky Co., 4th Edition Missouric, 2000.
11. Reed, PG, Sheare N.C., et al, Perspective on Nursing Theory, 4th
Edition, Philadelphia, Lippincott William's and Welkin's 2004.
12. Sorensen and Luck Man's Basic Nursing: Psychological Approach,
3rd Edition W.B. Saunders Co. 1994.
- 100 -
13. Smeltzer S.C. and Bare, B.G., Brunner and Suddarth's Medical
Surgical Nursing. Gopsons Papers Ltd., Noida (India), 9th Edition,
2001.
14. Wilma J and Phipps, et al, Medical Surgical Nursing, St. Louis, CV
Mosby Co. 1979.

PY
15. Wesley, Ruby L., Nursing Theories and Models Prentice – Hall
Inc. Englewood Cliffs, NJ 07632, 1980.
16. NNC Act, Journal and Brochure
17. WHO Beyond 2000 in Nursing
18. ICN, NAN Constitutions, Journals and Brochure
19. Recent edition of the mention books and journals.
20. Internet
21. Research reports
CO
T
AF
DR

- 101 -
 COURSE TITLE: MENTAL HEALTH
(Psychiatric Nursing)
Placement: Second year
Course Code : BSN- 204 Full Mark: 100

PY
Total hours:100 (theory) Pass Mark: 50

COURSE DESCRIPTION

This course focuses on the principles and theory of psychiatric nursing

in providing care to persons’ with mental health disorders. This course
facilitates the students learning by using different theory related

CO
to mental health in the provision of holistic care to the client/ family
with mental disorders in various health care settings. This course
emphasizes on the roles and responsibilities of the mental health nurse
in various levels of health care settings.

COURSE OBJECTIVES

At the end of the course, the student will be able to:

Identify the role/ responsibilities of the mental health nurse in
various settings.
T
Develop knowledge/ skills about persons’ with psychiatric
problems and understand the nursing management.
Discuss the importance of therapeutic relationships in caring for
AF

persons’ with mental health problem

Identify different psychiatric disorders and their management
Identify ‘persons’ with substance and alcohol related disorders.
Discuss the role of the nurse in caring for the ‘person’ with various
psychiatric disorders.
Explain the importance of community mental health programs
DR

Explain the legal aspects related to mental health nursing in

Nepal.

COURSE OVERVIEW

Unit 1: Introduction 8 Hrs

Terminology use in psychiatric nursing
Definition of mental health and mental illness.
Characteristics of mentally healthy ‘person’ (Normalcy)

- 102 -
 Historical perspective of psychiatry and psychiatric nursing
Misconception about mental illness.
Major classification of mental illness: DSM IV , ICD 10
Principle of mental health nursing.

PY
Magnitude of mental health problems in Nepal
Causes of mental illness.
Roles of nurses in hospital & community.

Unit 2: Personality Development: 6 Hrs

Determinants of personality

CO
o Personality theories:
o Sigmund Freud
o Erik Erickson
o Piaget
o Sullivan

Unit 3: Mental Health Assessment (MSE) 10Hrs

History taking
Mental Status Examination
T
Charecteristics of mentally healthy person
Investigations:
o EEG
AF

o CT
o MRI
o Others
o Psychological Test: I.Q. Test, Personality Test.

Unit 4: Therapeutic Relationship 4Hrs

DR

Definition
Phases
Therapeutic communication,technique
Preocess Recording

Unit 5: Psychotic disorders: 8 Hrs

Classification of mental disorders: DSM IV, ICD 10. Simple
classification.

- 103 -
 Psychotic disorders
o Acute Transient psychotic disorder
o Schizophrenia ( chronic psychotic disorder)
o Organic psychosis: (Delirium/Dementia)
Diagnostic criteria

PY
Etiology
Treatment and nursing management.

Unit 6: Affective / Mood disorders 6 Hrs

Major depressive disorders
o Bipolar mood disorder/ Mania
o Major depression

Diagnostic criteria
Etiology
CO
o Bipolar I, Bipolar II

Treatment and nursing management

Unit 7: Neurotic/ Stress related disorder 8 Hrs

Phobic anxiety disorder (Phobia)
T
Generalized anxiety disorder (GAD)
Panic disorder
AF

Obsessive –compulsive disorder ( OCD)

Dissociative ( conversion disorders)
Post- Traumatic stress disorder
Hypochondriasis
Psychosomatic disorders: (CAD, Headache, Bronchial asthma,
Peptic ulcer, ulcerative colitis
DR

Eating disorders - Anorexia nervosa, Bulimia,

Treatment and nursing management

Unit 8: Personality disorders 6 Hrs

Hystrionic personality disorder
Schizoid personality disorder
Antisocial personality disorder (Psychopathic)
Paranoid personality disorder
Borderline personality disorder

- 104 -
 Obsessive compulsive personality disorder
Treatment and nursing care for personality disorder

Unit 9: Psychosexual disorders 4hrs

PY
Sexual orientation disorder
Sexual deviation
Male and female sexual dysfunction
Treatment and nursing responsibilities

Unit 10: Mental health Problems in Pregnancy/ Postnatal 3 Hrs

CO
Post natal blues
Postnatal psychosis
Postnatal depression

Unit 11: Substance and alcohol related disorders 8 Hrs

Definition
Alcohol use disorder
Drugs
T
o Opium
o Cannabis
o Sedatives
AF

o Stimulants
o Hallucinogen
Prevention and rehabilitation of substance abuse

Unit 12: Childhood Mental and Behavioral disorders 10 Hrs

Mental retardation
DR

Autistic disorder
Conduct disorder
Attention deficit hyperactive disorders
Separation anxiety disorder
School phobia
Behavioral problems: enuresis, encoperesis, pica
Learning disabilities
Speech Disorders: stuttering.
Anorexia nervosa/bulimia
- 105 -
 Nursing responsibilities in caring for these children and families

Unit 13: Mental health problem in old age 3 Hrs

Dementia

PY
Depression

Unit 14: Psychiatric Emergency 6 Hrs

Crisis intervention
Suicide
Lithium toxicity

CO
Panic attack
Aggressive patient (Violent Patient)

Unit 15: Treatment Modalities in Mental Health nursing 14 hrs

Therapeutic relationship
Psychotropic drugs
Physical therapy ( Electroconvulsive therapy)
Counseling
T
Psychotherapy
Restraining
Milieu therapy
AF

Rehabilitation
Occupational therapy
Therapeutic session

Unit 16: Legal Aspects of Mental Health nursing 4 Hrs

Admission and discharge procedure
DR

Right of the mentally ill

Mental health policy and act
Strategy of mental health.

Unit 17: Community Mental Health nursing 4 Hrs

Trends of care: institutionalisation de- institutionalisation
Public health model of care:
o Primary prevention

- 106 -
 o Secondary prevention
o Tertiary prevention
o Role of nurse in community mental health programs.

TEACHING/ LEARNING METHODS

PY
Lecture/ Discussion
Problem based learning
Case study presentation
Group projects

CO
EVALUATION

Internal Assessment
Written exam
Project work
Class assignment and presentation
Final Examination
Written examination
T
REFERENCES

1. Ahuja N. A short Textbook of Psychiatry, 2nd Ed, New Delhi,

AF

Jaypee Brothers. 1992.

2. Bhatia MS., Psychiatric Nursing, 2nd edition. CBS Publishers
Delhi. 1999.
3. Mitchell RG. Essential psychiatric Nursing. Churchill Livingstone.
Edinburg. 1986.
4. Kapoor B.A Text book of Psychiatric Nursing. Kumar Publishing
DR

House. New Delhi (Vol. I & II). 1992.

5. Fernald LD. Introduction to Psychology, 5th Edition. A.I.
T.B.S.Publishers India.1999.
6. Martin P. Care of the Mentally Ill. Mac Millen, 2nd Edition.
London.1987.
7. Mayer SB. A guide to nursing management of psychiatric patients.
Mosby Co.St Louis. 1975.
8. Nepal M.K., Christ W. Manual of Mental Health for Community
Health workers. HLMP. Kathmandu. 1988.

- 107 -
9. Sorensen LM. Basic Nursing Psychological Approach. 1986.
10. Nambi S. Psychiatry for Nurses. Jaypee Brothers Medical
Publishers. India.1998.
11. Recent Edition

PY
12. Journal of Mental Health
13. Internet

CO
T
AF
DR

- 108 -
 MENTAL HEALTH NURSING (CLINICAL)
Hours: 200 Full Marks: 100
Placement: BSN Second year Pass Marks: 60

PY
COURSE DESCRIPTION

This course offers the students opportunity to apply principle of mental

health nursing in providing holistic nursing care to the mentally ill
patients and their families. This course also helps to develop skills of
conducting therapeutic counceling.

OBJECTIVES

CO
At the end of this course the students will be able to:
Provide care to patients/families with mental illness using nursing
process.
Perform history taking and mental status examinationof mentally
ill client.
Prepare nursing care plans according to individual needs
Plan and conduct health teaching according to needs.
T
Communicate effectively
Conduct therapeutic session with clients/ families
Counsel the client and families with menta illness
AF

CLINICAL ACTIVITIES

History taking
Mental status examination
Planning and provide nursing care
DR

Counseling clients and families

Conduct therapeutic session
Observation of the services at specific mental health institution

EVALUATION

Internal assessment =50%

Clinical performance 15
Case study 10
Mental status examination 5

- 109 -
 Histry taking 5
Nursing care plan 5
Drug record 5
Presentation 5

PY
Final examination: 50%
Viva

CO
T
AF
DR

- 110 -
 Community Health Nursing – II
(Theory)
Placement: Second year
Total:100 hrs (theory) Full marks: 100

PY
Code: BSN - 205 Pass marks: 50

COURSE DESCRIPTION

To provide comprenhensive knowledge skill and attitude in relation to

school health programme, occupational health care, family planning,
maternal and chield health, care of communicable diseases including

CO
national nutrition strategies and activities.

OBJECTIVES

Describe the communicable diseases and state the national

programme expanded programme on immunijation.
Describe the school health programe, occupational health
programe, MCH care, family planning
Explain the concept of reproductive health, national policy and
T
strategy of reproductive health
Describe the national nutritional programe in relation to major
nutritional health problems.
AF

Discuss need based health education to client and group of

community, utilization of appropriate method and media.

Unit I: Community Health Resources 10 hrs

Define
Health resources
DR

o Human resources
o Financial
o Material
o Time
o Place/market
Local community resources
o Family
o TBA
o FCHV
o Traditional/political leaders
- 111 -
 o CBOs
o NGOs
Developmental partners
o National
- Government organization

PY
- Non-government organization (FPAN, Nepal Red
Cross Society)
o International
- WHO
- UNFPA
- UNICEF
-
-
-
-
-
USAID

CARE
GTZ
CO
Save the Children

The World Bank

Unit II: Communicable Diseases 8 hrs

Terminology
T
o Communicable
o Communicable disease
o Communicable period
AF

Terms used in Epidemiology (Review)

o Infections

o Dynamics of disease transmission

(Review- Epidemiology)
Modes of transmission (review)
DR

o
o Susceptible Host- (Review)
o Host Defences-
- Immunization
Effects of communicable disease and non- communicable
diseases health conditions
o Health status of individual, family, community
o Morbidity and Mortality
o Target population
Communicable diseases
- 112 -
 o Each of the disease to be emphasized as follows:
- Introduction
- Magnitude of the problem
- Epidemiological features
- Agents

PY
- Host factors
- Mode of transmission
- Patho-physiology
- Signs and symptoms
- Incubation period
- Complication
-
-
-
-
-
Treatment CO
Clinical features
Diagnosis

Prevention measures
National strategy

Unit III: Types of communicable diseases 12hrs

Viral
T
o Poliomyelitis
o Influenza
o Mumps
AF

o Measles
o Rubella (German Measles)
o Viral Hepatitis
o Chicken Pox
o Dengue Fever
o Trachoma
DR

o Rabies
o Japanese Encephalitis
Bacterial
o Diphtheria
o Pertusis
o Tetanus
o Tuberculosis
o Leprosy
o Cholera

- 113 -
 o Typhoid
o Diarrhoeal disease
Bacillary
Dysentery

PY
Protozoal Disease
o Amoebiasis (Amoebic Dysentery)
o Malaria
Worm Infestation
o Round worm (Ascariasis)
o Hook worm infestation
o Guinea worm infestation
o Filariasis

CO
o Tapeworm infestation
Sexually Transmitted Disease
o Syphilis
o Gonorrhoea
o AIDS (HIV/AIDS)
National Disease Control Programme
o Malaria Control Programme
T
o National Tuberculosis Control Programme
o Leprosy Control Programme
o Kalazar
AF

Unit IV: Primary Health Care 8 hrs

1. Definition and Concept
2. Elements of PHC
3. Principles of PHC
4. MDG (Millennium Development Goal)
DR

5. Role of community health nurse in working towards the PHC

6. Basic health needs
o Food
o Cloth
o Shelter

Unit V: Maternal and Child Health services (MCH) 10 hrs

1. Antenatal care
o Objective

- 114 -
 o Prenatal care and advice
o Antenatal visit (WHO recommended)
o Risk approach
2. Detrimental care/domiciliary care
o Objective

PY
o Preparation for delivery
o Safe clean delivery
o Birth preparedness
3. Postnatal care
o Objective
o Postnatal care and advice

CO
o Examination of mother and new born baby
o Immediate care of new born
o maternity care/newborn at the primary health care level

Unit VI: Family Planning (FP) 10 hrs

1. Introduction of family planning
o Definition
o Scope
T
o Type of FP
o Unmet need
o FP services in Nepal
AF

2. Counselling
o Introduction
o Informed choice
o Counselling approach (ABIBHADAN)
3. Emergency contraception
o Combine oral contraception
DR

o IUD (Intra Uterine Device)

o Others
4. Contraception for special group
o Adolescents
o Women over 35 years
o Post abortion
5. Management of family planning complication

- 115 -
Unit VII: Immunization 10 hrs
1. EPI (Expanded Program of Immunization) in Nepal:
2. Immunity
o Terminology

PY
o Classification of immunity
o Immune response
o Agent of immunization
3. National Immunization schedule
o Immunization of pregnant women
o Immunization for children
4. Preservation of vaccine

