In exercise of the powers conferred by sub section 1 of Section 16 of Indian Nursing Council Act

रजिस्ट्री स.ं डी.एल.- 33004/99 REGD. No. D. L.-33004/99 ससीी..जजीी..--डडीी..एएलल..--अअ..--2255001122002255--226600446699 xxxGIDHxxx CCGG--DDLL--EE--2255001122002255--226600446699 xxxGIDExxx असाधारण EXTRAORDINARY भाग III—खण् ड 4 PART III—Section 4 प्राजधकार स ेप्रकाजित PUBLISHED BY AUTHORITY स.ं 50] नई दिल्ली, िुक्रवार, िनवरी 17, 2025/पौष 27, 1946 No. 50] NEW DELHI, FRIDAY, JANUARY 17, 2025/PAUSHA 27, 1946 अजधसचू ना नई दिल्ली, 26 दिसम्बर, 2024 & & (IX) 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;≤ 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( 462 GI/2025 (1)2 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] 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 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 eas] LokLF; ds lHkh vk;keksa eas LokLF; ç.kkfy;ks a dks u;k vkdkj nus k jk"Vªh; LokLF; uhfr] 2017 eas ,d egRoiw.kZ vko';drkvks a eas ls ,d ekuk x;k gSA ;g fofu;eu rFkk dkuuw ds lkFk&lkFk f'k{kk vkSj çf'k{k.k ds {ks= eas ekuo lalkèku fodkl ij tksj nrs k gSA ;g vR;ar egRoiw.kZ gS fd LokLF; lsok dfeZ;ks a dks LokLF; lsok lek;kstuksa esa fof'k"V lsok,a çnku djus ds fy, mUur 'kSf{kd ,oa uSnkfud çf'k{k.k dh vko';drk gksrh gSA Hkkjr ljdkj lkoZtfud o futh nksuks a {ks=ks a ds lHkh LokLF; lsok lek;kstuksa eas egRoiw.kZ foLrkj dks Lohdkjrh gSA gekj s n's k eas LokLF; lsokvks a dk leFkZu djus ds fy, mUur rS;kjh oky s fo'ks"kK ulZ ,oa ulZ fpfdRldks a dh vko';drk eglwl dh tkrh gSA ulZ çSfDV'kuj bl ekax dks iwjk djus eas l{ke gksxa s] c'krZs fd os vPNh rjg çf'kf{kr gks a vkSj vko’;d {ks= eas vH;kl djus ds fy, vfèkÑr gksAa dsæa vkSj jkT; Lrj ij u, loaxZ dh LFkkiuk ds lkFk] LukrdksÙkj Lrj ij rS;kj ulZ çSfDV'kuj Hkkjr ds fofHkUu çklafxd lek;kstuks a eas jksfx;ks a dks ykxr çHkkoh] l{ke] lqjf{kr ,oa xq.koÙkk lapkfyr fof'k"V uÉlx n[s kHkky çnku djus eas l{ke gksxa sA ulZ çSfDV'kuj bu fØfVdy ds;j@,D;wV ds;j] vkWUdksykWth] ,ejtsla h ds;j] U;wjks&ds;j] dkÆM;ksoLdqyj ds;j] ,uLs Fksfl;k ,aM vnj Lis’kYVht dks çklafxd lek;kstuksa ds lHkh Lrjksa ij dk;Z djus ds fy, rS;kj fd, tk ldr s gSaA dBksj 'kSf{kd çf'k{k.k mUgs a tfVyrkvks a dh jksdFkke o LokLF;o)Zu ds fy, fofHkUu çfØ;k rFkk 'kY;fpfdRlk ikus oky s jksfx;ks a dk vkadyu dju s vkSj mueas Hkkx yus s eas l{ke cuk,xkA LukrdksÙkj Lrj ij ulZ çSfDV'kuj bu ,uLs Fksfl;k ¼,uih,½ r;S kj djus ds fy, ifj"kn ~ }kjk ,d ikBîØe lajpuk@ <kapk çLrkfor fd;k x;k gSA bl dk;ZØe dh [kkl ckr ;g gS fd ;g ,d uSnkfud vkoklh; dk;ZØe gS ftles a 15% lS)kafrd funsZ'k vkSj 85% çSfDVde ds lkFk ,d etcwr uSnkfud ?kVd ij tksj fn;k tkrk gSA çeq[k n`f"Vdks.k ;ksX;rk vkèkkfjr çf'k{k.k gS vkSj ,uih f'k{kk us'kuy vkWxZukbts'ku vkWQ ulZ çSfDV'kuj QSdYVht (NONPF) n{krkvks a ¼2022½] baVjus'kuy dkmafly vkWQ ulsZt (ICN, 2021)] vefsjdu ,lksfl,'ku vkWQ dkWyts vkWQ uÉlx ¼2021½] vefsjdu ,lkfsl,'ku vkWQ ulZ ,ufsLFkfl;ksykWth (AANA, 2023) ls :ikarfjr n{krkvks a ij vkèkkfjr gSA çR;sd ikBîØe n{krkvks a dh miyfCèk ij vkèkkfjr gSA LFkkuh; vkSj oSf’od LokLF; y{;ks a dks iwjk djus ds fy, i;kZIr 'kY;fpfdRlh; vkPNknu dk çkoèkku ,d iwokZis{kk gS ¿ySalsV deh'ku vkWu Xykscy ltZjh (LCoGS)] 2019ÀA 'kY;fpfdRlh; n[s kHkky dh vko’;drk oky s yksxks a dk ,d cM+k oxZ fpfdRlk mipkj dk foÙkh; cks> ugÈ mBk ldrk gSA fuEu vkSj fuEu&eè;e&vk; okys n's kks a eas yxHkx 66% jksfx;ks a dh çkFkfed 'kY;fpfdRlh; n[s kHkky rd igqap ugÈ gSA 'kY;fpfdRlk ds lqjf{kr ifj.kke lqfuf'pr djus ds fy, lqjf{kr ,uLs FksfVd n[s kHkky vko';d gSA nqfu;k Hkj eas ikap vjc yksxks a dh lqjf{kr ,usLFksfVd n[s kHkky rd igqap ugÈ gSA ykW Vh- t-s ,oa vU; ¼2019½ us lqjf{kr rFkk lqyHk ,uLs Fksfl;k n[s kHkky çkIr djus ds ekxZ eas fofHkUu eqíks a vkSj ckèkkvks a dks Li"Vr% crk;k gSA[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 3 ySalsV deh'ku vkWu Xykscy ltZjh (LCoGS) u s o"kZ 2030 rd çfr 100]000 tula[;k ij 5000 'kY;&fpfdRlk çfØ;kvks a dh vkSlr U;wure lhek dk lq>ko fn;k gSA bruh cM+h 'kY;&fpfdRlh; vko’;drk dks iwjk djus ds fy, i;kZIr çf'kf{kr ,usLFksfl;k n[s kHkky çnkrkvks a dh vko';drk gS] vkSj dk;Zcy dh bl deh dks vPNh rjg ls çf'kf{kr xSj&fpfdRlh; ,uLs Fksfl;k n[s kHkky çnkrkvks a (NPAP) }kjk iwjk fd;k tkuk pkfg,A lrr fodkl y{;] 2030 ds vuqlkj varj dks de djuk çkFkfedrk cu tkrk gS] tks Xykscy gSYFk bfDoVh ij dsfaær gSA ulZ çSfDV'kuj bu ,uLs Fksfl;k ¼,uih,½ dk;ZØe varj dks de djus dk ,d rjhdk gSA ,uih, dk;ZØe dk mís';

iathÑr ch-,llh- ulks± dks LukrdksÙkj Lrj ij çf'kf{kr djuk gS rkfd os jksfx;ks a dks isjh&,uLs Fksfl;k n[s kHkky çnku dj ld sa vkSj fofHkUu ,uLs Fksfl;k çklafxd lek;kstuksa eas tfVy n[s kHkky çfØ;kvks a dks iwjk dj ldsAa ulZ çSfDV'kuj bu ,uLs Fksfl;k dk è;ku jksfx;ks a vkSj ,uLs Fksfl;k rFkk 'kY;fpfdRlk ds fy, mudh fpfdRlh; LoLFkrk dk vkadyu djus] rhoz tfVyrkvks a dks jksdu s vkSj mudk mipkj dju s o isjh&,usLFksfl;k vofèk ds nkSjku mUgs a fLFkj dju s ij dsafær gksrk gSA bu ,uih, dks 'kY;fpfdRlh; d{k] çh&,usLFksfl;k Dyhfud] iksLV&,uLs Fksfl;k fjdojh :e] vkbZlh;w] cká jksxh o jksxh 'kY;fpfdRlh; bdkbZ] vkikrdkyhu d{k] çlo&osnuk ,oa çlo d{k] ,aMksLdksih lqbV] jfsM;ksykWftdy dsæa ] lkeqnkf;d LokLF; dsæa ¼lh,plh½ ds lkFk&lkFk euksfpfdRlk bdkb;ks a eas vH;kl djuk vko';d gSA dk;ZØe es a vè;;u ds fofHkUu ikBîØe 'kkfey gSa tks tfVy LokLF; ç.kkfy;ks a ds lk{; vkèkkfjr vH;kl vkSj çcaèku lfgr etcwr oSKkfud uÈo ij vkèkkfjr gSaA ;s ch-,llh- ufl±x dh lS)kafrd rFkk O;kogkfjd n{krkvks a ij vkèkkfjr gSaA dk;ØZ e iwjk gksus vkSj lacafèkr ,l,uvkjlh es a iathÑr gksus ij] mUgs a ifj"kn~ ds ikBîØe dh ykWxcqd es a lwphc) lHkh n{krkvks a dk vH;kl djus dh vuqefr gksrh gSA os ,usLFksfl;ksykWftLV dh ns[kjs[k es a lkekU;] {ks=h; vkSj LFkkuh; ,usLFksfl;k çnku djus es a l{ke gksxa sA os laLFkkxr çksVksdkWy@LFkk;h vkns'kks a ds vuqlkj ,usLFksfl;k ns[kHkky ds nk;js ls lacafèkr vkS"kfèk;ka nsus] uSnkfud ijh{k.k] çfØ;k] fpfdRlh; midj.k vkSj mipkj dk vkns'k nsus es a Hkh l{ke gksxa sA mUgs a iksLV ,usLFksfl;k ds;j ;wfuV ¼ih,lh;w½ esa iksLV&vkWijsfVo jksfx;ksa dks laHkkyus vkSj fof'k"V ekunaMks a ds vkèkkj ij Nqêh nsus dh vuqefr gksxhA bl vfèkdkj dk ç;ksx djrs le; ,uih, fuEufyf[kr n{krkvksa s ds fy, mÙkjnk;h gksxa s a & a) iwoZ&laosnukgkjh vkadyu ¼izh&,uLs FksfVd vlsleaVs ½ b) {ks=h; ,uLs Fksfl;k ds fy, i;Zos{k.k ds lkFk rS;kjh djuk] nus k vkSj can djuk c) jksxh lqj{kk d) egRoiw.kZ ladsrks a dh fuxjkuh djuk e) midj.kks a dh gSaMÇyx f) cqfu;knh vkSj mUur dkfMZ;kd ykbQ liksVZ g) iksLV vkWijfsVo n[s kHkky h) nnZ çcaèku i) tksf[ke dh jksdFkke j) nLrkosthdj.k k) LokLF; eè;orZu l) O;kolkf;drk mDr LukrdksÙkj mikfèk dks ,l,uvkjlh }kjk vfrfjDr ;ksX;rk ds :i eas iathÑr fd;k tk,xkA ulZ çSfDV'kuj bu ,uLs Fksfl;k ¼,uih,½ dk;ZØe oafpr vkcknh dh 'kY;&fpfdRlh;] ,usLFksfl;k vkSj çlwfr lacaèkh vko’;drkvks a dks iwjk djus dk ç;kl djrk gS] ftlls LokLF; lsok forj.k ç.kkyh eas varj dks de fd;k tk lds vkSj n's k ds LokLF; çksQkby dks c<k+;k tk ldsA4 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] ifj"kn~ dk ekuuk gS fd Hkkjr eas LokLF; lsokvks a dh pqukSfr;ks a vkSj ekaxks a dks iwjk djus] tSlk fd jk"Vªh; LokLF; uhfr] 2017 eas ifjyf{kr gS vkSj fof'k"V LokLF; n[s kHkky lke;kstuksa eas ,uLs Fksfl;k ikus oky s jksfx;ks a dks lqjf{kr] xq.koÙkkiw.kZ n[s kHkky çnku djus ds fy, ulZ çSfDV'kuj bu ,usLFksfl;k uked ,d LukrdksÙkj dk;ZØe LFkkfir djus dh cgqr vko';drk gSA ifj"kn~ dk ekuuk gS fd vkoklh; dk;ZØe ls izf’kf{kr LukrdksÙkj n{krk&vkèkkfjr çf'k{k.k dk mi;ksx djrs gq, etcwr uSnkfud ?kVd ij è;ku dsfaær djasxsA os etcwr lS)kafrd vkSj lk{;&vkèkkfjr tkudkjh ds vkèkkj ij uSnkfud {kerk dk çn'kZu djus eas l{ke gksxa sA f'k{k.k&vfèkxe n`f"Vdks.k o;Ld f'k{k.k fl)karks]a n{krk&vkèkkfjr f'k{k.k] lg;ksxh vfèkxe] fizlsIVjf’ki] vuHq kokRed vfèkxe] fleqy’sku csLM yfuZax vkSj Lo&funsZf'kr vfèkxe ij è;ku dsfaær djxs kA f'k{kk çnkrk@fizlsIVj@esVa j vkWijsÇVx :e ulZ vkSj ,usLFksfl;ksykWftLV gks ldr s gSaA os fo"k; fo'ks"kK gksxa s vkSj os mPp ;ksX;rk oky s gksxa sA ifj"kn~ dk ;g Hkh ekuuk gS fd ;ksX; dÆe;ks a dh deh dks njw djus ds fy, uSnkfud lek;kstuks a eas fofHkUu 'kSf{kd j.kuhfr;ks a dk mi;ksx fd;k tk ldrk gSA vk’kk dh tkrh gS fd blls iathdj.k@ykblsla ds fy, fodkl'khy uhfr;ks a dks lqxe cukus vkSj ulZ çSfDV'kulZ bu ,uLs Fksfl;k dh fu;qfDr ds fy, mfpr loaxZ inks a dk l`tu dju s eas enn feysxhA II.

