Home India Indian Nursing Council In exercise of the powers conferred by sub section (1) of Se...
Date: 17-Jan-2025 Category: Extra Ordinary State: Union Government Country: India

In exercise of the powers conferred by sub section (1) of Section 16 of Indian Nursing Council Act, 1947 (XLVIII of 1947), as amended from time to time, the Indian Nursing Council

Issued by Indian Nursing Council · Not Applicable

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Executive Summary & Key Takeaways

Gazette Notification Description

  • This Extraordinary Gazette of India, Part III—Section 4, Notification No. 51, dated January 17, 2025, publishes the Indian Nursing Council {Nurse Practitioner in Nephrology Nursing (NPNepN) - Postgraduate Residency Program} Regulations, 2024.
  • The regulations establish a two-year postgraduate residency program for registered B.Sc. nurses to become Nurse Practitioners in Nephrology Nursing (NPNepN).
  • The program emphasizes competency-based training with a strong clinical component (85% practicum, 15% theory).
  • Upon completion, NPNepNs will be able to provide advanced nephrology nursing care, including independent drug administration and ordering of diagnostic tests, within institutional protocols.

Key Changes

  • Establishment of a new two-year postgraduate residency program: Indian Nursing Council {Nurse Practitioner in Nephrology Nursing (NPNepN) - Postgraduate Residency Program} Regulations, 2024.
  • Competency-based curriculum aligned with international standards (ICN, AACN, ANNA, NONPF).
  • 85% clinical practicum, 15% theoretical instruction.
  • Independent practice authorization for NPNepNs post-completion and registration with the State Nurse and Midwives Registration Council (SNRC).
  • Specific competencies outlined for NPNepNs, including assessment, treatment planning, hemodialysis, peritoneal dialysis, patient education, and participation in government initiatives.
  • Detailed examination regulations, including minimum attendance requirements (80% theory, 100% practical), passing score (60%), and OSCE guidelines.
  • Minimum requirements for institutions offering the program, including essentiality certificate (with exemptions), hospital bed capacity (200 beds minimum), nephrology unit staffing, faculty resources, and equipment.

Impact Analysis

Impact on Healthcare System

  • Enhanced patient outcomes and quality of life for individuals with kidney diseases.

Impact on Nurses

  • Greater autonomy and responsibility in patient care.

Impact on Educational Institutions

  • Potential for collaboration with medical institutions and nephrology specialists.

Impact on Government

  • Requirement to provide Essentiality Certificates to institutions (with exemptions).

Suggested Action Items

  • Conduct regular monitoring and evaluation of the program's effectiveness.