5.
CO
o Cold chain system-refrigerator:
Administration of vaccine
o Checking the vaccine
o Vaccine containers- ampoule/vial
o Site of injection (see on immunization schedule)
6. Steps of administering various vaccine
o Injectable +Oral
o Measles + BCG
T
o Counseling to parents, families
7. Community health nurse responsibility in immunization program/
coverage
AF

o Clinic management
o Equipments and vaccines
o Health education

Unit VIII: Reproductive Health 8 hrs

1. Definitions and concept of (Cairo conference 1994)
DR

2. Platforms for Action (Beijing conference 1995)

3. Principles of RH
4. Family reproductive healths
5. Component of reproductive health
6. Areas of RH care
7. National RH package
8. Roles of nurse in RH elements

- 116 -
Unit IX: Gender Issue 6 hrs
1. Introductions and definition
2. Equity and bias
3. Discrimination

PY
4. Violence
5. Main streaming
6. Roles and responsibilities of nurses in gender issues

Unit X: Family Health 6 hrs

1. Concept of family health
o Definition family and its types, functions

2.
CO
o Definition of family health and family health nursing
Freeman’s topology of health problems
o Health threat
o Health deficit
o Crisis situation
3. Nursing process in relation to family health care
o The assessment phase
o The intervention phase
T
o The evaluation phase
4. Home based health care
5. Role of nurses in family health
AF

Unit XI: School Health Programme 6 hrs

1. Introduction and concept
2. Objectives and activities
3. Common school health issues and their management
4. Identification of high risk school children
DR

5. Roles and responsibilities of community health nurse in school

health programme

Unit XII: Occupational Health 6 hrs

1. Introduction
2. Occupational hazards
o Physical
o Chemical
o Biological

- 117 -
 o Mechanical
o Psychosocial
3. Occupational diseases
o Physical agents
o Chemical agents

PY
o Biological agents
4. Occupational environment
o Man and man
o Man and machine
o Man and physical, chemical and biological agents
5. Measures for protection

o Safety work place

o Legislation
o Other measures
CO
o Medical examination
o Safety measures

- Nutrition
- Control of communicable disease
- Mental health
T
- Health education
- Family planning
6. Roles of nurses in occupational health
AF

REFERENCES

1. Basavanthapa B.T, Community Health Nursing, Jaypee Brothers,

2003.
2. Prabhakar G.N, Textbook of Community Health for Nurses,
peepee, 1st Ed, 2004.
DR

3. Park .K, Preventive and Social Medicine, M/S Banarasdas Bhanot,

Latest Edition.
4. Annual Report, Dept of Health survives, HMG Nepal MOH, Dept
of Health survives KTM, Latest Ed.
5. Sapkota Shiv. Prasad, A Handbook of Health Education and
Communication, Vidyarthi Pustak Bandar, 1st Ed, 2004.
6. Shavema. S.R, Koushik Vijay, Nursing and Health Education,
Anmol Publication PVT. LTD. New Delhi; 2002.
7. Health Care Management, National open college.

- 118 -
8. Community As Partner, Elizabeth T Analysis Judith MC Far lance
Theory of practice in Nursing, Lippincott, 3rd edition.
9. Annual Report DHS 2057/58(2000/2001).
10. Strategic Guidelines for National Immunization Program of Nepal

PY
EPI Section Child Health Div., DHS, Teku, Ktm. September 2000.
11. Recent edition of the mention books and journals.
12. Internet
13. Research reports

CO
T
AF
DR

- 119 -
 Community Health Nursing II
Practicum
Placement: Second year
Total hour : 200 Full marks: 100

PY
Code: BSN - 205 Pass marks: 60

COURSE DESCRIPTION

This course is the continuation of BSN-205. It will provide the

opportunity to the students to gain experience and develop the skills
on school health, occupational health, family planning, Maternal and

CO
Child Health programs by utilizing the knowledge of community health
nursing focusing on reproductive health.

COURSE OBJECTIVES

Upon the successful completion of this course, students will be able to:

Assess and identify health related problems of the school and

industry/factory.
Plan, implement and evaluate the health activities using nursing
T
process.
Make referrals of cases to appropriate agencies if required.
Assist and participate the ongoing health activities/programs in
AF

school and industry/factory/FP MCH clinics.

Assist and Participate in providing services from F/P MCH clinics
as per the national policy and strategy.
Store, prepare and administer vaccines to children, pregnant
women and others.
Provide FP counseling to the mothers/eligible couples regarding
DR

various methods available in Nepal.

Coordinate with school, industries, and clinic staffs and other
concerned organizations in providing health services.
Assess the services provided by the various health related
organizations/institutions/centers through observation visit.

TEACHING/LEARNING AREAS AND ACTIVITIES

Students will be exposed to the following areas for 5 weeks as specified

in evaluation scheme under close supervision by the faculty.

- 120 -
 F/P MCH and Immunization clinic (either outreach or health
facility based)
Local Schools for SHP
Industries/factories for occupational health program
Observation visit: Students will spend a week period visiting at

PY
least five (5) specified organization(s)/ institution(s), centre(s)/
unit(s) (listed below) and write and submit the report as per the
guidelines provided.
o Possible organization/institutions/centers related to:
- Tuberculosis
- Leprosy

CO
- Nutritional programs
- HIV/AIDS
- Community based rehabilitation centers
- Others.
Students will be assigned to F/P MCH clinic for two weeks.
Students assist in providing immunization, F/P services to the
clients and teaching to ANC and PNC mothers as per their needs.
Students to keep the log book of the cases attended by them
during their practicum at F/P MCH clinic.
T
Students to identify the health problems of the school and factory/
industry and plan one health teaching as per the need.
Students to prioritize the identified health problems and conduct
AF

one micro health project either at school or industry/factory.

Students to hold pre and post conference every week with the
faculty, staffs and friends in order to discuss the problems faced
by them at the practicum site.
DR

- 121 -
EVALUATION SCHEME

Allocated time Total Marks

Internal Assessment (50)

PY
i. FP/MCH 2 weeks (40)
- Student’s performance 10
- Health teaching 5
- Completion of HMS-32 form 2.5
- Log book (Immunization, 2.5

CO
family planning, growth
monitoring, ANC/PNC and
common illness in children)
ii. School Health program 1 week 10
iii. Industrial Health program Micro 1 week 10
health project and health teaching
(One in SHP and one in IHP)
iv. Observation visit report 1 week 5
T
v. Report writing and Final 2-3 days 5
Presentation
Total 5 weeks 50
AF

Final Examination (Viva) (50)

DR

- 122 -
 Course Title: Medical Sociology/
Anthropology
Placement: Second year
Course Code: BSN- 206 Full Marks: 100

PY
Total Hours: 100 Pass Marks: 50

COURSE DESCRIPTION

The course aims to provide the students the knowledge on different

patterns of human behavior, cultural beliefs and practices, which
influence the patient’s perception and response to illness. This course

CO
will also help them to understand the relationship between health and
sociological/anthropological theories and tradition and encourages.
They will be able to apply the knowledge acquired more effectively and
productively during health services to the people.

COURSE OBJECTIVES

Upon the successful completion of the course, the students will be able
to:
Explain the concept of sociology/anthropology in health.
T
Describe historical evolution of society and health care practices.
Develop a cross-cultural approach in planning, executing,
monitoring and evaluating the heath programmers.
AF

Use the knowledge of psychology in understanding different

patterns of human behaviour in self and others.
Describe the importance of psychology in the planning,
implementation and evaluation of health programmers.
Describe the relationship between health policy and political
process.
DR

Explain the legislative procedures, executive set up, and

procedures of health policy formation.
Advocate issues affecting health of common people.

COURSE CONTENT

A. MEDICALSOCIOLOGY 32hours
Unit 1: Historical Development of Society 6 hours
Introduction, definition, nature and scope of sociology /

- 123 -
 anthropology
Branches of health sociology / anthropology
History, present status,emergence of medical sociology, and
medical anthropology
Health sociology and health anthropology.

PY
Unit 2: Health and disease in different stages of human
evolution. 6 hours
Health and sickness in different stages hunting and food gathering
stages, agricultural stage, industrial stage.
Definition of health, disease, illness and sickness

CO
Social role of illness and sickness
Stages in illness
The symptom experience stage
Assumption of sick role stage
The medical care contact stage
The recovery of rehabilitation stage

Unit 3: Nurse Patient Relationship 4 hours

T
Meaning and significance of the interpersonal relationship
Parson’s and Saaz-Hollender sick role model
Communication pattern between modern provider – consumer
AF

and indigenous provider

Barriers on effective provider consumer relationship

Unit 4: Culture and Health 8 hours

Meaning and definition of culture.
DR

Characteristics of culture.
Elements of culture.
Ethno medicine.
Non-medical system, strength and weakness.
Personality, naturalistic medical system.
Cross cultural examples of culture in relation to behaviour and
health problem in
Health care system.
Indigenous healers in changing world with particular reference
to Nepal
- 124 -
 Role of indigenous healers in primary health care
Self medication and other prevailing health care practice in Nepal
Perception of illness, hierarchy and food habit in Nepal
Anthropological research methodology

PY
Unit 5: Socio cultural change, social problem, and control 4 hrs
Definition and nature of social and cultural change
Causes and barriers of change
Meaning nature and course of social problem
Social problems: prostitution, sexual abuse, alcoholism, drug
abuse models, crime, suicide, child labour and their impact in
society and health

CO
Meaning of social control
Purpose of social control
Control by law, morality, social sanction and other means
Practice of social control in health in Nepal

Unit 6: Cultural Groups of Nepal 2 hours

T
Nutritional beliefs in child bearring and rearing practices in
different cultural groups of Nepal

B. APPLIED PSYCHOLOGY 16 hrs.

AF

Unit 1: Introduction to behavioral Science

Definition of psychology
Definition and significance of behavioural science in nursing
Relationship of sociology, psychology, and anthropology
DR

Unit 2: Emotion 4 hours

Characteristics of emotion
Emotional development throughout life cycle by Erick Erickson emotion
Purpose of emotion
Way of expressing emotion and controlling
Emotion and health

Unit 3: Motivation 6hours

Definition

- 125 -
 Types of motivation
Theories of motivation
Role of motivation in learning and education in relation to
behaviour.

PY
Unit 4: Learning 4 hours
Definition
Factors of effective Learning
Law of Learning’

Unit 5: Perception 4hours

C.
CO
Meaning and definition of attention, Perception & Sensation
Factors affecting perception
Role of Perception in Health believe and practice

HEALTH POLITICS 16 hours

Unit 1: Introduction to health politics 2hours

T
Concept of health politics
Relationship between health and politics
World trends of health politics
AF

Unit 2: Legislative aspects of Health 4 hours

Political decisions and their effects on health policy formation
Role of health advocacy and lobbying in health policy formation
Legislative procedure related to health
DR

Unit 3: Executive aspects of health 4 hours

Health related role and functions of the executive
Executive decision and their effects on health policy formation
and health programmed, and implementation.

Unit 4: Judicial Aspects of Health 4hours

Health laws: nature, implementation strategies, and challenges.
Health behavior modification through legal measures and
challenges.

- 126 -
 Control of health hazards through health laws and regulations.
Legal protection against the threats in physical, mental and social
health of the public.

REFERENCES

PY
1. Beats, Ralph L, “An Introduction to Anthropology” New York: Mac
Millan Publishing Co., 1977
2. Bhatia Bhatia, Psychology for nurses
3. Bista DB. “People of Nepal” Ratna Pustak Bhandar, Kathmandu,
Nepal.

CO
4. Daily, Weekly, and other Newspapers
5. Different Manifestoes of Political Parties
6. Dixit H. Quest for Health, Educational Enterprises 1999
7. Foster / Andersen “Medical Anthropology”: Alfred A knop – New
York, 1978.
8. Gartoulla RP, “An Introduction to Medical Sociology / Anthropology”
RECID, 1998
9. Gartoulla RP, “Therapy pattern of conventional medicine, RECID/N
T
1998, Kathmandu
10. Law and Nepalese Constitution 1990
11. Legal documents of HMG
AF

12. Me Ghie, Anderson, “Psychology as Applied to Nursing” London,

Chwchill, Livingston, 1979
13. Park and Park “ A text book of preventive and social medicine,
Banaridas, India, 2000.
14. Pradhan HB, “A text book of health education” Educational
Resources for Health – Kathmandu, 1995
DR

15. Publication of DDA

16. Ramchandran L. Dharmalingam, T: A text book of health education,
Vikas Publishing House, Pvt. Ltd, Delhi
17. Rules and Regulation / Job description of different professional
organization.
18. Sanders D, Caver R, The Struggle for Health: Medicine and
Politics of Underdevelopment
19. Sharma S, “Behavioural Science” Health Learning materials
Centre, 1997
- 127 -
20. Smeltyer, “Psychology for student nurses New York the Macmillan
Company.
21. Volkov FM et al edited psychology: Progress publishers Moscow,
1986

PY
22. Wemer D – The Life and Death of PHC – 1995
23. Wood – Fundamental of Psychology
24. Recent edition of the mention books and journals.
25. Internet
26. Research reports

CO
T
AF
DR

- 128 -
 Course Title: Child Health Nursing

Placement: Third year

Course Code: BSN -301 Full Marks:100

PY
Hours:100 Pass Marks: 50

COURSE OBJECTIVE

This course is designed to extend knowledge related to health care

needs of children at different stage of childhood period in hospital and
community setting. Emphasis is given to promotion of growth and
development and prevention of childhood illness.

COURSE OBJECTIVES
CO
At the end of this course students will be able to:
Describe the historical overview of child health nursing.
Define the terminologies used in child health nursing
Describe the concepts trends and issues of child care
Discuss the process of growth and development of children from
T
birth to adolescence
Explain the measures to be taken for optimum level of growth
and development of children
Explain the neonatal assessment and different level of essential
AF

neonatal care according to national neonatal care strategies.

Discuss the roles of nurse in the care of sick children promotive,
preventive, curative and rehabilitative aspects.
Discuss the common psychosocial, emotional and behavioral
problem of different age group children and their management
Explain the IMCI approach on child health care.
DR

Discuss common childhood disease/problems related to various

systems, etiology patho-physiology of the diseases diagnostic
test treatment and nursing care.
Explain general pre and post operative needs and care of
children.

CONTENT

Unit: I Historical Overview of Child Health Nursing 3 hours

- 129 -
Unit: II Terminologies used in child Health Nursing: 3 hours
Neonate
Infant
Toddler

PY
Pre-school children
School Age
Adolescent
Pediatric
Pediatric nursing
Pediatric Nurse
Pediatrician
Growth and development
Developmental milestone CO
Unit: III Concepts, trends and issues on Child Health Care. 4 hrs
Philosophy of Child Health Care
Meaning of illness to Child/ Family
Child Health Indicators
T
New trends and issues in child health
Child right to health.
High risk children and it’s classification
AF

Role of child health nurse.