;g dk;ZØe Nk=ks a dks ,uLs Fksfl;k uÉlx ds {ks= eas fo'ks"kKrk vkSj xgu le> fodflr djus eas lgk;rk djus ds fy, rS;kj fd;k x;k gSA ;g Nk= dks ulZ çSfDV'kuj bu ,uLs Fksfl;k ds :i eas dk;Z djus eas l{ke cuk,xkA ;g Nk= dks vkxs pydj ,uLs Fksfl;k uÉlx ds {ks= eas f'k{kd] çcaèkd vkSj 'kksèkdrkZ ds :i eas dk;Z djus esa Hkh l{ke cuk,xkA[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 5 ,uih, dk;ZØe ,d LukdrksÙkj uÉlx vkoklh; dk;ZØe gS ftles a n{krk vkèkkfjr çf'k{k.k ij cy fn;k tkrk gSA lS)kafrd ?kVd ds lkFk ikBîØe dh vofèk nks o"kZ dh gS ftles a eq[; ikBîØe] mUur vH;kl ikBîØe vkSj uSnkfud ikBîØe ds vykok uSnkfud vH;kl 'kkfey gSa tks fd ,d çeq[k ?kVd gS ¼ ns[ks½aA III.

ulZ çSfDV'kuj bu ,uLs Fksfl;k ¼,uih,½ dk;ZØe iathÑr ch-,llh- ulks± dks uSnkfud fo'ks"kK] f'k{kd vkSj lykgdkj

ds :i eas mUur vH;kl Hkwfedkvks a ds fy, rS;kj djrk gS] tks vkxs pydj ,e-,llh- uÉlx ¼ulZ çSfDV'kuj bu ,uLs Fksfl;k½ curs gSaA IV. dk;ZØe ds iwjk gksus ij] ulZ çSfDV'kuj bu ,usLFksfl;k ¼,uih,½ fuEufyf[kr dk;ks± ds laiknu eas l{ke gks tk,axs& 1- fofHkUu LokLF; lsok lek;kstuksa es a jksfx;ks a ds çh&,usLFksfVd vkadyu es a ftEens kjh ysukA 2- i;Zos{k.k ds lkFk ,uLs Fksfl;k ds fy, rS;kj djus] nus s vkSj can djus es a uSnkfud {kerk dk çn'kZu djukA 3- isjh&,usLFksfl;k vofèk ds nkSjku jksxh dh lqj{kk dh ftEesnkjh yus kA 4- egRoiw.kZ thou ladsrks a dh fuxjkuh vkSj ewY;ks a dh O;k[;k dju s eas dkS'ky dk çn'kZu djukA 5- ,uLs Fksfl;k es a mi;ksx fd, tku s oky s fofHkUu midj.kks a dh dk;Zç.kkyh dk o.kZu djukA 6- ,uLs Fksfl;k lacafèkr lek;kstuksa eas jksfx;ks a ds çcaèku dh] ;k rks Lor=a :i ls ;k ny ds lkFk feydj] ftEesnkjh yus k rkfd jksxh ds LokLF; dks fLFkj vkSj cgky fd;k tk ldsA 7- nnZ dk çcaèku djuk vkSj isjh&,usLFksfl;k ls lacafèkr tfVyrkvks a dks jksdukA 8- jksxh] ifjtuks a vkSj lacafèkr ny ds chp laidZ LFkkfir djukA V.

laLFkku dks ,uih, dk;ZØe vkSj mlds Nk=ks a ds çfr tokcngs h Lohdkj djuh gksxh vkSj ifj"kn~ ds ekudks a ds vuq:i dk;ZØe dh is'kd'k djuh gksxhA bls fuEufyf[kr vko';drkvks a dks iwjk djuk gksxk & a. ulZ çSfDV'kuj bu ,uLs Fksfl;k dk;ZØe 'kq: djus ds bPNqd laLFkku dks jkT; ljdkj 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) ,sl s laLFkku@fo’ofo|ky; tks igy s ls gh ch-,llh- uÉlx ;k ,e-,llh- uÉlx dk;ZØe lapkfyr dj jgs gSa vkSj vfèkfu;e dh èkkjk 13 rFkk 14 ds rgr ifj"kn ~ }kjk mi;qDr ik, x, gSa(

(ii) ,sl s laLFkku@fo’ofo|ky; tks ,echch,l@Mh,uch dk;ZØe lapkfyr dj jgs gSaA a. laLFkku eas de ls de 200 'k¸;k okyk ,d eyw vLirky@r`rh;d n[s kHkky dsæa gksuk pkfg, vkSj iwjh rjg QaD’kuy vkWijÇsVx :e ¼'kY;&fpfdRlk d{k½ rFkk vkbZlh;w gksuk pkfg,A b. eyw vLirky ls tqM+k ,d efsMdy dkWyst@uÉlx dkWyst gksuk csgrj gksxkA vLirky es a ets j ltZjh ds fy, de ls de nks Vcs y vkSj lacafèkr vkbZlh;w ds lkFk de ls de 10 vkWijsÇVx csM@Vscy gksus pkfg,A a. vkWijsÇVx :e ifjlj eas vfèkekur% ch-,llh- uÉlx ;k ,e-,llh- uÉlx ;ksX;rk ds lkFk ,d pktZ ulZ@ulZ eSustj gksuk pkfg,A b. ets j vkWijÇsVx :e ds fy,% çR;sd QaD’kuy vkWijs'ku Vscy ds fy, 2 LVkQ ulZA c. ekbuj vkWijÇsVx :e ds fy,% çR;sd QaD’kuy vkWijs'ku Vscy ds fy, 1 LVkQ ulZA d. iksLV ,uLs Fksfl;k ds;j ;wfuV ¼ih,lh;w½ eas çR;sd f'k¶V ds fy, ulZ jksxh vuqikr cky jksfx;ks a ds fy, 1%1 vkSj o;Ld jksfx;ks a ds fy, 1%2 gksuk pkfg,A e. vodk'k vkjf{kr ds fy, 40&45% vfrfjDr çf'kf{kr uÉlx LVkQ dk çkoèkku gksuk pkfg,A a.

i. uÉlx çhlsIVj% vkWij's ku fFk;sVj eas 6 o"kZ vuHq ko ds lkFk iw.kZdkfyd ;ksX; th,u,e ¼vfèkekur% iksLV csfld fMIyksek bu vkWijsÇVx :e uÉlx ,aM eus ts easV ds lkFk½ ;k vkWij's ku fFk;sVj eas 2 o"kZ vuqHko ds lkFk ch- ,llh- uÉlx ;k vkWijs'ku fFk;sVj es a 1 o"kZ vuqHko ds lkFk ,e-,llh- ¼efsMdy lÆtdy uÉlx½A ii. efsMdy çhlsIVj% 2 o"kZ vuHq ko ds lkFk Mh,@,eMh ,uLs Fksfl;ksykWftLV@,eMh baVsfalfoLVA iii. çhlsIVj Nk= vuiqkr% uÉlx 1%10] efsMdy 1%10 ¼çR;sd Nk= ds fy, ,d efsMdy vkSj uÉlx çhlsIVj gksuk pkfg,½A6 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] b.