Key Entities Referenced

Indian Nursing Council Act, 1947 (XLVIII of 1947): The primary legislation under which these regulations are made. It grants the Indian Nursing Council the power to make regulations. Indian Nursing Council (INC): The body responsible for creating and overseeing the NPNepN program. State Nurse and Midwives Registration Council (SNRC): The state-level body responsible for registering nurses, including those completing the NPNepN program. National Health Policy, 2017 (NHP 2017): A policy document that highlights the need for specialized healthcare professionals, including nurse practitioners. International Council of Nurses (ICN): An international organization whose competencies are used as a basis for the NPNepN program curriculum. American Association of Colleges of Nursing (AACN): A US-based organization whose competencies inform the NPNepN program curriculum. American Nephrology Nurses Association (ANNA): A US-based organization whose competencies inform the NPNepN program curriculum. National Organization of Nurse Practitioner Faculties (NONPF): A US-based organization whose competencies inform the NPNepN program curriculum. National Informatics Centre (NIC): Government of India agency involved in developing the Nurses Registration & Tracking System (NRTS). Nurses Registration & Tracking System (NRTS): A system used for registering nurses and maintaining the Indian Nurses Register.
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रजिस्ट्री स.ं डी.एल.- 33004/99 REGD. No. D. L.-33004/99 सी.जी.-डी.एल.-अ.-27012025-260514 xxxGIDHxxx CG-DL-E-27012025-260514 xxxGIDExxx असाधारण EXTRAORDINARY भाग III—खण् ड 4 PART III—Section 4 प्राजधकार स ेप्रकाजित PUBLISHED BY AUTHORITY स.ं 51] नई दिल्ली, िुक्रवार, िनवरी 17, 2025/पौष 27, 1946 No. 51] NEW DELHI, FRIDAY, JANUARY 17, 2025/PAUSHA 27, 1946 अजधसचू ना नई दिल्ली, 26 दिसम्बर, 2024 (X) le;&le; ij ;Fkkla'kksfèkr Hkkjrh; mip;kZ ifj"kn~ vfèkfu;e] 1947 ¼1947 dk XLVIII½ dh èkkjk 16¼1½ ds vèkhu çnÙk 'kfDr;ks a dk ç;ksx djrs gq,] Hkkjrh; mip;kZ ifj"kn~ ,rí~okjk fuEufyf[kr fofu;e cukrh gS] ;Fkk & 1. i. ;s fofu;e dgs tk,axsA ii. ;s fofu;e Hkkjr ds jkti= es a budh vfèklwpuk dh frfFk ls çHkkoh gksxa sA 2. bu fofu;eksa es]a tc rd fd lanHkZ ls vU;Fkk visf{kr u gks] i. ^vfèkfu;e* dk vfHkçk; le;&le; ij ;Fkkla'kksfèkr Hkkjrh; mip;kZ ifj"kn~] 1947 ¼1947 dk XLVIII½ ls gS( ii. ^ifj"kn~* dk vfHkçk; vfèkfu;e ds rgr xfBr Hkkjrh; mip;kZ ifj"kn~ ls gS( iii. ^,l,uvkjlh* dk vfHkçk; lacafèkr jkT; ljdkjks a }kjk fdlh Hkh uke ls xfBr jkT; mip;kZ ,oa çlkfodk iathdj.k ifj"kn~ ls gS( iv. ^vkj,u ,aM vkj,e* dk vfHkçk; ,d iathÑr mip;kZ ,oa iathÑr çlkfodk ¼vkj,u ,aM vkj,e½ ls gS vkSj ,d ,sl s ulZ dks n'kkZrk gS ftlus ekU;rk çkIr uÉlx Lukrd ¼ch-,llh- uÉlx½ ;k fMIyksek bu tujy uÉlx ,aM 463 GI/2025 (1)2 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] feMokbQjh ¼th,u,e½ ikBîØe] tSlk fd ifj"kn ~ }kjk fuèkkZfjr fd;k x;k gks] lQyrkiwoZd iwjk dj fy;k gks vkSj fdlh ,d ,l,uvkjlh es a iathÑr mip;kZ ,oa iathÑr çlkfodk ds :i es a iathÑr gks( v. ^ulZ iathdj.k ,oa VªSÇdx ç.kkyh ¼,uvkjVh,l½* dk vfHkçk; ifj"kn~ }kjk jk"Vªh; lwpuk foKku dsæa ¼,uvkbZlh½] Hkkjr ljdkj ds lg;ksx ls fodflr lkW¶Vos;j ç.kkyh ls gS] ftls Hkkjrh; mip;kZ jftLVj ds j[kj[kko o lapkyu ds fy, ,uvkbZlh }kjk gkWLV fd;k x;k gSA bles a iathÑr mip;kZ ,oa iathÑr çlkfodk ¼vkj,u ,aM vkj,e½@iathÑr lgk;d ulZ feMokbQ ¼vkj,,u,e½@iathÑr efgyk LokLF; ifjnÆ'kdk ¼vkj,y,poh½ ds vkadM+ksa ds laxzg ds fy, ^vkèkkj* ck;ksesfVªd çek.khdj.k ij vkèkkfjr ekudhÑr çk:i gSa( vi. ^,u;wvkbZMh* dk vfHkçk; ,uvkjVh,l ç.kkyh }kjk çR;k'kh dks fn;k tku s okyk ulsZt ;wfud vkbMsfaVfQds'ku uca j ls gS( vii. ^tujy uÉlx ,aM feMokbQjh ¼th,u,e½* dk vfHkçk; ifj"kn~ }kjk vfèkfu;e dh èkkjk 10 ds rgr LohÑr rFkk vfèkfu;e dh vuqlwph ds Hkkx&I eas 'kkfey fMIyksek bu tujy uÉlx ,aM feMokbQjh çf'k{k.k ls gSA I. Hkkjr es]a LokLF; ds lHkh vk;keksa eas LokLF; ç.kkfy;ks a dks u;k :i nsus dks jk"Vªh; LokLF; uhfr] 2017 ¼,u,pih 2017½ eas ,d egRoiw.kZ vko';drk ds :i es a ekU;rk nh xbZ gSA ;g fofu;eu vkSj dkuwu ds lkFk&lkFk f'k{kk vkSj çf'k{k.k ds {ks=ks a es a ekuo lalkèku fodkl ij tksj nrs h gSA ljdkj lkoZtfud vkSj futh LokLF; nksuks a {ks=ksa eas r`rh;d n[s kHkky lsokvks a eas egRoiw.kZ o`f) dks ekU;rk nrs h gSA viuh {kerk fuekZ.k ds fy, ;g vR;ar egRoiw.kZ gS fd LokLF; n[s kHkky dfeZ;ks a dks fof'k"V vkSj vfr&fof’k"V lsokvks a eas mUur 'kSf{kd rS;kjh dh vko';drk gksrh gSA fof'k"V vkSj vfr&fof'k"V LokLF; ns[kHkky lsokvks a dk leFkZu djus ds fy,] mUur rS;kjh okys fo'ks"kK ulZ vko';d gSaA r`rh;d n[s kHkky ds {ks= eas çf'k{k.k dk;ZØe vkSj ikBîØe fodflr djuk le; dh vko';drk ds :i eas igpkuk tkrk gSA ulZ çSfDV'kuj ¼,uih½ bl ekax dks iwjk djus eas l{ke gksxa s] c'krZs os vPNh rjg ls çf'kf{kr gks a vkSj vH;kl djus ds fy, vfèkÑr gksAa dsæa vkSj jkT; Lrj ij u, laoxZ dh LFkkiuk ds lkFk] ijkLukrd Lrj ij rS;kj ulZ çSfDV'kuj r`rh;d n[s kHkky dsæa ksa ds fofHkUu xaHkhj n[s kHkky lek;kstuks a eas jksfx;ksa dks ykxr çHkkoh] mfpr] lqjf{kr vkSj xq.koÙkk ijd fof'k"V uÉlx n[s kHkky çnku djus eas l{ke gksxa sA ulZ çSfDV'kulZ ;w,l, rFkk dukM+k eas 1960 ds n'kd ls] ;wds eas 1980 ds n'kd ls] vkWLVªfsy;k eas 1990 ds n'kd ls o uhnjyaSM esa 2010 ls rS;kj fd, tk jgs gSa rFkk dk;Zjr gSaA ulZ çSfDV'kuj bu fØfVdy ds;j@,D;wV ds;j] vkWUdksykWth] uÝs ksykWth ds;j] ,ejtsla h ds;j] U;wjks ds;j] dkÆM;ksoLdqyj ds;j] ,uLs Fksfl;k ds;j ,aM vnj Lis’kfyVht dks ekè;fed vkSj r`rh;d ns[kHkky lek;kstuks a eas dk;Z djus ds fy, rS;kj fd;k tk ldrk gSA ijkLukrd Lrj ij ulZ çSfDV'kuj bu usÝksykWth uÉlx ¼,uih,ubZih,u½ rS;kj djus ds fy, ifj"kn~ }kjk ,d ikBîp;kZ lajpuk@:ij[s kk çLrkfor dh xbZ gSA bl dk;ZØe dk fof'k"V y{k.k ;g gS fd ;g ,d uSnkfud vkoklh; dk;ZØe gS tks 15% lS)kafrd funsZ'k vkSj 85% O;kogkfjdrk ds lkFk ,d lqn`< + uSnkfud ?kVd ij cy nrs k gSA bldk çeq[k n`f"Vdks.k n{krk vkèkkfjr çf'k{k.k gS vkSj ,uih f'k{kk baVjus'kuy dkmafly vkWQ ulsZt ¼vkbZlh,u] 2020½] vefsjdu ,lksfl,'ku vkWQ dkWyts vkWQ uÉlx ¼,,lh,u] 2021½] vefsjdu uÝs ksykWth ulsZt ,lksfl,'ku ¼,,u,u,] 2020½ vkSj u's kuy vkWxZukbts'ku vkWQ ulZ çSfDV'kuj QSdYVht daihVaslht ¼,uvks,uih,Q daihVsla ht] 2022½ ls yh xbZ n{krkvks a ij vkèkkfjr gSA çR;sd ikBîØe n{krkvks a dh miyfCèk ij vkèkkfjr gSA ulZ çSfDV'kuj bu uÝs ksykWth ufl±x dk;ZØe dk mís'; iathÑr ch-,llh- ulks± dks r`rh;d n[s kHkky dsæa ksa es a fdMuh jksx ls ihfM+r jksfx;ks a dks mUur uÉlx n[s kHkky çnku djus ds fy, rS;kj djuk gSA ulZ çSfDV'kuj bu usÝksykWth uÉlx ¼,uih,ubZih,u½ tfVy ;k thMZ fdMuh@;wjksykWftdy fodkjks a ls ihfM+r] Mk;fyfll yus s oky s vkSj fdMuh çR;kjksi.k ds bPNqd ;k fdMuh çR;kjksi.k djok pqds jksfx;ks a dks çkFkfed ns[kHkky çnku djrk gSA uÉlx n[s kHkky jksx c<u+ s dh xfr dks èkhek djus] çkjafHkd çcaèku 'kq: djus] tfVyrkvks a dks de djus vkSj thou dh xq.koÙkk dks c<k+u s ij dsfaær gSA dk;ZØe eas vè;;u ds fofHkUu ikBîØe 'kkfey gSa tks fdMuh jksx ls ihfM+r O;fDr;ks a ds vkadyu vkSj çcaèku eas etcwr oSKkfud vkèkkj vkSj lk{; vkèkkfjr vH;kl ij vkèkkfjr gSaA ;s ch-,llh- çf'kf{kr ulks± dh lS)kafrd vkSj O;kogkfjd n{krkvks a ij vkèkkfjr gSaA dk;ZØe ds iwjk gksus vkSj lacafèkr ,l,uvkjlh eas iathÑr gksus ij] mUgs a ifj"kn~ ds ikBîØe dh ykWx cqd eas lwphc) lHkh n{krkvks a dk vH;kl djus vkSj laLFkkxr çksVksdkWy@LFkk;h vkn's kks a ds vuqlkj Lor=a :i ls vkS"kfèk;ka nus s vkSj uSnkfud ijh{k.k] çfØ;k vkSj mipkj djus dk vkn’sk nus s dh vuqefr nh tkrh gSA ulZ çSfDV'kuj bu usÝksykWth uÉlx bl vfèkdkj dk ç;ksx djrs le; bu n{krkvks a ds fy, tokcnsg gksxa s & a) vkadyu vkSj uSnkfud ijh{k.k b) leL;k dks igpkuuk vkSj mipkj ;kstuk rS;kj djuk c) gseksMk;fyfll vkSj isfjVksfu;y Mk;fyfll dh ;kstuk cukuk vkSj çnku djuk d) fdMuh çR;kjksi.k mipkj ds fy, jksfx;ks a vkSj ifjtuks a dks rS;kj djuk e) xzkgdks a vkSj muds ifjtuks a dks vax nku ds fy, rS;kj djuk f) vkS"kfèk ;k midj.kks a ;k mipkj dk p;u@ç'kklu g) jksxh f'k{kk h) mipkjkRed vkS"kfèk;ks a dh ikjLifjd çHkko dh tkudkjh i) ifj.kkeks a dk fu:i.k j) tfVyrkvks a vkSj çfrdwy çfrfØ;kvks a dh igpku vkSj çcaèku[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 3 k) uSnkfud vH;kl es a lk{; vkèkkfjr uokpkjks a eas ;ksxnku l) fdMuh nku vkSj çR;kjksi.k dks c<k+ok nus s eas ljdkjh vkSj xSj&ljdkjh xfrfofèk;ks a eas HkkxhnkjhA ulZ çSfDV'kuj bu usÝksykWth uÉlx ¼,uih,ubZih,u½ viuh n[s kj[s k eas fdMuh jksx ls ihfM+r jksfx;ks a dh n[s kHkky ds fy, ftEens kjh vkSj tokcnsgh yus s ds fy, rS;kj vkSj ;ksX; gksrs gSaA mDr LukrdksÙkj mikfèk dks ,l,uvkjlh }kjk vfrfjDr ;ksX;rk ds :i eas iathÑr fd;k tk,xkA ifj"kn~ dk ekuuk gS fd fdMuh jksx ls ihfM+r jksfx;ks a vkSj muds ifjtuks a dks xq.koÙkkiw.kZ ns[kHkky çnku djus ds fy, Hkkjr es a r`rh;d LokLF; ns[kHkky lsokvks a dh pqukSfr;ks a vkSj ekaxks a dks iwjk djus gsrq ulZ çSfDV'kuj bu usÝksykWth uÉlx ¼,uih,ubZih,u½ uked ,d LukrdksÙkj dk;ZØe LFkkfir djuk vR;fèkd vko';d gS] tSlk fd jk"Vªh; LokLF; uhfr] 2017 eas ifjyf{kr gSA ifj"kn~ dk ekuuk gS fd lqn`<+ uSnkfud ?kVd vkSj n{krk&vkèkkfjr çf'k{k.k ij dsfaær ,d vkoklh; dk;ZØe ls çkIr Bksl lS)kafrd vkSj lk{; vkèkkfjr Kku ds vkèkkj ij LukrdksÙkj] uSnkfud {kerk dk çn'kZu djus eas l{ke gksxa sA f'k{k.k&vfèkxe n`f"Vdks.k dks o;Ld vè;;u fl)karks]a n{krk&vkèkkfjr f’k{kk] lg;ksxh vè;;u] çf'k{kd funsZf'kr uSnkfud vè;;u] vuqHkokRed vè;;u vkSj Lo&funsZf'kr vè;;u ij dsfaær gksuk pkfg,A f'k{kk çnkrkvks@a çhlsIVlZ@esVa lZ dks viu s orZeku Kku vkSj çFkkvks a dks v|ru j[kuk pkfg,A çf'k{k.k eas çhlsIVj ds :i eas Hkkx yus s ds fy, fpfdRlk ladk; dks vkeaf=r fd;k tkrk gSA ifj"kn~ dk ;g Hkh ekuuk gS fd ;ksX; usÝksykWth uÉlx ladk; dh deh dks njw djus ds fy, uSnkfud lek;kstuksa es a fofHkUu çdkj dh 'kSf{kf.kd j.kuhfr;ks a dk mi;ksx fd;k tk ldrk gSA vk’kk dh tkrh gS fd blls iathdj.k@ykblsal dh fn’kk es a uhfr;ks a dks fodflr djus eas enn feysxh vkSj bu LukrdksÙkj ,uih,ubZih,u dks usÝksykWth lsok,a çnku djus oky s ekè;fed vkSj r`rh;d n[s kHkky vLirky lek;kstuks a ;k lkeqnkf;d LokLF; n[s kHkky lek;kstuks a esa dk;Z djus gsrq mfpr fu;qfDr ds fy, inks a dk l`tu fd;k tk ldsxkA os Øksfud fdMuh jksx Dyhfud@dsaæ] Mk;fyfll dsæa vkSj çkFkfed ns[kHkky lek;kstuksa] ftues a ?kj vkèkkfjr gseksMk;fyfll vkSj isfjVksfu;y Mk;fyfll 'kkfey gSa] es a Hkh lsok,a çnku dj ldr s gSaA ,uih ikBîØe ds fy, ,d 'kS{kf.kd :ijs[kk çLrkfor gS ¼n[s ks a½ • mUur uÉlx vH;kl ds fy, lS)kafrd vkèkkj • usÝksykWth uÉlx eas 'kksèk vuqç;ksx rFkk lk{; vkèkkfjr vH;kl • usr`Ro] çcaèku rFkk f'k{k.k es a mUur dkS'ky • usÝksykWth• uÉlx vH;kl ds ewy vkèkkj • usÝkys kWth uÉlx I • usÝksykWth uÉlx II4 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] II. ulZ çSfDV'kuj bu uÝs ksykWth ufl±x ¼,uih,ubZih,u½ dk;ZØe ,d vkoklh; uÉlx dk;ZØe gS ftles a eq[;r% n{krk&vkèkkfjr çf'k{k.k ij cy fn;k tkrk gSA ikBîØe dh vofèk nks o"kZ gS ftles a lS)kfUrd ds ewy ikBîØe] mUur vH;kl ikBîØe vkSj uSnkfud ikBîØe ds vykok uSnkfud vH;kl 'kkfey gSa tks fd ,d çeq[k ?kVd gS ¼ ns[ksa½A ;g dk;ZØe ,uih Nk=ks a dks usÝksykWth uÉlx ds {ks= es a fo'ks"kKrk vkSj xgu le> fodflr djus es a lgk;rk djus ds fy, rS;kj fd;k x;k gSA ;g mUgs a fdMuh jksx ls ihfM+r jksfx;ks a dh n[s kHkky djrs le; uÉlx eè;orZu ds fy, mUur dkS'ky fodflr djus es a enn djxs kA III. ,uih,ubZih,u dk;ZØe] iathÑr ch-,llh- ulks± dks mUur vH;kl Hkwfedkvks a tSls uSnkfud fo'ks"kK] çcaèkd] f'k{kd vkSj lykgdkj ds :i eas rS;kj djrk gS] tks vkxs pydj ,e-,llh- uÉlx ¼ulZ çSfDV'kuj bu uÝs ksykWth ufl±x½ curs gSaA IV. dk;ZØe ds iwjk gksus ij] ,uih,ubZih,u fuEufyf[kr dk;ks± ds laiknu eas l{ke gksxa s & 1- fofHkUu LokLF; ns[kHkky lek;ktuksa eas fdMuh jksx ls ihfMr jksfx;ks a dks l{ke ifjokj dsfaær n[s kHkky çnku djus ds fy, ftEens kjh vkSj mÙkjnkf;Ro ysukA 2- fofHkUu fdMuh fodkjks]a f'k{kk] uSnkfud rdZ] tfVy fuxjkuh vkSj vkgkj ds lkFk&lkFk mipkj rFkk lalkèku ,tsfal;ks a ds lkFk laidZ ds lkFk jksfx;ks a ds uSnkfud vkadyu eas fo'ks"kKrk lfgr uSnkfud {kerk dk çn'kZu djukA 3- uÝs ksykWth uÉlx es a mipkj@eè;orZu dks ykxw djus ds fy, uSnkfud tkudkjh] oSKkfud fl)kar] fNækUos"kh lkps dkS'ky vkSj lk{; vkèkkj ykxw djukA 4- uÝs ksykWth ny ds ,d lnL; ds :i eas Lor=a ;k lg;ksxkRed :i ls jksxh ds LokLF; dks fLFkj o cgky djus vkSj tfVyrkvks a dks de dju s ;k çcafèkr djus ds fy, fdMuh jksx ls ihfMr jksfx;ks a ds bykt eas Hkkx ysukA 5- n[s kHkky dh fujarjrk eas usÝksykWth ny eas 'kkfey vU; LokLF; dfeZ;ks a ds lkFk lg;ksx djukA V. laLFkk dks ,uih,ubZih,u dk;ZØe vkSj mlds Nk=ks a ds çfr tokcngs h Lohdkj djuh gksxh vkSj dk;ZØe dh is'kd'k ifj"kn~ ds ekudks a ds vuq:i djuh gksxhA bls fuEufyf[kr vgZrkvks a dks iwjk djuk gksxk & 1. vfuok;Zrk çek.ki= a. tks dksbZ Hkh laLFkku ulZ çSfDV'kuj bu uÝs ksykWth ufl±x ¼,uih,ubZih,u½ dk;ZØe 'kq: djuk pkgrs gSa] mUgsa jkT; ls vfuok;Zrk çek.ki=@ljdkjh vkns'k yus k gksxkA b. fuEufyf[kr laLFkkuks a dks vfuok;Zrk çek.ki= yus s ls NwV nh xbZ gS & i. ifj"kn~ }kjk vfèkfu;e dh èkkjk 13 vkSj 14 ds rgr mi;qDr ik, x, rFkk ch-,llh- uÉlx ;k ,e-,llh- uÉlx dk;ZØeks a dk igys ls gh lapkyu dju s oky s laLFkku@fo'ofo|ky;( ii. ,echch,l@Mh,uch dk;ZØe dk lapkyu djus oky s laLFkku@fo’ofo|ky;A 2. vLirky a. laLFkku es a de ls de 200 'k¸;k okyk ,d ewy vLirky@rr` h;d n[s kHkky dsæa gksuk pkfg,A b. eyw vLirky ls lac) ,d esfMdy dkWyts @uÉlx dkWyts gksuk csgrj gksxkA 3. uÝs ksykWth 'k¸;k vLirky esa de ls de 20 'k¸;k okyk ,d uÝs ksykWth okMZ] de ls de 10 'k¸;k okyk ,d gseksMk;fyfll bdkbZ vkSj fdMuh çR;kjksi.k lsok,a miyCèk gksuh pkfg,A de ls de 2 'k¸;k okyh ,d isjhVksfu;y Mk;fyfll bdkbZ gksuk csgrj gksxkA 4. uÝs ksykWth bdkbZ LVkÇQx a. okMZ rFkk Mk;fyfll bdkbZ eas ,d pktZ ulZ gksuk pkfg,] vfèkekur% ch-,llh- uÉlx ;k ,e-,llh- uÉlx ;ksX;rk èkkjdA b. tujy okMZ eas çR;sd f'k¶V ds fy, ulZ jksxh vuiq kr 1%6 gksuk pkfg,A c. Mk;fyfll bdkbZ esa çR;sd f'k¶V ds fy, ulZ jksxh vuiq kr 1%1 gksuk pkfg,A d. vodk'k vkjf{kr ds fy, 45% vfrfjDr deZpkfj;ks a dk çkoèkku gksuk pkfg,A 5. ladk;@LVkQ lalkèku a. i. uÉlx çhlsIVj & uÝs ksykWth uÉlx eas 6 o"kZ ds vuqHko ds lkFk iw.kZdkfyd th,u,e ¼vfèkekur% iksLV csfld fMIyksek bu jhuy uÉlx½ ;ksX;rk èkkjd ;k uÝs ksykWth uÉlx eas 2 o"kZ vuHq ko ds lkFk ch-,llh- uÉlx ;k uÝs ksykWth uÉlx eas ,d o"kZ vuqHko ds lkFk ,e-,llh- ¼fof’k"Vrk & efsMdy lÆtdy uÉlx½ ii. efsMdy çhlsIVj & Mh,e bu uÝs ksykWth iii. çhlsIVj Nk= vuqikr & uÉlx 1%10] efsMdy 1%10 ¼çR;sd Nk= ds fy, ,d esfMdy vkSj uÉlx çhlsIVj gksuk pkfg,½[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 5 b. i. çksQslj@,lksfl,V çksQslj% 1 ¿'kS{kf.kd vuqHko% ,e-,llh- ¼fof’k"Vrk & efsMdy lÆtdy uÉlx½ LukrdksÙkj ds ckn 5 o"kZÀ ¼çR;sd 10 Nk=ks a ds fy, ,d ladk;½ i. lgk;d çksQslj & 1 ¼’kS{kf.kd vuqHko% ch-,llh- uÉlx ds ckn 3 o"kZ½ ii. mijksDr ladk; nksgjh Hkwfedk fuHkk,axs ;k uÝs ksykWth bdkbZ es a fu;qDr ,e-,llh- uÉlx ;ksX;rk èkkjd ,d ofj"B ulZ gksaxsA iii. QkekZdksykWth vkSj iSFkksfQft;ksykWth ds fy, vfrfFk çkè;kid 6. vLirky@dkWyst eas HkkSfrd vkSj f'k{k.k lalkèku a. uSnkfud {ks= eas ,d vè;;u d{k@lEeys u d{k b. flE;qysVsM vè;;u ds fy, dkS'ky ç;ksx'kkyk ¼vLirky@dkWyst½ c. vkWuykbu if=dkvks a rd igqap ds lkFk iqLrdky; vkSj daI;Vw j lqfoèkk,a d. bZ&yÆud lqfoèkk,a 7. midj.k lwph ¼layXu ½ 8. Nk= HkrÊ@ços'k lacaèkh vgZrk,a a. ukekadu ls igy s vkosndks a dks vfèkekur% uÝs ksykWth ns[kHkky lek;kstu eas de ls de 1 o"kZ uSnkfud vuqHko ds lkFk iathÑr ch-,llh-@ih-ch-ch-,llh- ulZ gksuk pkfg,A b. ifj"kn~ }kjk mi;qDr ik, x, laLFkku ls ch-,llh-@ih-ch-ch-,llh- uÉlx dh gksuh pkfg, vkSj lacafèkr ,l,uvkjlh es a iathÑr gksuk pkfg,A c. ch-,llh- uÉlx dk;ZØe es a dqy çkIrkad 55% ls de ugÈ gksus pkfg,A d. p;u ,d ços'k ijh{kk dh Js"Brk vkSj l{ke çkfèkdkjh }kjk vk;ksftr lk{kkRdkj ds vkèkkj ij gksuk pkfg,A e. 'kkjhfjd :i ls LoLFk gksuk pkfg,A vH;fFkZ;ks adh la[;k & 3 Mk;fyfll 'k¸;k vkSj usÝksykWth bdkbZ eas HkrhZ 5 jksxh ds fy, 1 vH;FkhZA 1- lsokjr vH;FkhZ dks fu;fer osru feysxkA 2- vU; vH;fFkZ;ks a ds fy, o`fÙkdk@osru ml vLirky dh osru lajpuk ds vuqlkj gksxk tgka ikB~;Øe lapkfyr fd;k tk jgk gSA VI. ijh{kk eas cSBus ds fy, ik=rk mifLFkfr% fo'ofo|ky; dh vafre ijh{kk eas cSBus ls igy s lS)kafrd vkSj ç;ksxkRed ds fy, U;wure 80%] ysfdu fMxzh çnku djus ls igy s ç;ksxkRed es a 100% iwjh djuh vfuok;Z gSA vkarfjd vkadyu vadks a ds fy, dksbZ U;wure lhek ugÈ gS] D;ksfad mÙkh.kZ ?kksf"kr djus ds fy, vkarfjd vkSj cká vad ,d lkFk tksM+ s tkr s gSaA ijh{kk lapkyu ,oa fMxzh çnkrk çkfèkdj.k% lacafèkr fo'ofo|ky; ifj.kkeks adh ?kks"k.kk ;fn çkIrkad 60% ;k mlls vfèkd gSa rks vH;FkhZ dks ijh{kk eas mÙkh.kZ ?kksf"kr dj fn;k tkrk gSA ;g çkIrkad çR;sd ikBîØe@fo"k; eas lS)kafrd vkSj ç;ksxkRed dh vkarfjd ,oa cká fo'ofo|ky;h nksuks a ijh{kkvks a dk dqy ;ksx gS vkSj 60% ls de vuqÙkh.kZ ekuk tk,xkA Js.kh dh x.kuk ds fy,] nksuks a o"kZ ds dqy vadks a dks ekuk tk,xkA ;fn dksbZ vH;FkhZ lS)kfUrd vFkok ç;ksxkRed ijh{kk eas vuqÙkh.kZ gks tkrk gS] rks mls og ç'u&i= fQj ls nus k gksxk ftles a og vuqÙkh.kZ gqvk gSA ,sl s vH;FkhZ dh Js.kh ?kksf"kr ugÈ dh tk,xh tks fdlh Hkh fo"k; eas vuqÙkh.kZ gksA dk;ZØe dks iwjk djus dh vfèkdre vofèk 4 o"kZ gksxhA çk;ksfxd ijh{kk vks,llhbZ ijh{kk ekSf[kd ijh{kk ds lkFk&lkFk gksxh & eas fn, x, vks,llhbZ fn'kkfunsZ'k n[s ksAa çk;ksfxd ijh{kk ds fy, çfr fnu Nk=ks a dh vfèkdre la[;k 10 Nk= gksxhA ijh{kk dsoy uSnkfud {ks= eas gh vk;ksftr dh tkuh pkfg,A çk;ksfxd ijh{kd ny eas ,d vkarfjd ijh{kd ¿,uih,ubZih,u dk;ZØe i<k+u s ds 2 o"kZ vuqHko ds lkFk ,e-,llh- uÉlx ladk;@LukrdksÙkj ds mijkar 5 o"kZ vuHq ko ds lkFk ,e-,llh- ¼efsMdy lftZdy uÉlx½ ladk;À] ,d cká ijh{kd ¼mijksDr ds leku½ vkSj ,d fpfdRlh; vkarfjd ijh{kd] tks ,uih,ubZih,u dk;ZØe ds fy, çhlsIVj gksxkA 'kksèk fucaèk* 'kksèk xkbM% eq[; xkbM% LukrdksÙkj ds mijkar ,uih,ubZih,u dk;ZØe i<+kus ds 3 o"kZ vuqHko okyk uÉlx ladk;] lg&xkbM% efsMdy çhlsIVj 'kksèk çLrko dh çLrqfr% çFke o"kZ es a ços'k dh frfFk ds 6&9 ekg mijkar xkbM Nk= vuiqkr% 1%56 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] 'kksèk lfefr% dkWyst@vLirky eas 'kksèk ds ekxZn'kZu vkSj mldh çxfr dk i;Zos{k.k djus ds fy, ,d vyx 'kksèk lfefr gksxh ¼çèkkukpk;Z ;k lh,uvks] tks ,e-,llh- uÉlx mikfèk èkkjd gksuk pkfg,] ds lkFk U;wure 5 lnL;½A uSfrd eta wjh% pwafqd bles a uSnkfud 'kksèk 'kkfey gS] laLFkkxr leh{kk cksMZ@vLirky vkpkj lfefr }kjk ufSrd eta wjh çkIr djuh gksxhA fo"k; dk p;u% fo"k; uÝs ksykWth uÉlx ds fy, çklafxd gksuk pkfg, tks uÉlx eè;orZu eas tkudkjh ;k lk{; tksM+As 'kksèk fdlh Hkh uÝs ksykWth ns[kHkky lek;kstu es a vk;ksftr fd;k tkuk pkfg,A MsVk laxzg.k% MsVk laxzg.k ds fy, 7 lIrkg vkoafVr fd, tkr s gSa] ftls igys o"kZ es a 6 ekg ds ckn vkSj nwlj s o"kZ ds iwjk gksus ls 6 ekg igys uSnkfud vuHq ko ds nkSjku ,dhÑr fd;k tk ldrk gSA 'kksèk fjiksVZ y[sku% nlw js o"kZ ds 6&9 ekg easA 'kksèk fucaèk dh çLrqfr% nlw js o"kZ ds iwjk gksus ls 3 ekg igysA 'kksèk fucaèk ijh{kk vkarfjd vkadyu% ekSf[kd ijh{kk vkSj 'kksèk fucaèk fjiksVZ ¾ 50 vad fo'ofo|ky;h ijh{kk% ekSf[kd vkSj 'kksèk fucaèk fjiksVZ ¾ 50 vad ¼vkadyu gsrq vU; ,e-,llh- uÉlx fof'k"Vrkvks a ds fy, mi;ksx eas yk, tkus oky s vad fn'kkfunsZ'kks a dk mi;ksx fd;k tk ldrk gSA½ *'kksèk çcaèk ds LFkku ij bZchih ifj;kstuk lapkfyr dh tk ldrh gS vkSj fu:i.k ds fy, fjiksVZ çLrqr dh tk ldrh gSA VII. • ç’uksÙkjh • lsfeukj • fyf[kr fufgr dk;Z • ekey s dh çLrqfr@uSnkfud çLrqfr • uSnkfud ;k ns[kHkky ekxZ@ns[kHkky vè;;u fjiksVZ • uSnkfud çn'kZu leh{kk • ykWx cqd% esfMdy@uÉlx ladk;@çhlsIVj }kjk gLrk{kfjr çfØ;kRed n{krk rFkk uSnkfud vgZrk dk laiknu • oLrqfu"B lajfpr uSnkfud ijh{kk ¼vks,llhbZ½ • ç’u i=] ç’uksÙkjh • vafre ijh{kk ¼vkadyu fn'kkfunsZ'kks a ds fy, dk lanHkZ ysa½a % % 1 mUur vH;klh; uÉlx ds fy, lS)kafrd vkèkkj 2 50 2 uÝs ksykWth uÉlx eas 'kksèk vuçq ;ksx rFkk lk{; vkèkkfjr 3 30 70 vH;kl 3 urs `Ro] çcaèku rFkk f'k{k.k es a mUur dkS'ky 3 30 70 4 uÝs ksykWth uÉlx eas vuqç;qDr mUur iSFkksfQft;ksykWth rFkk 3 30 70 mUur QkekZdksykWth 5 mUur LokLF;@'kkjhfjd vkadyu 3 30 70 50 50 1 uÝs ksykWth uÉlx vH;kl ds ewy vkèkkj 3 30 70 100 100 2 uÝs ksykWth uÉlx I 3 30 70 100 100 3 uÝs ksykWth uÉlx II 3 30 70 100 100 4 'kksèk fucaèk vkSj ekSf[kd ijh{kk 50 50 VIII.[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 7 I mUur vH;klh; uÉlx ds fy, lS)kafrd vkèkkj 40 II uÝs ksykWth uÉlx eas 'kksèk vuçq ;ksx rFkk lk{; 56 24 336 ¼7 lIrkg½ vkèkkfjr vH;kl III urs `Ro] çcaèku rFkk f'k{k.k es a mUur dkS'ky 56 24 192 ¼4 lIrkg½ IV uÝs ksykWth uÉlx eas vuqç;qDr mUur 60 336 ¼7 lIrkg½ iSFkksfQft;ksykWth V uÝs ksykWth uÉlx eas vuqç;qDr mUur QkekZdksykWth 54 336 ¼7 lIrkg½ VI mUur LokLF;@'kkjhfjd vkadyu 70 48 576 ¼12 lIrkg½ dqy ;ksx ¾ 2208 ?kaVs 336 ¼7 lIrkg½ 96 ¼2 lIrkg½ 1776 ¼37 lIrkg½ VII uÝs ksykWth uÉlx vH;kl ds ewy vkèkkj 96 48 576 ¼12 lIrkg½ VIII uÝs ksykWth uÉlx I 96 48 576 ¼12 lIrkg½ IX uÝs ksykWth uÉlx II 96 48 624 ¼13 lIrkg½ dqy ;ksx ¾ 2208 ?kaVs 288 ¼6 lIrkg½ 144 ¼3 lIrkg½ 1776 ¼37 lIrkg½ ,d o"kZ eas miyCèk lIrkgksa dh la[;k ¾ 52 & 6 ¼okÆ"kd vodk'k] vkdfLed vodk'k] #X.krkodk'k ¾ 6 lIrkg½ ¾ 46 lIrkg × 48 ?kaVs ¾ 2208 ?kaVs nks o"kZ ¾ 4416 ?kaVs ¼ijh{kk uSnkfud inLFkkiu ds nkSjku½ lS)kafrd ¾ 624 ?kaV]s dkS'ky ç;ksx'kkyk ¾ 240 ?kaV]s uSnkfud ¾ 3552 ?kaVs dqy ;ksx ¾ 4416 ?kaVs çFke o"kZ% 336&96&1776 ?kaV s ¼lS)kfUrd&O;kogkfjd½ ¿lS)kfUrd ¾ 15%] O;kogkfjd ¾ 85%À f}rh; o"kZ% 288&144&1776 ?kaV s ¼lS)kfUrd&O;kogkfjd½ ¿lS)kfUrd ¾ 15%] O;kogkfjd ¾ 85%À çFke o"kZ ¾ 46 lIrkg@2208 ?kaVs ¼46×48 ?kaVs½ ¼lS)kfUrd$ç;ksx'kkyk% 44 lIrkg ds fy, 7-5 ?kaVs çfr lIrkg ¾ 330@336$96 ?kaVs*½ *lS)kfUrd $ ç;ksx'kkyk ¾ ifjp;kRed CykWd d{kkvks a vkSj dk;Z'kkykvks a ds :i eas 2 lIrkg ds fy, 96 ?kaVs fn, tk ldr s gSa f}rh; o"kZ ¾ 46 lIrkg@2208 ?kaVs ¼46×48 ?kaVs½ ¼lS)kfUrd$ç;ksx'kkyk% 45 lIrkg ds fy, 8-5 ?kaVs çfr lIrkg ¾ 384$48 ?kaVs½ ¼1 lIrkg CykWd d{kk,a ¾ 48 ?kaVs½ A. U;wure 48 ?kaVs çfr lIrkg fuèkkZfjr gS] gkykafd] ;g vyx&vyx ikfj;ks a vkSj vkWu dkWy MîwVh djus ds ckn NqV~Vh ds vkèkkj ij ifjorZu'khy gSA B. ¼ifjp;kRed CykWd d{kkvks a vkSj dk;Z'kkyk ds 2 lIrkg dks NksM+dj½ • o;Ld usÝksykWth okMZ & 10 lIrkg • ihfM;kfVªd usÝksykWth okMZ & 4 lIrkg • Mk;fyfll ;wfuV & 14 lIrkg • ;wjksykWth okMZ & 2 lIrkg • jhuy VªkalIykaV ;wfuV & 5 lIrkg • uÝs ksykWth vksihMh & 4 lIrkg ¼VªkalIykaV vksihMh lfgr½ • efsMdy vkbZlh;w & 4 lIrkg • vaxnku bdkbZ@uksVks & 1 lIrkg8 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] ¼CykWd d{kkvks a ds ,d lIrkg dks NksM+dj½ • efsMdy vkbZlh;w & 4 lIrkg • lÆtdy vkbZlh;w & 2 lIrkg • cky fpfdRlk vkbZlh;w & 2 lIrkg • o;Ld usÝksykWth okMZ & 8 lIrkg • ihfM;kfVªd usÝksykWth okMZ & 2 lIrkg • uÝs ksykWth vksihMh & 6 lIrkg • Mk;fyfll ;wfuV & 10 lIrkg ¼isfjVksfu;y Mk;fyfll&ihMh lfgr½ • fdMuh VªkalIykaV ;wfuV & 5 lIrkg • vkWijs'ku fFk;sVj & 4 lIrkg • ;wjksykWth okMZ & 2 lIrkg C. vè;;u ladk; }kjk Lo&funsZf'kr gksxk] tks uSnkfud vuHq ko ds lkFk ,dhÑr gksxkA • vuqHkokRed vè;;u • Çpru'khy vè;;u • fleqy's ku vkèkkfjr vè;;u • uSnkfud dkUÝsla • ekeyk@uSnkfud çLrqfr • xgu vkS"kèkh; vè;;u] çLrqfr vkSj fjiksVZ • uÉlx jkmaM • bZ&yÉux] oÆ.kr çLrqfr;ka • f¶yIM vè;;u d{k • uSnkfud lsfeukj • tuZy Dyc • ekey s dk vè;;u@uSnkfud ;k n[s kHkky ekxZ • mUur LokLF; vkadyu • uSnkfud {ks= eas ladk; O;k[;ku • funsZf'kr iBu • çn'kZu] i;Zosf{kr dkS’ky vH;kl • fufgr dk;Z • ekey s ds vè;;u dk fo'y"sk.k • dk;Z'kkyk,a • çfØ;kvks a dk voyksdu • çn'kZu vkSj i;Zosf{kr dkS’ky vH;kl D. çR;sd uSnkfud inLFkkiu ds var eas] uSnkfud ykWx cqd ¼fof'k"V çfØ;kRed n{krk,@a uSnkfud dkS'ky½ 3 vkSj uSnkfud vgZrk, a ij çR;sd i[kokM+ s çhlsIVj@ladk; }kjk gLrk{kj fd, tkus pkfg,A E. 1- mUur O;kid vkadyu] funku] mipkj ;kstuk] dk;kZUo;u vkSj fu:i.k dkS'ky dk mi;ksx djrk gSA 2- th.kZ vkSj@;k vfLFkj okrkoj.k eas mUur dkS'ky dk s ykxw djrk gS vkSj viukrk gSA 3- O;ogkj es a lwfpr dju]s ekxZn'kZu dju s vkSj fl[kkus ds fy, Bksl mUur uSnkfud rdZ o fu.kZ; ykxw djrk gSA 4- nLrkostks a dk vkadyu] funku] çcaèku vkSj jksfx;ks a dh Hkkxhnkjh ea s mipkj vkSj vuqorÊ n[s kHkky dh fuxjkuh djrk gSA 5- laLFkkxr çksVksdkWy ds vuqlkj vkS"kfèk;ks a vkSj mipkjks a dk çcaèku djrk gSA 6- fpfdRlh; lacaèkks a dks 'kq: dju]s fodflr djus vkSj can djus ds fy, vuçq ;qDr lapkj] ijke'kZ] odkyr vkSj ikjLifjd dkS'ky dk mi;ksx djrk gSA 7- n[s kHkky dh fujarjrk cuk, j[ku s ds fy, vU; LokLF; ns[kHkky dfeZ;ks a dks jQs j djrk gS vkSj muls jQs jy Lohdkj djrk gSA 8- jksxh] ifjtuks a vkSj leqnk; ds fgr es a çkfèkdj.k vkSj fu;ked <kapk tgka vuqefr nsrk gS] Lor=a :i ls vH;kl djrk gSA 9- vU; LokLF; n[s kHkky dfeZ;ks a vkSj vU; yksxks a ds lkFk ijke'kZ djrk gS vkSj muls ijke'kZ yrs k gSA 10- jksxh ds fgr es a LokLF; ny ds lnL;ks a ds lkFk feydj dk;Z djrk gSA 11- ,d ,slh çFkk fodflr djrk gS tks orZeku oSKkfud lk{;ks a ij vkèkkfjr gks rFkk jksxh] ifjtuksa vkSj leqnk; ds LokLF; çcaèku es a 'kkfey gksA[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 9 12- lk{;&vkèkkfjr vH;kl 'kq# djrk gS] vkSj mldk vkadyu rFkk çcaèku djrk gSA 13- Lor=a vkSj var%is'ksoj 'kksèk ds }kjk n[s kHkky dh lqj{kk] n{krk vkSj çHkko'khyrk es a lqèkkj yku s ds fy, lk{;&vkèkkfjr vH;kl dk çn’kZu dju s ds fy, 'kksèk dk mi;ksx djrk gSA 14- ,ih,u Hkwfedk vkSj ftEesnkjh ds lHkh igyvq ks a eas uSfrd vH;kl eas layXu jgrk gSA 15- viu s mUur is'ksoj fu.kZ;] dk;Z vkSj fujarj {kerk ds fy, tokcngs h vkSj ftEens kjh Lohdkj djrk gSA 16- tksf[ke çcaèku j.kuhfr;ks a vkSj xq.koÙkk lqèkkj mi;ksx dj ,d lqjf{kr fpfdRlh; okrkoj.k cukrk gS vkSj cuk, j[krk gSA 17- cnyrh LokLF; n[s kHkky ç.kkyh eas dq'ky mUur vH;kl uÉlx lsokvks a ds forj.k eas urs `Ro vkSj çcaèku dh ftEesnkjh laHkkyrk gSA 18- LokLF; n[s kHkky ç.kkfy;ks a eas jksfx;ks a ds fy, vfèkoDrk ds :i eas dk;Z djrk gS vkSj oS;fDrd jksxh] ifjtuks a vkSj leqnk; dks c<k+ok nus s vkSj mudh j{kk djus okyh LokLF; uhfr;ka fodflr djrk gSA 19- vH;kl dks çklafxd vkSj lkaLÑfrd ifjos'k ds vuq:i <kyrk gSA 1- uÝs ksykWth eas mUur Kku ftlesa iSFkksfQft;ksykWth vkSj fdMuh@;wjksykWftdy fLFkfr;ks a vkSj mudh tfVyrkvks a dk çcaèku 'kkfey gSA 2- mRÑ"V ikjLifjd] lapkj vkSj fNækUos’kh lkps dkS'kyA 3- fdMuh fodkjks a ls xzflr jksfx;ks a ds vkadyu] funku vkSj çcaèku eas mUur uSnkfud dkS'ky ftles a fdMuh fjIysleasV Fksjsih 'kkfey gSA 4- fdMuh jksx vkSj mlds çHkkoks a ls fuiVus ds nkSjku jksfx;ks a vkSj muds ifjtuks a dh t:jrks a ds çfr laosnu'khyrkA 5- fdMuh jksx] mipkj vkSj thou 'kSyh es a cnyko ds ckj s eas jksfx;ks a dks fl[kku s dh {kerkA 6- fdMuh jksx ls tqM+ s 'kksd vkSj uqdlku ls fuiVus dh {kerkA 7- n[s kHkky leUo; eas ,d cgq&fo"k;d ny eas dke dju s dh {kerkA F. Nk=ks a dks laLFkkxr çksVksdkWy@LFkk;h vkn's kks a ds vulq kj Lor=a :i ls vkS"kfèk nus s vkSj uSnkfud ijh{k.k] çfØ;k] fpfdRlk midj.k o mipkj dk vkn's k nus s ds fy, çf'kf{kr fd;k tk,xk ¼ LFkk;h vkns'k½A vkikrdkyhu vkS"kfèk;ka lacafèkr fpfdRld ds ijke'kZ ls nh tkrh gSa vkSj ckn eas fyf[kr vkns'k }kjk leÆFkr dh tkrh gSaA 1- mUur vH;klh; uÉlx ds 8 ?kaVs 1×32¾32 ?kaVs • lsfeukj@lS)kafrd vuqç;ksx fy, lS)kafrd vkèkkj ¼40½ • O;k[;ku ¼ladk;½ • tuZy çLrqfr • f¶yIM vè;;u d{k 2- uÝs ksykWth uÉlx eas 'kkès k 8 ?kaVs 40 ¼5 fnu½ 1×24¾24 ?kaVs • 'kksèk vè;;u fo'y"sk.k vuqç;ksx rFkk lk{; vkèkkfjr $ 8 ?kaVs • vH;kl@fufgr dk;Z ¼ç;ksx'kkyk½ vH;kl ¼56$24½ 3- urs `Ro] çcaèku rFkk f'k{k.k eas 4 ?kaVs 16 ?kaVs 1×26¾26 ?kaVs • uSnkfud dkUÝsla mUur dkS'ky ¼56$24½ ¼2 fnu½ 2×16¾32 ?kaVs • lsfeukj] vH;kl vè;;u • dk;Z’kkyk • vH;kl@fufgr dk;Z ¼ç;ksx'kkyk½ 4- uÝs ksykWth uÉlx eas vuqç;qDr 1-5×40¾60 ?kaVs • ekey s dh çLrqfr mUur iSFkksfQft;ksykWth ¼60½ • lsfeukj • uSnkfud dkUÝsla • dulsIV eSfiax 5- uÝs ksykWth uÉlx eas vuqç;qDr 10 ?kaVs 1×44¾44 ?kaVs • uÉlx jkmaM~l mUur QkekZdksykWth ¼54½ • vkS"kfèk vè;;u çLrqfr • LFkk;h vkns'k • O;k[;ku@ppkZ • vkS"kfèk Mk;jh 6- mUur LokLF;@'kkjhfjd 8 ?kaVs 2×26¾52 ?kaVs • uSnkfud çn'kZu ¼ladk;½ vkadyu ¼70$48½ 1-5×18¾27 ?kaVs • okilh çn'kZu 1×15¾15 ?kaVs • uÉlx jkmaM~l 2×6¾12 ?kaVs • 'kkjhfjd vkadyu ¼lHkh ç.kkfy;ka½ 2×2¾4 ?kaVs10 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] • ekey s dk vè;;u & ifjp;kRed d{kk,a ¾ 1 lIrkg ¼48 ?kaVs½] dk;Z'kkyk ¾ 1 lIrkg ¼48 ?kaVs½] 44 lIrkg ¾ 7-5 ?kaVs çfr lIrkg ¼330@336 ?kaVs½ ¼48 ?kaVs½ 1- uÝs ksykWth uÉlx vH;kl ds ewy 9×16 ¾ 144 ?kaVs • çn'kZu vkèkkj • i;Zosf{kr vH;kl ¼96$48 ?kaVs½ ¾ 144 ?kaVs • uSnkfud çf'k{k.k • ekey s dk vè;;u • lsfeukj • uSnkfud dkUÝsla • ladk; O;k[;ku 2- uÝs ksykWth uÉlx I 9×16 ¾ 144 ?kaVs • çn'kZu ¼96$48 ?kaVs½ ¾ 144 ?kaVs • i;Zosf{kr vH;kl • uSnkfud dkUÝsla @tuZy Dyc • f¶yIM vè;;u d{k • lsfeukj • ekey s dh çLrqfr • vkS"kfèk vè;;u ¼vkS"kèkh; ikjLifjd çHkko lfgr½ • uÉlx jkmaM~l • ladk; O;k[;ku • Çpru'khy vè;;u • oÆ.kr ihihVh] ohfM;ks • funsZf'kr iBu 3- uÝs ksykWth uÉlx II 9×16 ¾ 144 ?kaVs • çn'kZu ¼ç;ksx'kkyk½ ¼96$48 ?kaVs½ ¾ 144 ?kaVs • uSnkfud n{krkvks a dk i;Zosf{kr vH;kl • uÉlx jkmaM~l • uSnkfud dkUÝsla @tuZy Dyc • lsfeukj] ekeys dk vè;;u • ladk; O;k[;ku • Çpru'khy vè;;u • funsZf'kr iBu] lkfgfR;d leh{kk CykWd d{kk,a & 1 lIrkg] 45 lIrkg & 8-5@9 ?kaVs çfr lIrkg çR;sd f'k{k.k i)fr gsrq fo"k; dks lacafèkr f'k{kd@laLFkku }kjk foLr`r ;kstuk eas fuÆn"V fd;k tk,xkA I. 1- oSf'od LokLF; n[s kHkky ço`fÙk;ks a vkSj pqukSfr;ks a dk fo'y"sk.k djukA 2- Hkkjr eas LokLF; n[s kHkky rFkk f'k{kk uhfr;ks a ds uÉlx ij çHkko dk miyCèk nLrkots ks a ls ijke'kZ djds fo'y"sk.k djukA 3- Hkkjr es a LokLF; lsok forj.k ç.kkyh vkSj bldh pqukSfr;ks a dh xgu le> fodflr djukA 4- fØfVdy ds;j es a LokLF; lsokvks a ds forj.k ds fy, çklafxd vkÆFkd fl)karks a dks ykxw djukA 5- ykxr] xq.koÙkk rFkk larqf"V tSls LokLF; ifj.kkeks a dks çHkkfor djus ds fy, LokLF; tkudkjh dk çcaèku vkSj :ikarj.k djukA 6- ulZ çSfDV’kuj dh Hkwfedkvks a rFkk n{krkvks a dk vH;kl djus es a tokcngs h vkSj ftEens kjh Lohdkj djukA 7- fØfVdy ds;j eas LokLF; n[s kHkky ny ds lHkh lnL;ks a dks 'kkfey djrs gq, lg;ksxh vH;kl eas lfØ; :i ls Hkkx yus k vkSj vfèkÑr nk;js ds vanj fu;ked Hkwfedk fuHkkukA 8- fofèkd] uSfrd vkSj mUur uÉlx vH;kl ds fu;eu dh vPNh tkudkjh ds lkFk uSfrd vH;kl eas layXu gksukA[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 11 9- lqfu;ksftr çhlsIVjf'ki ds ekè;e ls çnku fd, x, çf'k{k.k ds voljks a dk mi;ksx djuk rFkk uÉlx çfØ;k@ds;j ikFkos ;k fDyfudy ikFkos ykxw djr s gq, lqjf{kr vkSj l{ke ns[kHkky djukA 10- xqnZs dh chekjh oky s jksfx;ks a dks l{ke ns[kHkky çnku dju s eas uÉlx fl)karks a dh tkudkjh dks ykxw djukA 11- fo'ks"k :i ls Hkkjr eas fofHkUu LokLF; n[s kHkky lek;kstuksa eas ulZ çSfDV'kuj dh Hkwfedkvks a eas vkxkeh pqukSfr;ks a dk iwokZuqeku yxkukA 1- oSf'od LokLF; n[s kHkky pqukSfr;ka vkSj #>ku ¼n{krk&1½ 2 2- Hkkjr es a LokLF; ç.kkyh & Hkkjr eas LokLF; n[s kHkky forj.k ç.kkyh & cnyr s ifjn`'; ¼n{krk&3½ 2 3- jk"Vªh; LokLF; ;kstuk & iapo"kÊ; ;kstuk,a vkSj jk"Vªh; LokLF; uhfr ¼n{krk&2½ 2 4- LokLF; vFkZ'kkL= vkSj LokLF; n[s kHkky foÙkik"sk.k ¼n{krk&4½ 4 5- uÉlx lwpuk foKku lfgr LokLF; lwpuk ç.kkyh ¼daI;Vw j dk mi;ksx½ ¼n{krk&5½ 4 6- ,ih,u & ifjHkk"kk] nk;jk] n'kZu] tokcngs h] Hkwfedk vkSj ftEens kfj;ka 3 ¼lg;ksxh vH;kl vkSj ulZ fu;ked Hkwfedk,a½ ¼n{krk&6 o 7½ 7- fofu;eu ¼çf'k{k.k laLFkkuks a dh ekU;rk vkSj çek.ki=½ vkSj 3 mUur uÉlx vH;kl Hkwfedk ds uSfrd vk;ke ¼n{krk&8½ 8- ulZ çSfDV’kuj% Hkwfedk] çdkj] n{krk] vH;kl ds fy, uSnkfud lek;kstu] lkaLÑfrd {kerk ¼n{krk&6½ 3 9- ,uih ds fy, çf'k{k.k & çhlsIVjf'ki ¼n{krk&9½ 2 10- ,uih vH;kl dh Hkfo"; dh pqukSfr;ka ¼n{krk&11½ 4 11- ,ih,u eas vuqç;qDr uÉlx ds fl)kar ¼n{krk&10½ 3 12- ,ih,u eas vuqç;qDr uÉlx çfØ;k@ds;j ikFkos ¼n{krk&9½ 2 6 1- LokLF; n[s kHkky rFkk f'k{kk uhfr;ks a dh igpku djuk vkSj uÉlx ij blds çHkko dk fo'y"sk.k djuk 2- ,uih vH;kl ds fy, Hkkjr eas dkuuw h fLFkfr dh O;k[;k djukA vU; n's kks a eas bu uhfr;ks a dh çklafxdrk ds lkFk Hkkjr eas ulZ fu;ked uhfr;ks a dk Hkfo"; D;k gS\ 3- vkids r`rh;d dsæa dh usÝksykWth bdkbZ@fdMuh çR;kjksi.k bdkbZ@Mk;fyfll bdkbZ eas ik, tkus okys ,uih vH;kl ls lacafèkr uÉlx çksVksdkWy dh tkap djuk • ,,lh,u ¼2021½ n ,lsfa’k;Yl% dksj daihVsla ht QkWj çksQs’kuy uÉlx ,twds’ku & ,aVªh yos y ,aM ,MokaLM yos y uÉlx ,twds’ku] vesfjdu ,lksfl,'ku vkWQ dkWystst vkWQ uÉlx • ,,u,u, ¼2021½ n uÝs ksykWth ulsZt Ldksi ,aM LVsMa MZ~l vkWQ çsfDVl% LVsMa MZ~l vkWQ çksQs’kuy ijQkWjeasl ,aM daihVsla ht] uÝs ksy ulZ ts- 2022 tqykbZ&vxLr • MsfuLdks ,aM ckdZlZ ,-,e- ¼2015½ ,MokaLM çsfDVl uÉlx% ,lsfa’k;y uksyst QkWj n çksQs’ku ¼r`rh; laLdj.k½] eSlkpqlsV~l% tksla ,aM ckVZyVs ifCy’klZ bad • fgdh ts-oh-] vksbesV vkj-,e- ,aM osusxksuh ,l-,y- ¼1996½ ,MokaLM çsfDVl uÉlx% pasÇtx jksYl ,aM fDyfudy ,Iyhds'kUl] fQykMsfYQ;k% fyÇidkWV fofy;El ,aM foÇYdl • vkbZlh,u ¼2020½ xkbMykbal vkWu ,MokaLM çsfDVl uÉlx] ftuos k% vkbZlh,u • ,uvks,uih,Q ¼2022½ ulZ çSfDV'kuj jksy daihVaslht] us’kuy vkWxsZukbts’ku vkWQ ulZ çSfDV'kuj QSdYVht • 'kkWcj ,e- ,aM vQkjk ,Q-,- ¼2006½ ,MokaLM uÉlx çSfDVl] vkWDlQksMZ% CydS osy ifCyÇ'kx • LVhoVZ th-ts- ,aM MsfuLdks ,l-,e- ¼2015½ jksy MsoyieasV QkWj n ulZ çSfDV'kuj] ;w,l,% ÇLçxj ifCyÇ'kx daiuh II. 1- uÝs ksykWth ns[kHkky lek;kstu es a Lor=a 'kksèk djus es a xgu 'kksèk tkudkjh vkSj dkS'ky dk s ykxw djukA 2- jksxh n[s kHkky xq.koÙkk es a lqèkkj ykus ds fy, lg;ksxh 'kksèk eas Hkkx yus kA 3- lk{k&vkèkkfjr vH;kl ¼bZchih½ mRiUu dju s ds fy, mUur vH;kl eas 'kksèk fu"d"kks± dh O;k[;k vkSj mi;ksx djukA 4- mUur vH;kl eas loksZÙke vH;klks a vkSj LokLF; ifj.kkeks a rFkk xq.koÙkkijd n[s kHkky dks fodflr djus ds fy, orZeku vH;kl dk ijh{k.k@vkda yu djukA 5- n[s kHkky dh lqj{kk vkSj çHkko'khyrk dks c<+kus ds fy, uÝs ksykWth uÉlx vH;kl es a fd, x, uÉlx eè;orZu ds fy, lk{; dk fo'y"sk.k djukA12 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] 6- oSKkfud 'kksèk fjiksVZ y[s ku es a dkS'ky fodflr djukA 1- 'kksèk vkSj mUur uÉlx vH;kl 2 mUur uÉlx Hkwfedk ls lacafèkr 'kksèk vkSj iwNrkN dk egRo ¼n{krk&1½ 2- ,ih,u vH;kl ds fy, 'kksèk ,tsMak 5 loksZÙke vH;kl fodflr djus ds fy, orZeku vH;kl dk ijh{k.k] LokLF; ifj.kke vkSj mUur vH;kl eas xq.koÙkkiw.kZ n[s kHkky ds ladsrd ¼n{krk&3] 4] 5½] 'kksèk laLÑfr dk lao)Zu 3- 'kksèk tkudkjh vkSj dkS'ky 40 ,ih,u ds fy, vko';d 'kksèk n{krk, a ¼'kksèk dh O;k[;k vkSj mi;ksx] vH;kl dk vkadyu] lg;ksxh ¼5 fnolh; 'kksèk eas Hkkxhnkjh½ dk;Z'kkyk½ lk{; vkèkkfjr vH;kl ¼bZchih½ ifj;kstuk dk ifjp; & PiCOT ç'u] ;kstuk ds pj.k] dk;kZUo;u] vkadyu vkSj çlkj ¼ifj;kstuk çLrko vkSj ifj;kstuk fjiksVZ½ 'kksèk fØ;kfofèk pj.k@lksiku ¼'kksèk ç'u] lkfgfR;d leh{kk] oSpkfjd lajpuk] 'kksèk fMtkbu] ueuw kdj.k] MsVk laxzg.k] i)fr;ka vkSj midj.k] fo'ys"k.k vkSj fjiksÉVx½ 'kksèk çLrko vkSj 'kksèk fjiksVZ y[s ku ¼n{krk&1 vkSj 2½ 4- çdk'ku ds fy, y[sku 5 ¼y[s ku dk;Z'kkyk & ik.Mqfyfi rS;kj djuk vkSj foÙk iks"k.k ds lzksr <aw<uk½ ¼n{krk&6½ ¼dk;Z'kkyk½ 5- lk{; vkèkkfjr vH;kl 4 - voèkkj.kk,a] fl)kar] egRo vkSj pj.k - vkbZlh;w okrkoj.k es a bZchih dks ,dhÑr djuk - fØfVdy ds;j eas lk{; ds {ks= - bZchih dks ykxw dju s eas ckèkk,a - bZchih dks c<k+ok nsus okyh j.kuhfr;ka ¼n{krk&3] 4] 5½ • 'kksèk çkFkfedrkvks a dh igpku djuk • 'kksèk ç'u] mís'; vkSj ifjdYiuk ij vH;kl ys[ku • 'kksèk çLrko@bZchih ifj;kstuk çLrko rS;kj djuk • MsVk laxzg.k] fo’y"sk.k vkSj O;k[;k • oSKkfud i= y[s ku & çdk'ku ds fy, ikaMqfyfi rS;kj djuk • lkfgfR;d leh{kk & usÝksykWth lek;kstu es a fof’k"V uSnkfud vH;kl ds lk{; dk fo'ys"k.k djuk • 'kksèk fucaèk ¼336 ?kaVs ¾ 7 lIrkg½@lk{; vkèkkfjr vH;kl ifj;kstuk ¼bZchih ifj;kstuk½ • xzs ts- ,aM xzkso ,l-ds- ¼2020½ cUlZ ,aM xzksOl n çsfDVl vkWQ uÉlx fjlpZ% vçsty] ÇlFksfll ,aM tujs'ku vkWQ ,foMsal ¼9oka laLdj.k½] lsVa yqbl% ,Ylsfo;j lkWUMlZ • iksfyr Mh-,Q- ,aM csd lh-Vh- ¼2021½ uÉlx fjlpZ% tsusjsÇVx ,aM ,lsÇlx ,foMsal QkWj uÉlx çsfDVl ¼11oka laLdj.k½] ubZ fnYyh% okWYVlZ Dywoj • f'eV ,u-,- ,aM czkmu ts-,e- ¼2021½ ,foMsla csLM çsfDVl QkWj ulsZl vçsty ,aM ,fIyds'ku vkWQ fjlpZ] ,lMh% tksla ,aM ckVZysV ifCy'klZ bad III. 1- uÝs ksykWth bdkbZ eas usr`Ro vkSj çcaèku fl)karks a dks ykxw djukA 2- fl)karks a dh csgrj tkudkjh dk mi;ksx djrs gq, usÝksykWth n[s kHkky lek;kstu eas ruko o la?k"kZ dks çHkkoh <xa ls çcafèkr djukA 3- leL;k lekèkku vkSj fu.kZ; dkS'ky dk s çHkkoh <ax ls ykxw djukA 4- uÝs ksykWth ns[kHkky lek;kstuksa eas urs `Ro çnku djus vkSj jksxh n[s kHkky ds çcaèku eas egRoiw.kZ fparu vkSj lapkj dkS'ky dk mi;ksx djukA 5- uÝs ksykWth ns[kHkky lek;kstu es a ny cukuk vkSj nwljks a dks çsfjr djukA 6- uokpkj vkSj cnyko ds le; mfpr rjhds ls Hkkx yus kA[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 13 7- f'k{k.k ds Bksl fl)karks a ds vkèkkj ij çHkkoh f'k{k.k fofèk;ks]a ehfM;k vkSj vkadyu dk mi;ksx djukA 8- n[s kHkky çnku djus es a xq.koÙkk vkSj uSfrdrk cuk, j[kdj jksxh n[s kHkky es a i{kèkj Hkwfedk fodflr djukA 9- ifjtuks a vkSj jksfx;ks a dks ijke'kZ çnku djuk] ftlls mipkj ;kstukvks a ij lk>k fu.kZ; yus s eas lqfoèkk fey ldsA 1- fl)kar] urs `Ro 'kSyh vkSj orZeku #>ku 2 2- fl)kar] çcaèku 'kSyh vkSj orZeku #>ku 2 3- uÝs ksykWth ns[kHkky lek;kstu es a vuqç;qDr usr`Ro vkSj çcaèku ds fl)kar 4 4- ruko çcaèku ,oa Vdjko çcaèku & fl)kar vkSj vuçq ;ksx] çHkkoh le; çcaèku 4 5- xq.koÙkk lqèkkj ,oa laijh{k.k 4 6- leL;k lekèkku] egRoiw.kZ Çpru o fu.kZ;] uÝs ksykWth uÉlx vH;kl eas vuqç;qDr lapkj dkS'ky 5 7- uÝs ksykWth ns[kHkky lek;kstu es a ny cukuk] çsfjr djuk vkSj lykg nsuk 2 8- ctV cukuk o lalkèku çcaèku ftles a ekuo lalkèku & lkexzh] deZpkjh] le; ’kkfey gSa 5 9- cnyko vkSj uokpkj 2 10- vH;kl ds fy, çn'kZu ladsrd vkSj çn'kZu ;qfDr 6 11- uÝs ksykWth uÉlx eas vuqç;qDr f'k{k.k&vè;;u fl)kar vkSj fu;e 2 12- n{krk vkèkkfjr f'k{kk vkSj ifj.kke vkèkkfjr f'k{kk 2 13- f'k{k.k fofèk;ka@j.kuhfr;ka] ehfM;k% uÝs ksykWth n[s kHkky lek;kstu es a jksxh vkSj deZpkfj;ks a dks f'kf{kr 8 djuk 14- deZpkjh f'k{kk vkSj vkadyu es a midj.kks a dk mi;ksx 4 15- ,ih,u & ,d f'k{kd ds :i eas Hkwfedk 2 16- uÝs ksykWth ns[kHkky lek;kstu es a leFkZu Hkwfedk,a 2 1- LVkQ jksxh fufgr dk;Z dh rS;kjh 2- jksxh + ns[kHkky laijh{k.k 3- uÉlx n[s kHkky ekudks a vkSj çksVksdkWy dh rS;kjh 4- laØe.k fu;a=.k çFkkvks a dh fuxjkuh] eYw ;kadu vkSj fjiksVZ ys[ku 5- mi;qDr çkS|kfsxdh dh lgk;rk ls f'k{k.k lkexzh dk mi;ksx djrs gq, deZpkfj;ksa+ rFkk jksfx;ks a ds fy, çf'k{k.k i)fr dk fodkl 6- lw{e f'k{k.k@jksxh f'k{kk l= 7- vks,llhbZ@vks,lihbZ ;kstuk cukuk vkSj lapkyu djuk 8- xq.koÙkk lqèkkj laijh{k.k 9- ijh{k.k fuekZ.k 10- çn'kZu ladsrd eki fdlh ,d Mk;fyfll bdkbZ ds fy, uÉlx n[s kHkky ekud rS;kj djuk • ckLVscy ,l-ch- ¼2019½ ulZ ,t ,tqdsVj% ÇçfliYl vkWQ VhÇpx ,aM yÉux QkWj uÉlx çsfDVl ¼5oka laLdj.k½ ubZ fnYyh% tksla ,aM ckVZysV ifCy'klZ bad- • fcÇyXl Mh-,e- ,aM gYLVhM ts-,- ¼2019½ VhÇpx bu uÉlx% , xkbM QkWj QSdYVh ¼6oka laLdj.k½ lsaV yqbl felkSjh% lkWUMlZ ,Ylsfo;j • DykdZ lh-lh- ¼2010½ fØ,fVo uÉlx yhMjf'ki ,aM eSuts easV] ubZ fnYyh% tksla ,aM ckVZyVs ifCy'klZ bad- • yhcyj ts-th- vkSj edS dksusy lh-vkj- ¼2008½ esusteasV fçafliYl QkWj gSYFk çksQs’kuYl] lMcjh] ,e-,-% tksla ,aM ckVZysV ifCy'klZ bad- • jlSy ,y- ,aM LokalcxZ vkj-lh- ¼2010½ eus ts easV ,aM yhMjf’ki QkWj ulZ ,MfefuLVªVs lZ ¼5oka laLdj.k½ ubZ fnYyh% tklsa ,aM ckVZyVs ifCy'klZ bad-14 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] IV. 1- funku vkSj ns[kHkky dh ;kstuk fodflr djus es a fdMuh dh n[s kHkky es a iSFkksfQft;ksykWftdy çfØ;k dh tkudkjh dks ,dhÑr djukA 2- fdMuh jksx ls lacafèkr tfVyrkvks a ds y{k.k çcaèku vkSj f}rh;d jksdFkke eas iSFkksfQft;ksykWftdy fl)karks a dks ykxw djukA 3- funku] mipkj] n[s kHkky vkSj jksx funku ds eYw ; dks igpkurs gq, xqnkZ çR;kjksi.k dh vko';drk okyh çR;sd fLFkfr ds fy, çklafxd iSFkksfQft;ksykWftdy ifjorZuks a dk fo'y"sk.k djukA IV. A. I 10 • xqnZs] e=w okfguh] e=w k'k; dh LFkwy lajpuk • xqnZs dh lw{e lajpuk • e=w fuekZ.k dh fQft;ksykWth o Xykses#yj fQYVªs’ku o Vîwcyj jh,ctkWiZ’ku o Vîwcyj lsØh’ku • jfsuu ,aft;ksVsfalu r=a • xqnZs] e=w okfguh] e=w k'k; ds dk;Z II 7 • 'kjhj esa æo forj.k • 'kjhj esa æo fofu;eu r=a • byDs VªksykbV forj.k] byDs VªksykbV~l dh Hkwfedk ¼lksfM;e] iksVsf'k;e] dSfY'k;e] QkLQksjl] eSXuhf'k;e½ • æo vkSj bysDVªksykbV vlarqyu dh igpku vkSj çcaèku o ikuh o lksfM;e o iksVsf'k;e o QkLQksjl o dSfY'k;e o eSXuhf'k;e III 5 • 'kjhj esa vEy {kkj fofu;ked ra= • çfriwjd r=a • 'kjhj esa vEy {kkj larqyu dk çHkko • lkekU; eku • vEy {kkj vlarqyu dh igpku • ,chth fo'ys"k.k ifj.kkeks a dh O;k[;k IV 8 • dkfMZ;kd fQft;ksykWth • bZlhth dh O;k[;k • 'olu r=a • var%lzkoh ra= • rfa=dk r=a IV. B. I 5 • jDr dh lajpuk[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 15 • jDr dksf'kdkvks a ds çdkj • jDr dksf'kdkvks a dk fuekZ.k • jDr legw ¼CyM xzqi½ • gsesVksfØV • FkDdk teus dh çfØ;k ¼DykWfVax eds sfuTe½ • xqnZs dh chekjh eas vke jDr lacaèkh leL;k,a II 3 vè;ko.khZ; fLFkfr;ks a dh mUur iSFkksfQft;ksykWftdy çfØ;k • ?kko Hkjuk • tyuk • LVhou tkWulu ÇlMªkse • fdMuh fodkjks a eas Roph; ifjoruZ III 5 • 'kkWd ¼lnek½ o gkbiksokys fsed o dkÆM;kstsfud5 o fMLVªhC;wfVo • flLVfsed bu¶ysesVjh ÇlMªkse • eYVhiy vkWxZu fMlQaD'ku ÇlMªkse • lsfIll • vkS"kfèk dh vfèkd ek=k vkSj fo"kkDrrk • fo"kgj.k IV 5 fof'k"V laØe.kks a dh mUur iSFkksfQft;ksykWftdy çfØ;k • ,pvkbZoh • VVs ul • lklZ] dksfoM • gsisVkbfVl , • gsisVkbfVl ch • yIsVksfLijksfll • Msaxw • eysfj;k • V~;cw jdqyksfll V 4 fuEufyf[kr ls xqnZs dh pksV • çloiwoZ jDrlzko • xHkkZoLFkk çsfjr mPp jDrpki] çh&,DysefIl;k • ,pbZ,y,yih ¼gseksfyfll] ,yhosVsM fyoj ,atkbe] yks IysVyVs dkmaV½ • çloksÙkj jDrlzko • tPpk iwfr VI 8 • bE;quksXykscqfyu • ,aVhtu ,aVhckWMh çfrfØ;k,a • ØkWl eSÇpx • lsy ehfM,VsM bE;wukykWth • bEehfM,V ,aM fMysM gkbijVas’ku • vkWVksbE;wfuVh • VªkalIykaV bE;wukykWth • ,p,l, VkbÇix • cdksZfoV~t ,- ¼2021½ fDyfudy iSFkksfQft;ksykWth ¼nwljk laLdj.k½ esMekLVj bad-16 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] • áFw kj ,l-bZ-] eSDdSal ds-,y- ,aM czk'klZ oh-,y- ¼2019½ vaMjLVsfaMax iSFkksfQft;ksykWth ¼7oka laLdj.k½ lsaV yqbl] felkSjh% ,Ylsfo;j • ukWfjl Vh-,y- ¼2020½ iksFlZ ,lsafl;Yl vkWQ iSFkksfQft;ksykWth ¼5oka laLdj.k½ okWYVlZ Dywoj • iksFkZ lh-,e- ¼2014½ ,lsfa'k;Yl vkWQ iSFkksfQft;ksykWth% dkWUlsIV~l vkWQ vYVMZ gSYFk LVsV~l ¼pkSFkk laLdj.k½ fQykMsfYQ;k% fyÇidkWV fofy;El ,aM foÇYdl • LVksjh ,y- ,aM Myqxk'k ,y- ¼2019½ ,MokaLM iSFkksfQft;ksykWth QkWj n ,MokaLM çsfDVl ulZ ¼igyk laLdj.k½ tksla ,aM ckVZysV ifCy'klZ bad- • fofyl ,y-,e- ¼2019½ çksQs'kuy xkbM Vw iSFkksfQft;ksykWth ¼pkSFkk laLdj.k½ ,yMCY;wMCY;w V. 1- xqnZs dh chekfj;ks a ls ihfM+r jksfx;ks a dks ns[kHkky çnku djus esa vkS"kèkh; fl)karks a dks ykxw djukA 2- uÝs ksykWth fLFkfr;ks a ds mipkj eas mi;ksx dh tkus okyh vkS"kfèk;ks a ls lacafèkr QkekZdksFksjsI;wfVDl vkSj QkekZdksMk;usfeDl dk fo'ys"k.k djukA 3- fl)karks a rFkk laLFkkxr çksVksdkWy ds vkèkkj ij lqjf{kr vkS"kfèk nus kA 4- lVhd nLrkost rS;kj djuk vkSj vuqorÊ ns[kHkky çnku djukA 5- uÝs ksykWth n[s kHkky lek;kstuksa eas jksfx;ksa dks vkS"kfèk ç'kklu eas vkS"kfèk;ks a ds ikjLifjd çHkko dh csgrj tkudkjh ykxw djuk vkSj muds ifjtuks a dk Lo&ns[kHkky çcaèku es a ekxZn'kZu djukA I 2 • bfro`Ùk • vkS"kfèk;ks a dk oxÊdj.k rFkk vulq wph II 3 • ifjp; • uktqd ns[kHkky es a leko's k.k] forj.k] p;kip; vkSj mRltZu • IykTek dalaVª’sku] gkQ ykbQ • vkS"kfèk;ks a dh yksÇMx vkSj j[kj[kko • fpfdRlh; lwpdkad vkSj vkS"kfèk lqj{kk • {kerk vkSj çHkkodkfjrk • vkS"kfèk nsus ds fl)kar o vkS"kfèk nsus ds vfèkdkj o eki ç.kkyh o ,aVsjy vkS"kfèk nus k o lkef;d vkS"kfèk nsuk o iSjasVsjy vkS"kfèk nus k% III 5 • oSlks,fDVo vkS"kfèk;ka • oSlksfMyVs j] oSlksçslj] vkbuksVªksIl • dkÆM;d XykbdkslkbM~l & fMxkWfDlu • flEiSFkksfeesfVDl & Mkis kekbu] MkscqVkekbu] ,fiufsÝu] vkblkçs ksVsjsukWy] uksjsfiufsÝu] fQukbyfÝu • QkWLQksfM,LVjts bufgfcVlZ & ,fezuksu] fefyzuksu • ,aVhfjFkfed vkS"kfèk;ka • ân; lacafèkr fLFkfr;ka • ân; ladqpu eas lqèkkj dju s okyh vkS"kfèk;ka o gVZ QsY;j ds çcaèku okyh vkS"kfèk;ka o ,utkbuk isDVksfjl vkSj ek;ksdkÆM;y jksèkxyu ds çcaèku es a nh tkus okyh vkS"kfèk;ka o fMlfjFkfe;k] gVZ CykWd vkSj pkyu xM+cM+h ds çcaèku es a nh tku s okyh vkS"kfèk;ka o Qq¶Qqlh; mPp jDrpki ds çcaèku es a nh tku s okyh vkS"kfèk;ka o vvksVkZ ds ,FksjksLDyjs ksfVd jksx vkSj ifjèkh; èkeuh jksx ds çcaèku es a nh tku s okyh vkS"kfèk;ka o Mhi osu FkzksEcksfll ds çcaèku esa nh tkus okyh vkS"kfèk;ka IV 4 ladsr] fØ;k r=a] [kqjkd] ekxZ] ç'kklu lacaèkh fn'kkfunsZ'k] vkS"kfèk;ks ads çfrdwy çHkko% • ,aVhcSDVhfj;y vkS"kfèk;ka • ,aVhck;ksfVDl[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 17 o xzke ikWftfVo cSDVhfj;k o xzke usxsfVo cSDVhfj;k • igyh] nwljh] rhljh vkSj pkSFkh ih<+h dh ,aVhck;ksfVDl • ,aVhck;ksfVd çfrjksèk • ,aVhQaxy ,tsVa • ,aVhok;jy ,tsVa • ,aVhçksVkstksvy vkS"kfèk;ka V 4 • e=w oèkZd • dSfY'k;e pSuy CykWdlZ • chVk ,MªhuÆtd CykWdlZ • vYQk ,MªhuÆtd CykWdlZ • ,aft;ksVsfalu duofV±x ,atkbe bufgfcVlZ • ,aft;ksVsfalu fjlsIVj CykWdlZ VI 5 • lYQksuhyqjls ¼fXyihtkbM] XykbcqjkbM] fXyDyktkbM] fXyefsijkbM½ • efsXyfVukbM~l ¼jsikfXyukbM vkSj usVsfXyukbM½ • fcxqvkukbM~l ¼eVs QkWÆeu½ • fFk;ktksfyMkbuMk;ul ¼jksflfXyVktksu] fi;ksfXyVktksu½ • α-XywdksflMsl bufgfcVlZ ¼,dkjcksl] fefXyVksy] oksfXycksl½ • DPP-4 bufgfcVlZ ¼flVkfXyfIVu] lSDlkfXyfIVu] foYMkfXyfIVu] fyukfXyfIVu] ,yksfXyfIVu½ • SGLT2 bufgfcVlZ ¼MsikfXy¶yksftu vkSj dSukfXy¶yksftu½ • lkbDykslVs ¼czkseksfØfIVu½ • rts h ls dke djus okyk balqfyu • de le; rd dke dju s okyk balqfyu • eè;e le; rd dke dju s okyk balqfyu • fefJr balqfyu • yca s le; rd dke dju s okyk balqfyu VII 4 • eds sfudy osfaVys'ku ij jksfx;ks a ij bLrseky dh tkus okyh vkS"kfèk;ka • iYeksujh ,fMek ds çcaèku es a bLres ky dh tkus okyh vkS"kfèk;ka • iYeksujh ,acksfyTe ds çcaèku es a bLrseky dh tku s okyh vkS"kfèk;ka • ,D;wV jls fijVs jh QsY;j vkSj ,D;wV jls fijVs jh fMLVªSl ÇlMªkse ds çcaèku es a bLrseky dh tkus okyh vkS"kfèk;ka • ØkWfud vkWClVªfDVo iYeksujh fMtht ds çcaèku es a bLrseky dh tkus okyh vkS"kfèk;ka • fueksfu;k ds çcaèku es a bLrseky dh tku s okyh vkS"kfèk;ka • Iyjw y ,¶;wtu ds çcaèku es a bLrseky dh tkus okyh vkS"kfèk;ka VIII 6 • nnZ o NSAID o vksfi;ksbM ,ukYtsfl;k • csgk's kh o xkek ,feuks C;wfVfjd ,flM fLVeqyasV~l o MsDlesMsVksfeMkbu o ,ukYxkslMs s'ku • çyki o gsyksisfjMksy o ,fVihdy ,aVh&lkbdksfVDl • LFkkuh; vkSj lkekU; ,usLFksfl;k ds fy, mi;ksx dh tkus okyh vkS"kfèk;ka o LFkkuh; & ,ekbM] ,LVj vkSj fofoèk ,tsVa o lkekU; & xSlsa] ok"i'khy rjy inkFkZ] IV ,uLs FksfVDl o ltZjh ds fy, lgk;d xSj laosnukgkjh vkS"kfèk;ka • ydokxzLr ds fy, mi;ksx dh tku s okyh vkS"kfèk;ka18 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] o ukWu&fMiksyjkbftax vkSj fMiksyjkbftax ,tsVa o Çprkuk'kd • Lok;Ùk vkS"kfèk;ka o ,MªsuÆtd ,tsVa @flEiSFkksfeesfVDl o ,MªsuÆtd CykWfdax ,tsVa o dksyhuÆtd ,tsVa o ,aVh&dksyhuÆtd ,tsVa • Çprk vkSj vfuæk ds çcaèku es a nh tkus okyh vkS"kfèk;ka o ,aVhfMçslasV o csta ksMk;tsikbu o ckÆcVqjsV~l IX 7 • e=w oèkZd • ¶Y;wM fjiyls esVa o fØLVykW;M o dksykbM • byDs VªksykbV~l o lksfM;e o iksVsf'k;e o dSfY'k;e o eSXuhf'k;e o QkWLQksjl • uÝs ksykWth fLFkfr;ka o ,D;wV@Øksfud fdMuh jksx ds çcaèku es a nh tku s okyh vkS"kfèk;ka o ,D;wV Vîwcyj uØs ksfll ds çcaèku es a nh tku s okyh vkS"kfèk;ka • CYSMj vkmVyVs vkCLVªD’ku ds çcaèku es a nh tku s okyh vkS"kfèk;ka o byDs VªksykbV bEcsysla ds çcaèku es a nh tku s okyh vkS"kfèk;ka o ,flM csl bEcsysla ds çcaèku esa nh tkus okyh vkS"kfèk;ka o Mk;fyfll ds nkSjku bLrseky dh tku s okyh vkS"kfèk;ka o uÝs ksVkWfDld vkS"kfèk;ka • uÝs ksykWth fØfVdy ds;j bejtsla h ds fy, LFkk;h vkn's k X 4 • ,aVh&vYlj vkS"kfèk;ka • tqykc • ,aVh Mk;fj;y • ,aVh besfVDl • iSufØ;kfVd ,atkbe • iks"k.k lacaèkh iwjd] foVkfeu vkSj [kfut XI 4 • ,aVhdks,xqyVa ~l • ,aVhIysVyVs vkS"kfèk;ka • FkzksEcksykbfVDl • gseksLVSfVd@,aVhQkbfczuksykbfVDl • gseVksiksb,fVd xkzsFk QSDVlZ o ,fjFkzksikbs fVu o dkWyksuh fLVeqysfVax QSDVlZ o IyVs ysV ,ugkallZ • jDr vkSj jDr ?kVd • Vhds XII 6 • buMD’ku ,tsVa o ikWyhDyksuy ,aVhckWMh ¼ATG½ o baVjY;wfdu 2 fjlsIVj ,aVkxlsfuLV~l ¼csflfyfDleSc½ • easVhuasl Fksjsih[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 19 o dSfYluqfju bufgfCVlZ ¼lkbDyksLiksfju] VSØksfyel½ o mTOR bufgfCVlZ ¼fljksfyel] ,ojksfyel½ o ,aVhçksfyQsjsfVo ,tsVa ¼,tSfFk;ksfçu] ekbdksQsuksfyd ,flM½ o dkWÆVdksLVjs kWbM~l ¼çsMfulksyksu½ • VªhVesVa QkWj fjtsD’ku o dkWÆVdksLVjs kWbM~l] ATG, IVIG • gfj o#.k dYyqjh] djsu ,y- gkÉMxj] djasV LVsVl vkWQ jhuy VªkalIykaV bE;wukslçs'ku% çstsaV ,aM ¶;wpj] oYMZ ts VªkalIykaV 2012 vxLr ¼24½] 2¼4½% 51&68 • bZlsu ,p-ts- ¼2020½ QkekZdksykWth vkWQ bE;wukslçs'ku ¼çFke laLdj.k½ ÇLçxj • eSds th-,- ,aM okYVlZ ,e-vkj- ¼2021½ fDyfudy QkekZdksykWth ,aM FksjsI;fwVDl ¼10oka laLdj.k½ foyh&CySdosy • 'ksfjy ,Q- oksMa jlsd ,aM vkbtSd VVs cs ke] fçafliYl vkWQ fdMuh QkekZdksFksjsih QkWJ n uÝs ksykWftLV% dksj dqfydye 2021] u's kuy fdMuh QkmaMs'ku] vesfjdu tuZy vkWQ fdMuh fMtht] 16 tqykbZ 2021 • fou s ,-,y-] ow Vh-,e- 'ksfjy ,aM vksY;kbZ ,-ts- ¼2007½ QkekZdksFksjsI;fwVDl QkWj ulZ çSfDV'kuj fçLØkbclZ ¼nlw jk laLdj.k½ fQykMsfYQ;k% Msfol VI. 1- mi;qDr ç.kkyhokj ijh{k.k dkS'ky fodflr djus es a 'kkjhfjd vkadyu fl)karks a dks ykxw djukA 2- lkekU; o vlkekU; fu"d"kks± dh fHkUurkvks a eas varj djus ds fy, mUur LokLF; vkadyu dkS'ky dk mi;ksx djukA 3- ijh{k.k fu"d"kks± rFkk laLFkkxr çksVksdkWy ds vkèkkj ij LØhÇux vkSj uSnkfud ijh{k.k ds vkn's k nus kA 4- 'kkjhfjd tkap fu"d"kks± vkSj fofHkUu tkap ifj.kkeks a dk fo'ys"k.k djuk rFkk uSnkfud fodkl ds fy, uSÝksykWftLV ds lkFk feydj dke djukA 5- nLrkost vkadyu] funku] rFkk çcaèku djuk vkSj LokLF; n[s kHkky ny ds lnL;ks]a jksfx;ks a o ifjtuks a dh lk>snkjh eas vuqorÊ n[s kHkky dh fuxjkuh djukA I 4 • çHkkoh lapkj ds vko';d rRo • O;kolkf;d lapkj ds fl)kar • bfro`Ùk laxzg ds ?kVd vkSj 'kkjhfjd vakdyu II 6 • ân; lacaèkh bfro`Ùk • 'kkjhfjd tkap • ân; ç;ksx'kkyk vè;;u & tSo jklk;fud ekdZj] gseVksykWftdy vè;;u • ân; uSnkfud vè;;u & byDs VªksdkÆM;ksxzke] bdksdkÆM;ksxzkQh] ruko ijh{k.k] jsfM;ksykWftdy beÇstx] dksjksujh ,aft;ksxzke III 6 • bfro`Ùk • 'kkjhfjd tkap • ’olu fuxjkuh & vkfVZfj;y CyM xSl] iYl vkWDlhesVªh] ,aM&VkbMy dkcZu MkbvkWDlkbM fuxjkuh • ’olu uSnkfud ijh{k.k & pSLV jfsM;ksxzkQh] osfaVys'ku ij¶;wtu LdSÇux] iYeksujh ,aft;ksxzkQh] czksda ksLdksih] FkksjSlsUVfsll] LiqVe dYpj] iYeksujh QaD’ku VSLV] vYVªklkmaM] yxa ck;ksIlh IV 6 • rfa=dk lacaèkh bfro`Ùk • lkekU; 'kkjhfjd tkap • laKkukRed dk;Zç.kkyh dk vkadyu • diky raf=dk dk;Zç.kkyh dk vkadyu • thlh,l • eksVj vkadyu & ekalisf'k;ks a dh rkdr] 'kfDr vkSj ltxrk • laosnh vkadyu & Roph; vkadyu • U;wjksMk;XuksfLVd vè;;u & lhVh LdSu] ,evkjvkbZ] ihbZVh20 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] V 6 • bfro`Ùk • 'kkjhfjd tkap • xqnZs dh dk;Zç.kkyh dk vkadyu & ç;ksx’kkyk vè;;u] uSnkfud ijh{k.k o e=w fo'y"sk.k o jDr vè;;u o ,Dl&js ds;wch o vYVªklkmaM fdMuh] fdMuh ck;ksIlh o jhuy MkWiyj o jhuy ,aft;ksxzke o th,Wvkj dk vuqeku o vof'k"V jhuy Q+Da 'ku • byDs VªksykbV~l dk vkadyu vkSj ,flM csl cSyasl • æo larqyu dk vkadyu VI 5 • bfro`Ùk • 'kkjhfjd tkap • iks"k.k lacaèkh vakdyu • ç;ksx'kkyk vè;;u & ;Ñr dk;Z vè;;u] jDr iSjkehVj] ey ijh{k.k • uSnkfud vè;;u & jfsM;ksykWftdy vkSj beÇstx vè;;u] ,aMksLdksfid vè;;u VII 5 • bfro`Ùk • 'kkjhfjd tkap • fuEufyf[kr dk ç;ksx'kkyk vè;;u vkSj uSnkfud vè;;u o gkbiksFkSysel vkSj fiVîwVjh XySaM o Fkk;jkWbM XySaM o iSjkFkkbjkWbM XySaM o iSufØ;kt o ,fMªuy XyaSM VIII 5 • bfro`Ùk • 'kkjhfjd tkap • ç;ksx'kkyk vè;;u & jDr iSjkehVj • uSnkfud vè;;u IX 3 • bfro`Ùk • 'kkjhfjd tkap • iSFkksykWftdy ijh{k.k & Årdh; tkap X 6 • bfro`Ùk • 'kkjhfjd tkap & xVs vlsleasV] tkWbaV vlsleasV • ç;ksx'kkyk vè;;u & jDr iSjkehVj ¼bu¶ysesVjh ,atkbe] ;wfjd ,flM½ • uSnkfud vè;;u & fof’k"V jfsM;ksykWftdy vkSj besÇtx vè;;u] o`Dd ra= lacaèkh folaxfr;ks a dk ,aMksLdksfid vè;;u XI 5 • bfro`Ùk • 'kkjhfjd tkap • ç;ksx'kkyk vè;;u • uSnkfud vè;;u XII 4 • bZ,uVh dk cqfu;knh vkadyu • mPp jDrpki] eèkqegs vkSj vkS"kèkh; çHkko ls lacafèkr vka[kks a eas gksus oky s ifjorZuks a dh igpku djuk XIII 4[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 21 • o`f) vkSj fodkl • iks"k.k lacaèkh vkadyu • fof'k"V ç.kkyh vkadyu XIV 5 • bfro`Ùk • vk;q lacaèkh ifjorZuks a dks è;ku es a j[kr s gq, 'kkjhfjd tkap • euksoSKkfud vkadyu • fof'k"V ç.kkyh vkadyu ¼48 ?kaVs es aladk; }kjk çn'kZu vkSj Nk=ks a}kjk vH;kl 'kkfey gS½ • O;kid bfro`Ùk yus k • dsfaær bfro`Ùk ysuk ¼ç.kkyh okj½ • O;kid 'kkjhfjd tkap • dsfaær 'kkjhfjd tkap ¼ç.kkyh okj½ • uSnkfud ekinMa kas dh fuxjkuh ¼ç.kkyh okj½ o buosfto chih ekWfuVÇjx] eYVh&iSjkehVj ekWfuVlZ] bZlhth] isfjQsjy oLdqyj LVsVl] ,chth] iYl vkWDlhehVj] baVªkØSfu;y çs'kj (ICP), Xyklxks dksek Ldsy (GCS), Øsfu;y uoZ vlsleaVs ] xaHkhj :i ls chekj dk nnZ vkSj csgk's kh Ldksj] eksVj vkadyu] laosnh vkadyu] jhuy QaD’ku VSLV] ¶Y;wM larqyu] ,flM csl larqyu] byDs VªksykbV~l] ckWoy lkmaM] fyoj QaD'ku VSLV] GRBS, ySc VSLV] jfsM;ksykWftdy rFkk beÇstx VSLV ¼ç.kkyh okj½] ,fMek dh xszfMax • LØhÇux vkSj Mk;XuksfLVd ijh{k.kks a dk vkn's k nus k vkSj mudh O;k[;k djuk ¼ç.kkyhokj½ ¼layXu ½ • th,Qvkj dk vuqeku • ,oh fQLVqyk dk vkadyu • lhohlh dk vkadyu • ihMh dSFksVj lkbV dk vkadyu • fcdyh ,y-,l- ,aM fLtykxh ih-th- ¼2018½ csV~l xkbM Vq fQftdy ,Xtkfeus'ku ,aM fgLVªh VÇsdx ¼11oka laLdj.k½ ubZ fnYyh] fyÇidkWV fofy;El ,aM foÇYdl • jksM~l ts- ¼2013½ ,MokaLM gSYFk vlsleasV ,aM Mk;XuksfLVd jhtfuxa ] fQykMsfYQ;k% fyÇidkWV fofy;El ,aM foÇYdl • foYlu ,l-,Q- ,aM fxMsal ts-,Q- ¼2021½ gSYFk vlsleaVs QkWj uÉlx çsfDVl ¼pkSFkk laLdj.k½] lsaV yqbl] felkSjh% lkWUMlZ ,Ylsfo;j I II VII. 1- xqnZs dh chekfj;ks a ds vkadyu] funku vkSj çcaèku es a uÝs ksykWth uÉlx dh mUur voèkkj.kkvks a dks ykxw djrk gSA 2- 'kkjhfjd fLFkjrk dk vkadyu] fuxjkuh vkSj c<k+ok nus s ds fy, buosftl vkSj ukWu&buosfto VSDuksykWth vkSj eè;orZuks a dk mi;ksx djrk gSA 3- LokLF; ns[kHkky ny ds vU; lnL;ks a ds lkFk feydj dke djrk gS vkSj fofHkUu uÝs ksykWth fLFkfr;ks a oky s jksfx;ks a ds vkadyu] funku vkSj çcaèku es a n[s kHkky@uSnkfud ekxZ rS;kj djrk gSA 4- LokLF; lqj{kk] jksx dh jksdFkke] iwokZuqeku ekxZn'kZu] ijke'kZ] xqnZs dh chekfj;ks a ds çcaèku] mi'kked ns[kHkky vkSj thou ds var dh ns[kHkky ls lacafèkr uÉlx n[s kHkky çnku djrk gSA 5- lkekU; uÝs ksykWth fLFkfr oky s jksfx;ks a ds vkadyu] funku vkSj çcaèku es a mUur dkS'ky dk mi;ksx djrk gSA 6- O;fDr] leqnk; o ns[kHkky ç.kkfy;ks a ls lacafèkr eqíks a ds fy, ufSrd :i ls lqn`<+ lekèkku ykxw djrk gSA 7- uÝs ksykWth lek;kstuks a ds fy, çklafxd laØe.k fu;a=.k ds fl)karks a dk vH;kl djrk gSA 8- jksxh] ifjtuks a vkSj leqnk; ds fgr esa n's k ds dkuuw h <kap s ds Hkhrj Lor=a :i ls vH;kl djrk gSA 9- ,sl s vH;kl fodflr djrk gS tks oSKkfud çek.kks a ij vkèkkfjr gksAa 10- fpfdRlh; lacaèkks a dks 'kq: dju]s fodflr djus vkSj can dju s ds fy, ykxw lapkj] ijke'kZ] odkyr vkSj ikjLifjd dkS'ky dk mi;ksx djrk gSA 11- tksf[ke çcaèku j.kuhfr;ks a vkSj xq.koÙkk lqèkkj dk mi;ksx djds ,d lqjf{kr fpfdRlh; okrkoj.k cukrk gS vkSj cuk, j[krk gSA 12- vH;kl dks lkekftd] lkaLÑfrd vkSj çklafxd ifjos'k ds vuq:i <kyrk gSA22 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] I 10 • ikBîØe dk ifjp; • uÝs ksykWth uÉlx dk bfro`Ùk vkSj nk;jk • ldy 'kjhj jpuk foKku] Hkzw.k foKku] Ård foKku & bysDVªkWu lfgr • xqnZs dk ekbØksLdksih vè;;u • xqnZs dk ifjlapj.k vkSj Xykses#yj vYVªkfQYVªs'ku • lksY;Vw VªkaliksVZ@dkcZfud vkSj vdkcZfud nksuksa • xqnZs dk vEyhdj.k • ;wfju dalaVªs’ku ,aM Mk;y’wku • jDrpki fofu;eu eas xqnZs dh Hkwfedk • xqnZs ds var%lzkoh vkSj Lor%lzkoh dk;Z • uÝs ksykWth okMZ] Mk;fyfll ;wfuV vkSj VªkalIykaV ;wfuV] usÝksykWth vkbZlh;w dh LFkkiuk II 5 • ,fiMsfe;ksykWth vkWQ fdMuh fMlht • tksf[ke dkjd vkSj xqnZs dh chekjh • uÝs kWu ,aMksoesVa • Çyx vkSj xqnsZ dh chekjh • mez c<u+ s ds lkFk xqnsZ dh chekjh III 10 • oklks,fDVo isIVkbM~l@,jkfdMkfsud ,flM esVkcksykbV~l • lksfM;e&ty larqyu • iksVsf'k;e larqyu • ,flM csl larqyu • dSfY'k;e vkSj QkLQksjl eVs kcksfyTe • eSXuhf'k;e eVs kcksfyTe • jhuy gSaMfyxa vkWQ ;wfjd ,flM IV 12 • dkÆM;ks&iYeksujh&czsu fjlflVs'ku ds fl)kar • vkikr fLFkfr dk çcaèku% • ch,y,l • ,lh,y,l • ok;qekxZ çcaèku • vkWDlhtu's ku vkSj vkWDlhesVªh] vkWDlhtu forj.k midj.kks a ds lkFk jksxh dh n[s kHkky • osfaVys'ku vkSj osfaVysVj liksVZ ¼vkæÊdj.k vkSj lkal dh vkS"kèkh; fpfdRlk lfgr½] buosfto vkSj ukWu&buosfto osfaVys'ku ds lkFk jksxh dh n[s kHkky • ldqZys’ku vkSj ij¶;wtu ¼gseksMk;ukfed ewY;kadu vkSj rjxa xzkfQDl lfgr½ • ,flM csl LVsVl] ¶Y;wM vkSj byDs VªksykbV fLFkfr dk ewY;kadu • FkeksZjsX;wys'ku] gkbij@gkbiksFkÆe;k oky s jksxh dh n[s kHkky • fyczs’ku Ýkse ykbQ liksVZ ¼ohÇux½ • Xykblsfed fu;a=.k] Xykblsfed vlarqyu okys jksxh dh ns[kHkky • xaHkhj :i ls chekj jksfx;ks a eas xqnZs ds dk;Z dh fuxjkuh vkSj lqèkkj • xaHkhj :i ls chekj jksfx;ks a ds çcaèku es a lkekU; vkS"kfèk;ka vkSj vkS"kfèk forj.k ds rjhds V 8 • ck;ksIlh lfgr xqnsZ dh chekjh dk ç;ksx'kkyk vkadyu • jDr vkSj ew= eas byDs VªksykbV vkSj ,flM&csl ekinMa kas dh O;k[;k • uÝs kWu gkfu ds fy, vuqdwyu • Xykses#yj jksx dh xqnsZ vkSj ç.kkyhxr vfHkO;fDr;ka • xqnZs dh uSnkfud beÇstx VI 6 • ruko vkSj euks&rfa=dk&çfrj{kkfoKku ¼lkbdksU;wjksbE;wuksykWth½ • vkè;kfRed pqukSfr;ka[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 23 • ruko vkSj chekjh ls fuiVuk • ijke'kZ vkSj lapkj • 'kksd ijke'kZ • uÈn dh xq.koÙkk dk vkadyu] uÈn dh LoPNrk • Çprkuk'kd] 'kked vkSj vkjkenk;d vkS"kfèk;ka • thou ds var dh ns[kHkky vkSj thou ds ckn dh lsok,a VII 6 • jksxh vkSj ikfjokfjd f'k{kk dh pqukSfr;ka • o;Ld vfèkxe dh çfØ;k • LokLF; lk{kjrk dk vkadyu • f'k{k.k vfèkxe çfØ;k dks çHkkfor dju s okys dkjd • jksxh vkSj ifjtuks a dh lwpukRed vko’;drk,a • jksxh vkSj ifjtuks a dh ijke'kZ vko’;drk,a • ijke'kZ rduhdsa VIII 6 • iks"kd rRo p;kip; vkSj ifjorZu • iks"k.k fLFkfr dk vkadyu • iks"k.k lacaèkh fopkj o Øksfud fdMuh jksx o gseksMk;fyfll] ihMh o uÝs ksfVd ÇlMªkse o mPp jDrpki o eèkqegs IX 6 • ,dhÑr ns[kHkky ekWMy • cgq&fo"k;d n[s kHkky & vkgkj fo'ks"kK] lkekftd dk;ZdrkZ] O;kolkf;d fpfdRld] fQft;ksFksjsfiLV] ijke'kZnkrk] MkWDVj] ulZ dh Hkwfedk • lk>k fu.kZ; yus s dk ekWMy • jksxh ds vfèkdkj] ftEesnkfj;ka • fdMuh fodkj oky s jksfx;ks a dh n[s kHkky es a uÉlx çfØ;k dk vuqç;ksx • fdMuh fodkj oky s jksfx;ks a dh mipkj lgk;rk ds fy, miyCèk ljdkjh vkSj futh ;kstuk,a • lh-ds-Mh- jftLVªh] lek;kstuksa ds chp ns[kHkky leUo; • uÝs ksykWth es a jk"Vªh; vkSj varjkZ"Vªh; laxBu X 5 • laØe.k dh J`a[kyk dks rksM+uk • ekud lkoèkkfu;ka • ih-ih-bZ- dk mi;ksx & ladsr • ck;ksgstk+MZ çksVksdkWy • vif'k"V dk fuiVku vkSj i`FkDdj.k • Mk;fyfll ;wfuV] jhuy VªkalIykaV ;wfuV es a laØe.k fu;a=.k vH;kl XI 8 • lnkpkj vkSj uSfrdrk es a varj • uSfrd fl)kar] uÝs ksykWth ns[kHkky es a uSfrd fu.kZ; yus k] uSfrd fu.kZ; yus s dks c<+kok nsus okyh j.kuhfr;ka • mipkj jksduk vkSj can djuk • nqyZHk lalkèkuksa dk çcaèku • efLr"d e`R;q] vax nku vkSj ijke'kZ • Hkkjr es a jhuy VªkalIykaV's ku&lacafèkr dkuwu • iqutÊfor u djas ¼Mh-,u-vkj-½] bPNkeR` ;q] fyÇox foy • nhokuh eqdneks a dks c<+kok nsus oky s eqís • fpfdRlh; fujFkZdrk • ç'kklfud dkuwu% O;kolkf;d fofu;eu • VksVZ dkuwu% ykijokgh] O;kolkf;d dnkpkj] tkucw>dj fd, x, VksVZ] xyr rjhds ls ekSr] ekugkfu]24 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] geyk vkSj ekjihV • laoSèkkfud dkuuw % jksxh }kjk fu.kZ; yus k XII 8 • fujarj xq.koÙkk lqèkkj • Hkkjr es a xq.koÙkk ekU;rk fudk; & usÝksykWth • okMZ] Mk;fyfll ;wfuV] VªkalIykaV ;wfuV • ekud] çksVksdkWy] uhfr;k¡] çfØ;k,¡ • laØe.k fu;a=.k uhfr;k¡ vkSj çksVksdkWy • ekud lqj{kk mik; • uÉlx laijh{k.k • ekbØksck;ksykWth fuxjkuh • ty xq.koÙkk dh fuxjkuh • uÝs ksykWth es a çn'kZu ladsrd vkSj mik; 6 ¼48 ?kaVs es aladk; }kjk çn'kZu vkSj Nk=ks a}kjk vH;kl 'kkfey gS½ • xqnZs dk O;kid vkadyu • lhihvkj ¼ch,y,l vkSj ,lh,y,l½ • ok;qekxZ çcaèku o ySÇjft;y ekLd ,;jos o dQ bu¶ys’ku ,aM ,adfjxa n Vîwc o bZVh&Vîcw dh n[s kHkky o Vªsfd;ksLVkseh n[s kHkky o lD'kÇux & [kqyk@can o pSLV fQft;ksFksjsih • vkWDlhtu's ku vkSj vkWDlhesVªh] vkWDlhtu forj.k midj.kks a ds lkFk jksxh dh n[s kHkky o vkWDlhtu ekiu midj.k@vkWDlhtu's ku o vkWDlhesVªh & iYl vkWDlheVs ªh • ukWu&buosfto osfaVys'ku o de çokg okys ifjorZuh; fu"iknu midj.k% uls y dSFksVj@dsuqyk@Mcy uls y çksxa ] Qsl ekLd] fjtjok;j cSx ds lkFk Qsl ekLd o mPp çokg oky sfuf'pr fu"iknu midj.k% ,aVªus esaV ¼ospa qjh½ midj.k] ,uvkbZoh@lhih,ih@,uLs FksfVd ekLd] Vh ihlst] czhfnax lÆdV o iksLVqjy Mªus ts • osfaVys'ku vkSj osfaVysVj liksVZ o osfaVysVj ls tksM+uk o osVa hysVj ls gVkuk o ,DlVîcw s'ku o áfwefMQk;j o uCs;qykbtj & tsV] vYVªklksfud • bugsy's ku Fksjsih & ehVMZ Mkst bugsylZ ¼,eMhvkbZ½] MªkbZ ikmMj bugsylZ ¼MhihvkbZ½ • ldqZys’ku vkSj ij¶;wtu ¼gseksMk;ukfed ewY;kadu vkSj osoQkWeZ xzkfQDl lfgr½ o buosfto CyM çSlj ekWfuVfjax o ukWu&buosfto CyM çSlj ekWfuVfjax o ohul çSlj ¼isfjQsjy] lsVa ªy vkSj iYeksujh vkVZjh vkWDywtu çSlj½ o bul’kZu ,aM fjewoy vkWQ vkfVfZj;y ykbu o bul’kZu ,aM fjewoy vkWQ lsVa ªy ykbu o byDs VªksdkÆM;ksxzkQh ¼bZlhth½ • ¶Y;wM~l vkSj byDs VªksykbV~l o ¶Y;wM x.kuk vkSj ç'kklu ¼fØLVykW;M vkSj dksykW;M½ o jDr vkSj jDr mRikn p<+kuk o buksVªksi x.kuk] vuqekiu vkSj ç'kklu o dkÆM,d XykbdkslkbM~l & fMxkWfDlu[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 25 o flEiSFkksesfVDl & Mksikekbu] MkscqVkekbu] ,fiusÝkbu] vkblkçs ksVsjsukWy] ukWjisusÝkbu] fQukbyÝkbu o byDs VªksykbV djsD’ku ¼lksfM;e] iksVsf'k;e] dSfY'k;e] QkWLQksjl] eSXuhf'k;e½ o ¶Y;wM fMLisla j vkSj bU¶;wtu iai dk mi;ksx • vEy {kkj fLFkfr dk ewY;kadu o vkfVZfj;y CyM xSl ¼,chth½ • Xykblsfed fu;a=.k] Xykblsfed vlarqyu okys jksxh dh ns[kHkky o thvkjch,l dh fuxjkuh djuk o balqfyu Fksjsih ¼LykbÇMx Ldsy vkSj bU¶;wtu½ o gkbijXykblsfe;k dk çcaèku & IV ¶Y;wM~l] balqfyu Fksjsih] iksVsf'k;e vuqijw .k o gkbiksXykblsfe;k dk çcaèku & MsDlVªkst IV • ijke'kZ • ikfjokfjd f'k{kk • iks"kdh; vkadyu • xqnZs ds fodkjks a ds fy, fpfdRlh; vkgkj • xq.koÙkk vkadyu laijh{k.k VIII. I I 10 • ,dsvkbZ dh ,fV;yft] iSFkksfQft;ksykWth vkSj oxÊdj.k • fuEufyf[kr dh ,fV;yft] iSFkksfQft;ksykWth] uSnkfud vfHkO;fDr;ka] funku vkSj çcaèku o tfVy vkSj th.kZ Vîwcqyj uÝs kbfVl o daVªkLV uÝs ksiSFkh o ,uYtsfld uÝs ksiSFkh o gSoh eSVy uÝs ksiSFkh o ek;yksek ls lacafèkr fdMuh jksx II 15 • Xykses#yj jksxks a dk oxÊdj.k • fuEufyf[kr dh ,fV;yft] iSFkksfQft;ksykWth] uSnkfud vfHkO;fDr;ka] funku vkSj çcaèku% o eEs czsuksçksfyQjsfVo Xykses#yksuÝs kbfVl ¼,eihth,u½ o fefuey psat fMlht o Qksdy lsxeasVy Xykses#yksLdsysjksfll ¼,Q,lth,l½ o eEs czsul uÝs ksiSFkh o vkbZth, usÝksiSFkh o jfsiMyh çksxzflo Xykses#yksuÝs kbfVl ¼vkjihth,u½ o Y;wil uÝs kbfVl o Mk;fcVht uÝs ksiSFkh o uÝs ksfVd ÇlMªkse III 4 • jhuy vkVZjh LVus ksfll • jhuy ohu FkzksEcksfll • flLVfsed Y;wil ,fjFksesVksll • ikWyh vkVsZjkbfVl uksMkslk IV 7 • jhuy dSydqyh ¼xqnZs dh iFkjh½ • fcukbu çksLVfsVd gkbijVªkWQh • CySMj vkmVyVs vkWCLVªD’ku • CySMj Vîew j V 6 • ik;yksusÝkbfVl & rhoz] th.kZ • Vhch fdMuh • dksfoM vkSj fdMuh VI 10 • ,fV;yft] iSFkksfQft;ksykWth] unS kfud vfHkO;fDr26 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] • LVsÇtx • funku • lhdsMh dk çcaèku VII 8 • fdMuh fMlht bu VªksfiDl • xHkkZoLFkk vkSj fdMuh jksx • xqnZs dks çHkkfor dju s okys ç.kkyhxr jksx VIII 8 • iksMkslkbV Q+Da 'ku ds oa'kkuqxr fodkj • o`Dd ufydk ds oa'kkuqxr fodkj • xqnZs ds flfLVd jksx IX 6 • çkFkfed vkSj f}rh;d mPp jDrpki • jus ksoSLdqyj mPp jDrpki vkSj bLdsfed usÝkis SFkh • xHkkZoLFkk eas mPp jDrpki vkSj xqnkZ jksx X 6 • uÝs ksiSFkh • Xykblsfed fu;a=.k] Xykblsfed vlarqyu okys jksxh dh ns[kHkky • eèkqegs fuxjkuh thvkjch,l • balqfyu Fksjsih ¼LykbÇMx Ldsy vkSj tylsd½ • gkbijXykblsfe;k dk çcaèku & IV ¶Y;wM] balqfyu Fksjsih] iksVsf'k;e iwjdrk • gkbiksXykblsfe;k dk çcaèku XI 10 • fodklkRed usÝksykWth • xqnZs] e=w okfguh] e=w k'k; vkSj ew=ekxZ ds tUetkr jksx • Xykses#yj vkSj Vîcw yj jksx • xqnZs dks çHkkfor dju s okys ç.kkyhxr jksx • ,D;wV ,aM Øksfud fdMuh QsY;j • ihfM;kfVªd usÝksykWth ds lacaèk eas Mk;fyfll vkSj çR;kjksi.k ¼48 ?kaVs es aladk; }kjk çn'kZu vkSj Nk=ks a}kjk vH;kl 'kkfey gS½A • ,LVhe’sku vkWQ th,Qvkj • LVsftax vkWQ lhdsMh • DyklhfQds’ku vkWQ ,dsvkbZ • uSnkfud funku ds fy, 'kkjhfjd vkadyu vkSj ç;ksx'kkyk fu"d"kks± dh O;k[;k • jksfx;ks a dk bfro`Ùk ysuk vkSj fuEufyf[kr ds lkFk 'kkjhfjd vkadyu o ,dsvkbZ o lhdsMh o lkekU; Xykses#yj fodkj o Y;wil uÝs kbfVl o VîwcyksbaVjLVhf'k;y jksx • lkekU; fdMuh fodkjks a dk vè;;u vkSj çLrqfr ¼4½ • jhuy ck;ksIlh es a lgk;rk djuk ¼5½ • jhuy ck;ksIlh djuk ¼10½ • jhuy ck;ksIlh fu"d"kks± dh O;k[;k & ,y,e] vkbZ,Q ¼10½ • vkS"kèkh; vè;;u ¼8½ • Mksuk Mh- bXukVkfofl;l] ,e- ÇyMk odZeSu ,aM eSjh ,&fe'kj ¼2021½ efsMdy&lÆtdy uÉlx% dulsIV~l QkWj baVjçksQs'kuy dksyScksjsfVo ds;j ¼10oka laLdj.k½] lsVa yqbl% fQykMsfYQ;k% ,Ylsfo;j • Çgdy ,y- tsful ,aM lqjs'k ds- 'kekZ ¼2018½ czwuj ,aM lqnjFl VSDLVcqd vkWQ esfMdy lÆtdy uÉlx ¼lkmFk ,f'k;u laLdj.k½ okWY;we 2 • tkWu jsukMZ ,aM lkbeu ,Q- ysoLVj ¼2019½ vkWDlQksMZ gSaMcqd vkQW ;wjksykWth ¼pkSFkk laLdj.k½] vkWDlQksMZ ;wfuoÆlVh çsl[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 27 • fudksyk FkkWel ¼2008½ jhuy uÉlx% ds;j ,aM esyts easV vkWQ fdMuh fMlht ¼5oka laLdj.k½] Dywoj% ,fMucxZ • uksekZ ts- xksest ¼2022½ usÝksykWth uÉlx% Ldksi ,aM LVasMMZ~l vkWQ çSfDVl ¼9oka laLdj.k½ • lSaMªk ,e- cksfMu ¼2022½ duVSEijjs h uÝs ksykWth uÉlx ¼pkSFkk laLdj.k½] vefsjdu uÝs ksykWth ulsZt ,lksfl,'ku • lqtSu ,- Dokfyp ,aM fe'ksy ts- yfstuls ¼2020½ ulZ çSfDV'kuj bu ;wjksykWth ¼nlw jk laLdj.k½] ÇLçxj ifCysds’kal • Vhukoh ,e- ¼2020½ viMsV vkWu n,fV;ksykWth] DykflfQds’ku ,aM eus ts easV vkWQ Xykses#yj fMlhtst] ,folsuk ts- eMs - 2020 vçSy&twu( 10¼2½% 61&67 IX. II I 25 • bfro`Ùk vkSj voyksdu • fl)kar vkSj voèkkj.kk,a • gseksMk;fyfll dh çfØ;k • ,pMh ij jksfx;ks a dks vkjaHk djuk% fn'kkfunsZ'k • Mk;fyfll e'khu & Hkkx] dk;Zç.kkyh • Mk;fyfll n{krk • 'kq"d Hkkj vkadyu • Mk;fyfll i;kZIrrk • ,pMh ls igys] mlds nkSjku vkSj ckn es a jksfx;ks a dk vkadyu • ,pMh es a tfVyrk,%a jksdFkke] igpku] çcaèku • lhvkjvkjVh lfgr Mk;fyfll ds rkSj&rjhds • lhohlh ,t oLdwyj ,Dlsl vkSj lhohlh ns[kHkky es a fn'kkfunsZ'k • vkfVZfj;ks&ohul fQLVqyk vkSj ,oh xzk¶V ,t oLdwyj ,Dlsl vkSj ,oh,Q rFkk ,ohth ds çcaèku es a lk{; vkèkkfjr fn'kkfunsZ'k • oLdwyj ,Dlsl dk vkadyu • oLdwyj ,Dlsl ls lacafèkr tfVyrk,a & igpku vkSj çcaèku • ;w,Q vkSj lksfM;e çksQkbÇyx • ckbdkcksZusV fçijs’ku • dhVk.kq'kksèku çksVksdkWy & e'khu] vkjvks VSad] ikbiykbu • ty xq.koÙkk dk vk’oklu ¼'kqf)dj.k çfØ;k] fuxjkuh½ • ,pMh es a iks"k.k lacaèkh fopkj • ,pMh ij jksfx;ks a dh O;kid] lexz n[s kHkky • bul’kZu vkWQ lhohlh & vLFkk;h] LFkk;h • IykLekQsjsfll • laØe.k fu;a=.k vH;kl • ,pMh es a xq.koÙkk vk’oklu • ,pMh es a gky ds #>ku vkSj fodkl II 20 • bfro`Ùk vkSj voyksdu • ihMh eas fl)kar vkSj voèkkj.kk,a • Lopkfyr ihMh lfgr ihMh rkSj&rjhdks a ds çdkj • ihMh ,Dlpsta çfØ;k • vkadyu ds vkèkkj ij ihMh ds fy, jksfx;ks a dk p;u • ihMh fçfLØI'ku] ihbZVh] ihMh ¶Y;wM • ihMh ,MhDoslh • ihMh dh laØked vkSj xSj&laØked tfVyrk,a% igpku vkSj çcaèku • ihMh dSFksVj bul’kZu & iD;wZVfsu;l vkSj vksiu • ihMh dSFksVj bul’kZu ls igys] blds nkSjku vkSj ckn es a jksfx;ks a dh n[s kHkky • isfjVksfufVl dh igpku vkSj çcaèku • ihMh ds ykHk vkSj uqdlku • ihMh eas iks"k.k lacaèkh fopkj • jksxh vkSj ifjtuks a dh f'k{kk vkSj ijke'kZ • ihMh eas lk{; vkèkkfjr vH;kl • ihMh ij jksfx;ks a vkSj muds ifjtuksa dh O;kid vkSj lexz n[s kHkky28 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] • ihMh eas gky ds #>ku III 25 • bfro`Ùk vkSj voyksdu • lÆtdy çfØ;k • çR;kjksi.k ds çdkj • çR;kjksi.k ds fy, nkrk vkSj çkIrdrkZvks a dh rS;kjh • çR;kjksi.k çfrj{kk foKku ¼VªkalIykaV bE;quksykWth½ • fdMuh çR;kjksi.k dh çkjafHkd vkSj ckn dh tfVyrk, a & igpku vkSj çcaèku • xzk¶V fjtsD’ku% jksdFkke] igpku] çcaèku • Mªx ,sl]s bE;wuks&lçslasV Fksjsih • fdMuh çR;kjksi.k ds ckn jksfx;ks a dh n[s kHkky • vkjVh;w es a æo çcaèku çksVksdkWy • vkjVh;w es a laØe.k fu;a=.k vH;kl • nkrk vkSj çkIrdrkZ dh vuqorÊ dkjoZ kbZ • vkjVh;w es a LFkk;h vkns'k • vkS"kèkh; çksVksdkWy • ekbØksck;ksykWth fuxjkuh] ihMh es a xq.koÙkk vk’oklu • fdMuh çR;kjksi.k fpfdRlk eas gky ds #>ku vkSj fodkl • NOTTO IV 4 • nkrk vkSj çkIrdrkZ dh NqV~Vh dh rS;kjh • iquokZl vkSj vuqorÊ dkjoZ kbZ • iks"k.k] vkjke] O;k;ke lfgr LoLFk thou 'kSyh • çR;kjksi.k ds ckn LokLF; tksf[ke vkSj fuxjkuh • dkeqdrk • çR;kjksi.k ds ckn lqjf{kr thou 'kSyh • çR;kjksi.k ds ckn QOL eíq s V 4 • nkrk vkSj çkIrdrkZ ij çR;kjksi.k dk euksoSKkfud çHkko • nkrk vkSj çkIrdrkZ dk euks&lkekftd vkadyu • jksdFkke% cgq&fo"k;d ns[kHkky • ulZ dh Hkwfedk • lgk;rk lewgkas dh Hkwfedk VI 4 • nkrk • cPpks a eas vax çR;kjksi.k ds ckn uSnkfud Çprk,a VII 4 • lgh tkudkjh dk vfèkdkj • o;Ld vfèkxe ds fl)kar • çHkkoh lapkj dkS'ky • lwpuk lk>k djus ds midj.k rS;kj djuk • lk>k fu.kZ; yus s dh çfØ;k • f'k{kk ds rjhds vkSj j.kuhfr;ka VIII 4 • xaHkhj :i ls chekj jksfx;ks a eas ,pMh • ,D;wV ihMh • xHkkZoLFkk eas ihMh • ,uhfe;k dk çcaèku • cPpks a vkSj cqtqxks± eas Mk;fyfll vkSj çR;kjksi.k ¼48 ?kaVs es aladk; }kjk çn'kZu vkSj Nk=ks a}kjk vH;kl 'kkfey gS½ • Mk;fyfll ds igy]s blds nkSjku vkSj ckn dk vkadyu[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 29 • oLdwyj ,Dlsl dk vkadyu & CVC, AVF, AVG • CVC lkbV ns[kHkky • 'kq"d Hkkj vkadyu & uSnkfud vkSj tSo&çfrckèkk fofèk • ;w,Q x.kuk] çksxzkÇex e'khu] ,pMh ’kq# djuk • ,pMh can djuk • ckbdkcZ rS;kjh • gsifju rS;kjh • vkS"kfèk iqul±;kstu • URR, Kt/V dk vuqeku yxkuk] Mk;fyfll i;kZIrrk dk vkadyu djuk • fu;fer tkap fuèkkZfjr djuk vkSj vuqorÊ ifj.kke • ,pMh fçfLØI'ku • ySc fjiksVZ ds vkèkkj ij lkekU; vkS"kfèk;ks a dk fçfLØI'ku% ,fjFkzksiksbfVu] QkWLQksjl ckbaMj] dSfY'k;e vkSj foVkfeu Mh iwjd] ,aVhgkbijVsfUlo] OGLA • balqfyu [kqjkd lek;kstu • fofHkUu Mk;fyfll eksMfyVht laikfnr djuk & SCUF] vkblksysVsM UF, SLED, CRRT • IykT+ekQsjsfll laikfnr djuk • gVkus ds fy, IykTek dh ek=k dh x.kuk djuk • bul’kZu vkWQ lhohlh buVq Qsekjy vkSj txyj ohu • ;wfju dYpj & ,lihlh • lhohlh fudkyuk • CyM dYpj • ,fLlfVd VSi • ihMh ds fy, jksfx;ks a dk vkadyu vkSj p;u djuk • ihbZVh laikfnr djuk] ihMh fçfLØI'ku fuèkkZfjr djuk • ihMh cnyuk • dySDV ihMh ¶Y;wM QkWj dYpj • ,fDtV lkbV laØe.k] Vusy laØe.k vkSj isfjVksfufVl dh igpku vkSj çcaèku djuk • baVªkifsjVksfu;y ,aVhck;ksfVDl nus k • uSnkfud vkaduu vkSj ihbZVh ds vkèkkj ij ihMh fçfLØI'ku es a cnyko djuk • dsVh@oh lfgr Mk;fyfll i;kZIrrk dk vkadyu djuk • ihMh dh xSj&laØked tfVyrkvks a dh igpku vkSj çcaèku djuk I II • nf{k.kkewÆr ds-oh-] f'kodqekj oh- ,aM laxhrk y{eh ¼2017½ isfjVksfu;y Mk;fyfll çkbej ¼igyk laLdj.k½] ck;ksdkWu bafM;k fyfeVMs • MSuksfop ¼2018½ gSaMcqd vkWQ fdMuh VªkalIykaVs'ku ¼6oka laLdj.k½] okWYVlZ Dywoj • tkWu Vh- MkSfxzMkl ,aM ihVj th- Cyds ¼2015½ gSaMcqd vkWQ Mk;fyfll ¼lkmFk ,f'k;u 5oka laLdj.k½] okWYVlZ Dywoj • tkW;l ,e- CySd ¼2009½ efsMdy&lÆtdy uÉlx% fDyfudy esusteasV QkWj ikWftfVo vkmVdEl ¼8oka laLdj.k½] ;w,l,% MCY;w-ch- lkWUMlZ daiuh • fjpMZ t-s tkuW lu] txZu ¶yksxs ,aM eklsyZ ks Vksusyh ¼2023½ dfEçgsfalo fDyfudy usÝksykWth ¼7oka laLdj.k½] ,Ylsfo;j daiuh 1- ,MtLVscy bysDVªkWfud dkWV fon eSVªsl & 20 2- IV LVSaM & 10 3- csM lkbM ykWdj & 20 4- vksoj csM VªkWyh & 10 5- MªsÇlx VªkWyh ¼NkVs h½ & 5 6- MªsÇlx VªkWyh ¼eè;e½ & 230 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] 7- flÇjt iai & 4 8- bU¶;wtu iai & 5 9- ekWfuVj & 5 10- VªkaliksVZ ekWfuVj@iYl vkWDlhehVj & 5 11- bZlhth e'khu & 1 12- vYVªklkmaM e'khu & 1 13- CART VªkWyh & 1 14- fMfQfczyVs j & 1 15- vYQk eSVªls fon eksVj & 3 16- VªkalQj VªkWyh & 4 17- OR VªkWyh & 2 18- lsQ LykbMj & 2 19- daI;Vw j & 2 20- ÇçVj & 1 21- cSu lÆdV & 12 22- vkWDlhtu ¶yks ehVj & 20 23- lD'ku iksVZ fon tkj & 20 24- ,;j ¶yks ehVj@iYeks,M & 5 25- jfsÝtjVs j & 2 ¼QhM~l & 1] MªXl & 1½ 26- eVs y QqV LVsi@QqV LVwy & 5 27- ,Ecqy's ku p;s j & 5 28- ;wih,l & 1 29- ¶ySV VªkWyh & 1 30- ycs Çyx e'khu & 1 31- XywdksehVj & 2 32- fofHkUu vkdkj ds ,Ecw cSx & 2 lsV 1- Mk;fyfll e'khu &10 2- ckbdkcksZusV fçijs’ku VSad & 1 3- vkjvks ds lkFk ty mipkj la;a=] ,aMksVkWfDlu fQ+YVj & 1 4- jklk;fud@xeÊ dhVk.kq'kksèku ds vuqdwy Mk;fyfll ikbiykbu 5- Mk;ykbtj vkSj VîÇwcx 6- bU¶;wtu iai & 1 7- flÇjt iai & 1 8- jksxh ekWfuVj & 5 9- CART VªkWyh & 1 10- fMfQfczyVs j & 1 11- lHkh 'k¸;kvks a ds fy, oSD;we vkSj vkWDlhtu ykbu 12- vkWDlhtu ¶yks ehVj & 10 13- osfaVysVj & 1 14- dSuqys'ku lsV & 20 15- lhohlh lsV & 20 16- e'khu fjçkslÇslx ;wfuV ¼;fn Mk;ykbtj dk nksckjk mi;ksx fd;k tkrk gS½ 17- daI;Vw j & 2 18- ÇçVj & 1 19- NksVh MªsÇlx VªkWyh & 10 20- cM+h MªsÇlx VªkWyh & 1 21- vksoj csM Vcs y & 10 22- dkWV@Mk;fyfll p;s j & 10 23- vksvkj Vscy ds lkFk NksVk vksvkj] ykbV~l & 1 ¼lhohlh vkSj ihMh dSFksVj yxku s tSlh çfØ;kvks a ds fy,½ 24- byDs VªkWfud IyVs Q+kWeZ osbax Ldsy & 1 25- byDs VªkWfud chih ekWfuVj & 1 26- iYl vkWDlhehVj & 2 27- XywdksehVj & 2 28- Oghy ps;j & 5 29- LVªps j & 2[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 31 30- LVksjst jSd 31- QkbÇyx dSfcusV 32- jfsÝtjVs j & 2 1- bU¶;wtu iai & 4 2- flÇjt iai & 2 3- ejht ekWfuVj & 5 4- CART VªkWyh & 1 5- fMfQ+fczyVs j & 1 6- lHkh csM ds fy, oSD;we vkSj vkWDlhtu ykbu 7- vkWDlhtu ¶y+ ks ehVj & 5 8- osfaVysVj & 1 9- Ýhtj & 1 10- jfsÝtjVs j & 2 11- ekbØksoso vksou & 1 12- daI;Vw j & 2 13- ÇçVj & 1 14- NksVh MªsÇlx VªkWyh & 5 15- cM+h MªsÇlx VªkWyh & 1 16- vksoj csM Vcs y & 5 17- ,MtLVscy dkWV & 5 18- HEPA fQ+YVj ds lkFk ,lh & 1 19- byDs VªkWfud osbax Ldsy & 1 20- byDs VªkWfud chih ekWfuVj & 1 21- iYl vkWDlhehVj & 2 22- XywdksehVj & 2 23- Oghy ps;j & 3 24- LVªps j & 2 25- ,Ecqy's ku p;s j & 5 ç'u&i=@ç'uksÙkjh% 10 vad fyf[kr dk;Z@vkofèkd ç'u&i=% 10 vad ¼oSf'od vkSj jk"Vhª; LokLF; n[s kHkky ds #>ku vkSj uhfr;ka½ uSnkfud lsfeukj% 5 vad ¼ fof'k"V uSnkfud fLFkfr es a uSnkfud@ns[kHkky ekxZ@fof'k"V uÉlx fl)kar dk vuqç;ksx½ ç'u&i=% 20 vad fyf[kr dk;Z% 5 vad ¼lkfgR;d leh{kk@'kksèk midj.k dh rS;kjh½ tuZy Dyc% 5 vad ¼uÝs ksykWth uÉlx n{krkvks a ds fy, 'kksèk lk{; dk fo'y"sk.k½ ç'u&i=% 15 vad tuZy Dyc% 5 vad ¼usr`Ro@çcaèku@f'k{k.k es a #>ku½ fyf[kr dk;Z% 5 vad ¼,d vkn'kZ Mk;fyfll ;wfuV vkSj jhuy VªkalIykaV ;wfuV dk fMtkbu r;S kj djuk½ lw{e f'k{k.k% 5 vad32 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] ç'u&i= vkSj ç'uksÙkjh% 20 vad ¼iSFkksfQft;ksykWth & 10] QkekZdksykWth & 10½ vkS"kfèk vè;;u% 5 vad ¼vkS"kfèk vè;;u ,oa çLrqfr½ ekey s dh çLrqfr vkSj ekeys dh vè;;u fjiksVZ ¼iSFkksfQft;ksykWth½% 5 vad ç'u&i=% 20 vad fyf[kr dk;Z% 10 vad ¼uSnkfud@tkap fjiksVZ & O;k[;k vkSj fu"d"kks± dk fo'y"sk.k½ uSnkfud çn'kZu vkadyu% 10 vad inLFkkiu ds i'pkr ijh{kk ¼vks,llhbZ½% 10 vad ekey s dh çLrqfr vkSj ekeys dh vè;;u fjiksVZ% 5 vad vkarfjd vks,llhbZ% 25 vad ¼inLFkkiu i'pkr ijh{kk uÝs ksykWth okMZ] gseksMk;fyfll ;wfuV] isfjVksfu;y Mk;fyfll ;wfuV ;k VªkalIykaV ;wfuV es a vk;ksftr dh tk ldrh gS½ ç'u&i= vkSj ç'uksÙkjh% 20 fyf[kr dk;Z% 10 vad uSnkfud çn'kZu vkadyu% 20 vad inLFkkiu ds i'pkr ijh{kk ¼vks,llhbZ½% 10 vad vkS"kfèk vè;;u ¼vkS"kfèk vè;;u vkSj çLrqfr½% 10 vad ekey s dh çLrqfr vkSj ekeys dh vè;;u fjiksVZ ¼ikfjokfjd f'k{kk@ijke'kZ½% 5 vad ekey s dh çLrqfr ¼uSnkfud@n[s kHkky ekxZ dk vuçq ;ksx½% 5 vad vkarfjd vks,llhbZ% 50 vad I ç'u&i= vkSj ç'uksÙkjh% 20 vad uSnkfud lsfeukj vkSj tuZy Dyc% 10 vad uSnkfud çn'kZu vkadyu% 20 vad inLFkkiu ds i'pkr ijh{kk ¼vks,llhbZ½% 10 vad uSnkfud çLrqfr% 10 vad ekey s dh vè;;u fjiksVZ% 10 vad vkarfjd vks,llhbZ% 50 vad II ç'u&i=% 20 vad uSnkfud lsfeukj % 10 vad uSnkfud çn'kZu vkadyu% 20 vad inLFkkiu ds i'pkr ijh{kk ¼vks,llhbZ½% 10 vad uSnkfud çLrqfr% 10 vad ekey s dh vè;;u fjiksVZ ¼fodflr uSnkfud@n[s kHkky ekxZ½% 10 vad vkarfjd vks,llhbZ% 50 vad[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 33 ¼inLFkkiu i'pkr ijh{kk usÝksykWth okMZ] Mk;fyfll ;wfuV ;k VªkalIykaV ;wfuV esa vk;ksftr dh tk ldrh gS½ çk;kSfxd% 50 vad lS)kafrd% y?kq mÙkj vkSj fucaèk çdkj ds ç'u ¼Hkkfjrk fo'ofo|ky; }kjk r; dh tk ldrh gS½ ¿fucaèk 2×15 vad ¾ 30] laf{kIr mÙkj 5×6 vad ¾ 30] vfry?kq 5×2 vad ¾ 10À 1- o;Ld jksxh dk ldsfaær bfro`Ùk yus k rFkk 'kkjhfjd tkap djuk 2- f’k’kq jksxh dk ldsfaær bfro`Ùk yus k rFkk 'kkjhfjd tkap djuk 3- fu"d"kks± rFkk ifj.kkeks a dh O;k[;k djuk 5- uSnkfud ekinMa kas dh fuxjkuh djuk ¼n{krk tkap lwph vkSj vkoafVr vadks a ds vuqlkj½ × 1- o;Ld jksxh dk ldsfaær bfro`Ùk yus k 2- o;Ld jksxh dh ldsfaær 'kkjhfjd tkap djuk 3- f’k’kq jksxh dk ldsfaær bfro`Ùk yus k 4- f’k’kq jksxh dh ldsfaær 'kkjhfjd tkap djuk 5- bfro`Ùk rFkk 'kkjhfjd tkap fu"d"kks± dh O;k[;k djuk 6- ç;ksx’kkyk rFkk uSnkfud ijh{k.k ifj.kkeks a dh O;k[;k djuk 7- uSnkfud ekinMa kas dh fuxjkuh djuk ¼n{krk tkap lwph vkSj vkoafVr vadks ds vuqlkj½ × 1- ldsfaær bfro`Ùk ysuk] 'kkjhfjd tkap djuk rFkk fu"d"kks± ,oa ifj.kkeks a dh O;k[;k djuk 2- buosfto rFkk ukWu&buosfto {kerkvks a dh fuxjkuh djuk 3- fpfdRlh; eè;orZu ¼vkikrdkyhu çfØ;kRed n{krk,a½ ftles a vkS"kfèk ç'kklu 'kkfey gS 4- ikfjokfjd f'k{kk ,oa ijke'kZ ¼n{krk tkap lwph vkSj vkoafVr vadks a ds vuqlkj½34 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] × 1- o;Ld jksxh dk ldsfaær bfro`Ùk yus k] 'kkjhfjd tkap djuk rFkk ifj.kkeks a dh O;k[;k djuk 2- f’k’kq jksxh dk ldsfaær bfro`Ùk yus k] 'kkjhfjd tkap djuk rFkk ifj.kkeks a dh O;k[;k djuk 3- buosfto rFkk ukWu&buosfto {kerkvks a dh fuxjkuh djuk 4- n[s kHkky ;kstuk fodflr djuk 5- ikfjokfjd f'k{kk ,oa ijke'kZ 6- fpfdRlh; eè;orZu ¼vkikrdkyhu çfØ;kRed n{krk,a½ ftlesa vkS"kfèk ç'kklu 'kkfey gS ¼n{krk tkap lwph vkSj vkoafVr vadks ds vuqlkj½ × I II 1- ldsfaær bfro`Ùk ysuk] 'kkjhfjd tkap djuk rFkk fu"d"kks± vkSj ifj.kkeks a dh O;k[;k djuk 2- buosfto rFkk ukWu&buosfto {kerkvks a dh fuxjkuh djuk 3- mipkjkRed çfØ;k,¡ ¼lhohlh yxkuk] ihMh dSFksVj yxkuk] gseksMk;fyfll] isfjVksfu;y Mk;fyfll] IykLeQsjsfll] lhvkjvkjVh] ,l,ybMZ h½ 4- n[s kHkky ;kstuk@ns[kHkky ekxZ fodflr djuk 5- uSnkfud eè;orZu ¼jhuy ck;ksIlh] ,fLlfVd VSi] CyM dYpj] lhohlh ,aM ihMh dSFksVj lkbV dYpj] ihMh ¶Y;wM dYpj] ihbZVh VsLV] lqçkI;wfcd ;wfju ,fLijsV QkWj dYpj] vYVªklkmaM fdMuh] vYVªklkmaM & ,oh ,Dlsl ¶yks½ 6- vkS"kfèk fuèkkZj.k rFkk nsuk 7- gseksMk;fyfll 8- isfjVksfu;y Mk;fyfll 9- fdMuh çR;kjksi.k & çR;kjksi.k ls igys vkSj ckn dh n[s kHkky ¼n{krk tkap lwph vkSj vkoafVr vadks ds vuqlkj½ × 1- o;Ld jksxh dk ldsfaær bfro`Ùk yus k] 'kkjhfjd tkap djuk rFkk ifj.kkeks a dh O;k[;k djuk 2- f’k’kq jksxh dk ldsfaær bfro`Ùk yus k] 'kkjhfjd tkap djuk rFkk ifj.kkeks a dh O;k[;k djuk 3- buosfto rFkk ukWu&buosfto {kerkvks a dh fuxjkuh djuk 4- n[s kHkky ;kstuk@ns[kHkky ekxZ fodflr djuk 5- ikfjokfjd f'k{kk ,oa ijke'kZ 6- vkS"kfèk ç'kklu 7- uSnkfud eè;orZu ¼jhuy ck;ksIlh] ,fLlfVd VSi] CyM dYpj] lhohlh ,aM ihMh dSFksVj lkbV dYpj] ihMh ¶Y;wM dYpj] ihbZVh VsLV] lqçkI;wfcd ;wfju ,fLijsV QkWj dYpj] vYVªklkmaM fdMuh] vYVªklkmaM & ,oh ,Dlsl ¶yks½ 8- mipkjkRed çfØ;k,¡ ¼gseksMk;fyfll] isfjVksfu;y Mk;fyfll] lhohlh yxkuk] ihMh dSFksVj yxkuk] IykLeQsjsfll] lhvkjvkjVh] ,l,ybMZ h½[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 35 ¼n{krk tkap lwph vkSj vkoafVr vadks a ds vuqlkj½ × 3 * I 1 'kksèk midj.k dh rS;kjh 2 O;ofLFkr leh{kk@lkfgR;d leh{kk ys[ku 3 çdk'ku ds fy, ikaMqfyfi rS;kj djuk ¼çFke ;k f}rh; o"kZ½ 4 'kksèk ifj;kstuk@bZchih ifj;kstuk fo"k;% II 1 LVkQ jksxh fufgr dk;Z rS;kj djuk 2 çn'kZu ladsrd vkSj mik; 3 jksxh f'k{kk lgk;rk fodflr djuk 4 bdkbZ es a jksxh n[s kHkky laijh{k.k 5 ulks± ds fy, çkS|kfsxdh lgk;d f'k{kk lgk;rk fodflr djuk 6 xq.koÙkk lqèkkj laijh{k.k 7 lw{e f'k{k.k & LVkQ ulZ 8 jksxh f'k{kk vkSj ijke'kZ 9 vks,llhbZ@vks,lihbZ ;kstuk cukuk vkSj lapkyu djuk 10 ijh{k.k fuekZ.k III 1-1 ,D;wV fdMuh pksV 1-2 VîwcqyksbaVjLVhf'k;y jksx 1-3 Øksfud fdMuh jksx 1-4 Xykses#yj jksx 1-5 uÝs ksfVd ÇlMªkse 1-6 æo ek=k fLFkfr 1-7 O;kid ç.kkyh okj 'kkjhfjd vkadyu 2-1 uotkr f'k'kq 2-2 cPpk 2-3 o;Ld 2-4 cqtqxZ 2-5 xHkZorh efgyk,a IV 1-1 tSo jlk;u foKku 1-2 uSnkfud jksx foKku 1-3 lw{e tho foKku 1-4 ,chth 2-1 iSjklsUVfsll36 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] * 2-2 FkksjklsUVfsll 2-3 yqacj iapj 2-5 jhuy ck;ksIlh 2-6 cksu ejs ks ,fLij’sku 2-7 vYVªklkmaM fdMuh 2-8 ,Dlsl ¶yks dk vYVªklkus ksxzkfQd vkadyu 2-9 bZlhth vkSj O;k[;k 2-10 ,chth fo'ys"k.k vkSj O;k[;k 3-1 jhuy MkWiyj 3-2 fQLVqyksxzke 3-3 Mªx ,sls 3-4 ,evkjvkbZ@lhVh 3-5 jhuy ,aft;ksxzke 3-6 xqnZs ds Årdks a dh iSFkksykWftdy tkap ¼,y,e] vkbZ,Q] bZ,e½ 3-7 bdksdkÆM;ksxzke V 1-1 ,aVhgkbijVsfUlo 1-2 Xywdkst de djus oky s ekSf[kd ,tsVa 1-3 lksfM;e 'kksèku 1-4 iksVsf'k;e 'kksèku 1-5 vkbuksVªksIl 1-6 foVkfeu vkSj [kfut iwjd 1-7 var%f'kjk æo ç'kklu 1-8 balqfyu [kqjkd lek;kstu 2-1 iks"k.k vkadyu djuk 2-2 lhdsMh oky s jksxh ds fy, fpfdRlh; vkgkj dh ;kstuk cukuk 2-3 eèkqegs okys jksxh ds fy, fpfdRlh; vkgkj dh ;kstuk cukuk 2-4 uklksxSfLVªd Vîcw bul’kZu 2-5 ,uth QhÇMx 2-6 VksVy iSjasVsjy iks"k.k ukWu&buosfto osfaVys'ku 3-1 de çokg ifjorZuh; çn'kZu midj.k% uts y dSFksVj@dSU;wyk@Mcy usty çksxa ] Qsl ekLd] fjtjok;j cSx ds lkFk Qsl ekLd 3-2 mPp çokg fuf'pr çn'kZu midj.k% ,uVªus esaV ¼ospa qjh½ midj.k] CPAP, BiPAP buosfto osfaVys'ku 3-3 eSdsfudy osfaVysVj dh LFkkiuk 3-4 eSdsfudy osfaVysVj ij jksxh dh n[s kHkky 3-5 ,aMksVªfsp;y Vîcw yxkuk 3-6 ,aMksVªfsp;y Vîcw gVkuk 3-7 ,aMksVªfsp;y lD'kÇux 3-8 Vªsfd;ksLVkseh n[s kHkky 3-9 bZVh Vîwc dh fLFkfr dh iqf"V djuk 3-10 pSLV fQft;ksFksjsih 3-11 iksLVqjy Mªus ts 4-1 bu¶;wtu iai 4-2 flÇjt iai[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 37 * 4-3 fMfQfczyVs j 5-1 ch,y,l 5-2 ,lh,y,l 5-3 'kksd ijke'kZ 5-4 cqjh [kcj lqukuk 6-1 lhdsMh dh çxfr dks èkhek djuk 6-2 lhdsMh eas fpfdRlh; vkgkj 6-3 eèkqegs çcaèku 7-1 uSnkfud ifjn`'; fleqy's ku 7-2 8-1 èkeuh jDr xSl ¼,chth½ 8-2 gheksMk;ukfeDl 8-3 byDs VªksdkÆM;ksxzke ¼bZlhth½ 8-4 buosfto chih ekWfuVÇjx 8-5 ukWu&buosfto chih ekWfuVÇjx 8-6 Xyklxks dksek Ldksj 8-7 csgk's kh Ldksj 8-8 nnZ Ldksj 8-9 czSMsu Ldksj 8-10 ckWoy lkmaM 8-11 thvkjch,l 8-12 th,Qvkj vuqeku vkSj lhdsMh LVsÇtx 8-13 pSLV ,Dl&js *Nk= ds dkS'ky çn'kZu es a l{ke ik, tkus ij] ml ij çhlsIVj }kjk gLrk{kj fd, tk,axsA ls ;g vis{kk dh tkrh gS fd os lwphc) dkS'kyks@a n{krkvks a dks rc rd dbZ ckj djas tc rd fd os Lrj 3 n{krk rd ugÈ igqap tkrs] ftlds ckn çhlsIVj çR;sd n{krk ds le{k gLrk{kj djsxa sA ;g lqfuf'pr djsxa s fd çR;sd n{krk ds fy, gLrk{kj] Lrj 3 ij igqapus ds ckn gh fn, x, gSaA • Lrj 3 n{krk ;g n'kkZrh gS fd ,uih,ubZih,u Nk= i;Zos{k.k ds fcuk ml n{krk dk laiknu djus es a l{ke gSA • Lrj 2 n{krk ;g n'kkZrh gS fd Nk= i;Zos{k.k ds lkFk çR;sd n{krk dk laiknu djus es a l{ke gSA • Lrj 1 n{krk ;g n'kkZrh gS fd Nk= i;Zos{k.k ds lkFk Hkh ml n{krk@dkS'ky dk laiknu djus es a l{ke ugÈ gSA * 1-1 çh] baVªk] iksLV Mk;fyfll vkadyu 1-2 lhohlh dk vkadyu 1-3 ,oh fQLVqyk dk vkadyu 1-4 lhohlh lkbV dh ns[kHkky 1-5 'kq"d otu vkadyu & uSnkfud vkSj tSo&çfrckèkk fofèk 1-6 ;w,Q x.kuk 1-7 çksxzkÇex e'khu vkSj ,pMh 'kq: djuk 1-8 ,pMh can djuk38 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] * 1-9 ckbdkcZ rS;kj djuk 1-10 URR, Kt/V dk vuqeku yxkuk] Mk;fyfll i;kZIrrk dk vkadyu djuk 1-11 fu;fer tkap fuèkkZfjr djuk vkSj vuqorÊ ifj.kke 1-12 ,pMh fçfLØI'ku 1-13 gsifju rS;kj djuk 1-14 Mªx fjdalhfy,’ku 1-15 ç;ksx’kkyk fjiksVZ ds vkèkkj ij lkekU; vkS"kfèk;ks a dk fuèkkZj.k% ,fjFkzksikbs fVu] QkWLQksjl ckbaMlZ] dSfY'k;e vkSj foVkfeu Mh iwjd] ,aVhgkbijVsfalo] vksth,y, 1-16 fofHkUu Mk;fyfll eksMfyVht laikfnr djuk a. ,llh;w,Q b. i`Fkd ;w,Q c. ,l,ybZMh d. lhvkjvkjVh 1-17 IykTekQsjsfll laikfnr djuk 1-18 gVkus ds fy, IykTek okWY;ew dh x.kuk djuk 1-19 lhohlh dks Qseksjy vkSj txyj ohu es a Mkyuk 1-20 ,pMh es a tfVyrkvks a dh igpku rFkk çcaèku djuk a. baVªkMk;fyfVd gkbiksVs'a ku b. gseksfyfll c. ekalisf'k;ks a eas ,sBa u d. ,;j ,EcksfyTe 1-21 lhohlh ls lacafèkr tfVyrkvks a dh igpku vkSj çcaèku djuk 1-22 ,oh,Q ls lacafèkr tfVyrkvks a dh igpku vkSj çcaèku djuk 2-1 ihMh ds fy, jksfx;ks a dk vkadyu vkSj p;u djuk 2-2 ihbZVh djuk] ihMh fçfLØI'ku fuèkkZfjr djuk 2-3 ihMh ,Dlpsta laikfnr djuk 2-4 dYpj ds fy, ihMh ¶ywbM laxzfgr djuk 2-5 fudkl LFky laØe.k] Vuy laØe.k vkSj isfjVksfufVl dh igpku vkSj çcaèku djuk 2-6 baVªkifsjVksfu;y ,aVhck;ksfVDl nsuk 2-7 uSnkfud vkadyu vkSj ihbZVh ds vkèkkj ij ihMh fçfLØI'ku es a cnyko djuk 2-8 Kt/V lfgr Mk;fyfll i;kZIrrk dk vkadyu djuk 2-9 ihMh dh xSj&laØked tfVyrkvks a dh igpku o çcaèku djuk 3-1 çR;kjksi.k iwoZ dk;Z vkSj Mksuj o çkIrdrkZ dk vkadyu 3-2 çR;kjksi.k ds fy, jksfx;ks a dks lykg vkSj mudk p;u 3-3 dkuuw h vkSipkfjdrk,a vkSj nLrkosthdj.k 3-4 Mksuj usQjsDVkseh eas lgk;rk djuk 3-5 fdMuh çR;kjksi.k es a lgk;rk djuk 3-6 fçvkWijsfVo n[s kHkky & Mksuj vkSj çkIrdrkZ 3-7 iksLV vkWijfsVo n[s kHkky & Mksuj vkSj çkIrdrkZ 3-8 e`r Mksuj jftLVªh 3-9 efLr"d e`R;q ¼czsu MSFk½ dk vkadyu 3-10 çR;kjksi.k ls igys xqnZs dh jDr okfgdkvks a dk æo fuos’ku 3-11 fdMuh çR;kjksi.k ds ckn æo çcaèku 3-12 xzk¶V fjtsD’ku dh igpku vkSj çcaèku 3-13 çR;kjksi.k ls lacafèkr laØe.kks a dh igpku vkSj çcaèku 3-14 ?kko vkSj cgko ns[kHkky 3-15 çR;kjksi.k ds ckn xzk¶V Q+Da 'ku dk vkadyu vkSj fu:i.k[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 39 * 4-1 oLdwyj ,lsl dk çcaèku 4-2 fdMuh fjIysleaVs Fksjsih ds fodYi 4-3 ihMh eas tfVyrkvks a dh jksdFkke vkSj çcaèku 4-4 fdMuh çR;kjksi.k ds ckn ns[kHkky 5-1 ¼x.kuk] vuqekiu vkSj ç'kklu½ a. ,Mªsuykbu b. ukWj,Mªsuykbu c. Mksikekbu d. MkscqVkekbu 5-2 a baMD’ku ,tsVa ikWyhDyksuy ,aVhckWMh ¼,Vhth½ baVjY;wfdu 2 fjlsIVj ,aVksxksfuLV ¼csflfyfDleSc½ b j[kj[kko mipkj dSYlhufqju bufgfcVlZ ¼lkbDyksLiksfju] VSØksfyel½ mTOR bufgfcVlZ ¼fljksfyel] ,ojksfyel½ c ,aVhçksfyQsjsfVo ,tsVa ¼,tSfFk;ksfçu] ekbdksQsuksfyd ,flM½ d dkWÆVdksLVjskWbM~l ¼çsMfulksyksu½ e vLohÑfr ds fy, mipkj dkWÆVdksLVjs kWbM~l] ATG, IVIG 5-3 ,fjFkzksikbsfVu batsD'ku vkSj [kqjkd lek;kstu 6-1 ekud lkoèkkfu;ka 6-2 ,pMh bdkbZ eas laØe.k fu;a=.k çksVksdkWy 6-3 ihMh bdkbZ es a laØe.k fu;a=.k çksVksdkWy 6-4 jhuy VªkalIykaV bdkbZ eas laØe.k fu;a=.k vH;kl 7-1 Mk;fyfll bdkbZ eas çn'kZu ladsrd mik;ks a dk vfHkxzg.k vkSj çLrfqdj.k 7-2 ,pMh bdkbZ eas ekbØksck;ksykWth fuxjkuh] vkjVh;w 7-3 ty xq.koÙkk çcaèku 7-4 xq.koÙkk lqèkkj laijh{k.k 8-1 var%f'kjk æo ç'kklu ¼dksykW;M@fØLVykW;M½ 8-2 jDr vkSj jDr mRikn ç'kklu 8-3 