Unit: IV Growth and development 12 hours

1. Normal growth and development of children
o Characteristic of a normal neonate and essential neonatal
care at various levels according to National Neonatal Care
DR

Strategy.
o Infant
o Toddler
o Pre school age
o School age
o Adolescent
2. Delay growth and development
3. Factors related to optimum growth and development of children.
o Nutrition/ breast feeding/

- 130 -
 o Rest/sleep/exercise
o Early stimulation and education
o Immunization
o Child to child care approach
Anticipatory guidance

PY
o
o Growth monitoring
o Early marriage.

Unit V: Common behavioural problems of specific age group:6 hrs

Separation anxiety
Thumb sucking, Tamper tantrum, Negativism, ritualism, sibling
rivelry

CO
Enuresis, attention deficit hyperactive disorder, learning disability,
school phobia, recurrent abdomen pain
Suicide, Juvenile delinquency, Substance abuse
Violence against children, Girl trafficking
HIV/AIDS, Sexually transmitted infections.

Unit VI: Assessment of children 2hrs

T
History taking
Physical examination
Investigation
AF

Nurses role

Unit VII: IMCI programmes on child health services 10 hrs

Introduction of IMCI
Objective of IMCI
DR

Strategies of IMCI
Principles of IMCI
Approaches/steps of IMCI
o Assessment of child
o Classification of diseases
o Selection of treatment
o Health teaching/ counselling
o Follow up service/ visit
Common childhood illness/ problem
o ARI/Pneumonia
- 131 -
 o Diarrhoea/ Dysentry
o Malnutrition
o PEM, Vit A deficiency conditions, ----Anemia
o Malaria
Tetanus

PY
o
o Otitis media
o Worm infestations

Unit VIII: Use of nursing process 2hrs

Nursing process (review)
Stressful and crisis events and their management

CO
Chronically and terminally ill children and their management
Parental coping with impeding death of children and nurses role

Unit IX: Pediatric variations in care of hospitalized child

1. Nursing process applied to care of the child
8 hrs

2. Admission of children to hospital

3. Stress of illness and hospitalization
o Care of critically ill child
T
o Care of dying child
4. Role of parents in care of child
5. Pre and post operative care of the children
AF

6. Clinical procedures
o Restraining
o Collecting specimen
o Administration of medicine
o Intravenous fluid therapy
o Oxygen inhalation
DR

o Steam inhalation/ Nebulization

o Tube feeding
o Resuscitation
o Care of children in incubator
- Care of the children with phototherapy
- Care of the children with ventilator.
- Care of child undergoing surgery

- 132 -
Unit X : Developmental and Health Deviations of child according
to various system:
Definition, Etiology, Pathophysiology, Clinical manifestations,
Diagnostic investigations,
Medical and surgical management, Nursing management,

PY
Complications and prevention

Unit XI: Disorders and nursing management of following

problems 25hrs
Gastro intestinal disorders
Review of GI system

CO
o Congenital malformations: Hare lip, cleft palate,
Tracheoesophageal fistula/ Atresia, Anorectal malformation
Hirschsprung , Pyloric stenosis
o Hernia, Intestinal obstruction
o Jaundice, viral hepatitis, worm infestations
o Diarrhoea/ dysentery, Malnutrition (micronutrient deficiency,
macro nutrient deficiency)
Respiratory disorders
o Review of respiratory system
T
o Acute respiratory Infection/ Pneumonia
o Tuberculosis
o Emphysema/ Pleuresy
AF

o Bronchial asthma
o Tonsilitis/ Pharyngitis
o Bronchitis /Broncheolitis
Cardiovascular disorder
o Review of cardiovascular system
o Congenital Heart Diseases
DR

- Cyanotic
- A cyanotic
o Rheumatic Heart Diseases
o Hodking’s and non Hodking’s Lymphoma
Hematological disorders
o Review of haematological system
o Anemia-Iron deficiency anemia, sickle cell anemia, Aplastic
anemia
o Leukemia

- 133 -
 o Nephritis
o Hemophilia
Genito uninary disorders
o Review of Genito urinary system
o Acute glamerulo nephritis

PY
o Nephrotic syndrome
o Wilm’s Tumor
o Bladder stone
o Undescended testis
o Phimosis
o Epispadiasis Hypospadiasis
Nurological Disorders

Epilepsy CO
Review of Nervous System

Meningitis/ Encephalitis
Mental retardation
Cerebral palsy
Hydrocephalus
Spinalbifida
T
Musculo Skeletal Disorders
o Review of Musculoskeletal System
o Club foot
AF

o Dislocation of hip
o Muscular dystrophy
o Gullain Barre Syndromme
Endocrine Disorders
o Review of Endocrine System
o Dwarfism, Gigantism, Acromegaly, Diabetes insipidus,
DR

Diabetes Mellitus, Critinism, Hypoparathyroidism, Hyper and

hypoparathyroidism, Addison’s disease, cushing syndrome,
precocious puberty.
o Integumentary disorders
o Review of integumentary system
o Scabies
o Burn
o Scabies
o Impetigo
o Boils
- 134 -
 o Eczema
EENT disorders:
o Congenital caterect
o Conjunctivitis
o Blephritis

PY
o Vision problem
o Otitis media
o Hearing problem
o Tonsilitis

Unit XII: Communicable diseases (review) 4 hrs

CO
UnitXIII: Vitamins and nutritional deficiency diseases
Night blindness, Xeropthelmia
Rickets
Scurvy
Malnutritions
6 hrs

Unit XIV: Pediatric emergency and management 4 hrs

T
Falls
Burn
Poisoning
AF

Drawning
Foreign body
Insect bite
Bleeding(epistaxis)

TEACHING LEARNING METHODS

DR

Interactive lecture
Individual assignment
Group work and assignment
Demonstration
Role play

EVALUATION

Internal assessment :- 20%

- 135 -
 Class room presentation
Participation in classroom
Project work
Assignment

PY
Written examination

Final examination: 80%

Written examination

REFERENCE

1.

2.
3.
latest Edition
CO
Achar. S.T. & Viswanathan, J. "Textbook of Paediatrics in
developing countries, 2nd edition, Madras,oreitn Longmann Ltd.,

Annual Report, Ministry of health, Latest edition.

Atkinson, Leslie D., and Many Ellen Murray, Understanding the
Nursing Process.
4. Blatter, Barbara, Holistic Nursing, Prentice Hall, Inc. New Jersey.
5. Bond. Meg Stress and Self-Awareness. A Guide for Nurses,
T
Willan
6. Chinn, Peggy L., Child Health Maintenance. The C.V. Mosby
Company, St. Conis.
AF

7. Datta P Child health nursing, Jaypee

8. Ghai,OP.Gupta,Essential Paediatrics 6th.Ghai,India
9. Henderson. Virginia Basic Principles of Nursing Care, ICN,
Geneva.
10. Heinemam Medical Books, London Marlow Dorothy R, & Redding
Bartara, Text book of paediatric Nursing, edition 6, W.. Saunders
DR

Co. Philadelphia,
11. Marley David, Paediatric Priorities in the developing world,
London, Butterworth & co.
12. McCaffry, Margo, Nursing Management of the Patient with Pain.
JB Lippincoitt Co, Philadelphia.
13. Mosby Wong’s,Wilson,Nursing Care of Infants & Children 8th.
Mobsy,Elsevier,India
14. Murray, Ruth. Zentner, Judith and Others, Nursing Concepts for
Health Promotion, Prentice – Hall, Inc., New Jersey.

- 136 -
15. Murray Ruth and Judith Zentner () Nursing Assessment and
Health Promotion Through the Life Span, Prentice – Hall Inc., New
Jersery.
16. Panda,UN & Others, Paediatric Nursing

PY
17. Potter P.A., Fundamentals of Nursing Concepts Process and
Practice C.V.S. Mosby Company St. Lovis Missatsi.
18. Phipps, Long Woods Medical Surgical Nursing (Concepts and
Clinical Practice). The C.V. MosWaechter, Engenia ., Nursing care
of Children, 10th edition, C.V. Mosby Co. St Louis 1985
19. Pillitteri,Adele,Child Health Nursing 6th .Lippincott, America
20. Sharma P.R, A Handbook of Paediatric problem. 4th edition.

CO
Whaley and Wong, Nursing Care of Infants and Children, the CV
Mosby Company, St. Louisehild Health Nursing.
21. Shrestha,Tumla,Essential Child Health Nursing
22. Thakur,Laxmi,Nursing Care of Children with Surgical Disorders
23. Thakur,Laxmi,Advanced Child Health Nursing
24. WHO UNFPA UNICEF IMCI Integrated Management of Childhood
Illness. WHO Library Catalog
25. Recent edition of the mention books and journals.
T
26. Internet
27. Research reports
AF
DR

- 137 -
Course Title: Child Health Nursing :
Practical
Placement: Third Year
Course Code: BSN-301 Full Mark: 100

PY
Total Hour: 180 Pass Mark: 60

OBJECTIVES

At the end of this course the student will be able to:

Admission/discharge of child according to hospital policy
Assess the children of various age groups from newborn to adolescence

CO
Prepare the nursing care plan according to needs
Implements and evaluate the nursing care plan
Provide care to the normal and sick child
Carryout the pediatric procedures
Give health education to parents/care giver for prevention and
promotion of health.

TEACHING/LEARNING ACTIVITIES AND EVALUATION

T
SCHEME

No. of
S.N. Internal Marks 50% Marks
AF

Assignment
1 Assessment of children of different age group 1 5
- History taking
- Physical Assessment
2 Case Study 1 5
3 Health Teaching 1 5
4 Nursing Care Plan 1 5
DR

5 Pediamic Procedure TPR, BP, Weighing

Measurement, Dressing Infection, Medication,
Specimen Collection, Neonatal Resuscitation, 10
Suction, 02 Inhalation Steam Inhalation,
Cord Care Eye Care, Bathing Tube feeding.
6 Play material 1 5
7 Day to Day Performance 15
Total Marks 50
Final Marks 50% - Practical Exam/Viva 50
Total Marks 100

- 138 -
 Obstetrical Nursing I (Midwifery)
Theory
(Normal Pregnancy: Antenatal)

Placement: Third year

PY
Course Code: BSN 302 Full Marks: 100
Hours: 100 Pass Marks: 50

COURSE DESCRIPTION

This course is aimed at enabling students to gain knowledge about the

normal reproductive process and a nurse/midwife’s role in providing

CO
care and advice for women during pregnancy, labor and the postnatal
period. The students will also be able to learn to provide high quality
antenatal care to maximize health during pregnancy. This course is
a pre-requisite for the course Obstetric Nursing II and III, in which
students will learn about complications and abnormalities of female
reproductive process.

COURSE OBJECTIVES

After the completion of this course, students will be able to:

T
Review anatomy and physiology of the male and female
reproductive organs be able to apply it in practice.
State the hormonal control in the physiology of reproduction.
AF

Describe the genetic endowment in the process of reproduction.

Explain spermatogenesis and oogenesis.
Discuss the concept, importance, and components of pre-
conceptional care.
Describe the process of fertilization, and development of the
product of conception.
DR

State significance of abnormal development of the product of

conception.
Describe the physiology and effect of pregnancy in different body
systems.
Discuss the physiological, socio-cultural, and psychological need
of a woman in pregnancy.
Describe the role of a midwife/nurse in preventive, curative
and promotive aspects of care for pregnant women, either in
community or in a health service center.
State the role of midwife/nurse in assessment of the well-being of

- 139 -
 the expecting mother and her unborn child (fetus).
Apply the knowledge of female bony pelvis with the fetal skull, for
describing the significance of feto-pelvic relationship.
Describe the physiology of labor onset, and explain the cardinal
movement of mechanism of labor.

PY
Describe the need for induction and augmentation of labor, and
discuss the role of midwife/nurse in caring for a woman who is on
induction/augmentation.
Identify different methods of fetal monitoring, and process of
recording the findings.
Describe the significance of PARTOGRAPH, and interpret the
findings recorded in the graph with 100% accuracy.

CO
Explain the physiology of normal puerperium, and the need of
mother and the baby during post-natal period.
Discuss the need of normal neonate.
Describe the methods of assessing a newborn and immediate
care for a newborn.
Differentiate the need of a preterm/post term with that of a normal
neonate.
Discuss recent trends in breast feeding, and issues regarding
T
baby feeding.
Describe preterm labor, and some obstetrical management to
delay/stop premature delivery.
AF

Take a comprehensive health and obstetric, gynecologic and

reproductive health history.
Perform a physical examination, including clinical breast
examination, focused on the presenting condition of women.
Describe physiology, signs, symptoms and management of
bleeding in different stages of pregnancy.Discuss the basic
principles of pharmacokinetics of drugs used during antenatal
DR

period

CONTENTS

Unit I – Introduction to Midwifery 4 hrs

Historical development of midwifery service in National and
international level.
Terminologies used in Midwifery
Legal aspect of Midwifery Services

- 140 -
 Definition and concept of Midwifery, Midwife, Skilled Birth
Attendant (SBA)
Standards in midwifery practice

Unit II –Reproductive Health and Safe Motherhood 4 hrs

PY
Concept, component and strategies of Reproductive Health
Reproductive Health Indicators
Safe motherhood and elements of safe motherhood
Safe Motherhood Initiative at global and national level
GoN plan and policies in reproductive health and safe motherhood

CO
Unit III- Structure & Function of Male and Female Reproductive
System
Female reproductive organs
o External/internal
o Breast anatomy and physiology
4 hrs

Male reproductive organs

Endocrinology in relation to reproduction
o Ovarian cycle
T
o Menstrual cycle
Sexuality: puberty-the age of sexual maturation, sexual response
patterns
AF

Production and mechanism in the control of male and female

sex hormones
Process of spermatogenesis and Ogenesis
Conception

Unit IV – Female Pelvic and the Pelvic Muscles 4 Hrs

DR

Pelvic structure and its landmark

Pelvic diameter
Pelvic joints and ligaments
Types of bony pelvis
Pelvic floor muscles
Inclination
Effect on labour

- 141 -
Unit V- Development of Embryo, Fetus 6 hrs
Review of human genome, chromosomes, cellular division
Formation of gametes
Genetic endowment and genetic determination

PY
Characteristic of the offspring
Fertilization and implantation
Embryonic development process
Fetal development process
Development of placenta, cord, membranes and their functions

CO
Unit VI- Placenta 6 hrs
Development of placenta
Function of placenta
Structure of mature placenta
Amniotic fluid and its functions
Umbilical cord
Anatomical variations of placenta and cord (Malformation of
placenta, cord and membranes)
T
Unit VII- Fetal Circulation 4hrs
The extra structure in the circulation during fetal life
AF