i. çksQslj@,lksfl,V çksQslj% 1 ¿f'k{k.k vuHq ko% ,e-,llh- ¼efsMdy lÆtdy uÉlx@,uih,½ LukrdksÙkj ds ckn 5 o"kZÀ ¼çR;sd 10 Nk=ks a ds fy, ,d ladk;½ ii. vflLVasV çksQslj% 1 ¿f'k{k.k vuqHko% ,e-,llh- uÉlx ds ckn 3 o"kZÀ iii. mijksDr ladk; nksgjh Hkwfedk fuHkk,xk ;k mlh vLirky eas vksVh@vkbZlh;w eas dk;Zjr] vko';d ;ksX;rk vkSj vuqHko ds lkFk mlh fof'k"Vrk eas ,e-,llh- uÉlx ds lkFk ,d ofj"B ulZ gksxk iv. QkekZdksykWth] iSFkksfQft;ksykWth] fØfVdy ds;j ds fy, vfrfFk O;k[;krk a. uSnkfud {ks= eas ,d vè;;u d{k@lEeys u d{k b. flE;qysVsM yÉux ds fy, dkS'ky ç;ksx'kkyk ¼vLirky@dkWyst½ c. vkWuykbu tuZy rd igqap ds lkFk iqLrdky; ,oa daI;Vw j lqfoèkk d. bZ&yÉux lqfoèkk ¼layXu ½ a. vkosndks a dks ukekadu ls igy s vkWijs'ku fFk;sVj@vkbZlh;w 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- uÉlx dh f’k{kk çkIr dh gksuh pkfg, vkSj fdlh Hkh ,l,uvkjlh es a iathÑr gksuk pkfg,A c. ch-,llh- uÉlx dk;ZØe es a dqy çkIrkad 55% ls de ugha gksus pkfg,A d. 'kkjhfjd :i ls LoLFk gksuk pkfg,A 2 estj vkWijsÇVx Vcs y ds fy, 1 vH;FkhZA 1- lsokjr vH;fFkZ;ks a ¼tks mEehnokj mlh laLFkku es a dke dj jgs gSa½ 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 ikBîØe 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)kafrd vFkok ç;ksxkRed ijh{kk es a vuqÙkh.kZ gks tkrk gS] rks mls og ç'u&i= fQj ls nus k gksxk ftles a og vuqÙkh.kZ gqvk gSA fdlh Hkh fo"k; eas vuqÙkh.kZ gksus oky s vH;FkhZ dh Js.kh ?kksf"kr ugÈ dh tk,xhA 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 çfr fnu Nk=ks a dh vfèkdre la[;k 10 gksxhA ijh{kk dsoy uSnkfud {ks= eas gh vk;ksftr djuh gksxhA çk;ksfxd ijh{kd ny eas ,d vkarfjd ijh{kd ¿,e-,l-lh- uÉlx ladk;] ftlds ikl ulZ çSfDV'kuj bu ,usLFksfl;k dk;ZØe dks i<k+u s dk 2 o"kZ dk vuqHko gks ;k] ,e-,l-lh- ladk; ¼vfèkekur% efsMdy lftZdy uÉlx½] ftlds ikl LukrdksÙkj ds ckn 5 o"kZ dk vuqHko gksÀ] mijksDr ds led{k ,d cká ijh{kd vkSj vkarfjd ijh{kd ds :i es a ,d ,uLs Fksfl;ksykWftLV] tks ,uih, dk;ZØe ds fy, çf'k{kd gks] 'kkfey gksus pkfg,A 'kksèk fucaèk@bZchih ifj;kstuk 'kksèk xkbM% eq[; xkbM & LukrdksÙkj ds mijkar 3 o"kZ ,uih, dk;ZØe çf’k{k.k vuHq ko okyk uÉlx ladk;[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 7 lg&xkbM% efsMdy çhlsIVj 'kksèk çLrko dh çLrqfr% çFke o"kZ es a ços'k dh frfFk ds 6 ls 9 ekg mijkar xkbM Nk= vuiqkr% 1%5 'kksèk lfefr% dkWyst@vLirky esa 'kksèk dh çxfr dk ekxZn'kZu vkSj i;Zos{k.k djus ds fy, çèkkukpk;Z ;k lh,uvks] tks ,e-,llh- uÉlx mikfèk èkkjd gksuk pkfg,] ds lkFk U;wure 5 lnL; okyh ,d vyx 'kksèk lfefr gksxhA uSfrd eta wjh% pwqfd 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; ,uLs Fksfl;k uÉlx ds fy, çklafxd gksuk pkfg, tks uÉlx eè;oruZ eas tkudkjh ;k lk{;

tksM+As 'kksèk fdlh Hkh vksvkj@ih,lh;w@vkbZlh;w 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] ftUgsa igy s o"kZ es a 6 ekg ds ckn vkSj nlw js o"kZ eas 6 ekg ls igys uSnkfud vuHq ko ds nkSjku ,dhÑr fd, tk ldr s gSaA '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, tku s okys vad fn'kkfunsZ'kks a dk mi;ksx fd;k tk ldrk gSA½ *'kksèk fucaèk ds LFkku ij bZchih ifj;kstuk lapkfyr dh tk ldrh gS vkSj fu:i.k gsrq fjiksVZ çLrqr dh tk ldrh gSA VII.

• ç’uksÙkjh • lsfeukj • fyf[kr fufgr dk;Z@vkofèkd ijh{kk i= • dsl@uSnkfud çLrqfr • uSnkfud ;k ns[kHkky ekxZ@ekey s dh vè;;u fjiksVZ • uSnkfud çn'kZu fu:i.k • efsMdy@uÉlx ladk; çhlsIVj }kjk çfrgLrk{kfjr ykWx cqd ¼çfØ;kRed n{krk lwph ,oa uSnkfud vgZrk,a½ • oLrqfu"B lajfpr uSnkfud ijh{kk ¼vks,llhbZZ½ • ç’u i= • vafre ijh{kk ¼vkadyu fn'kkfunsZ'k ds fy, n[s ks½a % % 1 mUur vH;klh; uÉlx ds fy, lS)kafrd vkèkkj 2 ?kaVs 50 2 ,uLs Fksfl;k ds;j es a 'kksèk vuqç;ksx rFkk lk{; vkèkkfjr 3 ?kaVs 30 70 vH;kl 3 urs `Ro] çcaèku rFkk f'k{k.k es a mUur dkS'ky 3 ?kaVs 30 70 4 ,uLs Fksfl;k ds;j es a vuqç;qDr mUur iSFkksfQft;ksykWth rFkk 3 ?kaVs 30 70 mUur QkekZdksykWth 5 mUur LokLF;@'kkjhfjd vkadyu 3 ?kaVs 30 70 50 50 1 ,uLs Fksfl;k uÉlx vH;kl ds ewy vkèkkj 3 ?kaVs 30 70 100 1008 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] 2 ,uLs Fksfl;k uÉlx I 3 ?kaVs 30 70 100 100 3 ,uLs Fksfl;k uÉlx II 3 ?kaVs 30 70 100 100 4 'kksèk fucaèk vkSj ekSf[kd ijh{kk 50 50 VIII.

I mUur vH;klh; uÉlx ds fy, lS)kafrd vkèkkj 40 II ,uLs Fksfl;k ds;j es a 'kksèk vuqç;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 ,uLs Fksfl;k ds;j es a vuqç;qDr mUur 60 336 ¼7 lIrkg½ iSFkksfQft;ksykWth V ,uLs Fksfl;k ds;j es a 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 ,uLs Fksfl;k uÉlx vH;kl ds ewy vkèkkj 96 48 576 ¼12 lIrkg½ VIII ,uLs Fksfl;k uÉlx I 96 48 576 ¼12 lIrkg½ IX ,uLs Fksfl;k 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 ?kaVs ¼lS)kafrd&dkS'ky ç;ksx'kkyk&uSnkfud½ ¿l)S kafrd ¾ 15%] O;kogkfjd ¼dkS’ky ç;ksx'kkyk o uSnkfud½ ¾ 85%À f}rh; o"kZ% 288&144&1776 ?kaVs ¼lS)kafrd&dkS'ky ç;ksx'kkyk&uSnkfud½ ¿l)S kafrd ¾ 15%] O;kogkfjd ¼dkS’ky ç;ksx'kkyk o uSnkfud½¾ 85%À çFke o"kZ ¾ 46 lIrkg@2208 ?kaVs ¼46×48 ?kaVs½ ¼lS)kafrd $ ç;ksx'kkyk% 44 lIrkg ds fy, 7-5 ?kaVs çfr lIrkg ¾ 330@336 $ 96 ?kaVs*½ *lS)kafrd $ ç;ksx'kkyk ¾ 96 ?kaVs ifjp;kRed CykWd d{kkvks a vkSj dk;Z'kkykvks a ds :i eas 2 lIrkg ds fy, fn, tk ldr s gSa f}rh; o"kZ ¾ 46 lIrkg@2208 ?kaVs ¼46×48 ?kaVs½ ¼lS)kafrd $ 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 MîVw h djus ds ckn Nqêh ds vkèkkj ij ifjorZu'khy gSA B.[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 9 ¼ifjp;kRed CykWd d{kkvks a vkSj dk;Z'kkyk ds 2 lIrkg dks NksM+dj½ * ¼tujy ltZjh] vkWFkksZisfMDl] vkbZ] bZ,uVh] 10 gSM ,aM uSd] U;wjks] dkÆM;ksFkksjsfdd] ;wjksykWth] thvkbZ@,pihch] ihfM;kfVªd ltZjh] jsfLijVs jh] ,aMksltZjh] vkschth] cqtqxZ] o;Ld vkSj cPp½s lÆtdy 2 fu;ksusVy 2 ihfM;kfVªd 2 dkÆM;ksFkksjsfdd 2 U;wjkslÆtdy 2 1 2 2 1 çlwfr vkSj L=h jksx 1 ihfM;kfVªd 1 tujy ltZjh 2 bZ,uVh 1 vkbZ 1 oLdwyj 1 Ms ds;j 1 VªkWek 1 ;wjksykWth 1 U;wjks 1 2 1 2 2 ¼CykWd d{kkvks a ds ,d lIrkg dks NksM+dj½ * tujy ltZjh 7 çlwfr ,oa L=h jksx 7 vkFkksZisfMDl ,oa VkWek 5 ihfM;kfVªd ltZjh 2 vkIFksYeksykWth 3 ;wjksykWth 2 bZ,uVh 2 IykfLVd ltZjh 2 dkÆM;ksFkksjsfdd 1 U;wjksltZjh 110 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] MsaVy 2 vkikrdkyhu ltZjh 2 jfsM;ks Mk;Xuksfll 2 ,aMksLdksih :e 1 vkbZlh;w 6 C.

• O;k[;ku ,oa ppkZ • lsfeukj • dk;Z'kkyk • uSnkfud dkUÝsla • dsl@uSnkfud çLrqfr • xgu vkS"kèkh; vè;;u] çLrqfr vkSj fjiksVZ • dsl LVMh@uSnkfud ;k n[s kHkky ekxZ çLrqfr • uÉlx jkmaM • tuZy Dyc • funsZf'kr iBu • fufgr dk;Z vkSj çkstsDV • dsl LVMh fo'y"sk.k • fleqy's ku vkèkkfjr vfèkxe • leL;k vkèkkfjr vfèkxe • vuqHkokRed vfèkxe • Çpru'khy vfèkxe D.