TED LVkWÇdx dk vuçq ;ksx 8-6 èkeuh j[s kk ls jDr laxzg.k 9-1 laosnh mÙkstuk 9-2 prs uk@dksek fLFkfr dh fuxjkuh 9-3 efLr"d e`R;q ¼czsu MSFk½ vkadyu 10-1 ECG 10-2 ABG 10-3 pSLV ,Dl&js 10-4 vYVªklkmaM 10-5 eyw tSo jlk;u tkap 10-6 eyw lw{e tho foKku tkap 11-1 ucs qykbts'ku40 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] * 11-2 pSLV fQft;ksFksjsih 11-3 gseksMk;fyfll 11-4 e=w dSFksVj yxkuk rFkk gVkuk 11-5 SCUF 11-6 TEDS 11-7 Isolated UF 11-8 SLED 11-9 igyk ,pMh çksVksdkWy 11-10 fpfdRlh; vkgkj *Nk= ds dkS'ky çn'kZu es a l{ke ik, tkus ij] ml ij çhlsIVj }kjk gLrk{kj fd, tk,axsA ls ;g vis{kk dh tkrh gS fd os lwphc) dkS'kyks@a n{krkvks a dks rc rd dbZ ckj djas tc rd fd os Lrj 3 n{krk rd ugÈ igqap tkrs] ftlds ckn çhlsIVj çR;sd n{krk ds le{k gLrk{kj djsxa sA ;g lqfuf'pr djsxa s fd çR;sd n{krk ds fy, gLrk{kj] Lrj 3 ij igqapus ds ckn gh fn, x, gSaA • Lrj 3 n{krk ;g n'kkZrh gS fd ,uih,ubZih,u Nk= i;Zos{k.k ds fcuk ml n{krk dk laiknu djus es a l{ke gSA • Lrj 2 n{krk ;g n'kkZrh gS fd Nk= i;Zos{k.k ds lkFk çR;sd n{krk dk laiknu djus es a l{ke gSA • Lrj 1 n{krk ;g n'kkZrh gS fd Nk= i;Zos{k.k ds lkFk Hkh ml n{krk@dkS'ky dk laiknu djus es a l{ke ugÈ gSA 1-1 * fof'k"V uSnkfud fLFkfr es a uSnkfud ekxZ@ fof'k"V uÉlx fl)kar dk vuqç;ksx ¼uSnkfud lsfeukj½ fo"k; dk 'kh"kZd% 1-2 * uÝs ksykWth uÉlx n{krkvks a ds fy, lk{; dh [kkst ¼uSnkfud dkUÝsla @tuZy Dyc½ fo"k; dk 'kh"kZd% 1-3 * urs `Ro@çcaèku@f'k{k.k es a #>ku ¼tuZy Dyc½ fo"k; dk 'kh"kZd% 2-1 ¼uSnkfud çLrqfr½ uSnkfud fLFkfr dk uke% 2-2 ¼uSnkfud çLrqfr½ ekey s dk vè;;u ¼fyf[kr fjiksVZ½ uSnkfud fLFkfr dk uke% 2-3 vkS"kfèk vè;;u ¼LFkk;h vkns'kks a ds rgr lwphc) vkS"kfèk;ka½ & 5 çLrqfr;ks a dh fyf[kr fjiksVZ ¼csMlkbM çLrqfr½ vkS"kfèk dk uke% 2-3-1 2-3-2 2-3-3 2-3-4 2-3-5 2-3-6 2-3-7[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 41 2-3-8 2-3-9 2-3-10 ¼fyf[kr fjiksVZ tek djus gsrq gSa½ 3-1 ¼o;Ld½ & bfro`Ùk vkSj 'kkjhfjd tkap ¼nks fyf[kr fjiksVZ½ 3-1-1- 3-1-2- 3-1-3- 3-1-4- 3-1-5- 3-2 ¼f’k’kq½ & bfro`Ùk vkSj 'kkjhfjd tkap ¼,d fyf[kr fjiksVZ½ 3-2-1- 3-2-2- 3-2-3- 3-3 ¼xHkZorh efgyk½ ¼,d fyf[kr fjiksVZ½ 3-3-1- 3-3-2- *mUur vH;klh; uÉlx & ,ih,u] 'kkès k vuqç;ksx & vkj,] usr`Ro] çcaèku rFkk f'k{k.k & ,y],e,aMVh42 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] 1-1 ¼uSnkfud dkUÝsla ½ fo"k; dk 'kh"kZd% 1-2 I ¼uSnkfud lsfeukj½ fo"k; dk 'kh"kZd% 1-3 I ¼tuZy Dyc½ fo"k; dk 'kh"kZd% 1-4 II ¼uSnkfud lsfeukj½ fo"k; dk 'kh"kZd% 1-5 II ¼tuZy Dyc½ fo"k; dk 'kh"kZd% ¼fyf[kr fjiksVZ tek djus ds fy, gSa½ 2-1 ¼ikfjokfjd f'k{kk@ijke'kZ½ & fyf[kr fjiksVZ 'kh"kZd dk uke% 2-2 ¼uSnkfud@n[s kHkky ekxZ½ 'kh"kZd dk uke% 2-3 I ¼uSnkfud çLrqfr½ uSnkfud fLFkfr dk uke% 2-4 I ¼ekey s dh vè;;u fjiksVZ½ uSnkfud fLFkfr dk uke% 2-5 II ¼uSnkfud çLrqfr½ uSnkfud fLFkfr dk uke% 2-6 II ¼ekey s dh vè;;u fjiksVZ½ uSnkfud fLFkfr dk uke% 2-7 csMlkbM çLrqfr ¼ikap fyf[kr fjiksVZ½ vkS"kfèk dk uke% 2-8 vkS"kfèk dk uke% 2-9 2-10 2-11 2-12 2-13 2-14 2-15 2-16 3-1 I uSnkfud fLFkfr dk uke% 3-2 3-3 3-4 3-5 ¼ekey s dh vè;;u fjiksVZ½ 3-6 II 3-7[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 43 3-8 3-9 ¼ekey s dh vè;;u fjiksVZ½ 3-10 fyf[kr fjiksVZ ¼fodflr uSnkfud@ns[kHkky ekxZ½ uSnkfud çLrqfr dks ekeys dh vè;;u fjiksVZ ds fy, fy[kk tk ldrk gSA ulZ çSfDV'kuj bu uÝs ksykWth ufl±x] uÝs ksykWth lacaèkh chekfj;ks a ls ihfM+r jksfx;ksa dh n[s kHkky djus ds fy, ftEens kjh vkSj mÙkjnkf;Ro yus s ds fy, rS;kj vkSj ;ksX; gksrs gSaA os mPp rh{.krk dh vko';drk oky s jksfx;ks a ds fy, lVhd fpfdRlk lqfuf'pr djus gsrq fQthf’k;u] ltZu vkSj fo'ks"kKks a ds lkFk lg;ksx djrs gSaA dk;ZØe ds iwjk gksus ij] ulZ çSfDV'kuj dks laLFkkxr LFkk;h vkn's kks a ds vuqlkj LFkk;h vkns'kks a eas lwphc) vkS"kfèk;ks a dks ç'kkflr djus dh vuqefr gksxhA mUgs a laLFkkxr çksVksdkWy ds vuqlkj uSnkfud ijh{k.k@çfØ;kvks a vkSj mipkjks a dk vkn's k nus s dh Hkh vuqefr gksxhA uÝs ksykWth okMZ@Mk;fyfll bdkbZ ;k xqnkZ çR;kjksi.k bdkbZ eas vkikrdkyhu fLFkfr ds nkSjku ulZ çSfDV'kuj }kjk fuEufyf[kr baVªkosul batsD'ku ;k bU¶;wtu fcuk fyf[kr vkns'k ds fn, tk ldr s gSa% 1- ,Mªsuykbu 2- uksj,Mªsuykbu 3- Mksikekbu 4- MkscwVkekbu 5- ,Msukslkbu44 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] 6- vfe;ksMsjksu 7- fyMksdsu@tkbyksdkMZ 8- ,QsfMªu 9- ,foy 10- gkbMªksdkWfVZlksu 11- MsDlkeFs kklkus 12- yfsoVªslVs e 13- QsfuVksbu 14- çksiksQksy 15- lksMk ckbdkcksZusV 8-4% 16- lksMk ckbdkcksZusV 7-5% 17- eXs usfl;e lYQsV 18- iksVsf’k;e DyksjkbM 19- IV ¶Y;wM~l & NS, DNS, 5% MSDLVªkst • ECG • ucs qykbts'ku • ABG • pSLV fQft;ksFksjsih • pSLV ,Dl&js • efgyk jksfx;ks a dks ;wfjujh dSFksVj yxkuk vkSj gVkuk • eyw tSojlk;fud tkap & Hb, PCV, • TEDS TIBC, WBC VksVy] WBC • 'kY;&fpfdRlh; ejge&iV~Vh fMQjsfa'k;Yl] ESR, byDs VªksykbV~l] • Mk;fyfll 'kq# djuk vkSj can djuk IyVs ysV~l] PT, aPTT, CyhÇMx vkSj • ,Iyhds’ku vkWQ bPFkkeksy fXyljhu@eSXuhf'k;e lYQsV MªsÇlx QkWj DykWÇVx Vkbe] çksdSfYlVksfuu] D- FkzksEcksf¶yfcfVl@,DlVªkokls'ku fMej] fØ,fVukbu] HbA1c, AC, PC, • ckgjh fQDlsVlZ ij jksfx;ks a ds fy, fiu lkbV ns[kHkky HDL, LDL, TIG, dksysLVªkWy VksVy] • vkblkes fsVªd ,aM vkblkVs ksfud ,Dljlkbt HIV, HbsAg, HCV • xeZ vkSj BaMs vuqç;ksx • eyw lw{etSfodh ¼ekbØksck;ksykWth½ • xeZ vkSj BaMs vuqijw d tkap & CyM ,aM ;fwju lsia Yl QkWj • fjewoy vkWQ lhohlh] dYpj Ýkse lhohlh ,aM ihMh dSFksVj lkbV dYpj ,aM lsfalfVfoVh] laoguh igqap • isfjVksfu;y bfDofyczs'ku VsLV dh ;qfDr;ka] lhohlh lkbV ls ueuw k] • ,pMh es a gsifju bU¶;wtu PD dSFksVj ,fDtV lkbV • ,fjFkzksikbs fVu batsD'ku çR;sd vLirky es]a vkikrdkyhu fLFkfr;ks a ds nkSjku nh tkus okyh fof'k"V [kqjkd ds lkFk vkS"kfèk ç'kklu ds LFkk;h vkn's k ,uih,ubZih,u Lukrdks a ds fy, fn'kkfunsZ'kks a ds :i es a miyCèk djk, tk ldr s gSaA ,uih Nk=ks a dks bu vkS"kfèkvks a dks nus s ds fy, çhlsIVlZ@,uih ladk; dh ns[kjs[k eas çf'kf{kr fd;k tk,xkA p;fur tkap ds vkn's k nus s vkSj fof'k"V fpfdRlh; çfØ;kvks a dks djus ds çksVksdkWy ,uih,ubZih,u Nk=ks a dks çf'kf{kr djus oky s çR;sd vLirky eas Hkh miyCèk gks ldr s gSaA [जवज्ञापन-III/4/असा./901/2024-25][भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 45 INDIAN NURSING COUNCIL NOTIFICATION New Delhi, the 26th December, 2024 INDIAN NURSING COUNCIL {NURSE PRACTITIONER IN NEPHROLOGY NURSING (NPNepN) - POSTGRADUATE RESIDENCY PROGRAM} REGULATIONS, 2024 F.No. 11-1/2024-INC (X):—In exercise of the powers conferred by sub-section (1) of Section 16 of Indian Nursing Council Act, 1947 (XLVIII of 1947), as amended from time to time, the Indian Nursing Council hereby makes the following regulations, namely:— 1. SHORT TITLE AND COMMENCEMENT i. These Regulations may be called the Indian Nursing Council {Nurse Practitioner in Nephrology Nursing (NPNepN) - Postgraduate Residency Program} Regulations, 2024. ii. These shall come into force on the date of notification of the same in the Official Gazette of India. 2. DEFINITIONS In these Regulations, unless the context otherwise requires, i. ‘the Act’ means the Indian Nursing Council Act, 1947 (XLVIII of 1947) as amended from time to time; ii. ‘the Council’ means the Indian Nursing Council constituted under the Act; iii. ‘SNRC’ means the State Nurse and Midwives Registration Council, by whichever name constituted, by the respective State Governments; iv. ‘RN & RM’ means a Registered Nurse and Registered Midwife (RN & RM) and denotes a nurse who has completed successfully, recognised Bachelor of Nursing (B.Sc. Nursing) or Diploma in General Nursing and Midwifery (GNM) course, as prescribed by the Council and is registered in a SNRC as Registered Nurse and Registered Midwife; v. ‘Nurses Registration & Tracking System (NRTS)’ means a system developed by the Council and software developed in association with National Informatics Centre (NIC), Government of India, and hosted by NIC for the purpose of maintenance and operation of the Indian Nurses Register. It has standardised forms for collection of the data of Registered Nurse and Registered Midwife (RN & RM)/Registered Auxiliary Nurse Midwife (RANM)/Registered Lady Health Visitor (RLHV) upon Aadhar based biometric authentication; vi. ‘NUID’ is the Nurses Unique Identification Number given to the registrants in the NRTS system; vii. ‘General Nursing and Midwifery (GNM)’ means Diploma in General Nursing and Midwifery qualification recognized by the Council under Section 10 of the Act and included in Part-I of the Schedule of the Act. NURSE PRACTITIONER IN NEPHROLOGY NURSING (NPNepN) - POSTGRADUATE RESIDENCY PROGRAM I. Introduction and Background In India, reshaping health systems in all dimensions of health has been recognized as an important need in the National Health Policy, 2017 (NHP 2017). It emphasizes human resource development in the areas of education and training alongside regulation and legislation. The government recognizes significant expansion in tertiary care services both in public and private health sectors. In building their capacity, it is highly significant that the healthcare professionals require advanced educational preparation in specialty and super-specialty services. To support specialized and super-specialized healthcare services, specialist nurses with advanced preparation are essential. Developing training programs and curriculum in the area of tertiary care is recognized as the need of the hour. Nurse Practitioners (NPs) will be able to meet this demand provided they are well trained and empowered to practice. With establishment of new cadres in the Center and State level, master level prepared Nurse Practitioners will be able to provide cost effective, competent, safe and quality driven specialized nursing care to patients in a variety of critical care settings in tertiary care centers. Nurse practitioners have been prepared and functioning in USA and Canada since 1960s, UK since 1980s, Australia since 1990s and Netherlands since 2010. Nurse practitioners in critical care/acute care, oncology, nephrology care, emergency care, neuro care, cardiovascular care, anesthesia care and other specialties can be prepared to function in secondary and tertiary care settings. A curricular structure/framework is proposed by the Council towards preparation of Nurse Practitioner in Nephrology Nursing (NPNepN) at Masters’ Level. The special feature of this program is that it is a clinical residency program emphasizing a strong clinical component with 15% of theoretical instruction and 85% of practicum.46 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] Competency based training is the major approach and NP education is based on competencies adapted from International Council of Nurses (ICN, 2020), American Association of Colleges of Nursing (AACN, 2021), American Nephrology Nurses Association (ANNA, 2020) and National Organization of Nurse Practitioner Faculties competencies, (NONPF competencies, 2022). Every course is based on achievement of competencies. Nurse Practitioner in Nephrology Nursing program is intended to prepare registered B.Sc. Nurses to provide advanced nursing care to patients at tertiary care centers who have kidney diseases. A Nurse Practitioner in Nephrology Nursing (NPNepN) provides primary care to patients with acute or chronic kidney/urologic disorders, those undergoing dialysis, and those who are candidates for or have undergone kidney transplants. The nursing care is focused on delaying disease progress, initiating early management, minimizing complications and optimizing quality of life. The program consists of various courses of study that are based on strong scientific foundations and evidence based practice in assessment and management of individuals with kidney diseases. These are built upon the theoretical and practice competencies of B.Sc. trained nurses. On completion of the program and registration with respective SNRC, they are permitted to practice all competencies listed in the log book of the Council syllabus and also independently administer drugs and order diagnostic tests, procedures and therapies as per institutional protocols/standing orders. Nurse Practitioners in Nephrology Nursing when exercising this authority are accountable for the competencies in - a) Assessment and clinical examination b) Problem identification and preparation of treatment plan c) Planning and providing Hemodialysis and Peritoneal Dialysis d) Preparing patients and families for Kidney Replacement Therapy e) Preparing clients and their families for organ donation f) Selection/administration of medication or devices or therapies g) Patients’ education h) Knowledge of interactions of therapeutics i) Evaluation of outcomes j) Recognition and management of complications and adverse reactions k) Contribution towards evidence based innovations in clinical practice l) Participation in government and non-government activities in promoting kidney donation and transplantation. The Nurse Practitioner in Nephrology Nursing (NPNepN) is prepared and qualified to assume responsibility and accountability for the care of patients with kidney diseases under his/her care. The said postgraduate degree will be registered as an additional qualification by the SNRC. Philosophy The Council believes that there is a great need to establish a postgraduate program titled Nurse Practitioner in Nephrology Nursing (NPNepN) to meet the challenges and demands of tertiary healthcare services in India, which is reflected in the National Health Policy, 2017 and provide quality care to patients with kidney diseases and their families. The Council believes that postgraduates from a residency program focused on strong clinical component and competency based training will be able to demonstrate clinical competence based on sound theoretical and evidence based knowledge. The teaching learning approach should focus on adult learning principles, competency based education, collaborative learning, preceptor guided clinical learning, experiential learning and self-directed learning. Education providers/preceptors/mentors must update their current knowledge and practices. Medical faculty are invited to participate as preceptors in the training. The Council also believes that a variety of educational strategies can be used in the clinical settings to address the deficit of qualified nephrology nursing faculty. It is hoped to facilitate developing policies towards registration/licensure and create cadre positions for appropriate placement of these postgraduate NPNepN to function in secondary and tertiary care hospital settings or community healthcare settings that offer nephrology services. They may provide services also in chronic kidney disease clinics/centers, dialysis centers and primary care settings including home based hemodialysis and peritoneal dialysis.[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 47 An educational framework for the NP curriculum is proposed (See Figure 1) R F e g ig is t e u r e r 1 e d . N C B u o mE .S r s p e t ed u c aT r a c ./P .B e P r a • • • • F o u n d a tio n s o f N e p h ro lo g y N u rs in g P ra c tic e • N e p h ro lo g y N u rs in g I • N e p h ro lo g y N u rs in g II n c y B a s e d t io n a n d in in g .B .S c . N u r s e w it h 1 - yN u r c t it io n e r in N e p h r o lo g S tr o n g C lin ic a l C o m p o n e n t (C lin ic a l R e s id e n c y ) T h e o re tic a l B a s is fo r A d v a n c e d N u rs in g P ra c tic e R e s e a rc h A p p lic a tio n a n d E v id e n c e B a s e d P ra c tic e in N e p h ro lo g y N u rs in g A d v a n c e S k ills in L e a d e rs h ip , M a n a g e m e n t a n d T e a c h in g • A d v a n c e d P a th o p h y s io lo g y N u r s e a p p lie d to N e p h ro lo g y N u rs in gP r a c t it io n e r • A d v a n c e d in N e p h r o lo g y P h a rm a c o lo g y N u r s in g a p p lie d to ( N P N e p N ) N e p h ro lo g y N u rs in g • A d v a n c e d H e a lth / P h y s ic a l A s s e s s m e n t AK n e a r C lin ic a l E x p e r ie n c e in M e d ic a l Ss in g ( E n tr y r e q u ir e m e n t) y N u r s in g ( N P N e p N ) - A n E d u c a t io n d v a n c e d o w le d g e a n d E t h ic s u r g ic a l N u r s in a l C u r r ic u la r F g /P r a e m d e ia w t r ic o r k II. Program Description The Nurse Practitioner in Nephrology Nursing (NPNepN) program is a residency nursing program with a main focus on competency based training. The duration is of two years with the curriculum consisting of theory that includes core courses, advanced practice courses and clinical courses besides clinical practicum which is a major Practicum - component (Refer Curricular framework). This program is designed to assist the NP studen8ts5 i%n d eveloping expertise and in depth understanding in the field of nephrology nursing. It will help them to develop advanced skills for nursing interventions while taking care of patients with kidney diseases. III. Aim The NPNepN program prepares registered B.Sc. nurses for advanced practice roles as clinical experts, managers, educators and consultants leading to M.Sc. degree (Nurse Practitioner in Nephrology Nursing). IV. Objectives On completion of the program, the NPNepN will be able to - 1. assume responsibility and accountability to provide competent family centered care to patients with kidney diseases in various healthcare settings.48 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] 2. demonstrate clinical competence including expertise in clinical assessment of patients with varied kidney disorders, education, diagnostic reasoning, complex monitoring, and therapies including diet and liaising with resource agencies. 3. apply clinical knowledge, scientific principles, critical thinking skills and evidence base to implementing therapies/interventions in nephrology nursing. 4. participate in treating patients with kidney diseases to stabilize and restore patient’s health and minimize or manage complications independently or collaboratively as a part of Nephrology team 5. collaborate with other healthcare professionals in the nephrology team, across the continuum of care. V. Minimum requirements to start the Nurse Practitioner in Nephrology Nursing (NPNepN) program The institution must accept the accountability for the NPNepN program and its students and offer the program congruent with the Council standards. It must fulfill the following requirements - 1. Essentiality Certificate a. Any institution who wishes to start Nurse Practitioner in Nephrology Nursing (NPNepN) program shall obtain an Essentiality Certificate/Government Order from the State. b. The following institutions are exempted from obtaining Essentiality Certificate - i. Institutions/Universities already offering B.Sc. Nursing or M.Sc. Nursing programs and found suitable by the Council under Sections 13 and 14 of the Act; ii. Institutions/Universities offering MBBS/DNB programs. 2. Hospital a. The institute should have a parent hospital/tertiary care centre with a minimum of 200 beds. b. It is preferable to have a medical college/nursing college attached to the parent hospital. 3. Nephrology Beds The hospital should have at least one nephrology ward with minimum of 20 beds, a hemodialysis unit with minimum 10 beds and scope for kidney transplant services. It is preferable to have a peritoneal dialysis unit with a minimum of 2 beds. 4. Nephrology Unit Staffing a. The ward and dialysis unit should have a Charge Nurse preferably with B.Sc. Nursing or M.Sc. Nursing qualification. b. The nurse patient ratio should be 1:6 for every shift in the general ward. c. For the dialysis unit, the nurse patient ratio should be 1:1 for every shift. d. Provision of additional 45% staff towards leave reserve. 5. Faculty/Staff Resources a. Clinical area: i. Nursing Preceptor - Full-time qualified GNM with 6 years of experience in nephrology nursing (preferably with Post Basic Diploma in Renal Nursing) or B.Sc. Nursing with 2 years of experience in Nephrology Nursing or M.Sc. (Specialty-Medical Surgical Nursing) with one year experience in Nephrology Nursing ii. Medical Preceptor - DM in Nephrology iii. Preceptor student ratio - Nursing 1:10, Medical 1:10 (Every student must have a medical and nursing preceptor) b. Teaching faculty: i. Professor/Associate professor - 1 {Teaching experience: 5 years post PG - M.Sc. (Specialty - Medical Surgical Nursing)} with faculty student ratio of 1:10 ii. Assistant professor - 1 (Teaching experience: 3 years post B.Sc.) iii. The above faculty shall perform dual role or be a senior nurse with M.Sc. Nursing qualification employed in nephrology unit iv. Guest Lecturers for Pharmacology and Pathophysiology 6. Physical and learning resources at hospital/college a. One classroom/conference room at the clinical area b. Skill Lab for simulated learning (hospital/college) c. Library and computer facilities with access to online journals d. E-Learning facilities 7. List of equipment (enclosed in Appendix 1). 8. Student Recruitment/Admission Requirements a. Applicants must be a registered B.Sc./P.B.B.Sc. nurse with a minimum of one year clinical experience, preferably in any Nephrology care setting prior to enrollment. b. Must have undergone the B.Sc./P.B.B.Sc. in an institution recognized by the Council and should be enrolled in the respective SNRC. c. Must have scored not less than 55% aggregate marks in the B.Sc. nursing program.[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 49 d. Selection must be based on the merit of an entrance examination and interview held by the competent authority. e. Must be physically fit. Number of candidates - 1 candidate for 3 dialysis beds and 5 in-patients in nephrology unit. Salary 1. In-service candidates will get regular salary. 2. Stipend/Salary for the other candidates as per the salary structure of the hospital where the course is conducted. VI. Examination Regulations Eligibility for appearing for the Examination Attendance: Minimum 80% for theory and practical before appearing for final University examination but must complete 100% in practical before the award of degree. There is no minimum cut off for internal assessment marks, as internal and external marks are added together for declaring pass. Examining and Degree Awarding Authority: Respective University Declaration of Results The candidate is declared to have passed the exam if the score is 60% and above. This score is the aggregate of both internal and external University examination in theory and practical in every course/subject and less than 60% is fail. For calculating the rank, the aggregate of the two years’ marks will be considered. If a candidate fails in theory or practical, he/she must appear for the paper in which he/she has failed. Rank will not be declared for candidates who fail in any subject. Maximum period to complete the program is 4 years. Practical examination OSCE type of examination is to be conducted alongside viva (oral examination) - Refer OSCE Guidelines found in Appendix 2. Maximum number of students for practical exam per day will be 10 students. Examination should be held in clinical area only. The team of practical examiners will include one internal examiner {(M.Sc. Nursing faculty with two years of experience in teaching the NPNepN program/M.Sc. Nursing faculty (Medical Surgical Nursing) with 5 years of post PG experience}, one external examiner (same as above) and one medical internal examiner who should be the preceptor for NPNepN program. Dissertation* Research Guides: Main guide: Nursing faculty (3 years Post PG experience) teaching NPNepN program, Co-guide: Medical preceptor Submission of Research Proposal: 6-9 months after date of admission in the first year Guide Student Ratio: 1:5 Research Committee: There shall be a separate research committee in the college/hospital to guide and oversee the progress of the research (minimum of 5 members with Principal or CNO who is M.Sc. Nursing qualified). Ethical Clearance must be obtained by the Institutional Review Board/Hospital Ethics Committee since it involves clinical research. Topic Selection: The topic should be relevant to Nephrology Nursing that will add knowledge or evidence for nursing intervention. The research should be conducted in any of the Nephrology care settings. Data Collection: 7 weeks are allotted for data collection, which can be integrated during clinical experience after 6 months in first year and before 6 months in second year. Writing the Research Report: 6-9 months in second year. Submission of Dissertation Final: 3 months before completion of the second year. Dissertation Examination Internal Assessment: Viva & Dissertation Report = 50 marks. University Examination: Viva & Dissertation Report = 50 marks. (Marking guide used for other M.Sc. Nursing specialties can be used for evaluation.) *EBP project may be conducted in place of dissertation and report submitted for evaluation. VII. Assessment (Formative and Summative) • Quiz • Seminar • Written assignments50 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] • Case/Clinical presentation • Clinical or care pathway/Case study report • Clinical performance appraisal • Log Book: Procedural competency and completion of clinical requirements signed by the medical/nursing faculty/preceptor • Objective Structured Clinical Examination (OSCE) • Test papers, Quiz • Final examination (Refer Appendix 2 for Assessment Guidelines) Scheme of Final Examination S.No. Title Theory % Practical % Hours Internal External Hours Internal External Ist year Core Courses 1 Theoretical Basis for Advanced Practice Nursing 2 50 2 Research Application and Evidence Based Practice 3 30 70 in Nephrology Nursing 3 Advanced Skills in Leadership, Management and 3 30 70 Teaching Advanced Practice Courses 4 Advanced Pathophysiology & Advanced 3 30 70 Pharmacology applied to Nephrology Nursing 5 Advanced Health/Physical Assessment 3 30 70 50 50 IInd year Specialty Courses 1 Foundations of Nephrology Nursing Practice 3 30 70 100 100 2 Nephrology Nursing I 3 30 70 100 100 3 Nephrology Nursing II 3 30 70 100 100 4 Dissertation and viva 50 50 VIII. Courses of Instruction S.No. Title Theory Lab/Skill Lab Clinical (hours) (hours) (hours) Ist year Core Courses I Theoretical Basis for Advanced Practice Nursing 40 II Research Application and Evidence Based Practice in 56 24 336 (7 weeks) Nephrology Nursing III Advanced Skills in Leadership, Management and Teaching 56 24 192 (4 weeks) Advanced Practice Courses IV Advanced Pathophysiology applied to Nephrology Nursing 60 336 (7 weeks) V Advanced Pharmacology applied to Nephrology Nursing 54 336 (7 weeks) VI Advanced Health/Physical Assessment 70 48 576 (12 weeks) TOTAL = 2208 hours 336 (7 weeks) 96 (2 weeks) 1776 (37 weeks) IInd year Specialty Courses VII Foundations of Nephrology Nursing Practice 96 48 576 (12 weeks) VIII Nephrology Nursing I 96 48 576 (12 weeks) IX Nephrology Nursing II 96 48 624 (13 weeks)[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 51 TOTAL = 2208 hours 288 (6 weeks) 144 (3 weeks) 1776 (37 weeks) Number of weeks available in a year = 52 - 6 (Annual leave, Casual leave, Sick leave = 6 weeks) = 46 weeks × 48 hours = 2208 hours Two years = 4416 hours (Examination during clinical posting) Instructional hours: Theory = 624 hours, Skill Lab = 240 hours, Clinical = 3552 hours TOTAL = 4416 hours Ist year: 336-96-1776 hours (Theory-Practicum) [Theory = 15%, Practicum = 85%] IInd year : 288-144-1776 hours (Theory-Practicum) [Theory = 15%, Practicum = 85%] Ist year = 46 weeks/2208 hours (46×48 hours) (Theory + Lab: 7.5 hours per week for 44 weeks = 330/336+96 hours*) *Theory + Lab = 96 hours can be given for 2 weeks in the form of introductory block classes and workshops IInd year = 46 weeks/2208 hours (46×48 hours) (Theory + Lab: 8.5 hours per week for 45 weeks = 384+48 hours) (1 week Block Classes = 48 hours) CLINICAL PRACTICE A. Clinical Residency Experience (A minimum of 48 hours per week is prescribed, however, it is flexible with different shifts and OFF followed by ON CALL duty) B. 8 hours duty with one day OFF in a week and ON CALL duty once per week. Clinical Placements Ist year: 44 weeks (excludes 2 weeks of introductory block classes and workshop) • Adult Nephrology ward - 10 weeks • Pediatric Nephrology ward - 4 weeks • Dialysis Unit - 14 weeks • Urology ward - 2 weeks • Renal Transplant Unit - 5 weeks • Nephrology OPD - 4 weeks (including transplant OPD) • Medical ICU - 4 weeks • Organ Donation Unit/NOTO - 1 week IInd year: 45 weeks (excludes one week of block classes) • Medical ICU - 4 weeks • Surgical ICU - 2 weeks • Pediatric ICU - 2 weeks • Adult Nephrology Ward - 8 weeks • Pediatric Nephrology Ward - 2 weeks • Nephrology OPD - 6 weeks • Dialysis Unit - 10 weeks (including Peritoneal Dialysis-PD) • Kidney Transplant Unit - 5 weeks • Operation Theatre - 4 weeks • Urology ward - 2 weeks C. Teaching/Learning methods Learning will be faculty facilitated self-directed, integrated with clinical experience. • Experiential learning • Reflective learning • Simulation based learning • Clinical conference • Case/clinical presentation • In depth drug study, presentation and report • Nursing rounds • E-learning, narrated presentations • Flipped classroom • Clinical seminars • Journal clubs52 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] • Case study/Clinical or care pathway • Advanced health assessment • Faculty lecture in the clinical area • Directed reading • Demonstrations, supervised skill practice • Assignments • Case study analysis • Workshops • Observation of procedures • Demonstration and supervised skill practice D. Procedures/Log Book At the end of each Clinical Posting, Clinical Log Book (Specific Procedural Competencies/Clinical Skills) (Appendix 3) and Clinical Requirements (Appendix 4) have to be signed by the preceptor/faculty every fortnight. E. Nurse Practitioner in Nephrology Nursing Competencies (Adapted from ICN, 2020) 1. Uses advanced comprehensive assessment, diagnosis, treatment planning, implementation, and evaluation skills. 