Adjustment in extra uterine life

Difference between adult and fetal circulation

Unit VIII - Physiology of pregnancy (changes and adaptation)6hrs

Effect of pregnancy in different body system
Diagnosis of pregnancy
DR

Sign of pregnancy
o Subjective (presumptive) signs objective (probable) signs,
Diagnostic (positive) signs
o Calculation of Expected Date of Delivery (EDD)
o Duration of pregnancy
o Nagel’s rule,
o Fundal height, USG
o General and specific need of women during pregnancy

- 142 -
Unit IX- Fetal skull 4hrs
Structures
Diameters
Sutures and fontanels

PY
Landmarks
Feto- pelvic relationship
Moulding, effects of moulding

Unit X- Prenatal care (health assessment of pregnancy) 8hrs

Aims and objectives

CO
Various methods used for prenatal assessment (growth
monitoring)
Modern concept of prenatal care
Midwifes role in prenatal care
Investigation required
Assessment of pregnant women: history taking, physical
examination ,pelvic examination
Assessment of fetal wellbeing
T
Immunization
Care needed
Components of antenatal care ( as per National Medical Standard
AF

for RH Vol.III)
Follow up visit according to WHO
Dangers signs and risk assessment
Birth preparedness and complication readiness

Unit XI - Prenatal advice and follow up 4hrs

DR

Nutritional needs during pregnancy

Rest and exercise
Immunization
Caution regarding use of drugs
Substance abuse and their effects

Unit XII- Minor Discomforts during Pregnancy 4hrs

Morning sickness
Backache
- 143 -
 Constipation
Heart burn
Indigestion
Itching

PY
Pica
Varicose vein
Muscle cramps

Unit XIII- Major Disorders of Pregnancy 10 hrs

Definition, causes, Pathophysiology, diagnosis, clinical manifestations
and managements (nursing and medical) of following disorders of
pregnancy:
Hyperemesis gravidraum
CO
Hypertensive disorders in pregnancy
Toxaemia
o Pre-eclampsia and severe pre-eclampsia
o Eclampsia
Pregnancy induced Hypertension
o Hypertension without proteinuria
T
o Mild pre-eclampsia
o Severe pre-eclampsia
o Eclampsia
AF

H E L LP Syndrome
DIC
Hydatidiform mole
Ectopic pregnancy
Anaemia
Bleeding in pregnancy
DR

o Early in pregnancy: Implantation bleeding, Ectopic pregnancy

Molar pregnancy, Abortion
o Late pregnancy : antepartum haemorrhage, Placenta
previa,Abruptio placenta

Unit XIV- Common Medical Diseases, Effects in Pregnancy and

management of: 8 hrs
Parasitic infestation
Anemia

- 144 -
 Cardiac disease
Renal disease
Urinary tract infection
Diabetes

PY
Malaria
Jaundice/Hepatitis
Tuberculosis
Epilepsy

Unit XV- Infections in Pregnancy, its effects and Management 3 hrs

CO
STIs/HIV/AIDS
Viral infections
TORCH infections (toxoplasmosis, rubella, cytomegalo virus,
herpes)
Hepatitis

Unit XVI- Multiple Gestation ( pregnancy) 4hrs

Types
T
Diagnosis
Effect in labor
Complication and management
AF

Unit XVII- Abnormalities of the Pelvis and Mal-presentations 4 hrs

Contracted pelvis/ CPD
Mal-presentations

Unit XVIII- Multiple Gestation 4hrs

DR

Types
Diagnosis
Effect in labor
Complication and management

Unit XIX- Abnormalities of the Pelvis and Mal-presentations 4 hrs

Contracted pelvis/ CPD
Abnormal pelvis
Mal-presentations:
- 145 -
 o Breech
o Transverse lie
o Oblique lie
o Unstable lie
Preterm premature rupture of membrane (PPROM)

PY
o

Unit XX- Abnormalities of Amniotic Fluid and effects 2hrs

Oligohydramnious
Polyhydramnious

Unit XXI- High risk pregnancy: 2 hrs

Late pregnancy
CO
Adolescence pregnancy

Unit XXII- Drugs used in pregnancy: 2hrs

T
AF
DR

- 146 -
 Obstetrical Nursing II Theory
(Labor/Natal care)
Placement: Third year
Course Code: BSN 303 Full Marks: 100

PY
Hours: 100 Pass Marks: 50

COURSE DESCRIPTION

This course is designed with the aim to provide knowledge in natal

care (labor) focusing mainly in normal and abnormal labour, including
emergency obstetric conditions. The students will also be able to

CO
learn to conduct deliveries, with competency in knowledge regarding
the mechanism of normal labor. It also includes a clinical components
theat sudent will provide nursing care to mothers with labor and their
newborn babies.

COURSE OBJECTIVES

After the completion of this course, students will be able to:

Describe the physiology of labor onset, and explain the cardinal
movement of mechanism of labor.
T
Differentiate the stages of labour and their physiological changes.
Explain management of mother in different stages of labour.
Describe the comfort measures during labour and use of pain
AF

relief therapy.
Discuss the mechanism of normal labour and abnormal labour
Explain the necessary step for conducting normal and abnormal
delivery.
Describe the significance of PARTOGRAPH, and interpret the
findings recorded in the graph with 100% accuracy.
DR

Describe the need for induction and augmentation of labor, and

discuss the role of midwife/nurse in caring for a woman who is on
induction/augmentation.
Identify different methods of fetal monitoring, and process of
recording the findings.
Explain and take care of mother and neonate in hospital situation.
Identify the abnormal presentation and position during labour
and assist their management.
Identify obstetrical emergencies that can arise during labor and
discuss appropriate action.
- 147 -
 Describe different types of obstetric operations and it’s
management.

CONTENTS

PY
Unit I: Terminologies used in labor/natal care 2hrs
Amenorrhoea
Gravida, para
Expected date of delivery (EDD)
LMP (last menstruation period)
Gestational age
Presentation
Position
Presenting part
Lie
Engagement
CO
Denominator
Moulding
Suture
T
Unit II- Skilled Birth Attendant (SBA) 4hrs
Concept and background
AF

Policy
Strategies
Core skills (Basic and advanced skill)

Unit III- Normal labor 16hrs

DR

Physiology of onset of normal labor

Theories and causes of labor onset
Stages of labor
Mechanism of labor
Sign and symptoms and management during first, second, third
and fourth stage of labor
Normal course of labour= 4Ps ( power, passages, passenger and
psychycological responses of mother)
Pain relief measures

- 148 -
 o Alternatives methods of pain relief
o Drug used
o Psychological measures
o Physical care
Use of partograph

PY
Principles and skills in conducting normal delivery
Immediate management of 3rd and 4th stage of labor

Unit IV: Pain relief and comfort measuresduring labor: 5hrs

Perception of labor pain
Psychological support during pain
Physical care

CO
Non pharmacological methods of pain relief
Pharmacological methods of pain relief and nurses responsibility

Unit VI: First stage of labor: 6hrs

Admission: History and physical examination
Abdominal examination
T
Vaginal examination
Dangers signs
Physical care of women and physical comfort
AF

Preparation of women for labor

Fetal monitoring
Counseling to the family

Unit VII: Physiology of first stage of labor: 6hrs

Duration
DR

Uterine contraction
o Fundal dominance
o Polarity
o Contraction and retraction of uterine muscle
o Formation of upper and lower uterine segments
o Development of retraction ring
o Cervical effacement and dilatation
Mechanical factors:
o Formation of fore water

- 149 -
 o General fluid pressure
o Rupture of the membranes
o Fetal axis pressure

Unit VIII: Management of first stage of labor: 4hrs

PY
Psychological support
Prevention of infection
Position and mobility
Nutrition
Bladder care

CO
Observation (mother, fetus and progress of labor)
Complication and it’s management
Record and report
Active management of labor

Unit IX: Second stage of labor: 6hrs

Physiological changes during second stage of labour
Mechanism/cardinal movement of vertex presentation
T
Sign and symptoms of second stage of labour
o Early phase (passive)
o Active phase or perineal phase (expulsive)
AF

Continuation of partograph
Preperation of mother, delivery room and equipment

Unit X: Management of second stage of labour: 6hrs

Constant supervision
Preparation for delivery
DR

Conduct the delivery step by step process (mechanism)

Immediate care and examination of baby
Apgar score
Identification of baby
Complication of second stage of lobour and it’s management
Record and report

Unit XI: Third stage of labour: 5hrs

Physiological changes of third stage of labour
- 150 -
 Sign of placenta separation
Active management of third stage of labour
Method of placenta delivery
Management of complication

PY
Unit XII: Fourth stage of labour: 4hrs
General assment of mother conditions
General assment of baby
Any anomalies
Basic needs: temperature, breast feeding, safty, cleanliness

CO
Kangaroo method (KMC)
Comfort
Medication
Discharge planning and education
Record and report

Unit XIII: Abnormal labour: 8hrs

Preterm labour, premature rupture of memberene
T
Post-term pregnancy ( induction of labour)
Multipal pregnancy
Prolonged labour
AF

o Augmentation of labour
o Maternal and fetal distress
o Obstructed labour
o Abnormal uterine contraction

Unit XIV: Trial Labour: 2hrs

DR

Unit XV: Assisted Labor 4hrs

Induction and augmentation
Vacuum extraction
Forceps delivery

Unit XVI: Surgical Procedures in Obstetrics 4hrs

Episiotomy and repair
Caesarean section

- 151 -
 Distructive operations

Unit XVII: Malposition, malpresentation and it’s management: 8hrs

Occipito posterior position

PY
Face presentation
Brow presentation
Breech presentation
Shoulder presentation
Unstable lie
Compound presentation

CO
External and internal verson

Unit XVIII: Obstetrical Emergency and it’s management 8hrs

Vasa Previa
Cord presentation and prolapsed
Shoulder dystocia
Ruptured uterus
Amniotic fluid embolism
T
Shock
Inversion of uterus
Retained placenta
AF

Adherent placenta
Vulval haematoma

Unit XIX: Drugs used during labour 2hrs

DR

- 152 -
 Obstetric nursing=III Theory
(postnatal and gynaecology)
Placement: Third year
Course Code : BSN-304 Full marks: 100

PY
Hours: 100 Pass marks: 50

COURSE DESCRIPTION

This course will provede in depth knowledge in post natal and

gynaecology with special focus on the normal and abnormal conditions
of the puerp[erium, newborn and gynecological problems of women

CO
requiring special nursing care.

This course will also enable students to apply knowledge, skill and
attitue to function competenly in providing holistic care to the mother ,
and newborn using nursing process and a primary health care approach
by applying National Neonatal Health strategies and R.H protocol in
hospital/community setting.

COURSE OBJECTIVES
T
On the complication of the postnatal and gynaecological care
course the students will be able to:
Describe normal puerperial changes and return to the non
AF

pregnant state.
Identify goals, components and principles of postnatal physiology
and emotional care.
Formulate nursing diagnosis in meeting the physical,
psychological and emotional needs of mother.
Determine the nursing responsibilities related discharege instructions
in the hospital community setting to ensure self care of women/
DR

mother , newborn care and adjustments to daily activites.

Anticipate and recognize minor disorders of the puerperium and
discuss their management
Discuss the major gyanecological problems.

COURSE CONTENTS

Unit I: The physiology of the Puerperium: 6hrs

Anatomical changes of associated structures

- 153 -
 Physiologic changes of reproductive system during puerperium
Psychological changes in puerperium
Lochia
Parent infant bonding

PY
Physiology of lactation and Midwives’ role
Trends in breast feeding
Minor disorders of puerperium

Unit II: Postnatal care: 6hrs

Goals, component and principles

CO
Assessment of postnatal mother and it’s managements.
Nurses roles/responsibilities in meeting physical, psychological
and emotional needs of the mother including cultural aspects of
care.
Provide postnatal nursing management in minor disorders of
puerperium.

Unit III: Management of lactation: 8hrs

Structure and physiology of lactation
T
Components and properties of breast milk
Technique of breast feeding
Concept of baby frienbly hospital initiative.
AF

Common breast problems and it” management

Discharge instructions

Unit IV: Danger signs and follow up ( postpartum) 2hrs

Unit V: Puerperium complication and it” managements: 6hrs
DR

Puerperal fever
Ppostpartum haemorrhage
Vulval haematoma
Puerperal sepsis
Puerperal psychosis
Breast abscess
Pulmonary embolism
Venous thrombosis

- 154 -
Unit VI:- Mental Health in Maternal Nursing 4hrs
Psychological aspects in child bearing and rearing.
Adjustment problems.
Undesired behaviors.

PY
UnitVII: - Normal Newborn Care 10 hrs
Characteristic of normal newborn.
Nurses responsibilities in newborn care
Essential Newborn Care
Neonatal Resuscitation

CO
Need of Neonate ( Breathing, Feeding, warmth and Prevention
of infection)
Periodic assessment of the neonates
Common problems of neonates including danger signs.
Status of Neonatal Health in Nepal and Government’s Policies
and Strategies.

Unit VIII: Neonatal problems and it’s nursing management: 6hrs

T
Asphyxia neonatrum
Low birth weight baby
Neonatal jaundice and sepsis
AF

Birth injuries
Congenital malformation
Baby born to HIV positive mother
Effect of intrauterine TORCH infection
Sudden infant death Syndrome
Neonatal mortality and its causes
DR

Dangers signs in newborns ( infection, hypothermia, respiratory

syndrome,tetanus neonatrum, convulsion and unable to suck
breast feeding

Unit IX: Care for small and large babies: 4hrs

Premature baby
Postmature baby
Small for dates baby/heavy for dates baby.