çR;sd uSnkfud inLFkkiu ds var eas] uSnkfud ykWxcqd ¼fof'k"V çfØ;kRed n{krk,a@uSnkfud dkS'ky½ ¼ ½ vkSj uSnkfud vgZrk, a ¼ ½ ij fçlsIVj@ladk; }kjk gLrk{kj fd, tku s pkfg,A E. ¼vkbZlh,u] 2020 ls :ikarfjr½ 1- O;kid vkadyu] uSnkfud çfØ;kvks]a isjh&,usLFksfl;k tfVyrkvks a ds çcaèku ls lacafèkr tkudkjh çkIr djrk gSA 2- tc jksxh tfVy vkSj@;k vfLFkj okrkoj.k eas gksrs gSa] rks jksxh lqj{kk eas mUur dkS'ky rFkk n{krkvks a dks ykxw djrk gS vkSj mUgs a vuqdwfyr djrk gSA 3- isjh&,usLFksfVd çcaèku es a Bksl mUur uSnkfud rdZ vkSj fu.kZ; ykxw djrk gSA 4- jksxh n[s kHkky ds vkadyu] çcaèku vkSj fu:i.k eas egRoiw.kZ lksp dk mi;ksx djrk gSA 5- vkadyu] funku] çcaèku dk nLrkosthdj.k djrk gS vkSj jksxh dh lk>snkjh eas mipkj rFkk vuqorÊ n[s kHkky dh fuxjkuh djrk gSA 6- laLFkkxr çksVksdkWy ds vuqlkj vkS"kfèk;ks a vkSj mipkjks a dk ç'kklu djrk gSA 7- fpfdRlh; lacaèkks a dks 'kq: djus] fodflr djus vkSj can djus ds fy, ykxw lapkj] ijke'kZ] i{k&leFkZu vkSj ikjLifjd dkS'ky dk mi;ksx djrk gSA 8- n[s kHkky dh fujarjrk cuk, j[ku s ds fy, vU; LokLF; lsok dfeZ;ks a ls jsQjy yrs k gS vkSj jsQj djrk gSA 9- tgka Hkh vfèkÑr gks] Lor=a :i ls vH;kl djrk gSA 10- vU; LokLF; lsok dfeZ;ks a vkSj vU; yksxks a ls ijke'kZ ysrk gS vkSj mUgs a ijke'kZ nsrk gSA 11- jksxh ds fgr es a vksvkj dÆe;ks a vkSj 'kY;&fpfdRlk ny ds lnL;ks a ds lkFk feydj dke djrk gSA 12- orZeku oSKkfud lk{; ij vkèkkfjr vkSj jksxh] ifjtuks a rFkk leqnk; ds LokLF; çcaèku eas 'kkfey vH;kl fodflr djrk gSA 13- Lor=a vkSj varj&is'ksoj 'kksèk ds ekè;e ls n[s kHkky dh lqj{kk] n{krk vkSj çHkko'khyrk eas lqèkkj djus ds fy, lk{;&vkèkkfjr vH;kl fodflr 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 rFkk xq.koÙkk lqèkkj dk mi;ksx djds ,d lqjf{kr fpfdRlh; okrkoj.k cukrk gS vkSj cuk, j[krk gSA 17- cnyrh LokLF; lsok ç.kkyh esa dq'ky mUur vH;kl uÉlx lsokvks a ds forj.k eas urs `Ro vkSj çcaèku dh ftEens kjh yrs k gSA[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 11 18- LokLF; lsok ç.kkfy;ks a eas jksfx;ks a ds fy, ,d i{k&leFkZd ds :i es a dk;Z djrk gS vkSj LokLF; uhfr;ks a dk fodkl djrk gS tks O;fDrxr jksxh] ifjtuks a vkSj leqnk; dks c<k+ok nrs s gSa vkSj mudh j{kk djrs gSaA 19- vH;kl dks çklafxd vkSj lkaLÑfrd ifjos'k ds vuqdwy cukrk gSA F.

Nk=ks a dks laLFkkxr çksVksdkWy@LFkk;h vkn's kks a ds vuqlkj Lora= :i ls ,uLs Fksfl;k 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;ks a dk ç'kklu lacafèkr ,uLs Fksfl;ksykWftLV ds ijke'kZ ls fd;k tkrk gS vkSj ckn eas fyf[kr vkns'kks a }kjk vuqeksfnr fd;k tkrk gSA 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

1.

2- ,uLs Fksfl;k ds;j es a 'kksèk 8 ?kaVs 40 ¼5 fnu½ 1×24¾24 ?kaVs • 'kksèk vè;;u fo'y"sk.k vuqç;ksx rFkk lk{; vkèkkfjr $ 8 ?kaVs • v 1H ;kl@fufgr dk;Z ¼ç;ksx'kkyk½ vH;kl ¼56$24½ 3- urs `Ro] çcaèku rFkk f'k{k.k es a 12$2 ?kaVs 1×26¾26 ?kaVs • uSnkfud dkUÝsla mUur dkS'ky ¼56$24½ 2-5×16¾40 ?kaVs • lsfeukj • vH;kl@fufgr dk;Z ¼ç;ksx'kkyk½ 4- ,uLs Fksfl;k ds;j es a vuqç;qDr 1-5×40¾60 ?kaVs • ekey s dh çLrqfr mUur iSFkksfQft;ksykWth ¼60½ • lsfeukj • uSnkfud dkUÝsla 5- ,uLs Fksfl;k ds;j es a vuqç;qDr 10 ?kaVs 1×44¾44 ?kaVs • uÉlx jkmaM~l mUur QkekZdksykWth ¼54½ • vkS"kèkh; vè;;u çLrqfr • LFkk;h vkns'k@çLrqfr 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 • ekey s dk vè;;u 2×2¾4 ?kaVs 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 7- ,uLs Fksfl;k uÉlx vH;kl ds ewy 9×16¾144 ?kaVs • çn'kZu ¼ç;ksx'kkyk½ vkèkkj • okilh çn'kZu ¼ç;ksx'kkyk½ ¼96$48 ?kaVs½ ¾ 144 ?kaVs • uSnkfud çf'k{k.k • ekey s dk vè;;u • lsfeukj • uSnkfud dkUÝsla • ladk; O;k[;ku 8- ,uLs Fksfl;k uÉlx I 9×16¾144 ?kaVs • çn'kZu ¼ç;ksx'kkyk½ ¼96$48 ?kaVs½ ¾ 144 ?kaVs • okilh çn'kZu ¼ç;ksx'kkyk½ • uSnkfud dkUÝsla @tuZy Dyc • lsfeukj • ekey s dh çLrqfr • vkS"kfèk vè;;u ¼vkS"kèkh; ikjLifjd çHkko lfgr½ • uÉlx jkmaM~l12 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] ¼48 ?kaVs½ • ladk; O;k[;ku 9- ,uLs Fksfl;k uÉlx II 9×16¾144 ?kaVs • çn'kZu ¼ç;ksx'kkyk½ ¼96$48 ?kaVs½ ¾ 144 ?kaVs • okilh çn'kZu • uÉlx jkmaM~l • uSnkfud dkUÝsla @tuZy Dyc • lsfeukj • ladk; O;k[;ku 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; lsok ço`fÙk;ks a vkSj pqukSfr;ks a dk fo'y"sk.k djrk gSA 2- miyCèk nLrkostks a ls ijke'kZ djds Hkkjr es a LokLF; lsok vkSj f'k{kk uhfr;ks a ds uÉlx ij çHkko dk fo'ys"k.k djrk gSA 3- Hkkjr es a LokLF; lsok forj.k ç.kkyh vkSj bldh pqukSfr;ks a dh xgu le> fodflr djrk gSA 4- ,uLs Fksfl;k uÉlx eas LokLF; lsok çnku djus ds fy, çklafxd vkÆFkd fl)karks a dks ykxw djrk gSA 5- ykxr] xq.koÙkk vkSj larqf"V tSls LokLF; ifj.kkeks a dks çHkkfor djus ds fy, LokLF; tkudkjh dk çcaèku vkSj :ikarj.k djrk gSA 6- ulZ çSfDV'kuj dh Hkwfedkvks a vkSj n{krkvks a dk vH;kl djus es a tokcngs h vkSj ftEens kjh Lohdkj djrk gSA 7- ,uLs Fksfl;k ns[kHkky es a LokLF; lsok ny ds lHkh lnL;ks a dks 'kkfey djrs gq, lg;ksxh vH;kl eas lfØ; :i ls Hkkx yrs k gS vkSj vfèkÑr nk;js es a fuèkkZfjr Hkwfedk fuHkkrk gSA 8- mUur uÉlx vH;kl ds dkuwu] uSfrdrk rFkk fofu;eu dh vPNh tkudkjh j[kr s gq, ufSrd vH;kl eas layXu jgrk gSA 9- lqfu;ksftr çf'k{kd ds ekè;e ls çnku fd, x, çf'k{k.k voljks a dk mi;ksx djrk gS vkSj uÉlx çfØ;k@ns[kHkky ekxks± ;k uSnkfud ekxks± dks ykxw djr s gq, lqjf{kr vkSj l{ke n[s kHkky djrk gSA 10- nkrkvks a vkSj çkIrdrkZvks a dks l{ke ns[kHkky çnku dju s eas uÉlx fl)karks a dh tkudkjh dks ykxw djrk gSA 11- fofHkUu LokLF; lsok lek;kstuksa eas] fo'ks"k :i ls Hkkjr eas] ulZ çSfDV'kuj Hkwfedkvks a esa vku s okyh pqukSfr;ks a dh Hkfo";ok.kh djrk gSA 1- oSf'od LokLF; lsok pqukSfr;ka vkSj #>ku ¼n{krk&1½ 2 2- Hkkjr es a LokLF; ç.kkyh% 2 Hkkjr es a LokLF; lsok forj.k ç.kkyh & cnyr s ifjn`'; ¼n{krk&3½ 3- jk"Vªh; LokLF; ;kstuk% iapo"kÊ; ;kstuk,a vkSj jk"Vªh; LokLF; uhfr ¼n{krk&2½ 2 4- LokLF; vFkZ'kkL= vkSj LokLF; lsok foÙkiks"k.k% LokLF; lsok forj.k eas jktuhfr vkSj vFkZ'kkL= dh 4 Hkwfedk ¼n{krk&4½ 5- LokLF; lsok eas fMftVy ifjoruZ % #>ku vkSj volj 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 fuèkkZj.k Hkwfedk,a½ ¼n{krk&6 o 7½ 7- fofu;eu ¼çf'k{k.k laLFkkuks a dh ekU;rk vkSj çek.ki=½ vkSj mUur vH;klh; uÉlx Hkwfedk ds uSfrd 3 vk;ke ¼n{krk&8½ 8- ulZ çSfDV’kuj% Hkwfedk] çdkj] n{krk] vH;kl ds fy, uSnkfud lek;kstu] lkaLÑfrd {kerk 3 ¼n{krk&6½ 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[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 13 12- ,ih,u eas vuqç;qDr uÉlx çfØ;k@ns[kHkky ekxZ ¼n{krk&9½ 2 6 1- LokLF; lsok o f'k{kk uhfr;ks a dh igpku djuk rFkk uÉlx ij blds çHkko dk fo'ys"k.k djuk 2- Hkkjr es a ,uih vH;kl ds fy, 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 fçLØkbÇcx uhfr;ks a dk Hkfo"; D;k gS\ 3- ,uLs Fksfl;k ns[kHkky bdkb;ks a eas ik, tkus okys ,uih vH;kl ls çklafxd 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, ¼2023½ Ldksi vkWQ ulZ ,uLs Fksfl;k çSfDVl] bfyuksbl] ;w,l,% ,,,u, • MsfuLdks ,aM ckdZlZ ,-,e- ¼2015½ ,MokaLM çSfDVl uÉlx% ,lsf’k;y uksyst QkWj n çksQs’ku ¼rhljk laLdj.k½] eSlkpqlsV~l% tksUl ,aM ckVZysV ifCy'klZ • fgdh ts-oh-] vksbesV vkj-,e- ,aM osusxksuh ,l-,y- ¼1996½ ,MokaLM çSfDVl uÉlx% psfatax jksYl ,aM fDyfudy ,Iyhds’kal] fQykMsfYQ;k% fyÇidkWV fofy;El ,aM foÇYdl • vkbZlh,u ¼2020½ xkbMykbla vkWu ,MokaLM çSfDVl uÉlx] https://www.icn.ch/system/ ls fy;k x;k files/documents/2020-4/ICN_APN%20Report_EN_WEB.pdf • u's kuy vkWxZukbts'ku vkWQ ulZ çSfDV'kuj QSdYVht ¼,uvks,uih,Q 2022½ ulZ çSfDV'kuj jksy daihVsla ht]