2. Applies and adapts advanced skills in complex and/or unstable environments. 3. Applies sound advanced clinical reasoning and decision making to inform, guide and teach in practice. 4. Documents assessment, diagnosis, management and monitors treatment and follow-up care in partnership with the patient. 5. Administer drugs and treatments according to institutional protocols. 6. Uses applicable communication, counseling, advocacy and interpersonal skills to initiate, develop and discontinue therapeutic relationships. 7. Refers to and accepts referrals from other healthcare professionals to maintain continuity of care. 8. Practices independently where authorized and the regulatory framework allows in the interest of the patients, families and communities. 9. Consults with and is consulted by other healthcare professionals and others. 10. Works in collaboration with health team members in the interest of the patient. 11. Develops a practice that is based on current scientific evidence and incorporated into the health management of patients, families and communities. 12. Initiates, evaluates and manages evidence based practice. 13. Uses research to produce evidence based practice to improve the safety, efficiency and effectiveness of care through independent and inter-professional research. 14. Engages in ethical practice in all aspects of the APN role and responsibility. 15. Accepts accountability and responsibility for own advanced professional judgement, actions, and continued competence. 16. Creates and maintains a safe therapeutic environment through the use of risk management strategies and quality improvement. 17. Assumes leadership and management responsibilities in the delivery of efficient advanced practice nursing services in a changing healthcare system. 18. Acts as an advocate for patients in the healthcare systems and the development of health policies that promote and protect the individual patient, family and community. 19. Adapts practice to the contextual and cultural milieu. Core Competencies of ANNA (2020) 1. Advanced knowledge in nephrology that includes pathophysiology and management of kidney/urologic conditions and their complications. 2. Excellent interpersonal, communication, and critical thinking skills. 3. Advanced clinical skills in assessment, diagnosis and management of patients with kidney disorders that include kidney replacement therapy. 4. Sensitivity to the needs of patients and their families as they deal with kidney diseases and its impact. 5. Ability to teach patients about kidney diseases, treatment, and life style changes. 6. Ability to deal with grief and loss that can be associated with kidney disease. 7. Ability to work in a multidisciplinary team in care coordination.[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 53 F. Institutional Protocol/Standing Orders based administration of drugs & ordering of investigations and therapies The students will be trained to independently administer drugs and order diagnostic tests, procedures, medical equipment and therapies as per institutional protocols/standing orders (Appendix 5 Standing Orders). Administration of emergency drugs is carried out in consultation with concerned physician and endorsed later by written orders. Implementation of Curriculum - A Tentative Plan Ist year Courses Introductory Workshop Theory integrated Methods of Teaching Classes into Clinical (Topic can be specified) Practicum 1. Theoretical Basis for 8 hours 1×32 = 32 hours • Seminar/Theory Application Advanced Practice Nursing • Lecture (Faculty) (40) • Journal Presentation • Flipped Classroom 2. Research Application and 8 hours 40 (5 days) 1×24 = 24 hours • Research Study Analysis Evidence Based Practice in + 8 hours • Exercise/Assignment (Lab) Nephrology Nursing (56+24) 3. Advanced Skills in 4 hours 16 hours 1×26 = 26 hours • Clinical Conference Leadership, Management and (2 days) 2×16 = 32 hours • Seminar, Practice Teaching Teaching (56+24) • Workshop • Exercises/Assignment (Lab) 4. Advanced Pathophysiology 1.5×40 = 60 hours • Case Presentation applied to Nephrology • Seminar Nursing (60) • Clinical Conference • Concept Mapping 5. Advanced Pharmacology 10 hours 1×44 = 44 hours • Nursing Rounds applied to Nephrology • Drug Study Presentation Nursing (54) • Standing Orders • Lecture/Discussions • Drug Diary 6. Advanced Health/ Physical 8 hours 2×26 = 52 hours • Clinical Demonstration Assessment (70+48) 1.5×18 = 27 hours (Faculty) 1×15 = 15 hours • Return Demonstration 2×6 = 12 hours • Nursing Rounds 2×2 = 4 hours • Physical Assessment (all systems) • Case Study TOTAL 48 hours 48 hours 336 hours Ist year - Introductory classes = 1 week (48 hours), Workshop = 1 week (48 hours), 44 weeks = 7.5 hours per week (330/336 hours) IInd year Courses Theory and Skill Lab integrated Methods of Teaching 1 week Block Classes (48 hours) into Clinical Practicum 1. Foundations of Nephrology 9×16 = 144 hours • Demonstration Nursing Practice • Supervised Practice (96+48 hours) = 144 hours • Clinical Teaching • Case Study • Seminar • Clinical Conference • Faculty Lecture 2. Nephrology Nursing I 9×16 = 144 hours • Demonstration (96+48 hours) = 144 hours • Supervised Practice • Clinical Conference/Journal Club • Flipped Classroom • Seminar54 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] IInd year Courses Theory and Skill Lab integrated Methods of Teaching 1 week Block Classes (48 hours) into Clinical Practicum • Case Presentation • Drug Study (including Drug Interaction) • Nursing Rounds • Faculty Lecture • Reflective Learning • Narrated PPT, Video • Directed Reading 3. Nephrology Nursing II 9×16 = 144 hours • Demonstration (Lab) (96+48 hours) = 144 hours • Supervised Practice of Clinical Skills • Nursing Rounds • Clinical Conference/Journal Club • Seminar, Case Studies • Faculty Lecture • Reflective Learning Directed Reading, Literature Review IInd year: Block classes - 1 week, 45 weeks - 8.5/9 hours per week Topic for every teaching method will be specified in the detailed plan by the respective teacher/institution concerned. CORE COURSES I. Theoretical Basis for Advanced Practice Nursing COMPETENCIES 1. Analyses the global healthcare trends and challenges. 2. Analyses the impact of healthcare and education policies in India on nursing consulting the documents available. 3. Develops in depth understanding of the healthcare delivery system in India, and its challenges. 4. Applies economic principles relevant to delivery of healthcare services in critical care. 5. Manages and transforms health information to effect health outcomes such as cost, quality and satisfaction. 6. Accepts the accountability and responsibility in practicing the Nurse Practitioner’s roles and competencies. 7. Actively participates in collaborative practice involving all healthcare team members in critical care and performs the prescriptive roles within the authorized scope. 8. Engages in ethical practice having a sound knowledge of law, ethics and regulation of advanced nursing practice. 9. Uses the training opportunities provided through well planned preceptorship and performs safe and competent care applying nursing process/care pathways or clinical pathways. 10. Applies the knowledge of nursing theories in providing competent care to patients with kidney disorders. 11. Predicts future challenges of Nurse Practitioner’s roles in variety of healthcare settings particularly in India. Hours of Instruction: Theory: 40 hours S.No. Topic Hours 1. Global Health Care Challenges and Trends (Competency-1) 2 2. Health System in India 2 Health Care Delivery System in India - Changing Scenario (Competency-3) 3. National Health Planning - 5-Year Plans and National Health Policy (Competency-2) 2 4. Health Economics & Health Care Financing (Competency-4) 4 5. Health Information System including Nursing Informatics (Use of Computers) 4 (Competency-5) Advanced Practice Nursing (APN) 6. APN - Definition, Scope, Philosophy, Accountability, Roles & Responsibilities 3 (Collaborative Practice and Nurse Prescribing Roles) (Competency-6&7) 7. Regulation (Accreditation of Training Institutions and Credentialing) & 3 Ethical Dimensions of Advanced Nursing Practice Role (Competency-8) 8. Nurse Practitioner - Roles, Types, Competencies, Clinical Settings for Practice, Cultural 3 Competence (Competency-6) 9. Training for NPs - Preceptorship (Competency-9) 2 10. Future Challenges of NP Practice (Competency-11) 4[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 55 S.No. Topic Hours 11. Theories of Nursing applied to APN (Competency-10) 3 12. Nursing Process/Care Pathway applied to APN (Competency-9) 2 Self-Learning Assignments 6 1. Identify Health Care and Education Policies and analyze its impact on Nursing 2. Describe the legal position in India for NP practice. What is the future of nurse prescribing policies in India with relevance to these policies in other countries? 3. Examine the nursing protocols relevant to NP practice found in nephrology unit/kidney transplant unit/dialysis unit in your tertiary center Total 40 hours Bibliography • AACN (2021) The essentials: Core Competencies for Professional Nursing Education - Entry Level and Advanced Level Nursing Education, American Association of Colleges of Nursing • ANNA (2021) The Nephrology Nurses Scope and Standards of Practice: Standards of Professional Performance and Competencies, Nephrol Nurs J. 2022 Jul-Aug. • DeNisco & Barkers A.M. (2015) Advanced Practice Nursing: Essential Knowledge for the Profession (3rd ed.), Massachusetts: Jones & Bartlett Publishers Inc. • Hickey J.V., Ouimette R.M. & Venegoni S.L. (1996) Advanced Practice Nursing: Changing Roles and Clinical Applications, Philadelphia: Lippincott Williams & Wilkins • ICN (2020) Guidelines on Advanced Practice Nursing, Geneva: ICN • NONPF (2022) Nurse Practitioner Role Competencies, National Organization of Nurse Practitioner Faculties • Schober M. & Affara F.A. (2006) Advanced Nursing Practice, Oxford: Blackwell Publishing • Stewart G.J. & DeNisco S.M. (2015) Role Development for the Nurse Practitioner, USA: Springer Publishing Company II. Research Application and Evidence Based Practice in Nephrology Nursing COMPETENCIES 1. Applies sound research knowledge and skills in conducting independent research in Nephrology care setting. 2. Participates in collaborative research to improve patient care quality. 3. Interprets and uses research findings in advanced practice to produce EBP. 4. Tests/evaluates current practice to develop best practices and health outcomes and quality care in advanced practice. 5. Analyzes the evidence for nursing interventions carried out in Nephrology Nursing practice to promote safety and effectiveness of care. 6. Develops skill in writing scientific research reports. Hours of Instruction: Theory: 56 hours + Lab/Skill Lab: 24 hours = 80 hours S.No. Topic Hours 1 Research and Advanced Practice Nursing 2 Significance of research and inquiry related to advanced nursing role (Competency-1) 2 Research Agenda for APN Practice 5 Testing current practice to develop best practice, health outcomes and indicators of quality care in advanced practice (Competency-3,4,5), promoting research culture 3 Research Knowledge and Skills 40 Research competencies essential for APNs (interpretation and use of research, evaluation of (5 days practice, participation in collaborative research) workshop) Introduction to Evidence Based Practice (EBP) project - PiCOT question, steps of planning, implementation, evaluation and dissemination (project proposal and project report) Research Methodology Phases/steps (Research question, review of literature, conceptual framework, research designs, sampling, data collection, methods & tools, Analysis and Reporting) Writing research proposal and research report (Competency-1 & 2) 4 Writing for Publication 5 (Writing workshop - Manuscript preparation and finding funding sources) (Competency-6) (workshop) 5 Evidence Based Practice 4 - Concepts, principles, importance and steps56 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] S.No. Topic Hours - Integrating EBP to ICU environment - Areas of evidence in critical care - Barriers to implement EBP - Strategies to promote EBP (Competency-3,4,5) Total 56 hours Practical Learning & Assignments: 24 hours • Identifying research priorities • Writing exercises on research question, objectives and hypothesis • Prepare research proposal/EBP project proposal • Data Collection, analysis and interpretation • Scientific paper writing - preparation of manuscript for publication • Literature review - analyze the evidence for specific clinical practices in nephrology setting. Practicum • Dissertation (336 hours = 7 weeks)/Evidence Based Practice Project (EBP project) Bibliography • Gray J. & Grove S.K. (2020) Burns & Groves’ The Practice of Nursing Research: Appraisal, Synthesis and Generation of Evidence (9th ed.), St. Louis: Elsevier Saunders • Polit D.F. & Beck C.T. (2021) Nursing Research: Generating and Assessing Evidence for Nursing Practice (11th ed.), New Delhi: Wolters Kluwer • Schmidt N.A. & Brown J.M. (2021) Evidence Based Practice for Nurses’ Appraisal and Application of Research, Sd: Jones & Bartlett Publishers Inc. III. Advanced Skills in Leadership, Management and Teaching COMPETENCIES 1. Applies principles of leadership and management in Nephrology unit. 2. Manages stress and conflicts effectively in any Nephrology care setting using sound knowledge of principles. 3. Applies problem solving and decision-making skills effectively. 4. Uses critical thinking and communication skills in providing leadership and managing patients care in Nephrology care settings. 5. Builds teams and motivates others in Nephrology care settings. 6. Participates appropriately in times of innovation and change. 7. Uses effective teaching methods, media and evaluation based on sound principles of teaching. 8. Develops advocacy role in patient care, maintaining quality and ethics in care delivery. 9. Provides counseling to families and patients that facilitates shared decision making on treatment plans. Hours of Instruction: Theory: 56 hours + Lab/Skill Lab: 24 hours = 80 hours S.No. Topic Hours 1. Theories, styles of leadership and current trends 2 2. Theories, styles of management and current trends 2 3. Principles of leadership and management applied to Nephrology care settings 4 4. Stress management and conflict management - principles and application, effective time 4 management 5. Quality improvement and audit 4 6. Problem solving, critical thinking and decision making, communication skills applied to 5 Nephrology nursing practice 7. Team building, motivating and mentoring within Nephrology unit set up 2 8. Budgeting and management of resources including human resources - material, manpower, time 5 9. Change and innovation 2 10. Performance indicators for practice and performance measures 6 11. Teaching-learning theories and principles applied to Nephrology Nursing 2 12. Competency based education and outcome based education 2[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 57 S.No. Topic Hours 13. Teaching methods/strategies, media: educating patients and staff in Nephrology care settings 8 14. Staff education and use of tools in evaluation 4 15. APN - Roles as a teacher 2 16. Advocacy roles in Nephrology care environment 2 Total 56 hours Practice: 24 hours • Preparation of staff patient assignment • Patient care audit • Preparation of nursing care standards and protocols • Monitoring, evaluation, and writing report of infection control practices • Development of teaching plan for staff and patients using appropriate technology assisted teaching aids • Micro teaching/patient education sessions • Planning and conducting OSCE/OSPE • Quality Improvement Audit • Construction of tests • Performance indicators measurement Assignment • Prepare Nursing care standards for one of the Dialysis units Bibliography • Bastable S.B. (2019) Nurse as Educator: Principles of Teaching and Learning for Nursing Practice (5th ed.), New Delhi: Jones & Bartlett Publishers Inc. • Billings D.M. & Halstead J.A. (2019) Teaching in Nursing: A Guide for Faculty (6th ed.), St. Louis, Missouri: Saunders Elsevier • Clark C.C. (2010) Creative Nursing Leadership and Management, New Delhi: Jones & Bartlett Publishers Inc. • Liebler J.G. & McConnel C.R. (2008) Management Principles for Health Professionals, Sudbury, M.A: Jones & Bartlett Publishers Inc. • Roussel L. & Swansburg R.C. (2010) Management and Leadership for Nurse Administrators (5th ed.), New Delhi: Jones & Bartlett Publishers Inc. ADVANCED PRACTICE COURSES IV. Advanced Pathophysiology applied to Nephrology Nursing COMPETENCIES 1. Integrates the knowledge of pathophysiological process in kidney care in developing diagnosis and plan of care. 2. Applies the pathophysiological principles in symptom management and secondary prevention of complications related to kidney disease. 3. Analyzes the pathophysiological changes relevant to each condition requiring kidney transplant recognizing the value of diagnosis, treatment, care and prognosis. IV. A. Advanced Pathophysiology applied to Nephrology Nursing Hours of Instruction: Theory: 30 hours Unit Hours Content I 10 Review of Anatomy and Physiology of Kidneys and Urinary system • Macroscopic structure of Kidney, Ureter, Bladder • Microscopic structure of Kidney • Physiology of Urine Formation o Glomerular filtration o Tubular Reabsorption o Tubular secretion • Renin Angiotensin Mechanism • Functions of Kidney, Ureter, Bladder II 7 Fluid and Electrolyte Regulation and Imbalances • Fluid Distribution in the body58 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] Unit Hours Content • Fluid regulation mechanisms in the body • Electrolyte distribution, Role of Electrolytes (Sodium, potassium, calcium, phosphorus, magnesium) • Identifying and Managing Fluid and Electrolyte imbalances o Water o Sodium o Potassium o Phosphorous o Calcium o Magnesium III 5 Acid base Regulation and Imbalances • Acid Base regulatory mechanisms in the body • Compensatory mechanism • Effect of Acid Base balance in the body • Normal Values • Identifying Acid base imbalances • Interpretation of ABG analysis results IV 8 Anatomy and Physiology of related systems • Cardiac physiology • Interpretation of ECG • Respiratory system • Endocrine system • Nervous system Total 30 hours IV.B. Advanced Pathophysiology applied to Nephrology Nursing Hours of Instruction: Theory: 30 hours Unit Hours Content I 5 Hematological function • Composition of Blood • Types of blood cells • Formation of Blood cells • Blood Groups • Hematocrit • Clotting Mechanism • Common hematological problems in kidney disease II 3 Integumentary function Advanced pathophysiological process of integumentary conditions • Wound healing • Burns • Steven Johnson Syndrome • Skin changes in Kidney Disorders III 5 Multisystem dysfunction • Shock o Hypovolemic o Cardiogenic o Distributive • Systemic inflammatory syndrome • Multiple organ dysfunction syndrome • Sepsis • Drug overdose and poisoning • Envenomation IV 5 Specific infections Advanced pathophysiological process of specific infections • HIV[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 59 Unit Hours Content • Tetanus • SARS, COVID • Hepatitis A • Hepatitis B • Leptospirosis • Dengue • Malaria • Tuberculosis V 4 Reproductive functions • Kidney Injury from: o Antepartum hemorrhage o Pregnancy induced hypertension, Pre-eclampsia o HELLP (Hemolysis, Elevated Liver enzymes, Low Platelet Count) o Postpartum hemorrhage o Puerperal sepsis VI 8 Basic Immunology • Immunoglobulins • Antigen Antibody reactions • Cross matching • Cell mediated Immunity • Immediate and Delayed hypersensitivity • Autoimmunity • Transplant immunology • HLA Typing Total 30 hours Bibliography • Berkowitz A. (2021) Clinical Pathophysiology (2nd ed.), MedMaster Inc. • Huether S.E., McCance K.L. & Brashers V.L. (2019) Understanding Pathophysiology (7th ed.), St. Louis, Missouri: Elsevier • Norris T.L. (2020) Porth’s Essentials of Pathophysiology (5th ed.), Wolters Kluwer • Porth C.M. (2007) Essentials of Pathophysiology: Concepts of Altered Health States (4th ed.), Philadelphia: Lippincott Williams & Wilkins • Story L. & Dlugasch L. (2019) Advanced Pathophysiology for the Advanced Practice Nurse (1st ed.), Jones & Bartlett Publishers Inc. • Willis L.M. (2019) Professional Guide to Pathophysiology (4th ed.), LWW V. Advanced Pharmacology applied to Nephrology Nursing COMPETENCIES 1. Applies the pharmacological principles in providing care to patients with kidney disorders. 2. Analyzes pharmaco-therapeutics and pharmacodynamics relevant to drugs used in the treatment of nephrology conditions. 3. Performs safe drug administration based on principles and institutional protocols. 4. Documents accurately and provides follow up care. 5. Applies sound knowledge of drug interactions in administration of drugs to patients in the nephrology care settings and guiding their families in self-care management.60 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] Hours of Instruction: Theory: 54 hours Unit Hours Content I 2 Introduction to Pharmacology • History • Classification of drugs and schedules II 3 Pharmacokinetics and Pharmaco-dynamics • Introduction • Absorption, distribution, metabolism and excretion in critical care • Plasma concentration, half life • Loading and maintenance dose • Therapeutic index and drug safety • Potency and efficacy • Principles of drug administration o The rights of drug administration o Systems of measurement o Enteral drug administration o Topical drug administration o Parenteral drug administration III 5 Pharmacology and Cardiovascular alterations • Vasoactive Medications • Vasodilator, Vasopressors, Inotropes • Cardiac glycosides - Digoxin • Sympathomimetics - Dopamine, dobutamine, epinephrine, isoproterenol, norepinephrine, phenylephrine • Phosphodiesterase inhibitors - amrinone, milrinone • Antiarrhythmic Medications • Cardiac conditions • Medications to improve cardiac contractility • Medications in the management of heart failure • Medications in the management of angina pectoris and myocardial infarction • Medications in the management of dysrhythmias, Heart block and conduction disturbances • Medications in the management of Pulmonary hypertension, • Medications in the management of Atherosclerotic disease of aorta and Peripheral artery disease • Medications in the management of Deep vein thrombosis IV 4 Medications in management of infection Indications, Mechanism of action, Dose, route, Administration guidelines, Adverse effects of drugs under: • Antibacterial drugs • Antibiotics against o Gram positive bacteria o Gram negative bacteria • First, Second, Third and Fourth generation antibiotics • Antibiotic resistance • Antifungal agents • Antiviral agents • Antiprotozoal drugs V 4 Medications in Management of Hypertension • Diuretics • Calcium channel blockers • Beta adrenergic blockers • Alpha Adrenergic blockers • Angiotensin Converting Enzyme inhibitors • Angiotensin Receptor Blockers[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 61 Unit Hours Content VI 5 Medications in Management of Hyperglycemia (Glucose Lowering Agents) • Sulfonylureas (glipizide, glyburide, gliclazide, glimepiride) • Meglitinides (repaglinide and nateglinide) • Biguanides (metformin) • Thiazolidinediones (rosiglitazone, pioglitazone) • α-Glucosidase inhibitors (acarbose, miglitol, voglibose) • DPP-4 inhibitors (Sitagliptin, Saxagliptin, Vildagliptin, Linagliptin, Alogliptin) • SGLT2 inhibitors (Dapagliflozin and Canagliflozin) • Cycloset (Bromocriptine) Insulin • Rapid-acting insulin • Short-acting insulin • Intermediate-acting insulin • Mixed insulin • Long-acting insulin VII 4 Pharmacology and Pulmonary alterations • Medications used on patients on mechanical ventilation • Medications in the management of Pulmonary edema • Medications in the management of Pulmonary embolism • Medications in the management of Acute respiratory failure and acute respiratory distress syndrome • Medications in the management of Chronic obstructive pulmonary disease • Medications in the management of Pneumonia • Medications in the management of Pleural effusion VIII 6 Pharmacology in management of Pain and anxiety • Pain o NSAID o Opioid analgesia • Sedation o Gamma amino butyric acid stimulants o Dexmedetomidine o Analgosedation • Delirium o Haloperidol o Atypical anti-psychotics • Medications used for local and general anesthesia o Local - Amides, esters, and miscellaneous agents o General - Gases, Volatile liquids, IV anesthetics o Non anesthetic drugs adjuncts to surgery • Paralytic Medications o Non-depolarizing and depolarizing agents o Anxiolytics • Autonomic drugs o Adrenergic agents/Sympathomimetics o Adrenergic blocking agents o Cholinergic agents o Anti-cholinergic agents • Medications in the management of anxiety and insomnia o Antidepressants o Benzodiazepines o Barbiturates IX 7 Pharmacology and Nephrology alterations • Diuretics • Fluid replacement o Crystalloids o Colloids • Electrolytes62 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] Unit Hours Content o Sodium o Potassium o Calcium o Magnesium o Phosphorus • Nephrology conditions o Medications in the management of Acute/Chronic Kidney Disease o Medications in the management of Acute tubular necrosis • Medications in the management of Bladder Outlet Obstructions o Medications in the management of Electrolyte imbalances o Medications in the management of Acid base imbalances o Medications used during dialysis o Nephrotoxic drugs • Standing orders for nephrology critical care emergencies X 4 Pharmacology and Gastrointestinal alterations • Anti-ulcer drugs • Laxatives • Anti diarrheal • Anti emetics • Pancreatic enzymes • Nutritional supplements, Vitamins and minerals XI 4 Pharmacology and Hematology alterations in Nephrology • Anticoagulants • Antiplatelet drugs • Thrombolytics • Hemostatic/antifibrinolytics • Hematopoietic growth factors o Erythropoietin o Colony stimulating factors o Platelet enhancers • Blood & Blood Components • Vaccines XII 6 Immunosuppressant Drugs in Nephrology • Induction agents o Polyclonal antibodies (ATG) o Interleukin 2 receptor antagonists (Basiliximab) • Maintenance Therapy o Calcineurin inhibitors (Cyclosporin, Tacrolimus) o mTOR inhibitors (Sirolimus, Everolimus) o Antiproliferative agents (Azathioprine, Mycophenolic acid) o Corticosteroids (Prednisolone) • Treatment for rejection • Corticosteroids, ATG, IVIG Total 54 hours Bibliography • Hari Varun Kalluri, Karen L. Hardinger, Current State of Renal Transplant Immunosuppression: Present and Future, World J Transplant 2012 Aug (24), 2(4): 51-68 • Eisen H.J. (2020) Pharmacology of Immunosuppression (1st ed.), Springer • McKay G.A. & Walters M.R. (2021) Clinical Pharmacology and Therapeutics (10th ed.), Wiley-Blackwell • SHERYL F. VONDRACEK & ISAAC TEITEBAUM, PRINCIPLES OF KIDNEY PHARMACOTHERAPY FOR THE NEPHROLOGIST: CORE CURRICULUM 2021, NATIONAL KIDNEY FOUNDATION, AMERICAN JOURNAL OF KIDNEY DISEASES, JULY 16 2021 • Wynne A.L., Woo T.M., Sheryl & Olyaei A.J. (2007) Pharmacotherapeutics for Nurse Practitioner Prescribers (2nd ed.), Philadelphia: Davis[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 63 VI. Advanced Health/Physical Assessment COMPETENCIES 1. Applies the physical assessment principles in developing appropriate system wise examination skills. 