- 155 -
Unit X: RH Incompatibility and Isoimmunization: 4hrs
Unit XI: Major Disorders of Newborn 6hrs
Inborn error of metabolism
Genetic counseling

PY
Congenital deformities
Hemolytic disease of newborn
Respiratory Distress Syndrome(RSD)
Meconium Aspiration Syndrome(MAS)
Fetal alcoholic Syndrome(FAS)

Amennorrhoea
Menorrhagia
Dysmenorrhagia
Metrorrhagia
CO
Unit XII: Menstrual Disorders 6hrs

DUB

Unit XIII: Infections of Female Reproductive Organs 6 hrs

T
Vulva
Vagina
Uterus
AF

Fallopian tubes
Ovaries

Unit XIV: Assessment of Women with Gynaecological Problem 4hrs

History taking
DR

Ensuring privacy and confidentiality

Positions
Investigations
Instruments for gynae procedure

Unit XV: Congenital Abnormalities of Reproductive Organs 2hrs

Unit XVI: Displacement of Pelvic Organs 4hrs
Cystocele
Rectocele
- 156 -
 Retroversion
Urethrocele
Prolapes of uterus

PY
Unit XVII: Complications Related to Child Birth and their
Management 4hrs
R.V.F
V.V.F

Unit XVIII: Tumors of Female Reproductive Organs 4hrs

Vulval
Vaginal
Ovarian
Uterine CO
Unit XIX: Pre and Postoperative care in Gynaecological Surgery 2 hrs
Hysterectomy
Abdominal
T
Vaginal

Unit XX: Sub-fertility (infertility) 4 hrs

AF

Definition
Causes/ factors
Diagnosis
Treatment Options
Assisted Reproduction with advance technique
DR

TEACHING LEARNING ACTIVITIES OF OBSTETRIC

(MIDWIFERY) AND GYNAECOLOGICAL NURSING

METHODS
White Board
OHP, Slides, CDs
Posters and Models
Manikin/
Website search

- 157 -
MEDIA
White board
OHP
Posters, charts and models

PY
Skeleton
CD, video cassettes
LCD system

EVALUATION
Class test, project work, presentations and viva.

PRESCRIBED TEXT BOOKS:

1.
2.
CO
Myles “Textbook for Midwives” 14th ed. Churchill Livingstone, 2003.
Integrated Management of Pregnancy and Childbirth (IMPAC),
WHO publication, RH/ 00.7, Geneva, 2003.
3. Dutta D.C. “Textbook of Obstetrics” 6thed, Central Publication,
India. 2004.
T
REFERENCES

1. American Journal of Gynae and Obstetrics.

AF

2. Babak, M.Irene and Jense, D. Mangael “Maternity and

Gynecological Care” 5th ed. Mosby. 1993.
3. Bhandari,Vineet,Manual of Neonatology 1st PEEPE
4. British Medical Journals
5. C.S. Dawn “ Textbook of Gynecology and Contraception”
6. Cloherty,John & Others, Manual of Neonatal Care 6th.Walters &
DR

Kluwer,India
7. Dechrney, A.H and Nathan, L “Current Obstetric and
GynecologicDiagnosis and Treatment”.9th ed. LANGE, 2003.
8. Gautum S. And Subedi D. Midwifery Part –I,II,II Edi 2011
9. IMPAC WHO clinical guaid for Nurses.
10. Journals of Institute of Medicine, TU, Nepal.
11. Luckman’S,Medical Surgical Nursing
12. Midwifery Standards- Volume 1, 2, 3 and 4. WHO Publications.
13. Nepal government ministry of health policy/plans on RH
- 158 -
14. Newborn care Training Package for nursing program. Save the
Children.2009
15. Recent Edition of all the mentioned books, journals.
16. RH Protocols and Safe Motherhood Materials, Produced by

PY
Family Health Division, Nepal
17. Save the Children, Newborn Care Training Package for Nursing
Program. Save the Children,
18. SBA Policy and Strategy MOHP
19. Shaw’s Textbook of Gynecology. 13thed. Elsevier Pub. India
20. Simkin, Whalley & Keppler, Pregnancy Child Birth & the Newborn,

CO
Meadowbrook, India
21. Sreevani & Prasanti,A Guide to Mental Health & Psychiatric
22. T.K Indreni “Textbook of Midwifery” Jaypee Pub. India. 2003.
23. Tui Tui R.Midwifery for Nurses. Recent Edition
24. TUTH, TU, Nursing Department, Maternal and Neonatal Care
Protocol Guidelines for Nurses. TUTH, Nepal.
25. Use SBA Learning guide
26. WHO Lib,Cataloguing,Managing Newborn Problems.
T
WHO,Geneva
27. WHO UNFPA UNICEF, Managing Newborn Problem. Health
Research WHO, Geneva
AF

28. WHO, Education for Safe Motherhood Management 2nd Edi,WHO

Lib.Catalog
29. WHO, Health Research, Kangaroo Mother Care. WHO Library
Catalog
30. WHO, Hospital Care for Children 1st WHO Library Cataloguing
Publication.
DR

31. WHO, Midwifery Standard. ASIA

32. WHO, UNICEF, Managing Complications in Pregnancy & Child
Birth. WHO SHR Department, Geneva
33. WHO,Pregnancy,Childbirth,Postpartum&New Born Care a Guide
2nd.WHO Library Catolog
34. Recent edition of the mention books and journals.
35. Internet
36. Research reports

- 159 -
 Obstetrical (Midwifery)
and Gynaecological Nursing
(Practicum)

PY
Placement: Third Year
Course Code: BSN 302, 303, 304 Total Hour: 600
Full Mark: 100 Pass Mark: 60x3=180

LEARNING OBJECTIVES

After the completion of this course students should be able to:

Identify and describe pelvic diameters and different parts of the

CO
female pelvis, in a given model.
Identify the different landmarks of the fetal skull in a given model.
Take a thorough obstetrical history of a pregnant woman.
Examine and make assessment of a pregnant woman with 100%
accuracy.
Advice a pregnant woman/family regarding the care needed for
maintaining a health pregnancy.
Recognize any deviation from normal signs and symptoms,
T
requiring immediate referral during pregnancy.
Identify minor discomforts and, advice the woman for relief
measure/s as needed.
AF

Assess the fetal well being in prenatal period and during labor.
Advice the woman/family for birth preparedness and complication
readyness in advance.
Recognize signs of labor and help the woman in management
of stress.
Teach the woman different ways to overcome/bear labor pain as
individual need of the woman.
DR

Make assessment of the progress of labor with the use of

PARTOGRAPH
Prepare the labor room and necessary equipments for conducting
normal delivery.
Pay attention for taking measures in preventing cross infection/s
in the labor room.
Conduct normal delivery with minimal discomfort to the woman
and the baby.
Assess the immediate need of the new born and the mother, and

- 160 -
 provide needed care.
Recognize signs of preterm baby and provide specific care as
needed.
Recognizes the sign/s of hemorrhage in pregnancy/labor and
manage accordingly.

PY
Make accurate calculation/ preparation and administration of
drugs specifically used in obstetric practice.

Learning Requirements:

Assessment of pregnant women - 25

Conduct of normal deliveries - 20
Repair of the perineum

Ante natal teaching CO

Resuscitation of the new born

Observation of abnormal labor

-
-
-
-
05
05
05
05
Care of post natal mother - 25
Care of normal neonate - 25
Neonatal resusitation
T
Perform MRP
Use of Vvcuum extraction
Perform MVA
AF

Breech delivery

Each student is required to do a complete case study as assigned by

the teacher

Duration for the clinical learning experiences for both Obstetric Nursing
I,II+III
DR

AN Clinic - 4 weeks
Labor Unit - 4 weeks
Post natal - 4 weeks
Gynecology - 4 weeks

Total 16 weeks experience in a well functioning Maternity Hospital.

Evaluation: Internal= 50%

Clinical performance in each area

- 161 -
 Case study
Case presentation
Submission of report
Procedures related in each area

PY
Final exam: 50%
Practical
Viva

CO
T
AF
DR

- 162 -
 Community Health Nursing III
(Theory)
Placement: Third year
BSN -305 Full marks: 100

PY
Hours : 100hrs Pass mark: 50

COURSE DESCRIPTION

This course has been mainly focused to equip the students with
comprehensive knowledge, skills and attitude in relation to concept
and process of Community Diagnosis, Community Development

CO
activity, Health Care delivery system as well as Domiciliary Midwifery
Services at Community level. He/She as a Community Health Nurse
will participate and provide Promotional and Preventive Health care
to the target population within a Community, applying epidemiological
approaches (Community Health Diagnosis Process, Community Health
Management process, and Maternal and Child inducing domiciliary
midwifery service.)

COURSE OBJECTIVES
T
Discuss epidemiological approaches to assess and provide
necessary health care to the Community in relation to preventive
and control measure against diseases.
AF

Explain the component/process of Community Diagnosis to

improve health status of a community.
Describe the concept and process of community Development in
health and applied at community level.
Discuss the organizational structure and activities (function) of
health delivery system in Nepal.
Explain the health care delivery system from central level to
DR

grass root level in Nepal context.

Describe the job description of various categories of personnel
working in different health setting within Health delivering system
in the country.

Unit: I Community Health Resources (review) 10 hrs

1. Define
2. Health resources
o Human resources

- 163 -
 o Financial
o Material
o Time
o Place/market
3. Local community resources

PY
o Family
o TBA
o FCHV
o Traditional/political leaders
o CBOs
o NGOs
4.

-
-
CO
Developmental partners
o National
Government organization
Non-government organization (FPAN, Nepal Red
Cross Society)
o International
- WHO
- UNFPA
T
- UNICEF
- USAID
- Save the Children
AF

- CARE
- GTZ
- The World Bank

Unit- II Community participation 20 hrs

1. Introduction of community participation (CP)
DR

2. Concept of CP (Purpose)
o To promote self reliance
o To develop community leader
o To ensure the felt and real needs of community
o To maximum use of local resources man, money and
materials
3. Level of community participation
o Use of health services
o Co-operation with health services and personnel
o Community empowerment
- 164 -
4. Various obstacles which interference with community participation
o Lack of community cohesion
o Diversity of interest
o Lack of experience in working together
o Traditional social stratification

PY
o Lack of commitment to equity in health care
o Lack of faith in community regarding health care system
o Difficulty in mobilizing previously uninvolved
5. Ways to mobilize the community
o Identify felt need with community leaders and members
o Include community leader in decision making process

CO
including planning, implementation and evaluation
o Change attitudes and value health workers toward community
cooperation
o Establish structure to ensure community inputs e.g. health
post health committee etc.
6. Enabling factors for health workers related to CP
o Communication skills interpersonal and group communication
o Process of decision making in group situation
o Process of conducting a discussion in meeting
T
7. Process of community participation
o Resource identification
o Involve community to identify health needs and prioritization
AF

o Involve community in planning health programme activities

o Involve community members to implementing health
programme
o Evaluation community participation in term of measurement
8. Common areas for intersectoral approach
o Health: HMG, NGOs
DR

o Economic: Bank loan, small income generation projects

o Agriculture: Nutrition, Forestry, Crops production, kitchen
garden, education, school formal and non-formal education,
health information messages
o Environment: water, sanitation, air and housing
9. Role of nurse in promotion of intersectoral action

Unit-IV Community Development and Health 20 hrs

1. Definitions of Community Development and Health
2. Concept and goal of Community Development

- 165 -
3. Features of community development in Nepal and their application
in health
o Emphasis on all around integrated development
o Emphasis in rural development
o Principles of mobilization of local resources sustainable development

PY
o Aims and impact of social chage in the community
o Maximum participation if the village development committee
o Poverty elevation
o Gender prospective/equity
4. Techniques of community development and their application in
public health programme

CO
o External agent technique
o Multiple agent technique
o Internal resource mobilization technique
o The role of community health nurse in community development
5. Community development programme
o Formal and informal education
o School health programme
o Healthy life style activities
o Health education
T
o Exercise programme
o Laughing club
o Income generation activities
AF

o Empowerment activities of the community

o Social security activities
o Development programme for
o Youth
o Adolescents
o Elderly
DR

o Religious group
o Handicapped

Unit-V Community Diagnosis 16 hrs

1. The concept of community diagnosis
2. Definition of community diagnosis
3. Purpose of community diagnosis
4. Component of community diagnosis
5. Process of community diagnosis

- 166 -
Unit- VI Disaster Management 14 hrs
1. Introduction/Definition
2. Types of disaster
o Man made disaster

PY
o Natural disaster
3. Consequences of disaster
o Causation
o Disease outbreak
o Orphanage
o Famine and starvation
o Low socio-economic status

4.
o Emotional stress

CO
Disaster management in community
o Health education on protective measures
o Preparation of plan
- Rescue operation
- Provision of supplies
- Waste management
- Control of diasease
T
o Plan for support
- Coordination, collaboration with
◊ Community leaders
AF

◊ CBOs/NGOs
◊ Developmental partners
o Assessment and action
o Referral and follow up
5. Disaster Management system in Nepal

Unit: VII Health care Delivery System 18 hrs

DR

1. Changing history from past to present (Review)

2. National health planning
o National health policy
o Five year plan and long term plan (20 years)
3. Health care delivery system from central to peripheral level
o Central/National level
o Regional level
o Zonal level
o Electoral level

- 167 -
 o Municipalities and VDCs level
4. Health care protocol from central TO GRASSROOT LEVEL
5. Objectives, targets, strategies/policies on
o Control of diarrhoeal disease
o Expanded programme on immunization

PY
o Family planning
o Acute respiratory infection (Pneumonia)

Unit-VIII Health System Reform 10hrs

1. Introduction
2. Approaches/techniques
3.
4.
5.
6.
7.
Barriers/obstacles CO
Stakeholders for reform
Supplies/resources needed for reform

Common areas for reform

Roles and responsibilities of community health nurse in health
system reform

Unit-IX Population Dynamics 12 hrs

T
1. Introduction
2. Population theory
3. Population momentum
AF

o Merits
o Demerits
4. Demographic cycle
5. National goal and policy to control population
6. Family welfare programme
o National level
DR

o Periphery level
o Role and responsibility of CHN in family welfare programme

REFERENCES

1. Bennet Prof FJ, Ed, Community Diagnosis and Health Activities,

A Manual for Tropical and Rural areas, London, Mae Milan, 1970.
2. Bhandari KL, Hale CB and Maskey H, Eds Field Training Manual,
KTM. TU IOM 1995.
3. Vanghan JP and Morrow RH. Manual of Epidemiology for District

- 168 -
 Health Management. Geneva WHO 1989.
4. Hale Cynthera, Shrestha Ishwar B and Bhattacharya Archana,
Community Diagnosis Manual, Learning Together from Community
Diagnosis HLMC, TUIOM 1996.