https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/competencies/20220825_nonpf_ ls fy;k x;k np_role_core_.pdf • '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- ,uLs Fksfl;k ns[kHkky lek;kstu es a Lor=a 'kksèk djus es a xgu 'kksèk tkudkjh vkSj dkS'ky dk s ykxw djrk gSA 2- jksxh n[s kHkky dh xq.koÙkk es a lqèkkj ds fy, lg;ksxh 'kksèk eas Hkkx yrs k gSA 3- bZchih rS;kj djus ds fy, 'kksèk fu"d"kks± dh O;k[;k vkSj mi;ksx djrk gSA 4- loksZÙke çFkkvks a vkSj LokLF; ifj.kkeks a rFkk xq.koÙkk ns[kHkky dks fodflr djus ds fy, oreZ ku vH;kl dk ijh{k.k@ eYw ;kadu djrk gSA 5- n[s kHkky dh lqj{kk vkSj çHkko'khyrk dks c<k+u s ds fy, ,usLFksfl;k uÉlx vH;kl eas fd, x, uÉlx eè;orZuks a ds lk{; dk fo'y"sk.k djrk gSA 6- oSKkfud 'kksèk fjiksVZ fy[kus es a dkS'ky fodflr djrk gSA 1- 'kksèk vkSj mUur vH;kl uÉlx% mUur uÉlx Hkwfedk ls lacafèkr 'kksèk vkSj iwNrkN dk egRo ¼n{krk&1½ 2 2- ,ih,u vH;kl ds fy, 'kksèk ,tsMa k% loksZÙke vH;kl fodflr djus ds fy, orZeku vH;kl dk ijh{k.k] 5 LokLF; ifj.kke rFkk mUur vH;kl eas xq.koÙkkiw.kZ ns[kHkky ds ladsrd ¼n{krk&3] 4] 5½] 'kksèk laLÑfr dks c<+kok nsuk 3- 'kksèk dk Kku 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 o midj.k] fo'y"sk.k vkSj fjiksÉVx½14 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] - 'kksèk çLrko vkSj 'kksèk fjiksVZ y[s ku ¼n{krk&1 vkSj 2½ 4- çdk'ku ds fy, y[s ku 5 ¼y[s ku dk;Z'kkyk% ik.Mqfyfi r;S kj djuk vkSj foÙk iks"k.k ds lzksr <aw<uk½ ¼n{krk&6½ ¼dk;Z'kkyk½ 5- lk{; vkèkkfjr dk;Z 4 - voèkkj.kk] fl)kar] egRo vkSj pj.k - ,uLs Fksfl;k ns[kHkky okrkoj.k eas bZchih dks ,dhÑr djuk - ,uLs Fksfl;k ns[kHkky es a lk{; ds {ks= - bZchih dks ykxw dju s eas ckèkk,a - bZchih dks c<k+ok nsus dh j.kuhfr;ka ¼n{krk&3] 4] 5½ 24 ?kaVs • 'kksèk çkFkfedrkvks a dh igpku djuk • 'kksèk ç'u] mís'; vkSj ifjdYiuk ij vH;kl ys[ku • 'kksèk çLrko@bZchih ifj;kstuk çLrko ys[ku • oSKkfud i= y[s ku & çdk'ku ds fy, ikaMqfyfi rS;kj djuk • O;ofLFkr leh{kk@lkfgfR;d leh{kk ys[ku% ,usLFksfl;k bdkbZ es a fn, x, uÉlx eè;orZu ds lk{; dk fo'ys"k.k djuk 'kksèk fucaèk ¼336 ?kaV s 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 tsuj's ku vkWQ ,foMsal ¼9oka laLdj.k½] lsVa yqbl% ,Ylsfo;j lkWUMlZ • iksfyr Mh-,Q- ,aM csd lh-Vh- ¼2021½ uÉlx fjlpZ% tsusjsÇVx ,aM ,lsÇlx ,foMsla QkWj uÉlx çSfDVl ¼11oka laLdj.k½] ubZ fnYyh% oksYVlZ ,aM Dywoj • f'eV ,u-,- ,aM czkmu ts-,e- ¼2021½ ,foMsla csLM çSfDVl QkWj ulsZl vçsty ,aM ,fIyds'ku vkWQ fjlpZ] ,lMh% tksUl ,aM ckVZysV ifCy'klZ III.

1- ,uLs Fksfl;k ns[kHkky bdkbZ es a usr`Ro vkSj çcaèku ds fl)karks a dks ykxw djrk gSA 2- fl)karks a dh csgrj tkudkjh dk mi;ksx djds ,usLFksfl;k n[s kHkky lek;kstu eas ruko o la?k"kZ dks çHkkoh <ax ls çcafèkr djrk gSA 3- leL;k lekèkku vkSj fu.kZ; ysus ds dkS'ky dk s çHkkoh <ax ls ykxw djrk gSA 4- ,uLs Fksfl;k ns[kHkky lek;kstu eas urs `Ro çnku djus rFkk çcaèku eas xgu Çpru vkSj lapkj dkS'ky dk mi;ksx djrk gSA 5- ny cukrk gS vkSj ,uLs Fksfl;k n[s kHkky lek;kstu es a nlw jks a dks çsfjr djrk gSA 6- bdkbZ dk ctV rS;kj djrk gS] vkiwÆr vkSj LVkQ dk çHkkoh <xa ls çcaèku djrk gSA 7- uokpkj vkSj cnyko ds le; mfpr Hkkxhnkjh djrk gSA 8- f'k{k.k ds xgu fl)kar o #>kuksa ds vkèkkj ij çHkkoh f'k{k.k fofèk;ks]a ehfM;k vkSj vkadyu dk mi;ksx djrk gSA 9- jksxh n[s kHkky eas i{k&leFkZu Hkwfedk fodflr djrk gS] vLirky o lkeqnkf;d lek;kstuksa dh isjh&,usLFksfl;k bdkb;ks a eas xq.koÙkk vkSj uSfrdrk cuk, j[krk gSA 10- ladV dh fLFkfr;ks a eas fo'ks"k :i ls Vscy vkikr fLFkfr;ks a eas jksfx;ks a rFkk ifjtuks a dks ijke'kZ çnku djrk gSA 1- fl)kar] urs `Ro 'kSyh vkSj orZeku #>ku 2 2- fl)kar] çcaèku 'kSyh vkSj orZeku #>ku 2 3- ,uLs Fksfl;k 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 ,uLs Fksfl;k n[s kHkky lek;kstu es a vuqç;ksx] çHkkoh le; 4 çcaèku 5- xq.koÙkk lqèkkj ,oa laijh{k.k 4 6- leL;k lekèkku] vkykspukRed lksp o fu.kZ; yus k] ,usLFksfl;k uÉlx vH;kl eas vuqç;qDr lapkj dkS'ky 5 7- vksvkj lek;kstu es a ny cukuk] çsfjr djuk vkSj lykg nsuk 2 8- ctV o lalkèku çcaèku ftles a ekuo lalkèku 'kkfey gS & vksvkj ctV] lkexzh çcaèku] LVkQ] fufgr dk;Z 5 9- cnyko vkSj uokpkj 2[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 15 10- LVkQ çn'kZu vkSj vkadyu ¼çn'kZu dk fu:i.k½ 6 11- f'k{k.k&vfèkxe fl)kar vkSj ,uLs Fksfl;k uÉlx eas vuqç;qDr 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 & vuqHkokRed] Çpru'khy] ifjn`'; vkèkkfjr] fleqys'ku vkfn] 8 ehfM;k% ,uLs Fksfl;k n[s kHkky lek;kstu es a ifjtuks a vkSj deZpkfj;ks a dks f'kf{kr 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- ,uLs Fksfl;k ns[kHkky lek;kstu es a i{k&leFkZu Hkwfedk,a 2 24 ?kaVs 1- LVkQ jksxh fufgr dk;Z rS;kj djuk 2- bdkbZ dk ctV rS;kj djuk 3- LVkQ MîwVh jksLVj rS;kj djuk 4- jksxh n[s kHkky laijh{k.k 5- uÉlx n[s kHkky ekud vkSj çksVksdkWy rS;kj djuk 6- midj.k vkSj vkiwÆr çcaèku 7- laØe.k fu;a=.k vH;klks a dh fuxjkuh] vkadyu vkSj fjiksVZ y[s ku 8- f'k{k.k ;kstuk dk fodkl 9- lw{e f'k{k.k@vfHkHkkod çf’k{k.k l= 10- jksxh rFkk deZpkfj;ks a ds fy, çf'k{k.k i)fr vkSj ehfM;k rS;kj djuk 11- vks,llhbZ@vks,lihbZ dh ;kstuk cukuk vkSj lapkyu djuk 12- ijh{k.k fuekZ.k vkWijs’ku :e dk;Z&LFky fgalk • cSLVscy ,l-ch- ¼2019½ ulZ ,t ,tqdsVj% fçaflIYl vkWQ Vhfpax ,aM yfu±x QkWj uÉlx çSfDVl ¼5oka laLdj.k½] ubZ fnYyh% tksUl ,aM ckVZyVs ifCy'klZ • fcÇyXl Mh-,e- ,aM gsyLVhM ts-,- ¼2009½ Vhfpax bu uÉlx% v xkbM QkWj QSdYVh ¼NBk laLdj.k½] lsaV yqbl] felkSjh% lkWUMlZ ,Ylsfo;j • DykdZ lh-lh- ¼2010½ fØ,fVo uÉlx yhMjf'ki ,aM eSuts easV] ubZ fnYyh% tksUl ,aM ckVZyVs ifCy'klZ • fyCyj ts-th- ,aM eSddksusy lh-vkj- ¼2008½ esusteasV fçaflIYl QkWj gSYFk çksQs’kuYl] lMcjh] ,e,% tksUl ,aM ckVZysV ifCy’klZ • jlsy ,y- ,aM LokUlcxZ vkj-lh- ¼2010½ eus ts easV ,aM yhMjf’ki QkWj ulZ ,MfefuLVªVs lZ ¼5oka laLdj.k½] ubZ fnYyh% tksUl ,aM ckVZysV ifCy’klZ IV.