2. Uses advanced health assessment skills to differentiate between variations of normal and abnormal findings. 3. Orders screening and diagnostic tests based on the examination findings and institutional protocols. 4. Analyzes the physical examination findings and results of various investigations and works collaboratively with nephrologists for development of diagnoses. 5. Documents assessment, diagnosis, and management and monitors follow up care in partnership with healthcare team members, patients, and families. Hours of Instruction: Theory: 70 hours + Lab/Skill Lab: 48 hours = 118 hours Unit Hours Content I 4 Introduction • Essentials of effective communication • Principles of professional communication • Components in history collection and physical assessment II 6 Cardiovascular system • Cardiac history • Physical examination • Cardiac laboratory studies - biochemical markers, hematological studies • Cardiac diagnostic studies - electrocardiogram, echocardiography, stress testing, radiological imaging, coronary angiogram III 6 Respiratory system • History • Physical examination • Respiratory monitoring - arterial blood gases, pulse oximetry, end-tidal carbon dioxide monitoring • Respiratory diagnostic tests - chest radiography, ventilation perfusion scanning, pulmonary angiography, bronchoscopy, thoracentesis, sputum culture, pulmonary function tests, ultrasound, lung biopsy IV 6 Nervous system • Neurological history • General physical examination • Assessment of cognitive function • Assessment of cranial nerve function • GCS • Motor assessment - muscle strength, power, and reflexes • Sensory assessment - dermatome assessment • Neurodiagnostic studies - CT scan, MRI, PET V 6 Renal system • History • Physical examination • Assessment of renal function - lab studies, diagnostic tests o Urine Analysis o Blood studies o X-ray KUB o Ultrasound Kidneys, Kidney Biopsy o Renal Doppler o Renal Angiogram o Estimation of GFR o Residual renal function • Assessment of electrolytes and acid base balance • Assessment of fluid balance VI 5 Gastrointestinal system • History • Physical examination64 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] Unit Hours Content • Nutritional assessment • Laboratory studies - liver function studies, blood parameters, stool test • Diagnostic studies - radiological and imaging studies, endoscopic studies VII 5 Endocrine system • History • Physical examination • Laboratory studies, and diagnostic studies of o Hypothalamus and pituitary gland o Thyroid gland o Parathyroid gland o Pancreas o Adrenal gland VIII 5 Hematological system • History • Physical examination • Laboratory studies - blood parameters • Diagnostic studies IX 3 Integumentary system • History • Physical examination X 6 Musculoskeletal system • History • Physical examination - gait assessment, joint assessment, • Laboratory studies - blood parameters (inflammatory enzymes, uric acid) • Diagnostic studies - specific radiological and imaging studies, endoscopic studies related to renal disorders XI 5 Reproductive system (Male & Female) • History • Physical examination • Laboratory studies • Diagnostic studies XII 4 Assessment of Eye, Ear, Nose, Throat • Basic assessment of ENT • Identify changes in the eye related to hypertension, diabetes and drug effects XIII 4 Assessment of children • Growth and development • Nutritional assessment • Specific system assessment XIV 5 Assessment of older adults • History • Physical assessment considering age related changes • Psychological assessment • Specific system assessment Total 70 hours List of skills to be practiced (48 hours include demonstration by the faculty and practice by the students) • Comprehensive history taking • Focused history taking (system-wise) • Comprehensive physical examination • Focused physical examination (system-wise) • Monitoring clinical parameters (system-wise) o Invasive BP monitoring, Multi-parameter Monitors, ECG, Peripheral vascular status, ABG, Pulse Oximeter, Intracranial Pressure (ICP), Glasgow Coma Scale (GCS), Cranial nerve assessment, Pain and Sedation score[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 65 of critically ill, Motor assessment, Sensory assessment, Renal function tests, Fluid balance, acid base balance, electrolytes, Bowel sounds, Liver function tests, GRBS, Lab tests, Radiological and Imaging tests (system wise), Grading of edema • Ordering and interpretation of screening and diagnostic tests (system-wise) (Enclosed Appendix-3) • Estimation of GFR • Assessment of AV Fistula • Assessment of CVC • Assessment of PD catheter site Bibliography • Bickley L.S. & Szilagyi P.G. (2013) Bates’ Guide to Physical Examination and History Taking (11th ed.), New Delhi: Lippincott Williams & Wilkins. • Rhoads J. (2006) Advanced Health Assessment and Diagnostic Reasoning, Philadelphia: Lippincott Williams & Wilkins • Wilson S.F. & Giddens J.F. (2006) Health Assessment for Nursing Practice (4th ed.), St. Louis, Missouri: Saunders Elsevier NEPHROLOGY NURSING SPECIALTY COURSES (Foundations of Nephrology Nursing Practice, Nephrology Nursing I and Nephrology Nursing II) VII. Foundations of Nephrology Nursing Practice COMPETENCIES 1. Applies advanced concepts of Nephrology nursing in assessment, diagnosis and management of kidney disorders. 2. Uses invasive and noninvasive technology and interventions to assess, monitor and promote physiologic stability. 3. Works in collaboration with other healthcare team members and prepares care/clinical pathways in assessment, diagnosis and management of patients with varied nephrology conditions. 4. Provides nursing care related to health protection, disease prevention, anticipatory guidance, counseling, management of kidney disorders, palliative care and end of life care. 5. Uses advanced skills in assessment, diagnosis and management of patients with common nephrology conditions. 6. Applies ethically sound solutions to issues related to individuals, populations and systems of care. 7. Practices principles of infection control relevant to nephrology settings. 8. Practices independently within the legal framework of the country towards the interest of patients, families and communities. 9. Develops practice that is based on scientific evidence. 10. Uses applicable communication, counseling, advocacy and interpersonal skills to initiate, develop and discontinue therapeutic relationships. 11. Creates and maintains a safe therapeutic environment using risk management strategies and quality improvement. 12. Adapts practice to the social, cultural and contextual milieu. Hours of Instruction: Theory: 96 hours + Lab/Skill Lab: 48 hours = 144 hours Unit Hours Content I 10 Introduction to Nephrology Nursing • Introduction to the course • History & Scope of Nephrology nursing • Gross Anatomy, Embryology, Histology including Electron • Microscopy study of the Kidney • Renal circulation and Glomerular ultrafiltration • Solute transport/Both Organic and inorganic • Renal Acidification • Urine Concentration & Dilution • Role of Kidney in Blood pressure regulation • Endocrine and Autocrine functions of the kidney • Setting up of Nephrology ward, Dialysis Unit and Transplant Unit, Nephrology ICU66 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] Unit Hours Content II 5 Epidemiology of Kidney Disease • Epidemiology of Kidney Disease • Risk Factors and Kidney Disease • Nephron Endowment • Gender and Kidney Disease • Aging and Kidney Disease III 10 Integrated control of body fluid volume and composition • Vasoactive peptides/Arachidonic Acid Metabolites • Sodium-Water Balance • Potassium Balance • Acid Base Balance • Calcium and Phosphorus Metabolism • Magnesium metabolism • Renal Handling of Uric acid IV 12 Advanced Concepts and Principles in care of critically ill in Nephrology • Principles of cardio-pulmonary-brain resuscitation • Managing Emergencies: • BLS • ACLS • Airway management • Oxygenation and oximetry, care of patient with oxygen delivery devices • Ventilation and ventilator support (including humidification and inhaled drug therapy), care of patient with invasive and non-invasive ventilation • Circulation and perfusion (including hemodynamic evaluation and waveform graphics) • Evaluation of acid base status, fluid and electrolyte status • Thermoregulation, care of patient with hyper/hypothermia • Liberation from life support (Weaning) • Glycemic control, care of patient with glycemic imbalances • Monitoring and improving kidney function in critically ill • Common drugs and drug delivery modes in management of critically ill patients V 8 Approach to the patient with kidney disease • Laboratory Assessment of Kidney Disease including Biopsy • Interpretation of Electrolyte and Acid-Base Parameters in Blood and Urine • Adaptation to Nephron Loss • Renal and Systemic Manifestations of Glomerular Disease • Diagnostic Kidney Imaging VI 6 Psychosocial, Spiritual and Sleep alterations: Assessment and management • Stress and psychoneuroimmunology • Spiritual challenges • Coping with stress and illness • Counseling and communication • Grief Counseling • Assessing the Sleep Quality, Sleep hygiene • Anxiolytics, Sedatives and Relaxants • End of Life Care and After Life Services VII 6 Patient and family education and counseling • Challenges of patient and family education • Process of adult learning • Assessing health literacy • Factors affecting teaching learning process • Informational needs of patients and families • Counseling needs of patient and family • Counseling techniques VIII 6 Nutrition Alterations and Management in Kidney Disorders • Nutrient metabolism and alterations • Assessing nutritional status[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 67 Unit Hours Content • Nutritional Considerations in o Chronic Kidney Disease o Hemodialysis, PD o Nephrotic syndrome o Hypertension o Diabetes mellitus IX 6 Holistic Care for patients with Kidney Disorders • Integrative Care Model • Multidisciplinary care - Role of Dietician, Social worker, Occupational therapist, Physiotherapist, Counselor, Doctor, Nurse • Shared Decision-Making Model • Patient Rights, Responsibilities • Nursing Process application in care of patients with Kidney disorders • Government and private schemes available for treatment support of patients with kidney disorders • CKD Registry, care coordination between settings • National and International Organizations in Nephrology X 5 Infection Control Practices in Nephrology setting • Breaking the Chain of Infection • Standard precautions • Use of PPE - Indications • Biohazard protocols • Disposal and segregation of Waste • Infection control practices in Dialysis Unit, Renal Transplant Unit XI 8 Bioethics in Nephrology Nursing • Difference between morals and ethics • Ethical principles, ethical decision making in nephrology care, strategies for promoting ethical decision making • Withholding and withdrawing treatment • Managing scarce resource • Brain death, organ donation & counseling • Renal Transplantation-related laws in India • Do Not Resuscitate (DNR), Euthanasia, Living will • Issues giving raise to civil litigation • Medical futility • Administrative law: Professional regulation • Tort law: Negligence, professional malpractice, intentional torts, wrongful death, defamation, assault and battery • Constitutional Law: Patient decision making XII 8 Quality Assurance in Nephrology settings • Continuous Quality Improvement • Quality Accreditation bodies in India - Nephrology • Ward, Dialysis Unit, Transplant Unit • Standards, Protocols, Policies, Procedures • Infection control policies and protocols • Standard safety measures • Nursing audits • Microbiology surveillance • Monitoring of water quality • Performance Indicators in Nephrology and Measures 6 Class tests Total 96 hours List of skills to be practiced (48 hours include demonstration by the faculty and practice by the students) • Comprehensive Renal Assessment68 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] • CPR (BLS and ACLS) • Airway Management o Laryngeal mask airway o Cuff inflation and anchoring the tube o Care of ET tube o Tracheostomy care o Suctioning - open/closed o Chest physiotherapy • Oxygenation and oximetry, care of patient with oxygen delivery devices o Devices to measure oxygen/oxygenation o Oximetry - Pulse oximetry • Noninvasive ventilation o Low flow variable performance devices: nasal catheters/cannulae/double nasal prongs, face mask, face mask with reservoir bags o High flow fixed performance devices: Entrainment (Venturi) devices, NIV/CPAP/Anesthetic masks, T pieces, breathing circuits o Postural drainage • Ventilation and ventilator support o Connecting to ventilator o Weaning from ventilator o Extubation o Humidifiers o Nebulizers - jet, ultrasonic • Inhalation therapy - metered dose inhalers (MDI), dry powder inhalers (DPI) • Circulation and perfusion (including hemodynamic evaluation and waveform graphics) o Invasive blood pressure monitoring o Non-invasive BP monitoring o Venous pressure (Peripheral, Central and Pulmonary artery occlusion pressure) o Insertion and removal of arterial line o Insertion and removal of central line o Electrocardiography (ECG) • Fluids and electrolytes o Fluid calculation and administration (crystalloids and colloids) o Administration of blood and blood products o Inotrope calculation, titration and administration o Cardiac glycosides - Digoxin o Sympathomimetics - Dopamine, dobutamine, epinephrine, isoproterenol, norepinephrine, phenylephrine o Electrolyte correction (Sodium, potassium, calcium, phosphorus, magnesium) o Use of fluid dispenser and infusion pumps • Evaluation of acid base status o Arterial blood gas (ABG) • Glycemic control, care of patient with glycemic imbalances o Monitoring GRBS o Insulin therapy (sliding scale and infusion) o Management of hyperglycemia - IV fluids, insulin therapy, potassium supplementation o Management of hypoglycemia - Dextrose IV • Counseling • Family education • Nutritional assessment • Therapeutic diet for kidney disorders • Quality Improvement audit VIII. Nephrology Nursing I Hours of Instruction: Theory: 96 hours + Lab/Skill Lab: 48 hours = 144 hours Unit Hours Content I 10 Acute Kidney Injury and Tubulointerstitial Diseases • Etiology, pathophysiology and classification of AKI • Etiology, pathophysiology, clinical manifestations, diagnosis and management of o Acute and Chronic Tubular Nephritis[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 69 Unit Hours Content o Contrast nephropathy o Analgesic nephropathy o Heavy metal nephropathy o Myeloma related kidney disease II 15 Glomerular Disease - Primary and Secondary • Classification of Glomerular diseases • Etiology, pathophysiology, clinical manifestation, diagnosis and management of: o Membranoproliferative glomerulonephritis (MPGN) o Minimal Change Disease o Focal Segmental Glomerulosclerosis (FSGS) o Membranous nephropathy o IgA Nephropathy o Rapidly Progressive Glomerulonephritis (RPGN) o Lupus Nephritis o Diabetes Nephropathy o Nephrotic syndrome II 4 Micro and Macrovascular Diseases of Kidney • Renal Artery Stenosis • Renal Vein Thrombosis • Systemic Lupus Erythematosus • Poly Arteritis Nodosa III 7 Urinary tract obstruction and Obstructive Nephropathy • Renal Calculi • Benign Prostatic Hypertrophy • Bladder Outlet Obstruction • Bladder Tumor IV 6 Infections • Pyelonephritis - Acute, Chronic • TB Kidney • COVID and Kidneys V 10 Chronic Kidney Disease • Etiology, Pathophysiology, clinical manifestation • Staging • Diagnosis • Management of CKD VI 8 Renal Neoplasia • Kidney disease in tropics • Pregnancy and kidney diseases • Systemic diseases that affect Kidneys VII 8 Inherited Diseases of the Kidney • Inherited Disorders of Podocyte Function • Inherited Disorders of the Renal Tubule • Cystic Diseases of the Kidney VIII 6 Hypertension and Kidney Disease • Primary and Secondary Hypertension • Renovascular Hypertension and Ischemic Nephropathy • Hypertension and Kidney Disease in Pregnancy IX 6 Diabetes and Kidney Disease • Nephropathy • Glycemic control, care of patient with glycemic imbalances • Diabetic Monitoring GRBS • Insulin therapy (sliding scale and infusion) • Management of Hyperglycemia - IV fluids, insulin therapy, potassium supplementation • Management of hypoglycemia70 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] Unit Hours Content IX 10 Pediatric Nephrology • Developmental nephrology • Congenital diseases of the kidneys, ureters, urinary bladder and urethra. • Glomerular and tubular diseases • Systemic diseases affecting the kidney • Acute and Chronic Kidney Failure • Dialysis and Transplantation with respect to Pediatric Nephrology 6 Class tests Total 96 hours List of skills to be practiced (48 hours include demonstration by the faculty and practice by the students). • Estimation of GFR • Staging of CKD • Classification of AKI • Interpretation of physical assessment and lab findings for clinical diagnosis • History collection and physical assessment of patients with o AKI o CKD o Common glomerular disorders o Lupus nephritis o Tubulointerstitial disease • Case study and presentation of common kidney disorders (4) • Assist Renal biopsy (5) • Perform Renal biopsy (10) • Interpreting Renal Biopsy findings - LM, IF (10) • Drug studies (8) Bibliography • Donna D. Ignatavicius, M. Linda Workman & Mary A-Misher (2021) Medical-Surgical Nursing: Concepts for Interprofessional Collaborative Care (10th ed.), St. Louis: Philadelphia: Elsevier • Hinkle L. Janice & Suresh K. Sharma (2018) Brunner & Suddarath’s Textbook of Medical Surgical Nursing (South Asian Edition) Volume 2 • John Reynard & Simon F. Lewster (2019) Oxford Handbook of Urology (4th ed.), Oxford University Press • Nicola Thomas (2008) Renal Nursing: Care and Management of People with Kidney Disease (5th ed.), Kluwer: Edinburgh • Norma J. Gomez (2022) Nephrology Nursing: Scope and Standards of Practice (9th ed.) • Sandra M. Bodin (2022) Contemporary Nephrology Nursing (4th ed.), American Nephrology Nurses Association • Susanne A. Qualich & Michelle J. Lajiness (2020) Nurse Practitioner in Urology (2nd ed.), Springer Publications • Tinawi M. (2020) Update on the Etiology, Classification and Management of Glomerular Diseases. Avicenna J Med. 2020 Apr-Jun; 10(2): 61–67 IX. Nephrology Nursing II Hours of Instruction: Theory: 96 hours + Lab/Skill Lab: 48 hours = 144 hours Unit Hours Content I 25 Hemodialysis (HD) • History and Overview • Principles and Concepts • Procedure of hemodialysis • Initiating patients on HD: Guidelines • Dialysis machine - Parts, functioning • Dialysis efficiency • Dry weight assessment • Dialysis Adequacy • Assessment of patients before, during and after HD[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 71 Unit Hours Content • Complications in HD: Prevention, Identification, Management • Dialysis Modalities including CRRT • CVC as Vascular access and Guidelines in CVC care • Arterio-Venous Fistula and AV graft as Vascular access and evidence based guidelines in management of AVF and AVG • Assessment of Vascular access • Vascular access related complications - Identification and management • UF and Sodium Profiling • Bicarbonate preparation • Disinfection protocols - Machine, RO tank, pipelines • Assurance of water quality (Purification process, Surveillance) • Nutritional considerations in HD • Comprehensive, holistic care of patients on HD • Insertion of CVC - temporary, permanent • Plasmapheresis • Infection Control Practices • Quality Assurance in HD • Recent trends and developments in HD II 20 Peritoneal Dialysis (PD) • History and overview • Principles and Concepts in PD • Types of PD modalities including Automated PD • PD Exchange procedure • Selection of patients for PD based on assessment • PD prescription, PET, PD fluids • PD Adequacy • Infectious and non-infectious complications of PD: Identification and management • PD catheter insertion - percutaneous and Open • Care of patients before, during and following PD catheter insertion • Identification and management of peritonitis • Advantages and Disadvantages of PD • Nutritional Considerations in PD • Education and Counseling of patients and families • Evidence based practices in PD • Comprehensive and Holistic care of patients on PD and their families • Recent trends in PD III 25 Kidney Transplant • History and Overview • Surgical Procedure • Types of Transplants • Preparation of Donor and recipients for Transplant • Transplant Immunology • Early and late complications of Kidney Transplant - Identification and management • Graft rejection: prevention, identification, management • Drug assays, Immuno-suppressant therapy • Care of patients following kidney transplant • Fluid management protocol in RTU • Infection Control practices in RTU • Donor and recipient follow-up • Standing orders in RTU • Drug protocols • Microbiology Surveillance, Quality Assurance in PD • Recent trends and developments in kidney transplant therapy • NOTTO IV 4 Healthy Living Post-transplant72 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] Unit Hours Content • Discharge preparation of donor and recipient • Rehabilitation & follow up • Healthy lifestyle including nutrition, rest, exercise • Health risks and surveillance post-transplant • Sexuality • Safe living after transplantation • QOL issues - post transplant V 4 Psycho-social issues in Transplantation • Psychological impact of transplant in donor and recipient • Psychosocial assessment of donor and recipient • Prevention: multidisciplinary care • Role of nurse • Role of support groups VI 4 Transplant in Children • Donor • Receipt clinical concerns following organ transplantation in children VII 4 Education and Counselling • Right to the correct information • Principles of adult learning • Effective communication skills • Preparation of information sharing tools • Shared decision-making process • Education methods and strategies VIII 4 Special Considerations • HD in Acutely ill patients • Acute PD • PD in pregnancy • Management of Anemia • Dialysis and Transplant in children and elderly 6 Class tests Total 96 hours List of skills to be practiced (48 hours include demonstration by the faculty and practice by the students). Hemodialysis • Pre, Intra, Post dialysis assessment • Assessment of Vascular Access - CVC, AVF, AVG • CVC site care • Dry Weight assessment - clinical and bio-impedance method • UF calculation, programming machine, starting HD • Closing HD • Bicarb preparation • Heparin preparation • Drug reciliation • Estimating URR, Kt/V, Assess dialysis adequacy • Prescribe routine investigations and follow up results • HD prescription • Prescription of common drugs based on lab reports: Erythropoietin, Phosphorous binders, Calcium and Vitamin D supplements, Antihypertensives, OGLA • Insulin dose adjustment • Perform varied dialysis modalities - SCUF, Isolated UF, SLED, CRRT • Perform Plasmapheresis • Calculate plasma volume for removal • Insertion of CVC into femoral and jugular vein[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 73 • Urine culture - SPC • CVC removal • Blood culture • Ascitic tap Peritoneal Dialysis • Assess and Select patients for PD • Perform PET, Determine PD prescription • Perform PD exchanges • Collect PD Fluid for culture • Identify and manage Exit site infection, Tunnel infection and peritonitis • Administer intraperitoneal antibiotics • Alter PD prescription based on clinical assessment and PET • Assess Dialysis adequacy including Kt/V • Identify and manage noninfectious complications of PD The skills listed under the Specialty courses such as Foundations of Nephrology Nursing Practice, Nephrology Nursing I and Nephrology Nursing II are taught by the faculty in skill lab. The students after practicing them in the lab, will continue to practice in the respective clinical areas. The log book specifies all the requirements to be completed and the list of skills that are to be signed by the preceptor once the students develop proficiency in doing the skills independently. Bibliography • Dakshinamurty K.V., Sivakumar V. & Sangeetha Lakshmi (2017) Peritoneal Dialysis Primer (1st ed.), Biocon India Limited • Danowich (2018) Handbook of Kidney Transplantation (6th ed.), Wolters Kluwer • John T. Daugridas & Peter G. Blake (2015) Handbook of Dialysis (South Asian 5th ed.), Wolters Kluwer • Joyce M. Black (2009) Medical-Surgical Nursing: Clinical Management for Positive Outcomes (8th ed.), USA: W.B. Saunders Company • Richard J. Johnson, Jurgen Floege & Marcello Tonelli (2023) Comprehensive Clinical Nephrology (7th ed.), Elsevier’s Company Appendix-1 EQUIPMENT LIST FOR A NEPHROLOGY UNIT (20 beds) 1. Adjustable electronic cot with mattress - 20 2. IV stand - 10 3. Bed side locker - 20 4. Over bed trolley - 10 5. Dressing trolley (small) - 5 6. Dressing trolley (medium) - 2 7. Syringe pump - 4 8. Infusion pump - 5 9. Monitors - 5 10. Transport monitor/pulse oximeter - 5 11. ECG machine - 1 12. Ultrasound machine - 1 13. CART trolley - 1 14. Defibrillator - 1 15. Alpha mattress with motor - 3 16. Transfer trolley - 4 17. OR trolley - 2 18. Safe slider - 2 19. Computer - 2 20. Printer - 1 21. Bain circuit - 12 22. Oxygen flow meter - 20 23. Suction port with jar - 20 24. Air flow meter/pulmoaid - 5 25. Refrigerator - 2 (feeds - 1, drugs - 1) 26. Metal foot step/foot stool - 574 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] 27. Ambulation chair - 5 28. UPS - 1 29. Flat trolley - 1 30. Labelling machine - 1 31. Glucometer - 2 32. Ambu bag with different sizes - 2 sets Hemodialysis Unit (10 beds) - some of the listed requirement may vary based on the number of dialysis shifts 1. Dialysis machines -10 2. Bicarbonate preparation tank - 1 3. Water