PY
5. Sapkota , S.P , Health Education and communication , Vidhyarthi
Pustak Bandar, Katmandu, 2004
6. K. Park, Essentials of community Health Nursing, Banarasidas
Bharat, Jabalpur. 3rd Ed;
7. The Tenth plan, National Planning Commission Kathmandu,
Nepal. 2003.
8. Tinkham W. Catherine and Voorhier F.Eleanor, Community Health

9. CO
Nursing. Evolution and Process; Appleton Century- CROFTS,
New York, 1977.
Bailen G.Salvacion and Maglaya S.Araceli, FAMILY HEALTH
NURSING .THE PROCESS, up College of Nursing, Diliman,
Qnezon City; 1978.
10. Annual Report published by DOH, and different documents of
various institutions, different Journals of IOM ,NNC, NAN, Nursing
Campus, INGOs NGOs, GO’s etc
T
11. Basic Information/Indicators to Support Implementation of Basic
Minimum Needs of HFA/2000 Strategies, Katmandu; WHO, 1987.
12. Kotwal, N.S, A Public Health Manual, New Delhi: TNAI.1982.
AF

13. King Maurice et.al. Primary Health Care Book I, Bombay / Calcutta
/ Oxford University Press 1992.
14. Lal, Ranavadar., Community Development: Principles, practice
and problems. Book Land Pvt. Ltd.
15. McCusker, R. et al, On Being in Charge, Geneva, WHO, 1980.
16. National Maternity care guidelines published by MOH/FHD
DR

17. National Medical standard for reproductive health. Vol II Edition (Revised)
18. Reference manual, certificate nursing programme, Community
Health Nursing II Family Planning unit, published by JHPIEGO.
19. UNDP Human Development Report. Latest Edition.
20. World health Report, WHO. Latest Ed.
21. Kumar Somesh ,Methods for Community Participation, Vistaar
Publication, New Delhi, 2002.
22. Recent edition and govt. publication

- 169 -
 Community Health Nursing III
Practicum
Placement: Third year
Course Code: BSN 305 Full marks: 100

PY
Hours : 100 Pass mark: 60

COURSE DESCRIPTION

This course is the continuation of BSN-304 which focuses on community

diagnosis and development along with health care delivery system of
Nepal. Student will spend 6 weeks total in community (4 wks) and

CO
district public health office (2 wks) to fulfill the following objectives.
In community, students will also utilize the knowledge of community
participation, obstetric nursing, child health nursing and epidemiology
in providing comprehensive care to the community and individuals.
Similarly in DPHO, students will analyze the organizations structure
and the function/programs of health care delivery system. Besides,
students will familiarize themselves with job descriptions of various
health personnel working for health care services of Nepal.

COURSE OBJECTIVES
T
Upon the completion of this course, students will be able to:
Conduct community diagnosis in order to identify, plan, implement
AF

and evaluate individuals, families and community problems/

needs.
Apply epidemiological approach in order to investigate and
control/prevent common diseases occurring in the community
and provided comprehensive care accordingly.
Mobilize community resources and encourage active community
participation in community development programs.
DR

Evaluate the sustainability of the programs/care conducted/

provided for the community.
Analyze the organizational structure of health care delivery
system of Nepal and evaluate its objectives/programs.
Identify the job description of health workers working within
health care delivering system of Nepal.
Identify high risk case and make referral to the appropriate
agencies accordingly.

- 170 -
Internal Allocation of marks:

Final Viva: 50
Internal: 50
Community diagnosis and micro health project (15)

PY
High risk family study and health teaching (10) (5 each)
Performance evaluation (10)
DPHO assignment (10)
Report presentation (5)

Total (Internal) (50)

TOTAL 100

CO
T
AF
DR

- 171 -
 Basic Epidemiology (theory)
Placement: Third year
Credit Hours : 50 Full marks: 50
Course Code: BSN-306 Pass marks: 25

PY
COURSE OBJECTIVE

Use Basic Epidemiological approach in the Community

Apply the different method used in community
Plan and control the different technique to control spread of
disease

COURSE CONTENT

Unit: 1 Basic Epidemiology

CO
Terminology used in Epidemiology
6 hours

Historical Context
Introduction & Definition
Components of Epidemiology
T
Aims of Epidemiology

Unit: 2 Use of Epidemiology 6 hours

AF

Measurements of Epidemiology
Tools of Measurement
Incidence & Prevalence
Uses of Epidemiology
Epidemiology Triad
DR

Unit: 3 Epidemiology Methods 6 hours

Observational Study
Descriptive Study
Analytical Study (Case control study of cohord study)
Experimental Study
Uses of Epidemiology

Unit: 4 Modes of Disease transmission 6 hours

- 172 -
 Dynamics of Disease Transmission
Modes of Transmission
Susceptible Host and Host defences
Specific defences

PY
Unit: 5 Disease prevention & control 4 hours
Controlling the reservoir
Interruptions
The susceptible host

CO
Unit 6 Investigation of an Epidemic 8 hours
Verification of diagnosis
Confirmation of the existence of an epidemic
Defining the population at risk
Rapid search for all cares cases and their Characteristics
Data analysis
Formulation of hypothesis
Testing of hypothesis
T
Evaluation of ecology factor
Further investigation of population of risk
Writing the report
AF

Unit: 7 Concept of prevention 4 hours

Introduction
Levels of Prevention
o Primordial
o Primary
DR

o Secondary
o Tertiary

Unit: 8 Modes of Intervention 4 hours

Introduction
Health promotion
Specific protection
Early diagnosis of treatment
Disability limitation

- 173 -
 Rehabilitation

Unit: 9 Field Technique 6 hours

Problem identification

PY
Proposal development
Method of collecting information
Interview
Observation
Questionnaire
Data analysis & interpretation

CO
Focus Group Discussion
Teaching Learning Activities
Lecture
Group Presentation
White board
Marker
OHP
LCD
T
Paper Presentation
PRA/RRA
AF

REFERENCES

1. Park, JE and Park K. “Text Book of Social and Preventive

Medicine”, 2008.
2. R. Beaglehole, R, Bonita, T. Kjellstrom. Basic Epidemiology.
WHO, Geneva 1993.
DR

3. Recent edition of the mention books and journals.

4. Internet
5. Research reports

- 174 -
 Nursing Research and Biostatistic
(Theory)
Placement: 4th year
Total Hours: 100 hrs, Full marks: 100

PY
Code No: BSN - 401 Pass marks: 50

COURSE DESCRIPTION

The course has been designed to impart the research and statistical
knowledge to the students. The course encompasses the basic
concepts, methodologies and applications of research and statistics

CO
in nursing

LEARNING OBJECTIVE

Define and explain the terminology used in Nursing Research

Discuss the historical evolution of research
Explain nursing research, its purpose and importance
Define the various types of research
Discuss the ethical aspect in conducting research.
T
Explain the basic steps of nursing research
Apply statistical concept and knowledge in collecting relevant
data and analysis of data
AF

Describe the steps of research proposal.

Describe the data analysis process
Explain the different techniques and interpretation of data and
report writing.
Evaluation/critique the research reports
Disseminate the research report
DR

Unit - 1 Define & Explain the Terminologies in Nursing Research

Basic terminologies
Research
Population
Sample
Sampling Technique
Variable

- 175 -
 Facts
Concept, Theory, Principles,
Conceptual Framework
Operational Definition

PY
Assumption
Validity
Reliability
Limitations

Unit – 2 Historical evolution of Nursing Research

CO
International
National

Unit – 3 Introduction of Research

Definition
Purpose
Importance
T
Unit – 4 Types of Research
Basic Applied, action research,
Quantitative & Qualitative
AF

Descriptive
o Case Study
o Survey
o Retrospectives, Vs prospective
o Longitudinal Vs cross sectional
Historical Research
DR

Research Design
Experimental Research

Unit – 5 Ethical Aspect of Nursing Research

Introduction
Clients Right
Basic Principles & Procedure
Code of Ethics
Principle of Ethics
- 176 -
 o The principle of beneficence
o The principle of respect for human dignity
o The Principle of justice
o Informed consent

PY
Unit – 6 Basic Steps of Nursing Research
1. Selection of Researchable problem
o Definition
o Purpose
o Characteristics
o Criteria for selection
2. Review of Literature
o Purpose
o Types
o Process
CO
o Source of literature Review
3. Formulation of objectives
o Meaning and types of research, objectives
4. Hypothesis
T
o Introduction
o Definition
o Purpose
AF

o Importance
o Characteristics
o Types and
o Sources of hypothesis
5. Variables
o Definition, types
DR

6. Sampling technique
o Definition
o Purpose
o Sampling technique
o Types of sampling
o Representative sample
o Sampling error
o Sampling mortality
o Sample size ( Review with biostatistics)
7. Tools/Research Instruments
- 177 -
 o Definition
o Types
o Checklist
o Observation guide
o Self Report form

PY
o Questionnaire
o Interview guide of the instruments
o Validity & Reliability
o Development of tools
o Pre-testing of tools
o Pilot Study
9. Date Collection
o Introduction
o Definition CO
o Type of Data collection methods
o Interview
o Survey
o Observation
o FGD
T
10. Data Analysis & Interpretation (Bio-stat)
o Statistical Analysis – SPSS
o Classification and categorization
AF

o Presentation in table/graphs
- Bar/Pie diagram
- Frequency curve
- Tabular presentation of data

Unit-7 Research Proposal

DR

Definition
Purpose
Contents of research proposal
o Introduction
o Review of the Literature
o Methodology
o Work plan
o References

- 178 -
Unit-8 Report Writing
Guideline for Students for writing research reports
Content of Research Report
Introduction

PY
Method
Result
Discussion

Unit – 9 Critiques of Research Report

Definition

CO
Guideline for critiquing the research report

Unit – 10 References
T
AF
DR

- 179 -
 Biostatistics in Nursing
Unit 1: Basic Concept and Usefulness of Statistics 8 hrs
Basic Concept of statistics ; Definition of bio-statistics; scope,
role, usefulness of statistics in the conduct of Nursing research

PY
Basic concept of variables, type of variables (discrete and
continuous, nominal, ordinal and categorical variables)

Unit – 2 Data Collection and Presentation 8 hrs

Data Collection
o Sources of data, collection and recording of statistical

CO
information and its related fields from primary and secondary
sources ( census, vital registration, ad-hoc surveys,
population register, hospital records and surveillance system
Tabulation and graphical presentation
o Processing and presentation of statistical data : frequency
distribution and different types of tables (one way, two way
and manifold tables)
o Preparation of diagrammatic and graphical representation
(graphs, histogram, bar charts, pie chars, etc).
T
Unit – 3 Measures of Central Tendency and Dispersion 8 hrs
Measures of central tendency
AF

o Different partition values (quartiles, deciles and percentiles)

measures of dispersion
o Range, inter-quartile range, standard deviation, variance
and coefficient of variation.
o Mean, median and mode
o Scale and measurement
DR

Unit – 4 Probability Distribution 8 hrs

Concept of probability ad chance, simple probability distribution
Probability distribution of continuous variables (normal
distribution)
Probability distribution of discrete variables (binomial distribution)

Unit – 5 Hypothesis Testing and Statistical Inference 8 hrs

Concept of hypothesis, null and alternative hypothesis,
formulation of statistical hypothesis, level of significance, type I
- 180 -
 and type II errors, beta and power of test.

Unit – 6 Simple Correlation and Regression Analysis 6 hrs

Basic concept of regression and correlation, definition of
correlation, correlation coefficients, Spearman’s rank correlation

PY
coefficient.

RESEARCH & BIOSTATISTICS IN NURSING: RELATED

REFERENCES

1. Gartoula Ritu Prasad, An Introduction to Medical Sociology and

Medical Anthropology, RECID/N Kathmandu
2.

3.
4. Lokesh
pub.
Koul,
CO
Park J E And K Park, Textbook of community health for nurses:
Jabalpur: M/S Banarsidas Bhanot,
Nursing research, B T Basavanthappa, Jaypee, India.
Methodology of educational research,Vikas

5. Mahajan B K , Methods in Biostatics, Jaypee, India

6. B C, Bajracharya, Text book of Statistics,
T
7. B. C. Bajracharya, Basic Statistics, M K Pub. Ktm.
8. Kothari CK " Research Methodology, Willey Eastern Limited
9. Park &Park, Text book of Preventive & Social Medicine, M./S
AF

Bhanot, Jabalpur, India,

10. Jaspal Singh, Methodology and Techniques of social
Research
11. Rao, NSN.Elements of health statistics varanasi: lare
12. JW Best & JV Kahn, Research in Education , PHI, New
Delhi
DR

13. Research Methodology, Anabeshan Pub, committee,

Biratnagar
14. Best John W. Research in Education, New Delhi , Prentice Hall of
India, Private Limited,
15. Nursing Research/B.T.Basanvanthappa.2nd ,recent edtion. New
Delhi:Jaypee Pub.2007.
16. Qualitative Research: Approaches for Health personnel/Dr.Sarala
Joshi.Kathmandu:Makalu Pub.house,2008.
17. Polit, Denise F and Bernadette P . Hungler, Nursing research:

- 181 -
 Principles and methods, Philadelphia: JB Lippincott Co.
18. Beth Dawson – Saunders Robert G. Trapp, Basic & Clinical
Biostatics, A Lange medical book, London
19. David Dooley, Social research methods, PHI,New Delhi

PY
20. Health research methodology, Bhimsen Devkota,Katma.
21. Polit & Beck, "Essential of Nursing research, Lippincott
22. Understanding Nursing research, Nancy Burns & Susan K Grove,
Harcourt(India) Pvt. Ltd.
23. Biostatistical Analysis, Jerrold H. Zar,Pearson Education,
India.

CO
24. Principles of Bistatistics, MarcelloPagano,K Gauvreau, Duxbury,
Thomsom,
25. Recent publication
26. Internet
27. WHO, Health System Research

TEACHING LEARNING ACTIVITIES

METHODS
T
Lectures
Discussion
AF

Demonstration
Project work
Presentation
Develop research
Conduct research proposal
Writing research report
DR

MEDIAS
Field practice assessment and management (Hospital/community)
Practicum

EVALUATION
Class test
Assignment

- 182 -
 EDUCATIONAL SCIENCE IN NURSING
(THEORY)
Placement: Fourth Year
Hours:100 hours, Full marks:100

PY
Course Code No: BSN-402 Pass marks:50

COURSE DESCRIPTION

This course aims to equip the students with the knowledge about
concepts, theories basic principles and methodology of teaching
learning including evaluation techniques and development of curriculum

CO
and in-service education program.

COURSE OBJECTIVES

At the end of the course, the student will be able to:

Explain the development of nursing education in Nepal.
Describe various concepts, terminologies used in educational
science
Discuss identification of learning needs of individual, family,
T
group and societies
Explain concept, theories, principles and approaches in the
teaching learning process
AF

Describe planning, organizing, conducting and evaluating the

teaching learning activities in assigned areas for an individual,
family and community in need based situation.
Explain behavioral objectives used in different domains
Discuss the use of various methods and media used in teaching
learning process
Explain the role of a teacher in effective students learning
DR

Explain the development of curriculum with the application of all

the required steps.
Describe planning , implementation and evaluation of in-service
training program
Discuss evaluation process and tools to be used in evaluating
students learning.
Describe guidance and counseling, its types, purposes and
process.
Course Content

- 183 -
Unit 1: Educational Sciences 2 hrs.
Definition of education
Terminology used in educational science
Purpose of education

PY
Development of nursing education in Nepal: past and present

Unit 2: Learning 10 hrs.