1- ,uLs Fksfl;k iwoZ vkadyu djus] ,uLs Fksfl;k ds nkSjku fuxjkuh vkSj ,usLFksfl;k ds i’pkr n[s kHkky djrs le; iSFkksfQft;ksykWth dh tkudkjh dks ,dhÑr djrk gSA 2- iSFkksfQft;ksykWth dh tkudkjh dk mi;ksx djds isjh&,usLFksfl;k lac) tfVyrkvks a ls lacafèkr y{k.kks a dk çcaèku djrk gSA 3- isjh&,usLFksfl;k jksxh n[s kHkky lacafèkr ifjorZuks a dk fo'y"sk.k djrk gSA IV. A.

6 I dkÆM;ksoLdqyj fLFkfr;ks a dh iSFkksfQft;ksykWth • mPp jDrpki ¼gkbijVs’aku½ • vYi jDrnkc ¼gkbiksVs'a ku½ • dksjksujh vkVZjh jksx • bLdsfed gVZ jksx • gVZ QsY;j16 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] • gkbijVªkWfQd dkÆM;ksek;ksiSFkh • okYoqyj gVZ jksx • tUetkr ân; jksx • isfjdkÆM;y jksx • ,uLs FksfVd ,tsVa ksa ls lacafèkr dkÆM;ksoLdqyj tksf[ke • dkÆM;ksoLdqyj flLVe ij LFkkiu dk çHkko 6 II iYeksujh fLFkfr;ks a dh iSFkksfQft;ksykWth • iYeksujh QaD’ku • QsQM+ksa dh fLFkfr;ks a dh iSFkksfQft;ksykWth • vkCLVªfDVo iYeksujh jksx • jSfLVªfDVo iYeksujh jksx • iYeksujh ,EcksfyTe • iYeksujh ,fMek • iYeksujh gkbijVs’aku • vLij’sku • ,Vys Ds Vkfll • dksj iYeksusy • ,uLs FksfVd ,tsVa ksa ls lacafèkr iYeksujh tksf[ke • iYeksujh flLVe ij LFkkiu dk çHkko 6 III rfa=dk lacaèkh fodkjks a dh iSFkksfQft;ksykWth • baVªkØSfuvy gkbijVs’aku • czsu LVes batjh • LVªksd • VªkWesfVd czsu batjh • ohul ,;j ,EcksfyTe • lsjhczy ,U;wfjTe • vkfVZfj;ks&ohul foÑfr;ka • lsjhczksoLdwyj nq?kZVuk • baVªkØSfuvy ekl ysflvu • nkSj s • vi{k;h raf=dk lacaèkh jksx • U;wjkseLdqyj jksx • jh<+ dh gìh dh pksV • U;wjksykWftdy VªkWek • ekufld fodkj & volkn] f}èkzqoh jksx] fltksÝsfu;k] U;wjksysfIVd efsyXuasV ÇlMªkse] eknd æO;ksa dk lsou • ,uLs FksfVd ,tsVa ksa ls lacafèkr raf=dk lacaèkh tksf[ke • U;wjksykWftdy flLVe ij LFkkiu dk çHkko 4 IV jhuy fLFkfr;ks a dh iSFkksfQft;ksykWth • fcukbu çksLVfsVd gkbijIykfl;k • Vîwej • CySMj VªkWek • jhuy QsY;j • ,uLs FksfVd ,tsVa ksa ls lacafèkr xqnZs ds tksf[ke 4 V xSLVªksbaVsLVkbuy vkSj gsisVksfcyjh fLFkfr;ks a dh iSFkksfQft;ksykWth • thvkbZ CyhM • ,CMkfseyu batjh ¼isV dh pksV½ • baVsLVkbuy vkWCLVªD’ku ¼vkarks a eas #dkoV½ • ijQksjsVsM visfaMDl • ,D;wV iSufØ;kfVfVl ¼rhoz vXuk'k;'kksFk½[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 17 • ,CMkfseuy ,vksVkZ ,U;wfjTe • gsisVkbfVl & rhoz] th.kZ • fljksfll • gsisfVd QsY;j ¼;Ñr foQyrk½ • ,uLs FksfVd ,tsVa ksa ls lacafèkr xSLVªksbaVsLVkbuy vkSj gsisVksfcyjh tksf[ke 4 VI var%lzkoh dk;ks± dh iSFkksfQft;ksykWth • Mk;fcVhl eys Vs l • gkbijFkk;jk;fMTe] gkbiksFkk;jk;fMTe • gkbijiSjkFkk;jk;fMTe] gkbiksiSjkFkk;jk;fMTe • feujyksdkWÆVdkWbM dh vfèkdrk] feujyksdkWÆVdkWbM dh deh] Xydw ksdkWÆVdkWbM dh vfèkdrk] XywdksdkWÆVdkWbM dh deh] dSVsdksykekbu dh vfèkdrk • eksVkik • dkÆlukWbM ÇlMªkse • ,uLs FksfVd ,tsVa ksa ls lacafèkr ,aMksfØuksykWftdy tksf[ke IV. B.

I 4 ,e,l fLFkfr;ks a dh iSFkksfQft;ksykWth • jh<+ dh gìh es a ÝSDpj • ,afdyksÇlx LikWfUMykbfVl • fMLyksds'ku • fyxkeasVy batjh • lwtu lacaèkh fLFkfr;ka • baVjoVZsczy fMLd çksySIl] ikWV~l jksx • tUetkr & dk;Qksfll] ykWMkZsfll] Ldksfy;ksfll • ,uLs FksfVd ,tsVa ksa ls lacafèkr ,e,l tksf[ke • ,e,l flLVe ij LFkkiu dk çHkko II 8 dku] ukd vkSj xy s dh fLFkfr;ks a dh iSFkksfQft;ksykWth • dku dh fLFkfr • vka[kks a dh fLFkfr • ukd dh fLFkfr • xy s dh fLFkfr III 6 fuEu fLFkfr;ks a dh mUur iSFkksfQft;ksykWftdy çfØ;k • 'kkWd & gkbiksokys fsed & dkÆM;kstsfud & fMfLVªC;wfVo • VªkWek & FkksjSfdd & isV & eLdqyksLdsyVs y & eSfDlyksQsf'k;y IV 418 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] fof'k"V laØe.kks a dh mUur iSFkksfQft;ksykWftdy çfØ;k • ,pvkbZoh • VVs ul • lklZ • fjdsV~fl;ksfll • yIsVksLik;jksfll • Msaxw • eysfj;k • fpduxqfu;k • jcs ht • ,fo;u ¶yw • Lokbu ¶yw • dksfoM&19 V 8 çtuu fLFkfr;ks a dh mUur iSFkksfQft;ksykWftdy çfØ;k • xHkkZoLFkk & lkekU;] vafCydy dkWMZ çksySIl] fMLVksfl;k ,aM ,CukWeZy QhVy çstsaVs’kal ,aM iksth’kal] eYVhiy xSLVs’kal] xHkkZoLFkk çsfjr mPp jDrpki] ckfèkr çlo] QVk gqvk xHkkZ'k;] le;&iwoZ çlo • çloiwoZ jDrlzko & IyslasVk çhfo;k] ,CjI’ku IyslasVk] ;wVhfju jIpj ¼xHkkZ'k; dk QVuk½ • f>Yyh dk le; ls igys VwVuk • dksfj;ks,fEu;ksfufVl • ,efu;ksfVd ¶Y;wM ,EcksfyTe • çloksÙkj jDrlzko • HELLP ¼gseksfyfll] ,yhoVs Ms fyoj ,atkbe] yks IysVyVs dkmaV½ • vk?kkr • cdksZfoV~t ,- ¼2021½ fDyfudy iSFkksfQft;ksykWth ¼nwljk laLdj.k½] esMekLVj bad • áFw kj ,l-bZ-] eSddSal ds-,y- ,aM czs’klZ oh-,y- ¼2019½ vaMjLVsfaMax iSFkksfQft;ksykWth ¼7oka laLdj.k½] lsaV yqbl] felkSjh% ,Ylsfo;j • áFw kj ,l-bZ- ,aM eSddSal ds-,y- ¼2012½ vaMjLVsfaMax iSFkksfQft;ksykWth ¼5oka laLdj.k½] lsVa yqbl] felkSjh% ,Ylsfo;j • ukxsygkmV ts-t-s ,aM ,yh'kk ,l- ¼2018½ ulZ ,uLs Fksfl;k] lsVa yqbl] felkSjh% ,Ylsfo;j • ukWfjl Vh-,y- ¼2020½ iksFlZ vlsaf’k;Yl vkWQ iSFkksfQft;ksykWth ¼5oka laLdj.k½] okYVlZ Dywoj • iksFkZ lh-,e- ¼2007½ vlsfa’kYl vkWQ iSFkksfQft;ksykWth% dulsIV~l vkWQ vYVMZ gSYFk LVVs ~l ¼pkSFkk laLdj.k½] fQykMsfYQ;k% fyÇidkWV fofy;El ,aM foÇYdl • iksFkZ lh-,e- ¼2007½ vlsaf’kYl vkWQ iSFkksfQft;ksykWth% dulsIV~l vkWQ vYVMZ gSYFk LVVs ~l ¼nlw jk 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] tksUl ,aM ckVZysV ifCy'klZ] bad- • fofyl ,y-,e- ¼2019½ çksQs'kuy xkbM QkWj iSFkksfQft;ksykWth ¼pkSFkk laLdj.k½] fQykMsfYQ;k% fyÇidkWV fofy;El ,aM foÇYdl V.