treatment plant with RO, Endotoxin filter - 1 4. Dialysis pipelines that are compatible to chemical/heat disinfection 5. Dialyzers and tubings 6. Infusion pump - 1 7. Syringe pump - 1 8. Patient monitors - 5 9. CART trolley - 1 10. Defibrillator - 1 11. Vacuum and oxygen lines for all the beds 12. Oxygen flow meters - 10 13. Ventilator - 1 14. Cannulation sets - 20 15. CVC sets - 20 16. Machine reprocessing unit (if dialyzers are reused) 17. Computers - 2 18. Printer - 1 19. Small dressing trolleys - 10 20. Large dressing trolley - 1 21. Over bed tables - 10 22. Cots/Dialysis chairs - 10 23. Minor OR with OR table, Lights - 1 (for procedures as CVC and PD catheter insertions) 24. Electronic platform weighing scale - 1 25. Electronic BP monitor - 1 26. Pulse oximeter - 2 27. Glucometer - 2 28. Wheel chairs - 5 29. Stretcher - 2 30. Storage racks 31. Filing cabinets 32. Refrigerators - 2 Renal Transplant Unit - 5 beds 1. Infusion pumps - 4 2. Syringe pump - 2 3. Patient Monitors - 5 4. CART trolley - 1 5. Defibrillator - 1 6. vacuum and oxygen lines for all the beds 7. Oxygen flow meters - 5 8. Ventilator - 1 9. Freezer - 1 10. Refrigerator - 2 11. Microwave oven - 1 12. Computers - 2 13. Printer - 1 14. Small dressing trolleys - 5 15. Large dressing trolley - 1 16. Over bed tables - 5 17. Adjustable cots - 5 18. AC with HEPA filter - 1 19. Electronic weighing scale - 1 20. Electronic BP monitor - 1[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 75 21. Pulse oximeter - 2 22. Glucometer - 2 23. Wheel chairs - 3 24. Stretcher - 2 25. Ambulation chairs - 5 Appendix-2 ASSESSMENT GUIDELINES (including OSCE guidelines) INTERNAL ASSESSMENT (Theory and Practical) Ist year 1. Theoretical Basis for Advanced Practice Nursing College examination of theory only: 50 marks Internal assessment: Test paper/Quiz: 10 marks Written assignment/term paper: 10 marks (Global and national healthcare trends & policies) Clinical seminar: 5 marks (Clinical/Care pathway in specific clinical condition/Application of specific nursing theory) Final theory college exam: 25 marks Total marks: 50 marks 2. Research Application and Evidence Based Practice in Nephrology Nursing Theory: Test papers: 20 marks Written assignment: 5 marks (Literature review/Preparation of research instrument) Journal club : 5 marks (Analysis of research evidence for competencies in Nephrology Nursing) Total : 30 marks 3. Advanced Skills in Leadership, Management and Teaching Theory: Test papers: 15 marks Journal club: 5 marks (Trends in Leadership/Management/Teaching) Written assignment: 5 marks (Designing an ideal Dialysis Unit and Renal Transplant Unit) Microteaching: 5 marks Total : 30 marks 4. Advanced Pathophysiology & Advanced Pharmacology applied to Nephrology Nursing Theory: Test papers and Quiz: 20 marks (Pathophysiology - 10, Pharmacology - 10) Drug studies:5 marks (Drug study and presentation) Case presentation and case study report (Pathophysiology): 5 marks Total : 30 Marks 5. Advanced Health/Physical Assessment Theory: Test papers: 20 marks Written assignment: 10 marks (Diagnostic/investigatory reports - interpretation and analysis of findings) Total: 30 marks Practicum: Clinical performance evaluation: 10 marks End of posting exam (OSCE): 10 marks Case presentation and case study report: 5 marks Internal OSCE: 25 marks Total Internal practical: 50 marks (End of posting exam may be conducted in nephrology ward, Hemodialysis unit, Peritoneal dialysis unit or transplant unit)76 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] IInd year 1. Foundations of Nephrology Nursing Practice Theory: Test papers and Quiz: 20 marks Written assignment: 10 marks Total: 30 marks Practicum: Clinical Performance evaluation: 20 marks End of posting exam (OSCE): 10 marks Drug studies (Drug study and presentation): 10 marks Case presentation and case study report (Family education/counseling): 5 marks Case presentation (Application of Clinical/Care Pathway): 5 marks Internal OSCE: 50 marks Total Internal practical: 100 marks 2. Nephrology Nursing I Theory: Test papers and Quiz: 20 marks Clinical seminar and Journal club: 10 marks Total: 30 marks Practicum: Clinical performance evaluation: 20 marks End of posting exam (OSCE): 10 marks Clinical presentation: 10 marks Case study report: 10 marks Internal OSCE: 50 marks Total Internal practical: 100 marks 3. Nephrology Nursing II Theory: Test papers: 20 marks Clinical Seminar: 10 marks Total: 30 marks Practicum: Clinical performance evaluation: 20 marks End of posting exam (OSCE): 10 marks Clinical presentation: 10 marks Case study report (developed clinical/care pathway): 10 marks Internal OSCE:50 marks Total Internal practical: 100 marks (End of posting exam may be conducted in nephrology ward, dialysis unit or transplant unit) 4. Dissertation/EBP Project Practicum: 50 marks EXTERNAL (FINAL) EXAMINATION (As per schedule in syllabus) Theory: Short answer and essay type questions (Weightage can be decided by the University) {Essay 2×15 marks = 30, Short answers 5×6 marks = 30, Very short 5×2 marks = 10} OSCE GUIDELINES FOR INTERNAL AND EXTERNAL PRACTICAL EXAMINATION Ist year 1. ADVANCED HEALTH/PHYSICAL ASSESSMENT INTERNAL OSCE: 25 marks CORE COMPETENCY DOMAINS TO BE EXAMINED 1. Focused history taking and physical examination of adult patient[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 77 2. Focused history taking and physical examination of pediatric patient 3. Interpretation of findings and results 4. Monitoring of clinical parameters Number of stations: 5 (4+1 Rest station) Time for each station: 10 minutes Marks for each station: 5 marks (as per competency check list and allotted marks) Total: 4×5 = 20 marks Oral exam = 5 marks Total = 25 marks EXTERNAL OSCE:50 marks CORE COMPETENCY DOMAINS 1. Focused history taking of adult patient 2. Focused physical examination of adult patient 3. Focused history taking of pediatric patient 4. Focused physical examination of pediatric patient 5. Interpretation of history and physical exam findings 6. Interpretation of results of lab and diagnostic tests 7. Monitoring clinical parameters Number of stations: 10 (8+2 Rest stations) Time for each station: 10 minutes Marks for each station: 5 marks (as per competency check list and allotted marks) Total: 8×5 = 40 marks Oral exam = 10 marks Total = 50 marks On completion of procedural competencies in log book and clinical requirements, the NP student is qualified to appear for final practical examination IInd year 1. FOUNDATIONS OF NEPHROLOGY NURSING PRACTICE INTERNAL OSCE: 50 Marks CORE COMPETENCY DOMAINS TO BE EXAMINED 1. Focused history and physical examination and interpretation of findings and results 2. Monitoring competencies (invasive and noninvasive) 3. Therapeutic interventions - (emergency procedural competencies) including drug administration 4. Family education and counseling Number of stations: 5 (4+1 Rest station) Time for each station: 10 minutes Marks for each station: 10 marks (as per competency check list and allotted marks) Total: 10×4 = 40 marks Oral exam = 10 marks Total = 50 marks EXTERNAL OSCE:100 marks CORE COMPETENCY DOMAINS 1. Focused history taking, physical examination and interpretation of results of adult patient 2. Focused history taking, physical examination and interpretation of results of pediatric patient 3. Monitoring competencies (invasive and noninvasive) 4. Development of care plan 5. Family education and counseling 6. Therapeutic interventions (emergency procedural competencies) including drug administration Number of stations: 10 (8+2 Rest stations)78 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] Time for each station: 10 minutes Marks for each station: 10 marks (as per competency check list and allotted marks) Total: 8×10 = 80 marks Oral exam = 20 marks Total = 100 marks 2. NEPHROLOGY NURSING I & II INTERNAL OSCE-50 marks CORE COMPETENCY DOMAINS 1. Focused history and physical examination and interpretation of findings and results 2. Monitoring competencies (invasive and noninvasive) 3. Therapeutic procedures (CVC insertion, PD catheter insertion, hemodialysis, peritoneal dialysis, plasmapheresis, CRRT, SLED) 4. Development of plan of care/care pathway 5. Diagnostic interventions (Renal biopsy, Ascitic tap, Blood culture, CVC and PD catheter site culture, PD Fluid culture, PET Test, Suprapubic urine aspirate for culture, Ultrasound kidneys, Ultrasonography - AV access flow) 6. Drug prescription and administration 7. Hemodialysis 8. Peritoneal Dialysis 9. Kidney Transplantation – pre- and post-transplant care Number of stations: 5 (4+1 Rest station) Time for each station: 10 minutes Marks for each station: 10 marks (as per competency check list and allotted marks) Total: 10×4 = 40 marks Oral exam = 10 marks Total = 50 marks EXTERNAL OSCE:100 marks CORE COMPETENCY DOMAINS 1. Focused history taking, physical examination and interpretation of results of adult patient 2. Focused history taking, physical examination and interpretation of results of pediatric patient 3. Monitoring competencies (invasive and noninvasive) 4. Development of plan of care/care pathway 5. Family education and counseling 6. Drug administration 7. Diagnostic interventions (Renal biopsy, Ascitic tap, Blood culture, CVC and PD catheter site culture, PD Fluid culture, PET Test, Suprapubic urine aspirate for culture, Ultrasound kidneys, Ultrasonography - AV access flow) 8. Therapeutic interventions (hemodialysis, peritoneal dialysis, CVC insertion, PD catheter insertions, plasmapheresis, CRRT, SLED) Number of stations: 10 (8+2 Rest stations) Time for each station: 10 minutes Marks for each station: 10 marks (as per competency check list and allotted marks) Total: 8×10 = 80 marks Oral exam = 20 marks Total = 100 marks On completion of procedural competencies in log book and clinical requirements, the NP student is qualified to appear for final practical examination.[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 79 Appendix-3 CLINICAL LOG BOOK FOR NURSE PRACTITIONER IN NEPHROLOGY NURSING (NPNepN) (Specific Procedural Competencies/Clinical Skills) Ist year S.No. Specific Competencies/Skills No. Date Signature of the performed Preceptor*/Faculty I RESEARCH APPLICATION AND EVIDENCE BASED PRACTICE 1 Preparation of research instrument 2 Writing systematic review/literature review 3 Preparation of a manuscript for publication (Ist or IInd year) 4 Research Project/EBP Project Topic: II LEADERSHIP, MANAGEMENT AND TEACHING 1 Preparation of staff patient assignment 2 Performance indicators and measures 3 Develop patient education aids 4 Patient care audit in the unit 5 Develop technology assisted education aid for nurses 6 Quality improvement audit 7 Microteaching - Staff nurses 8 Patient education and counseling 9 Planning and conducting OSCE/OSPE 10 Construction of tests III HEALTH ASSESSMENT 1 Comprehensive history taking and clinical assessment 1.1 Acute Kidney Injury 1.2 Tubulointerstitial disease 1.3 Chronic Kidney Disease 1.4 Glomerular disease 1.5 Nephrotic syndrome 1.6 Fluid volume status 1.7 Comprehensive system wise physical assessment 2 Age specific history & physical examination (Nephrology) 2.1 Neonate 2.2 Child 2.3 Adult 2.4 Geriatric 2.5 Pregnant women IV DIAGNOSTIC PROCEDURES 1 Collecting blood sample for laboratory tests 1.1 Biochemistry 1.2 Clinical pathology 1.3 Microbiology 1.4 ABG 2 Assist/Perform 2.1 Paracentesis 2.2 Thoracentesis 2.3 Lumbar puncture 2.5 Renal biopsy 2.6 Bone marrow aspiration 2.7 Ultrasound kidneys 2.8 Ultrasonographic assessment of access flow 2.9 ECG and interpretation 2.10 ABG analysis and interpretation 3 Observe procedures 3.1 Renal Doppler80 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] S.No. Specific Competencies/Skills No. Date Signature of the performed Preceptor*/Faculty 3.2 Fistulogram 3.3 Drug assay 3.4 MRI/CT 3.5 Renal angiogram 3.6 Pathological examination of kidney tissue (LM, IF, EM) 3.7 Echocardiogram V. COMPETENCIES IN NEPHROLOGY 1 Drug administration and prescription in kidney disorders 1.1 Antihypertensives 1.2 Oral glucose lowering agents 1.3 Sodium correction 1.4 Potassium correction 1.5 Inotropes 1.6 Vitamin and mineral supplements 1.7 Intravenous fluid administration 1.8 Insulin dose adjustment 2 Nutritional Assessment & Management 2.1 Perform nutritional assessment 2.2 Plan therapeutic diet for patient with CKD 2.3 Plan therapeutic diet for patient with diabetes 2.4 Nasogastric tube insertion 2.5 NG Feeding 2.6 Total Parenteral Nutrition 3 Airway Management Non-invasive ventilation 3.1 Low flow variable performance devices: nasal catheters/cannulae/double nasal prongs, face mask, face mask with reservoir bags 3.2 High flow fixed performance devices: Entrainment (Venturi) devices, CPAP, BiPAP Invasive ventilation 3.3 Setting of mechanical ventilators 3.4 Care of patient on mechanical ventilator 3.5 Insertion of endotracheal tube 3.6 Removal of endotracheal tube 3.7 Endotracheal suctioning 3.8 Tracheostomy care 3.9 Confirm the position of ET tube 3.10 Chest physiotherapy 3.11 Postural drainage 4 Use of equipment 4.1 Infusion pumps 4.2 Syringe pumps 4.3 Defibrillator 5 Life support and end of life care 5.1 BLS 5.2 ACLS 5.3 Grief counseling 5.4 Breaking bad news 6 Patient Education and Counseling 6.1 Slowing down the progress of CKD 6.2 Therapeutic diet in CKD 6.3 Diabetes management 7 Communication, Problem solving and Critical Thinking[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 81 S.No. Specific Competencies/Skills No. Date Signature of the performed Preceptor*/Faculty 7.1 Clinical Scenarios simulations 7.2 8 Monitoring and interpretation of critical parameters 8.1 Arterial Blood Gas (ABG) 8.2 Hemodynamics 8.3 Electrocardiogram (ECG) 8.4 Invasive BP monitoring 8.5 Noninvasive BP monitoring 8.6 Glasgow Coma Score 8.7 Sedation Score 8.8 Pain Score 8.9 Braden Score 8.10 Bowel sounds 8.11 GRBS 8.12 GFR Estimation and CKD staging 8.13 Chest X-ray *When the student is found competent to perform the skill, it will be signed by the preceptor. Students are expected to perform the listed skills/competencies many times until they reach level 3 competency, after which the preceptor signs against each competency. Preceptors/Faculty must ensure that the signature is given for each competency only after they reach level 3. • Level 3 Competency denotes that the NPNepN student is able to perform that competency without supervision. • Level 2 Competency denotes that the student is able to perform each competency with supervision. • Level 1 Competency denotes that the student is not able to perform that competency/skill even with supervision. Signature of the Program Coordinator/Faculty Signature of the HOD/Principal CLINICAL LOG BOOK FOR NURSE PRACTITIONER IN NEPHROLOGY NURSING (NPNepN) IInd year S.No. Specific Competencies/Skills No. Date Signature of the performed Preceptor*/Faculty ADVANCED COMPETENCIES 1 Hemodialysis 1.1 Pre, Intra, Post dialysis assessment 1.2 Assessment of CVC 1.3 Assessment of AV Fistula 1.4 CVC site care 1.5 Dry Weight assessment - Clinical and bio-impedance method 1.6 UF calculation 1.7 Programming machine and starting HD 1.8 Closing HD 1.9 Bicarb preparation 1.10 Estimating URR, Kt/V, Assess dialysis adequacy 1.11 Prescribe routine investigations and follow up results 1.12 HD prescription 1.13 Heparin preparation 1.14 Drug reconciliation 1.15 Prescription of common drugs based on lab reports: Erythropoietin, Phosphorous binders, Calcium and Vitamin D supplements, Antihypertensives, OGLA 1.16 Perform varied dialysis modalities a. SCUF b. Isolated UF c. SLED d. CRRT82 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] S.No. Specific Competencies/Skills No. Date Signature of the performed Preceptor*/Faculty 1.17 Perform Plasmapheresis 1.18 Calculate plasma volume for removal 1.19 Insertion of CVC into femoral and jugular vein 1.20 Identify and manage complications in HD a. Intradialytic hypotension b. Hemolysis c. Muscle cramps d. Air embolism 1.21 Identify and manage CVC related complications 1.22 Identify and manage AVF related complications 2 Peritoneal Dialysis 2.1 Assess and select patients for PD 2.2 Perform PET, Determine PD prescription 2.3 Perform PD exchanges 2.4 Collect PD Fluid for culture 2.5 Identify and manage Exit site infection, Tunnel infection and peritonitis 2.6 Administer intraperitoneal antibiotics 2.7 Alter PD prescription based on clinical assessment and PET 2.8 Assess Dialysis adequacy including Kt/V 2.9 Identify and manage noninfectious complications of PD 3 Kidney Transplantation 3.1 Pretransplant work up and evaluation of donor and recipient 3.2 Counseling and selection of patients for transplant 3.3 Legal formalities and Documentation 3.4 Assist for donor nephrectomy 3.5 Assist in Kidney Transplantation 3.6 Preoperative care – Donor & Recipient 3.7 Post operative care - Donor & Recipient 3.8 Deceased Donor registry 3.9 Assessment of brain death 3.10 Perfusion of renal blood vessels before transplantation 3.11 Fluid Management following Kidney Transplant 3.12 Identify and manage graft rejection 3.13 Identify and manage transplant related infections 3.14 Wound and drain care 3.15 Assess and evaluate the graft function following transplant 4 Patient Education and Counseling 4.1 Management of vascular access 4.2 Kidney Replacement Therapy options 4.3 Prevention and Management of complications in PD 4.4 Post Kidney transplantation care 5 Drug Administration and Prescription 5.1 Catecholamines (calculation, titration & administration) a. Adrenaline b. Noradrenaline c. Dopamine d. Dobutamine 5.2 Immunosuppressant Drugs in Nephrology[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 83 S.No. Specific Competencies/Skills No. Date Signature of the performed Preceptor*/Faculty a Induction agents Polyclonal antibodies (ATG) Interleukin 2 receptor antagonists (Basiliximab) b Maintenance Therapy Calcineurin inhibitors (Cyclosporin, Tacrolimus) mTOR inhibitors (Sirolimus, Everolimus) c Antiproliferative agents (Azathioprine, Mycophenolic acid) d Corticosteroids (Prednisolone) e Treatment for rejection Corticosteroids, ATG, IVIG 5.3 Erythropoietin injection and dose adjustment 6 Infection Control Practices 6.1 Standard Precautions 6.2 Infection control protocols in HD unit 6.3 Infection control protocols in PD unit 6.4 Infection control practices in Renal Transplant Unit 7 Quality Assurance/Improvement 7.1 Capture and present performance indicators measures in Dialysis unit 7.2 Microbiology surveillance in HD unit, RTU 7.3 Water quality management 7.4 Quality improvement Audit 8 Management of Cardiovascular Alterations 8.1 Intravenous fluid administration (Colloid/Crystalloid) 8.2 Blood and blood product administration 8.3 Application of TED stocking 8.6 Blood collection from arterial line 9 Management of Neurological Alterations 9.1 Sensory stimulation 9.2 Consciousness/Coma status monitoring 9.3 Brain death evaluation 10 Ordering Investigations 10.1 ECG 10.2 ABG 10.3 Chest X ray 10.4 Ultrasound 10.5 Basic biochemistry investigations 10.6 Basic microbiology investigations 11 Ordering Procedures/Treatment 11.1 Nebulization 11.2 Chest physiotherapy 11.3 Hemodialysis 11.4 Insertion and removal of urinary catheter 11.5 SCUF 11.6 TEDS 11.7 Isolated UF 11.8 SLED 11.9 First HD protocol 11.10 Therapeutic diet *When the student is found competent to perform the skill, it will be signed by the preceptor. Students: Students are expected to perform the listed skills/competencies many times until they reach level 3 competency, after which the preceptor signs against each competency. Preceptors/Faculty: Must ensure that the signature is given for each competency only after they reach level 3.84 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] • Level 3 Competency denotes that the NPNepN student is able to perform that competency without supervision. • Level 2 Competency denotes that the student is able to perform each competency with supervision. • Level 1 Competency denotes that the student is not able to perform that competency/skill even with supervision. Note: 5-10% of procedures that are rare should be practiced in skill lab and attained level 3 competency. Signature of the Program Coordinator/Faculty Signature of the HOD/Principal Appendix-4 CLINICAL REQUIREMENTS FOR NURSE PRACTITIONER IN NEPHROLOGY NURSING (NPNepN) Ist year S.No. Clinical Requirement Date Signature of the Preceptor/Faculty 1 Clinical Seminar/Journal Club/Clinical Conference 1.1 *APN - Clinical pathway in specific clinical condition/ Application of specific nursing theory (Clinical Seminar) Title of the topic: 1.2 *RA - Evidence search for nephrology nursing competencies (Clinical Conference/Journal Club) Title of the topic: 1.3 *L,M&T - Trends in Leadership/Management/Teaching (Journal Club) Title of the topic: 2 Clinical Rounds (with Nursing Staff, Faculty, Students) - Case/Clinical Presentation 2.1 Pathophysiology (Clinical Presentation) Name of clinical condition: 2.2 Pathophysiology (Clinical Presentation) Case Study (Written Report) Name of clinical condition: 2.3 Pharmacology - Drug Studies (Drugs listed under Standing Orders) - Written report of 5 presentations (Bedside Presentations) Drug name: 2.3.1 2.3.2 2.3.3 2.3.4 2.3.5 2.3.6 2.3.7 2.3.8 2.3.9 2.3.10 3 Interdisciplinary Clinical Rounds (with Doctors) - Case/Clinical Presentation (Written reports are for submission) 3.1 Health Assessment (Adult) - History & Physical Examination (Two written reports) 3.1.1. 3.1.2. 3.1.3. 3.1.4. 3.1.5. 3.2 Health Assessment (Pediatric) - History & Physical Examination (One written report) 3.2.1. 3.2.2. 3.2.3.[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 85 S.No. Clinical Requirement Date Signature of the Preceptor/Faculty 3.3 Health Assessment (Pregnant Woman) (One written report) 3.3.1. 3.3.2. *Advanced Practice Nursing - APN; Research Application - RA, Leadership, Management and Teaching - L,M&T Signature of the Program Coordinator/Faculty Signature of the HOD/Principal CLINICAL EXPERIENCE DETAILS Name of Clinical Area Clinical Condition No. of days Signature of care given Faculty/Preceptor Signature of the Program Coordinator/Faculty Signature of the HOD/Principal CLINICAL REQUIREMENTS FOR NURSE PRACTITIONER IN NEPHROLOGY NURSING (NPNepN) IInd year S.No. Clinical Requirement Date Signature of the Preceptor/Faculty 1 Clinical Seminar/Journal Club/Clinical Conference 1.1 Foundations of Nephrology Nursing Practice (Clinical Conference) Title of the topic: 1.2 Nephrology Nursing I (Clinical Seminar) Title of the topic: 1.3 Nephrology Nursing I (Journal Club) Title of the topic: 1.4 Nephrology Nursing II (Clinical Seminar) Title of the topic: 1.5 Nephrology Nursing II (Journal Club) Title of the topic: 2 Clinical Rounds (with Nursing Staff, Faculty, Students) - Clinical/Case Presentation86 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] S.No. Clinical Requirement Date Signature of the Preceptor/Faculty (Written reports are for submission) 2.1 Foundations of Nephrology Nursing (Family Education/Counseling) - Written Report Name of topic: 2.2 Foundations of Nephrology Nursing (Clinical/Care Pathway) Name of topic: 2.3 Nephrology Nursing I (Clinical Presentation) Name of clinical condition: 2.4 Nephrology Nursing I (Case Study Report) Name of clinical condition: 2.5 Nephrology Nursing II (Clinical Presentation) Name of clinical condition: 2.6 Nephrology Nursing II (Case Study Report) Name of clinical condition: 2.7 Drug Studies (drugs listed under Standing Orders) Bedside Presentation (Five written reports) Name of drug: 2.8 Name of drug: 2.9 2.10 2.11 2.12 2.13 2.14 2.15 2.16 3 Interdisciplinary Clinical Rounds (with ICU Doctors) - Clinical/Case Presentation 3.1 Nephrology Nursing I Name of clinical condition: 3.2 3.3 3.4 3.5 (Case Study Report) 3.6 Nephrology Nursing II 3.7 3.8 3.9 (Case Study Report) 3.10 Written Report (Developed Clinical/Care Pathway) Note: Clinical presentation can be written for case study report. Signature of the Program Coordinator/Faculty Signature of the HOD/Principal CLINICAL EXPERIENCE DETAILS Name of Clinical Area Clinical Condition No. of days Signature of care given Faculty/Preceptor[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 87 Name of Clinical Area Clinical Condition No. of days Signature of care given Faculty/Preceptor Signature of the Program Coordinator/Faculty Signature of the HOD/Principal Appendix-5 STANDING ORDERS AND PROTOCOLS Nurse Practitioners in Nephrology Nursing are prepared and qualified to assume responsibility and accountability for the care of patients with nephrology conditions. They collaborate with physicians, surgeons and specialists to ensure accurate therapy for patients with high acuity needs. On completion of the program, the Nurse Practitioners will be permitted to administer drugs listed in standing orders as per the institutional standing orders. They will also be permitted to order diagnostic tests/procedures and therapies as per institutional protocols. STANDING ORDERS The following intravenous injections or infusions may be administered by the Nurse Practitioner during emergency in nephrology ward/Dialysis unit or renal transplant Unit without a written order. Catecholamines 1. Adrenaline 2. Noradrenaline 3. Dopamine 4. Dobutamine Antidysrhythmic 5. Adenosine 6. Amiodarone 7. Lidocaine/Xylocard Adrenergic agent 8. Ephedrine Antihistamine 9. Avil Antihypertensives Corticosteroid 10. Hydrocortisone 11. Dexamethasone Antiepileptic 12. Levetiracetam 13. Phenytoin 14. Propofol Electrolytes & acid base, fluid correction agents 15. Soda bicarbonate 8.4% 16. Soda bicarbonate 7.5% 17. Magnesium sulphate 18. Potassium chloride88 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] 19. IV Fluids - NS, DNS, 5% Dextrose The following investigations and therapies may be ordered by the Nurse Practitioners Ordering Investigations Ordering Therapies • ECG • Nebulization • ABG • Chest physiotherapy • Chest X ray • Insertion and removal of urinary catheter for female patients • Basic Biochemistry investigations - • TEDS Hb, PCV, TIBC, WBC Total, WBC • Surgical dressing differentials, ESR, electrolytes, • Starting and closing dialysis platelets, PT, aPTT, bleeding and • Application of ichthammol glycerin/magnesium sulphate dressing for clotting time, procalcitonin, D-dimer, thrombophlebitis/extravasation creatinine, HbA1c, AC, PC, HDL, • Pin site care for patients on external fixators LDL, TIG, cholesterol total, HIV, • Isometric and isotonic exercises HbsAg, HCV • Hot and cold applications • Basic Microbiology investigations - • Hot and cold supplements blood and urine samples for culture • Removal of CVC, Culture from CVC and PD catheter site and sensitivity, tips of vascular • Peritoneal equilibration test access, sample from CVC site, PD • Heparin infusion in HD catheter exit site • Erythropoietin injections INSTITUTIONAL STANDING ORDERS AND PROTOCOLS In every hospital, the standing orders for drug administration with specific dosage to be administered during emergency situations can be made available as guidelines for NPNepN graduates. The NP students will be trained to administer these drugs under supervision by preceptors/NP faculty. The protocols for ordering selected investigations and carrying out specific therapeutic procedures can also be available in every hospital that trains NPNepN students. Dr. T. DILEEP KUMAR, President [ADVT.-III/4/Exty./901/2024-25] Uploaded by Dte. of Printing at Government of India Press, Ring Road, Mayapuri, New Delhi-110064 and Published by the Controller of Publications, Delhi-110054.

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