Definition
Types of learning (cognitive, affective and psychomotor)
Learning theories

CO
o Theory of mental discipline
o Behaviorist theory of learning
o Cognitive theory of learning
Learning process
learning principles
Characteristic of learning
Factors affecting learning
o Facilitating factors
T
o Hindering factors

Unit 3: Teaching 8 hrs.

AF

Definition
Purposes of teaching
Principals of teaching
Role of the teacher
Characteristics of a good teacher
Teaching ethics
DR

o Meaning
o Ethical responsibilities of a teacher
o Commitment of self, to students, client and teaching
profession

Unit 4: Educational Objectives 8 hrs.

Definition
Types of objectives
Behavioral objectives

- 184 -
 o Definition, benefits, criteria and taxonomy

Unit 5: Teaching/ Learning Methods 14 hrs.

Lecture, demonstration, group discussion, case study, role
play, panel discussion, symposium, workshop, exhibition,

PY
seminar, conference, team teaching, clinical teaching, field
trip, microteaching, self-directed learning, computer assisted
learning- distance learning/open learning, and brain storming.
Definition, Purposes, Advantages, Disadvantages and Process
to use and selection criteria of each method

CO
Unit 6: Teaching/Learning Media or Learning Resources 12 hrs.
Writing board, Over head projector (OHP), news print, flip chart,
meta card, poster, pamphlet, puppets, computer, power point
slide, CD Rom, floppy disc, video, audio cassette, models,
specimens, radio, library facilities with books, manuals, journals,
latest reference manuals and internet.
Definition, Purposes, Advantages, Disadvantages and Process
to use and selection criteria of each method
T
Unit 7: Lesson Planning 4 hrs.
Definition, benefits
Development of lesson plan used in class room and clinical
AF

teaching using all the required components

o Preliminary information
o The main body of lesson plan
o The end part of lesson plan

Unit 8: Evaluation 10 hrs.

DR

Definition, purpose
General principles of evaluation
Types of measurement (Placement, formative, diagnostic and
summative evaluation)
Characteristic of evaluation tools (validity & reliability, objectivity
and usability)
Types of evaluation
Test construction (paper and pencil test)
o Types of test items

- 185 -
 o Advantages and disadvantages
o General principal of test construction
o Development of different types of test
Clinical evaluation
o Characteristics of clinical evaluation tool

PY
o Purpose
o Methods of clinical evaluation tool
o Advantages and disadvantages of clinical evaluation tool
o Principals of using clinical evaluation tools
Feedback
o Types, process, and criteria of feedback

CO
Unit 9: Guidance/ Counseling
Definition of guidance/counseling
Purpose of counseling
Principal of counseling
4 hrs.

Steps of counseling

Unit 10: Clinical/Field Supervision 4 hrs.

T
Purpose of clinical/field supervision
Role and responsibilities of clinical/field supervisor
Planning of supervision
AF

Method of clinical/field supervision

Unit 11: In - Service Education 4 hrs.

Definition and purpose of in- service education
Planning of in-service program.
DR

Implementation of in- service education programme

Evaluation of in- service education

Unit 12: Curriculum Development 16 hrs.

Definition of curriculum
Purposes of curriculum development
Elements of curriculum
Curriculum development process
Fundamental steps Curriculum development

- 186 -
 Implementation and evaluation of curriculum
Models of curriculum
o Subject centered curriculum/traditional
o Integrated curriculum
o Competency based curriculum

PY
o Problem based curriculum / problem orientated curriculum
o Community based curriculum / community oriented
curriculum

TEACHING/LEARNING METHODS

Lecture
Group discussion

CO
Individual & Group presentations
Micro-teaching
Class room and clinical teaching
Individual/ group assignments
Test construction, implementation and evaluation
Clinical/field supervision
T
EVALUATION

Internal assessment
AF

o Written examination
o Micro-teaching
o Individual assignment
University examination
Written examination
DR

REFERENCE

1. Abbatt, F.R. (1980). Teaching for Better Learning: AGuide for

Teachers of Primary Health Care Staff, Geneva, World Health
Organization.
2. Abbat F. McMahon r.( 1988). Teaching Health Care Workers: A
Practical Guide. London: Macmillan Education Limited.
3. Adhikari, R.K & Jayawickramarajah, P.T.(1996). Essentials of
Medical Education. Health Learning Materials Center, T.UIOM:
Nepal.
- 187 -
4. Bloom, Benjamin, S. Ed.,( 1956). Taxonomy of Education,
Handbook 1: Cognitive Domain, New York: David McKay Co. Inc.
5. Bonwell, C.C. (1996). Enhancing the Lecture: Revitalizing a
Traditional Format. New Directions for Teaching and Learning, 67,
31- 45.

PY
6. Brown, G; Atkins M. (1988). Effective Teaching in Higher
Education. Chapter 2: Studies of Lecturing. New York, Menthuen
& Co. (pp7-18).
7. Brown, G; Atkins, M. (1988). Effecting Teaching in Higher
Education. Chapter 3: The Skills of Lecturing. New York, Menthuen
& Co. (pp. 19-49).

CO
8. Bruning, R.H, Schraw, G.J., Ronning, R.R. (1995). Cognitive
Psychology and Instruction. Prentice Hall: USA
9. Dahama, O.P; Bhatnagar, O.P. (1998). Education and
Communication for Development. 2nd ed. New Delhi, India. (pp.
150-161).
10. Dale, E. (1969). Audio Visual Methods in Teaching. The Dryden
Press Inc, Honsdale, Illinois, USA.
11. Golden, A.S. (1989) Lecture Skills in Medical Education. Teaching
Methods: Indian Pediatric Jan-Feb. 6 (1): 29-34.
T
12. Guilbert, J.J. (1981). Educational Handbook for Health Personnel,
Geneva; World Health Organization
AF

13. Hamblim, AC.(1974). Evaluation and Control of Training. London:

McGraw Hill.
14. Haribhakta Pradhan (2007) Textbook of Health education
philosophy and princip[al. Educational publishing house:
Kathmandu
15. Heiderken, Loretta E. (1982). Teaching and Learning in Schools of
Nursing, New Delhi: Himalayan Books, (1st Indian Ed.).
DR

16. Heidgerken, L.E. (1987). Teaching and Learning in Schools of

Nursing, Principles and Methods. Third Edition. J.B. Lippincott
Company: (pp. 414-470) New Delhi, India.
17. Hergenhahn, B.R. & Olson, M.H. (1997). An Introduction to
Theories of Learning. 5th ed. Prentice-Hall International, Inc: USA.
18. JHPIEGO, (1995). Clinical Training Skills for Reproductive Health
Professionals. USA.
19. Katz, F.M. and R. Snow,( 1980). Assessing Health Worker's
Performance, A Manual for Training and Supervision, Geneva:
WHO,
- 188 -
20. Khanna, S.D. et al. (1997). Technology of Teaching and Essentials
of Teaching Learning (Educational Innovations). DOABA HOUSE:
Delhi.
21. Mager, R.F. (1962) Preparing Instructional Objectives. California:
Feason Publishers.

PY
22. Neeraja KP. (2003) Textbook Of Nursing Education.Zaypee
Brothers Medical Publishers (P) Ltd, India
23. Dr. Singh I. Essentials of Education (2006). Kathmandu
24. WHO, (1977). Development of Educational Programmes for
Health Personnels, Geneva.
25. Park,JE and Park,K (2000) Textbook of Social and Preventive
Medicine. 16th ed.

CO
26. Pradhan, H.B. (1997). A Textbook of Health Education (Philosophy
and Principal). Kathmandu: Educational Resources for Health.
27. Reilly, Dorothy E., (
in Nursing, New York.
) Behavioural Objectives Evaluation

28. Thappa B. T. ( 2000 ) Nursing Education. JAPEE Publication,India.

29. Woolfolk, A.E. (1990). Educational Psychology. 4th ed.. Prentice-
Hall, Inc: USA.
T
30. Recent edition of the mention books and journals.
31. Internet
32. Research reports
AF
DR

- 189 -
 EDUCATIONAL SCIENCE (PRACTICUM)
Hours: 200 Full marks: 100
Course Code: BSN-402 Pass mark: 60

PY
CLINICAL OBJECTIVES

On the completion of the course, the student will be able to:

Develops lesson plan with clearly stated objectives, contents,
teaching- learning activities, time and evaluation.
Demonstrates effective teaching performance in the classroom
as well as clinical setting.

CO
prepares and use various audiovisual aids appropriate to the
topic
Design mini curriculum using all the steps of curriculum
development process.
Plans and prepares in-service education program in the given
setting.
Prepares a master plan, clinical rotation plan and performance
evaluation tools.
Plans, prepares, implements and evaluates test items
T
appropriately
Delegates responsibilities and supervise a nursing student.
Prepares in-service training program following the necessary
AF

steps.

CLINICAL EXPERIENCE

The clinical experience in Teaching Students will be responsible for

conducting class room and clinical teaching to nursing students.
They will conduct pre & post conference, monitor, guide, counsel and
DR

evaluate students in the clinical field as necessary.

CLINICAL ACTIVITIES

Identify learning need of student nurses

Select topic and prepare lesson plan.
Develop appropriate Medias (creativity) use correctly.
Intervene teaching learning using appropriate methods and
Medias in class room and clinical field.
Supervise, monitor and guide, and give feedback to students as
- 190 -
 per need.
Prepare questionnaire, checklist, rating scale, performance
evaluation tools and evaluate using prepared tools
Present prepared curriculum in the class.
Prepares for an in- service education program to small group of

PY
staff.
Prepare master plan, clinical rotation plan, class schedule,
evaluation tools etc.
Prepare her/his teaching learning activities plan.
Plan and conduct minimum of 10 class room teaching
Plan and conduct two clinical teaching

EVALUATION

Internal Assessment
CO
Conduct pre and post conferences during clinical practice

o 4 out of 10 class room teaching plan and performance

o 2 clinical teaching plan and performance
o Syllabus development (1) and presentation
o Master plan, clinical rotation plan, class schedule, evaluation
T
tools.
o Daily performance evaluation of clinical supervision
o Development of In-service Training Program.
AF

o Development of evaluation tools and test construction

DR

- 191 -
 Leadership and
Management(THEORY)
Placement: 4th year
Total Hour: 100 Full Mark: 100

PY
Course Code: BSN - 403 Pass Mark: 50

COURSE DESCRIPTION

This course has been designed to impart relevant knowledge and

modern concepts of leadership and management development
to nursing students. The course prepares the graduate nurses in

CO
application, participate and take lead in policy making process, planning
programming implementing monitoring and evaluation of health service
activities from the central to peripheral level. The student will also have
the opportunity to learn about human resource planning, development
and roles and responsibilities of different health personnel, specially
the nurses working in different health care settings, educational
organizations and other health agencies. Similarly students will also
be equipped regarding concepts of health economics and impact
of economical factor on health of the people and health services
management. Emphasis also been given to Information management
T
systems and emergency preparedness as it relates to the nursing
leadership role.

COURSE OBJECTIVES
AF

Upon completion of the course, students will be able to:

Discuss the philosophy, theories, concepts and principles of
nursing leadership and management.
Discuss general concept, principles and theories of Health care
management.
DR

Describe the national health strategies, planning, programming

and monitoring and evaluation system based on 10th National
Health Policy. (Latest)
Describe the different organizational structure of national health
settings.
Plan the nursing health manpower for different types of health
organization with the application of principles of human resources
development.
Describe the roles and responsibilities of different categories
of health personnel working at health organization, and in

- 192 -
 educational institutions.
Discuss the various types of resources management in health
services.
Explain the principles of economy affecting health, health
services and health personnel development at all level of the

PY
organizations.
Describe the management process of disaster and mass casualty
in hospital and community settings.
Describe the different roles and responsibilities of the nursing
manager.
Explain the components of patient assignments/care.

CO
Discuss the rationale for development, implementation and
evaluation of nursing policy.
Discuss the different legal/ethical aspects of nursing management
in health care organizations.
Describe the information management systems in the health
care setting.

COURSE CONTENT
T
Unit 1 Introduction of management: 6 hours
1. Definition, and terms used in leadership and management:
o Management
AF

o Administration
o Leadership
o Manager
o Leader
o Organization
o Power
DR

2. Concept and scope of Nursing administration and management

3. Principles of Management
4. Function of Management
o Planning
o Organizing
o Staffing
o Leading
o Directing
o Controlling
o Coordinating
- 193 -
 o Reporting and recording
o Budget
o Supervision

Unit 2 Planning, Policy and procedure;- 6 hours

PY
Overview of planning
o 2.2 Definition of planning, Policy and Procedures
- Nature and purposes
- Establishing objectives
- Benefits and limitation
- Planning process: steps of planning
-
-

-
-
health planCO
Strategies, policies and planning procedure
National health planning: short term and long term

Guidelines for development of effective policy

Nursing policy: hospital and community management
policy
- Legal implications of nursing policies
Application of management functions of planning to nursing,
T
health care
o Setting and other institutions.
AF

Unit 3 Organization 6 hours

1. Overview of organization formal structure
o Nature and purpose of organizing
o Principles of organizing
o Organizational design
o Elements of organization
DR

2. Authority relationship of organization

o Nature and sources of authority
o Line and staff authority
o Group dynamics, conflict: definition ,types, advantages,
characteristics.
3. Organizational structure of Nepalese health care delivery system
o Ministry of health
o Regional level
o Zonal level
o District level

- 194 -
 o Peripheral level
4. Organizational structure of
o Purbanchal University and its components
o Tribhuvan University and other universities
o Institute of Health Sciences and other Public and Private

PY
Campuses in Health Sciences.
5. Application of organizational function to nursing, health care
setting and Other institutions.
o Delegation
o Centralization and decentralization of authority
o Deligation of responsibilities

CO
o Patient care assignment: objectives, principles , methods.

Unit 4 Organizational changes: 4 hours

Change Definition of change and change agent
Need for change
Resistance to change
Behaviors favoring change
Change process
T
Unit 5 Staffing 6 hours
5.1 Introduction
AF

5.2 Meaning of staffing

5.3 Role and Responsibilities of Nursing Manager in staffing,
scheduling and patient Assignment.
5.4 Objectives of staffing in Nursing
5.5 Recruitment
o Meaning
o Policy
DR

5.5.1 Recruitment methods

5.6 Staff development program
5.7 Projecting staffing needs in nursing services
5.8 Important factors of staffing and staffing requirements in the
nursing.
o Services unit.