1- fofHkUu çdkj ds ,uLs Fksfl;k çnku djus vkSj ,uLs Fksfl;k ds i’pkr jksfx;ks a dh n[s kHkky eas vkS"kèkh; fl)karks a dk vuqç;ksx djrk gSA 2- ,uLs Fksfl;k es a QkekZdksFksjsI;fwVDl vkSj QkekZdksMk;ufseDl dk fo'y"sk.k vkSj vuqç;ksx djrk gSA 3- fl)karks a vkSj laLFkkxr çkVs ksdkWy ds vkèkkj ij lqjf{kr vkS"kfèk nus s dk vH;kl djrk gSA 4- vkS"kèkh; ,ytÊ] ,ukfQySfDll vkSj vkS"kèkh; vfèkdrk ds ekey s eas lgh rjhds ls nLrkost rS;kj djrk gS vkSj mfpr n[s kHkky çnku djrk gSA 5- ,uLs Fksfl;k çnku djrs le; vkS"kfèk;ks a dh ijLij fØ;k ds ckjs es a xgu tkudkjh dk vuqç;ksx djrk gSA I 2 • bfro`Ùk[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 19 • vkS"kfèk;ks a dk oxÊdj.k rFkk vulq wph II 4 • ifjp;

• fØfVdy ds;j es a lekos'k.k] forj.k] p;kip; vkSj mRltZu • IykTek dalaVª’sku] gkQ ykbQ • yksÇMx Mkst vkSj esVa us asl Mkst • fpfdRlh; lwpdkad vkSj vkS"kèkh; lqj{kk • {kerk vkSj çHkkodkfjrk • vkS"kfèk nsus ds fl)kar o vkS"kfèk nsus ds vfèkdkj o eki ç.kkyh o vkarfjd vkS"kfèk nus k o lkef;d vkS"kfèk nsuk o iSjasVsjy vkS"kfèk nus k III 4 • ifjp;

• QkekZdksdkbufsVDl • orZeku bugsys'ku mipkj dk unS kfud voyksdu • dkÆM;ksoLdqyj] iYeksujh] gsisfVd] U;wjkseLdqyj] lkekU; çHkko] çlwfr ij buosflo ,usLFksfl;k dh U;wjksQkekZdksykWth] vkSj Hkzw.k fodkl ds çHkko • ,uLs Fksfl;k MhxzsMs’ku ckb dkcZu MkbvkWDlkbM • ok"i'khy ,uLs Fksfl;k dh uSnkfud mi;ksfxrk • LFkk;h vkns'k@laLFkkxr çksVksdkWy IV 5 • ifjp;

• QkekZdksdkbufsVDl • baVªkohul ,uLs Fksfl;k ds lkekU; fl)kar • fuEufyf[kr dh QkekZdksdkbusfVDl] QkekZdksMk;ufseDl] uSnkfud mi;ksx vkSj nq"çHkko o çksiksQksy o ,VksfeMsV o dsVkekbu o MsDlesMsVksfeMkbu o csta ksMk;tsikbal o ckÆcpqjsV~l • U;w baVªkohul ,usLFksfVDl • LFkk;h vkns'k@laLFkkxr çksVksdkWy V 4 • ifjp;

• vksfivksbM dh QkekZdksdkbusfVDl vkSj QkekZdksMk;ufseDl • vksfivksbM eSdsfuTe • vksfivksbM çsfjr ’olu volkn • vksfivksbM lacafèkr vU; nq"çHkko • çlo ihM+k ds fy, jfseQsVa kfuy • vkuoq af'kd varj • vksfivksbM çsfjr bE;wuksekWMîyw 's ku vkSj dSalj iqujko`fÙk • vksfivksbM ij fuHkZj jksfx;ks a eas rhoz nnZ çcaèku VI 6 • ifjp;

• QkekZdksdkbufsVDl vkSj QkekZdksMk;ufseDl • vkS"kèkh; fo'ks"krk,a • MhiksyjkbÇtx U;wjkseLdqyj CykWÇdx MªXl • ukWu&MhiksykjkbÇtx U;wjkseLdqyj CykWÇdx MªXl • Mªx baVjDs 'ku • U;wjkseLdqyj CykWÇdx ,tsVa ds fodYi20 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] • ekWfuVfjxa vkWQ U;wjkseLdqyj CykWdsM • fjolZy vkWQ U;wjkseLdqyj CykWdsM VII 4 • ifjp;

• fuEufyf[kr dh QkekZdksdkbusfVDl vkSj QkekZdksMk;ufseDl o fu;ksfLVXekbu o ikbfjMksfLVXekbu o ,MªksQksfu;e o fQtksfLVXekbu o lqxkekMsDl o ,y&flLVhu VIII 2 • ifjp; • fuEufyf[kr dh QkekZdksdkbusfVDl vkSj QkekZdksMk;ufseDl o ,Vªksfiu o Ldksikys kfeu IX 4 • ifjp;

• fuEufyf[kr dh QkekZdksdkbusfVDl vkSj QkekZdksMk;ufseDl o QsfuysÝhu o vYQk 2 ,xksfuLV o ,fiusÝhu o bQsfMªu o ukWj,fiusÝhu o Mksikekbu o vkblkçs ksVsjsukWy o MkscqVkekbu o MksisDlkekbu o QsuksYMksiSe X 4 • ifjp;

• fuEufyf[kr dh QkekZdksdkbusfVDl vkSj QkekZdksMk;ufseDl o vYQk CykWdlZ & QsVa ksykehu o feDLM ,aVkxksfuLV~l & yscsVkyksy o chVk CykWdlZ & ,Leksyksy] eVs ksçksyksy] çksçkuksyksy] ufscyksy] dkosZfMyksy XI 4 • ifjp;

• fuEufyf[kr dh QkekZdksdkbusfVDl vkSj QkekZdksMk;ufseDl o fgLVkekbu fjlsIVj ,aVkxksfuLV~l & H1 fjlsIVj ,aVkxksfuLV~l] H2 fjlsIVj ,aVkxksfuLV~l o ,aVkflM & esVksDyksçekbM] çksVkWu iai bufgfcVlZ] 5 HT3 fjlsIVj ,aVkxksfuLV~l o C;wfVjksQsuksUl o MsDlkeFs kklkus o U;wjksfdfuu 1 fjlsIVj ,aVkxksfuLV XII 4 • ifjp;

• fuEufyf[kr dh QkekZdksdkbusfVDl vkSj QkekZdksMk;ufseDl o dsVksjksykd o DyksfuMhu o MsDlesMsVksfeMhu o MksDlk çke o ukyksDlksu o ukYVªsDlksu o ¶yqektsfuy XIII 3[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 21 • ifjp;

• fuEufyf[kr dh QkekZdksdkbusfVDl vkSj QkekZdksMk;ufseDl o ukbVªks oklkfsMysVj & lksfM;e ukbVªksçqlkbM] ukbVªksfXyljhu] gkbMªSykftu o ukWu&ukbVªks oklksfMyVs j & QsuksYMksise] dSfY'k;e ,aVkxksfuLV~l XIV 4 • ifjp;

• QkekZdksdkbufsVDl vkSj QkekZdksMk;ufseDl • yksdy ,uLs FksfVDl dk fØ;k ra= • QkekZdksykWth vkSj QkekZdksMk;ufseDl • yksdy ,uLs Fksfl;k dh QkekZdksdkbusfVDl • yksdy ,uLs Fksfl;k dk uSnkfud mi;ksx • yksdy ,uLs Fksfl;k dh fo"kkDrrk • U;w yksdy ,uLs FksfVDl • Hkfo"; dh fpfdRlk vkSj rkSj&rjhds • bZlsu ,p-ts- ¼2020½ QkekZdksykWth vkWQ bE;wukslçs'ku ¼igyk laLdj.k½] ÇLçxj • eSds th-,- ,aM okYVlZ ,e-vkj- ¼2021½ fDyfudy QkekZdksykWth ,aM FksjsI;fwVDl ¼10oka laLdj.k½] okbyh&CySdosy • fQfyIl ,u-,e- ¼2013½ csjh ,aM dksgUl vkWijsÇVx :e VSduhd] ,Ylsfo;j% ubZ fnYyh • fou s ,-,y-] ow Vh-,e- ,aM vksysbZ ,-ts- ¼2007½ QkekZdksFksjsI;fwVDl QkWj ulZ çSfDV'kuj fçLØkbclZ ¼nwljk laLdj.k½] fQykMsfYQ;k% Msfol VI.