Unit 6 Co-ordination 4 hours

6.1 Introduction

- 195 -
 o Definition/Terms
o Importance
o Principles
o Technique of co-ordination
Types of co-ordination

PY
o
o Hindrance to co-ordination

Unit 7 Directing 6 hours

7.1 Concept
7.2 Human factor
7.3 Influencing factors to effective directing

CO
7.4 Delegation as a means of directing (Detail)
7.5 Motivational aspects (Detail)
7.6 Leadership aspects
7.7 Communication aspects
7.8 Supervision function (Detail)
7.9 Monitoring and Evaluation function
7.10 Controlling functions for effective directing (Detail)
T
Unit 8 Reporting and record: 6 hours
8.1 Introduction
8.2 Communication in Administration
AF

8.3 Structure of communication

8.4 Methods of communication
8.5 Record:-
o Concept and Meaning
o Importance of Records in
o Hospital Community Health Agencies
DR

Reports
Concept and Meaning
Purpose of reports
Types of reports
Meeting
Types, method of conducting meeting, writing minutes (Theory
and Practical)
Nurses responsibility for record keeping and reporting
8.6 Meeting types, method of conducting meeting, writing minutes
- 196 -
 o Nurses responsibility for record keeping and reporting

Unit 9 Financial management 6 hours

(Budget)

PY
9.1 Introduction, definition, objectives, benefits, and limitation
9.2 Process of budgeting
9.3 Fiscal planning
9.4 Classification
9.5 Audit: internal and external
9.6 Importance of budgeting in nursing Administration

CO
Unit 10 Monitoring and supervision
Definition, purpose, process of monitoring and supervision
Tools of supervision, styles and challenges
Supervision process: planning, implementation and evaluation
and feedback.
4 hours

Unit 11 Leadership 6 hours

11.1 Different approaches to leadership
T
o Autocratic leadership style
o Democratic leadership style
o Free-Rein leadership style
AF

11.2 Personal characteristics of a leader

11.3 Leadership theories
o Trait theory
o Behavior theory
o Situational theory
11.4 Application of different leadership approaches and leadership
DR

theories to Nursing, health care setting and other institutions.

Unit 12 Job satisfaction and moral 4 hours

Definition and factors contributing to job satisfaction
Consequnces of job satisfaction in the organization
Leader role in providing in job satisfaction moral

Unit 13 Discipline of personnel 2 hours

Priniciple of discipline action
- 197 -
 Role and function of administrator action in disciplinary

Unit 14 Human Resource Development (HRD) in Health 10 hrs

14.1 Introduction and background of HRD in Nepal
14.2 Concept, Principle steps of health Planning

PY
14.3 Meaning and Objectives of HRD
14.4 Pre requisites and basic criteria of Human Resource Planning in
Health
14.5 Methods of determining human resource requirement in health
14.6 Steps of Human Resource Planning in Health.
14.7 Conflict management (Detail)
14.8 Problem solving process

CO
14.9 Evaluation and measurement Tools
14.10 Job description of different categories of health personnel
working at
o Different health care setting and educational organization.

Unit 15 Quality Assurance Mechanism 10 hrs

Introduction (Dimension, advantages, Disadvantages)
T
Objective
Resources Management
o Equipment supplies
AF

o Drugs
o Time
o Space/Physical facilities
o Process of quality assurance
o Indicator for quality service.
o Nursing audits and nursing standard
DR

o National Policy and strategy on Quality Assurance

o Quality Assurance Committee and their Roles and
responsibilities
o Setting Standards

Unit 16 Information Management System 4 hrs

HMIS (Health Management information System)
FIS (Financial Information System)
HuRDIC (Human Resource Development Information Centre)
LMIS (Logistic Management Information System)
- 198 -
Unit 17: Health Economics 8 hrs
Economics - Definition
o Concept and the framework of health economics and its
significance in Health planning
o Theory of demand, supply and price system in health

PY
o Definition, law, limitation and importance of demand and
supply in health Care; elasticity of demand and supply
o Pricing, policy change and externalities in demand/supply
analysis
Health care cost concept
o Capital cost, recurrent cost, opportunity cost, cost analysis,
direct and indirect cost, fixed and variable cost, marginal,

CO
average and total cost.
o Economic evaluation
o Cost benefit, cost effectiveness and cost efficiency analysis
in health.
Budgeting process in health sector
o Principle of budgeting
o Preparation of budgeting
o Preparation, screening, Sanction, receipt of budget
T
o Agencies involved in budgetary process
o Overview of national budget and budget of health care in
various 5yrs plans.
AF

Unit 18: Disaster Management 2 hrs

Introduction
Types
Consequences of disaster
Management of disaster at hospital and community.
DR

Unit 19 Caree planning

Emerging opportunity in nursing job
Searching job
Developing resume
Writing letters: job application, recommendation letter, resignation
letter, acceptance letter, thank you letter.

- 199 -
TEACHING LEARNING ACTIVITIES

METHODS
Lecture/Discussion
Presentation

PY
Talk Programme
Project Work

MEDIA
White Board
OHP

.
Library Resources
Internet

EVALUATION
Class Test
CO
Presentation
Class Interaction
T
Project Work.
Report Writing
Management Assignment
AF

o Problem solving
o Meeting Conduct
o Daily Plan
o Schedule
o Logistic Management
o Documentation
DR

REFERENCES

1. Ahuja, KK, personnel Management, New Delhi, Kalyani publishers,

1986.
2. Basnet Sabitry (2002) Clinical Nursing Management.
3. Basic Information/Indicators to support Implementation of Basic
Minimum Needs and HFA/2000 Strategies, Nepal: HMG/WHO
Management Group, June 1987.
4. Banerjee, Mrityunjoy, Essentials of Modern Management,

- 200 -
 Calcutta: Indian Book Distributing Co.1986.
5. Banerjee, Shyamal, Principles and Practice of Management, New
Delhi, Oxford and IBH Publishing Co.1986.
6. Dewitt, KK and Verma, JD, Elementary Economic Theory, New

PY
Delhi: S Chand & Company Ltd 1984.
7. Fulop, Tamas and Milton J. Roemer, Reviewing Health Manpower
Development, WHO Public Health Papers 83, 1987.
8. Health Manpower Recruitment for the Achievement of Health for
All by the year 2000 Through Primary Health Care, WHO Technical
series no 717, Geneva: WHO, 1985.
9. Hornby, P. and others, Guidelines for Health Manpower Planning,

CO
A course book; Geneva: WHO, 1980.
10. Koontz, H and Weihrch, H. (1999). Essentials of Management.
Tata MC G raw-Hill Publishing Company, 1984.
11. Leadership in Nursing for Health for all, the challenge to Nursing,
Geneva: WHO, Division of Health Manpower Development, 1987.
12. Lele, RK, and J.P Maharjan, Principles of Management, New
Delhi: Pitamber Publishing Company, 1984.
13. Management of Nursing Services by standards; Kathmandu:
T
HMG Nepal, Division of Nursing Technical series.
14. Mariner, Ann, Guide to Nursing Management, St. Louis: The C.V
Mosby Company.
AF

15. McMahan, Rosemary and others, on being in charge: A Guide for

Middle-level Management in Primary Health Care. Geneva: WHO
1980.
16. Research Needs for Health for all by 2000, SEARO Technical
Publication No.2, WHO, 1986.
17. Sullivan, M.P (1990). Nursing Leadership and Management. A
DR

study and learning tool.

18. TU Teaching Hospital Disaster Plan, Handout, 1988, Bir Hospital
Mass Casualty Management(Handout)
19. Basvanthapa BT, Nursing Administration, Jaypee Brothers,
Medical Publishers Ltd, New Delhi 2001.
20. Ahuja, KK, personnel Management, New Delhi, Kalyani publishers,
1986.
21. Basnet Sabitry (2002) Clinical Nursing Management.
22. Basic Information/Indicators to support Implementation of Basic

- 201 -
 Minimum Needs and HFA/2000 Strategies, Nepal: HMG/WHO
Management Group, June 1987.
23. Banerjee, Mrityunjoy, Essentials of Modern Management,
Calcutta: Indian Book Distributing Co.1986.

PY
24. Banerjee, Shyamal, Principles and Practice of Management, New
Delhi, Oxford and IBH Publishing Co.1986.
25. Dewitt, KK and Verma, JD, Elementary Economic Theory, New
Delhi: S Chand & Company Ltd 1984.
26. Fulop, Tamas and Milton J. Roemer, Reviewing Health Manpower
Development, WHO Public Health Papers 83, 1987.
27. Health Manpower Recruitment for the Achievement of Health for

CO
All by the year 2000 Through Primary Health Care, WHO Technical
series no 717, Geneva: WHO, 1985.
28. Hornby, P. and others, Guidelines for Health Manpower Planning,
A course book; Geneva: WHO, 1980.
29. Koontz, H and Weihrch, H. (1999). Essentials of Management.
Tata MC G raw-Hill Publishing Company, 1984.
30. Leadership in Nursing for Health for all, the challenge to Nursing,
Geneva: WHO, Division of Health Manpower Development, 1987.
T
31. Lele, RK, and J.P Maharjan, Principles of Management, New
Delhi: Pitamber Publishing Company, 1984.
32. Management of Nursing Services by standards; Kathmandu:
AF

HMG Nepal, Division of Nursing Technical series.

33. Mariner, Ann, Guide to Nursing Management, St. Louis: The C.V
Mosby Company.
34. McMahan, Rosemary and others, on being in charge: A Guide for
Middle-level Management in Primary Health Care. Geneva: WHO
1980.
DR

35. Research Needs for Health for all by 2000, SEARO Technical
Publication No.2, WHO, 1986.
36. Sullivan, M.P (1990). Nursing Leadership and Management. A
study and learning tool.
37. TU Teaching Hospital Disaster Plan, Handout, 1988, Bir Hospital
Mass Casualty Management(Handout)
38. Basvanthapa BT, Nursing Administration, Jaypee Brothers,
Medical Publishers Ltd, New Delhi 2001.
39. Harold Koontz, Heinz Weihrich, Essentials of Management (An
International Perspective)
- 202 -
40. Bessie L. Marquis, Carol J. Huston , Leadership Roles and
Management Functions in Nursing (Theory & Application)
41. Dr. Singh I, Leading and Managing in Health, Kathmandu, 2006.
42. Thapa P, Nursing Leadership Management Advance Books

PY
Suppliers, Kathmandu, 2012.
43. Recent edition of the mention books and journals.
44. Internet
45. Research reports

Placement: IVth Year

BSN- 404
Hour: 300
Full Marks: 100
Pass Marks: 60
CO
T
AF
DR

- 203 -
 LEADERSHIP AND MANAGEMENT
PRACTICUM
Placement: 4th year
Total Hour: 100 Full Mark: 100

PY
Course Code: BSN - 403 Pass Mark: 50

COURSE DESCRIPTION

This course will provide opportunity to the students to apply concepts,

principles, and management functions at work situation in hospital units
and district public health office at district level. The students will have

CO
exposure during this placement period to develop managerial skill and
competency working as nurse unit in-charge as well as subordinate
staff at hospital. The student will spend 5 weeks in total during the
placement period.

The student will also gain knowledge and skill regarding district health
management, in health care system during DPHO placement.

COURSE OBJECTIVES
T
At the completion of the practicum student will be able to:

1. Demonstrate the management skill in the given area in relation

AF

to administration & management activities of hospital unit/District

Health office.
2. Observe and collect required information regarding administration
and management of Campus Chief/Principal as assigned in the
campus.

COURSE CONTENT
DR

Unit I- Hospital Management practicum

Unit II- DPHO Management

UNIT I: Hospital Management Practicum

The students will spend 4 weeks at Hospital and will have to manage
hospital unit by carrying out daily activities and (sharing) responsibilities
of nursing unit in-charge and subordinate nursing staff to provide
effective patient care as well as apply change process to strengthen
nursing administration process.

- 204 -
1. Hospital - 4 weeks
2. DPHO - 1 week
3. Nursing College - 1 week

ASSIGNMENTS

PY
1. Daily performance
2. Organize and conduct meeting
3. Implement/introduce a change process
4. Conduct in-service education
5. Write a report (hospital)
6. Write report of DPHO and nursing college submit in time.

Internal Evaluation
1.
2.
Performance evaluation
Meeting
CO -
-
Total
20 + 5 = 25
5 (Group)
3. Change process - 5 (Pair)
4. In-service training - 10 (Respective unit)
5. Hospital report - 15+5 (Presentation)
T
6. DPHO & Nursing college report - 5+5=10
Total 75
External Evaluation (Viva) - 25
AF

Unit II: District Health Management

The students will spend 1 week at DPHO and work with Public Health
Nurse and also other health personnel to participate in regular district
health management activities to gain required skill, knowledge, and
attitude of district Public Health Nurse.
DR

Students will also be assigned 1 week to Nursing College to learn about

Campus Chiefs’ role and responsibilities in academic and administrative
activities.

- 205 -
 MEDICAL SURGICAL NURSING
(ADVANCED PRACTICE) PRACTICUM
Placement: 4th year
Total Hour: 300 Full Mark: 100

PY
Course Code: BSN - 404 Pass Mark: 60

COURSE DESCRIPTION

This course enables students to apply deeper knowledge in practical

situation while caring the clients in the specialized units of the hospital.
This exposure in specialist practical areas in provided to develop

CO
competency while taking care of the client with special gazettes and
their care as per need.

COURSE OBJECTIVES

At the end of this Advanced Nursing Practicum Students will be able to:
Demonstrate confidence in the assessment of patients and
providing the needed care independently.
Observe special cases and provide the specific care needed by
such patients.
T
Develop skill in the interpersonal relationships with other health
team members in the hospital.
Assist the ward in-charge in planning and implementing care to
AF

concerned patient.
Take full responsibility and be accountable in her work.
Teach/guide other workers who are under the supervision of staff nurses.

Area of practice:
1. Cardio-thoraxic…………. 4 weeks
2. Oncology…………………2 weeks
DR

3. Ortho……………………..2 weeks
Or
Neuro or Renal or Psychiatry (2 case study & 2 case presentation)

Total Weeks 8 weeks

Evaluation Scheme:
1. Performance Evaluation 30 marks
2. Case study at Cardio thoracic unit 10 marks (5+5)
3. Case study at any one of the above elective unit 10 marks (5+5)

50 marks is allocated for final practical exam

- 206 -