1- ç.kkyhokj 'kkjhfjd vkadyu ds fl)karks a dks ykxw djrk gS vkSj mfpr ijh{k.k dkS'ky fodflr djrk gSA 2- lkekU; o vlkekU; fu"d"kks± ds chp varj dju s ds fy, mUur LokLF; vkadyu dkS'ky dk mi;ksx djrk gSA 3- ijh{k.k fu"d"kks± rFkk laLFkkxr çksVksdksy ds vkèkkj ij LØhÇux vkSj uSnkfud ijh{k.kks a dk vkn's k nrs k gSA 4- HkkSfrd ijh{k.k ds fu"d"kks± rFkk fofHkUu tkapks a ds ifj.kkeks a dk fo'y"sk.k djrk gS vkSj ,uLs Fksfl;k dk lgh fodYi pquus es a ,uLs Fksfl;ksykWth ny ds lkFk feydj dke djrk gSA 5- vkadyu] funku rFkk çcaèku dk nLrkots hdj.k djrk gS vkSj LokLF; lsok ny ds lnL;ks]a jksfx;ks a rFkk ifjtuks a ds lkFk vuoq rÊ ns[kHkky dh fuxjkuh djrk gSA I 4 • bfro`Ùk ysuk • 'kkjhfjd tkap II 6 • ,uVs kWeh ,aM fQft;ksykWth vkWQ lhoh,l & leh{kk o ân; dh lajpuk o ân; ls jDr çokg o ân; dh pkyu ç.kkyh o èkeuh vkSj f'kjk,a • lhoh,l ds lkekU; y{k.k% lhus es a nnZ] lkal Qwyuk] èkM+du] csgk's kh] ÇiMyh es a nnZ • ân; lacaèkh bfro`Ùk yus k • 'kkjhfjd vkadyu% fujh{k.k% Ropk dk jax] tqxqyj ohu fMLVsa’ku] ,fMek • 'kkjhfjd vkadyu% vkWLdYVs'ku% ân; èofu] dSjksfVM èofu • 'kkjhfjd vkadyu% Li'kZ% ukM+h] dsfiyjh jhfQy] ,fMek] ghOl ;k fFkzYl • vU; vkadyu% jDrpki] tqxqyj ohul çslj • ân; ç;ksx'kkyk vè;;u% tSo jklk;fud ekdZj] gseVksykWftdy vè;;u • ân; funku vè;;u% byDs VªksdkÆM;ksxzke] bdksdkÆM;ksxzkQh] VªkallkQs sft;y bdksdkÆM;ksxzkQh] LVªSl VSfLVax] gksYVj ekWfuVÇjx] ek;ksdkÆM;y ij¶;wtu LdSu] dksjksujh ,aft;ksxzkQh] VªkalØSfu;y MkWiyj] okYo ,fj;k vkSj VªkalokYoqyj xszfM,aV] jxs ÆxVsVa QSD’ku • èkeuh jDrpki% vkSlr vkfVZfj;y çslj22 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] III 6 • ,uVs kWeh ,aM fQft;ksykWth vkWQ jfsLijVs jh flLVe • ’olu ç.kkyh ds lkekU; y{k.k • ’olu ç.kkyh dk bfro`Ùk yus k • 'kkjhfjd tkap% fujh{k.k% psruk ds Lrj dk vkadyu] ’olu nj] lkal yus s dk iSVuZ] gksB] psgj]s gkFk vkSj iSjks a dh Ropk dk jax] le:irk vkSj foU;kl ds fy, Nkrh] DyÇcx • 'kkjhfjd tkap% vkWLdYV's ku% QsQM+ksa dh vkokt • 'kkjhfjd tkap% iD;wZ'ku% lqLr vkokt] Li"V de&fip okyh vkokt] [kks[kyh vkokt • ’olu ekWfuVfjax% vkfVfZj;y CyM xSl] iYl vkWDlhesVªh] ,aM&VkbMy dkcZu MkbvkWDlkbM ekWfuVfjxa • ’olu funku ijh{k.k% pSLV jfsM;ksxzkQh] osfaVys'ku ij¶;wtu LdSÇux] iYeksujh ,aft;ksxzkQh] czksda ksLdksih] FkksjSlsUVfsll] LiqVe dYpj] iYeksujh QaD’ku VSLV • bykfLVd jsftLVsla dk vkadyu% vuqikyu] yxa okWY;qe] QaD’kuy jfstMqvy dsisflVh] okbVy dsisflVh • ukWu&bykfLVd jfstLVsla dk vkadyu & ,;jos jsftLVsla Vq xSl ¶yks] fVL;w jsftLVsla • ,fYo;ksyj] vkfVZfj;y vkSj ohul xSl ruko dk vkadyu o vkWDlhtu & ,fYo;ksyj vkWDlhtu ruko] iYeksujh ,aM dsfiyjh vkWDlhtu ruko] vkfVfZj;y vkWDlhtu ruko] feDLM ohul vkWDlhtu ruko o dkcZu MkbvkWDlkbM & feDLM ohul dkcZu MkbvkWDlkbM ruko] ,fYo;ksyj dkcZu&MkbvkWDlkbM ruko] iYeksujh ,aM dsfiyjh dkcZu MkbvkWDlkbM ruko] vkfVZfj;y dkcZu MkbvkWDlkbM ruko] ,aM VkbMy dkcZu MkbvkWDlkbM ruko IV 6 • rfa=dk lacaèkh bfro`Ùk • lkekU; 'kkjhfjd tkap% lapkj] vuqHkwfr] èkkj.kk ¼ekufld fLFkfr½] diky raf=dk ijh{k.k] laosnh ijh{k.k] eksVj ijh{k.k] xfr dh lhek] ekalisf'k;ks a dh rkdr] ekalisf'k;ks a dh lgu'kfDr] ltxrk] larqyu] pky • U;wjksMk;XuksfLVd vè;;u & byDs Vªks,UlsQsyksxzkQh] boksDM iksVsaf'k;y] lhVh LdSu] ,evkjvkbZ] iSV LdSu V 5 • bfro`Ùk • 'kkjhfjd tkap • vlsleasV vkWQ jhuy QaD’ku & CyM ;wfj;k ukbVªkstu] lhje fØ,fVfuu] fØ,fVfuu Dyh;jasl] fØ,fVfuu jsf’k;ks • vlsleasV vkWQ bysDVªksykbV~l ,aM ,flM csl cSyasl • vlsleasV vkWQ ¶Y;wM cSysla VI 6 • bfro`Ùk • 'kkjhfjd tkap • thvkbZ VªSDV dk vkda yu • fyoj QaD'ku dk vkadyu & lhje fcyh#fcu] lhje VªkalQsjsfll] lhje ,Ydykbu QkWLQsVst] lhje ,YC;wfeu] CyM veksfu;k] çksFkzksfEcu Vkbe VSLV • Mk;XuksfLVd vè;;u & jfsM;ksykWftdy vkSj beÇstx vè;;u] ,aMksLdksfid vè;;u VII 5 • bfro`Ùk • 'kkjhfjd tkap • ,aMksØkbu xzafFk;ks a dk vkadyu vkSj mudh xfrfofèk & gkeksZuy Lrj] byDs VªksykbV Lrj • ç;ksx'kkyk vè;;u & byDs VªksykbV Lrj] CyM lqxj • uSnkfud ijh{k.k & jsfM;ksykWftdy vkSj beÇstx vè;;u] bZlhth VIII 4 • bfro`Ùk • 'kkjhfjd tkap & pky dk vkadyu] tksM+ksa dk vkadyu • ç;ksx'kkyk vè;;u & CyM iSjkehVj ¼bu¶ysesVjh ,atkbe] ;wfjd ,flM½ • uSnkfud vè;;u & jfsM;ksykWftdy vkSj beÇstx vè;;u IX 5 • bfro`Ùk[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 23 • 'kkjhfjd tkap • ç;ksx'kkyk vè;;u • uSnkfud vè;;u X 5 • bfro`Ùk • 'kkjhfjd tkap • ç;ksx'kkyk vè;;u • uSnkfud vè;;u & jfsM;ksykWftdy vkSj beÇstx vè;;u] ,aMksLdksfid vè;;u XI 4 • o`f) vkSj fodkl • iks"k.k vkadyu • fof'k"V ç.kkyh vkadyu XII 4 • bfro`Ùk • 'kkjhfjd tkap • ç;ksx'kkyk vè;;u • uSnkfud vè;;u & jfsM;ksykWftdy vkSj beÇstx vè;;u XIII 4 • bfro`Ùk • 'kkjhfjd tkap • uotkr f'k'kq ds LØhÇux ijh{k.k • Lruiku • iks"k.k XIV 3 • bfro`Ùk • 'kkjhfjd tkap • ç;ksx'kkyk vè;;u • uSnkfud & fLdu Leh;j] fLdu LoSc] fLdu ck;ksIlh] ,ytsZu VSLV XV 3 • bfro`Ùk • 'kkjhfjd tkap • ç;ksx'kkyk vè;;u • tsfj,fVªd vlsleasV VYw l & fDyfudy fMesfa'k;k jsÇVx Ldsy] feuh&esVa y LVsV ,Xtkfeus’ku] vYtkbej jksx ds ekunaM] dkedkt ds iSekus dk oSf’od vkadyu] tsfj,fVªd fMçs'ku Ldsy] LVªksd vlsleasV Ldsy ¼48 ?kaVs es aladk; }kjk çn'kZu vkSj Nk=ks a}kjk vH;kl 'kkfey gS½ 48 ?kaV s • O;kid bfro`Ùk ysuk • 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 • ,uLs Fksfl;k ik jgs cPpks a dk vkadyu o uotkr f'k'kq vkSj cPps • ,uLs Fksfl;k ik jgs o`)ks a dk vkadyu • ,uLs Fksfl;k ik jgh xHkZorh efgykvks a dk vkadyu • fofHkUu çdkj ds ,uLs Fksfl;k ds rgr fofHkUu 'kY;&fpfdRlkvks a ls xqtj jgs jksfx;ks a dk ,uLs Fksfl;k iwoZ vkadyu • laLFkkxr çksVksdkWy ds vuqlkj ç;ksx'kkyk@uSnkfud ijh{k.kks a dk vkn's k nus k vkSj mudh O;k[;k djuk24 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] • cjk'k ih-th-] dqysu vkj-ch-] LVksÇYVx vkj-d-s] fe'ksy ds-] dgyu ,e-] fØLVhu ,l-] vksVsZxk vkj-] lSe vkj- 'kjkj ,aM urkyh ,Q-,p- ¼2023½ fDyfudy ,uLs Fksfl;k ¼9oka laLdj.k½] ;,w l,% oksYVlZ ,aM Dyow j • fcdys ,y-,l- ,aM fltykxh ih-th- ¼2013½ csV~l xkbM V w fQftdy ,Xtkfeus'ku ,aM fgLVªh VÇsdx ¼11oka laLdj.k½] ubZ fnYyh% fyÇidkWV fofy;El ,aM foÇYdl • jksM~l ts- ¼2006½ ,MokaLM gSYFk vlsleasV ,aM Mk;XuksfLVd jhtÇux] fQykMsfYQ;k% fyÇidkWV fofy;El ,aM foÇYdl • jkWcVZ vkj-ds-] xzsosuLVhu ,u-] yksckVks bZ-ch- ,aM xzsosuLVhu ts- ¼2002½ fDyfudy ,usLFksfl;k] lsVa yqbl] felkSjh% lkWUMlZ ,Ylsfo;j • foYlu ,l-,Q- ,aM fxMsal ts-,Q- ¼2006½ gSYFk vlsleaVs QkWj uÉlx çSfDVl ¼pkSFkk laLdj.k½] lsaV yqbl] felkSjh% lkWUMlZ ,Ylsfo;j I II VII.

1- ,uLs Fksfl;k dh mUur voèkkj.kkvks a dks ykxw djrk gSA 2- cgq&fo"k;d ny ds lnL;ks a ds lkFk lg;ksx djrk gS vkSj ,uLs Fksfl;k ikus okys jksfx;ks a ds vkadyu vkSj çcaèku eas n[s kHkky@uSnkfud ekxZ rS;kj djrk gSA 3- LokLF; lqj{kk ls lacafèkr ns[kHkky] ,uLs Fksfl;k çcaèku] iwokZuqeku ekxZn'kZu vkSj ijke'kZ çnku djrk gSA 4- isjh&,usLFksfl;k n[s kHkky es a uSfrd fl)karks a dks ykxw djrk gSA 5- isjh&,usLFksfl;k okrkoj.k ds fy, çklafxd laØe.k fu;a=.k fl)karks a dk vH;kl djrk gSA 6- jksxh] ifjtuks a vkSj leqnk; ds fgr ds fy, ns'k ds dkuwuh <kap s ds Hkhrj Lor=a :i ls vH;kl djrk gSA 7- ,uLs Fksfl;k dk;Z&LFky ds dk;Z dks le>rk gSA 8- 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 I 15 • ikBîØe dk ifjp;

• egRoiw.kZ vaxks a ¼efLr"d] jh< + dh gìh] QsQM+]s ân;] fdMuh] ;Ñr] vXU;k'k;] Fkk;jkW;M] ,fMªuy vkSj fiVîwVjh XySaM½ dh 'kkjhfjd jpuk vkSj 'kjhj foKku dh leh{kk • ,sfrgkfld leh{kk & ,uLs Fksfl;k • ,uLs Fksfl;k uÉlx dh voèkkj.kk • ,uLs Fksfl;k uÉlx ds fl)kar • ,uLs Fksfl;k es a ,uih dk nk;jk • vkWijsÇVx :e vkSj fØfVdy ds;j ;wfuV lek;kstu ¼ftles a vksvkj vkSj vkbZlh;w ds çdkj] midj.k] vkiwÆr] vksvkj Vscy vkSj lgk;d midj.k] fofHkUu çdkj ds ekWfuVj vkSj osfaVysVj dk mi;ksx vkSj n[s kHkky] ¶yks 'khV] vkiwÆr ykbu vkSj i;kZoj.k 'kkfey gSa½ • vksvkj deÊ o uÉlx LVkQ ¼ulZ eSuts j] pktZ ulZ] LØc ulZ] ldqZyÇsVx ulZ] ih,lh;w ulZ½ o ,uLs Fksfl;ksykWftLV o ltZu o ,uLs Fksfl;k rduhf'k;u o lgk;d deZpkjh • ,uLs Fksfl;k es a çkS|ksfxdh • LoLFk dk;Z okrkoj.k • ,uih, eas Hkfo"; dh pqukSfr;ka II 10 • xaHkhj :i ls chekj jksfx;ks a eas nnZ • nnZ & çdkj] fl)kar • fQft;ksykWth] nnZ ds çfr ç.kkyhxr çfrfØ;k,a vkSj nnZ dk euksfoKku & leh{kk • rhoz nnZ lsok,a • nnZ dk vkadyu & nnZ ds iSeku]s O;ogkj vkSj ekSf[kd vfHkO;fDr • nnZ çcaèku & vkS"kèkh; ¼vksfivksbM] csta ksMk;tsikbu] çksikQs ksy] vYQk ,xksfuLV] VªSafDoykbtj] U;wjkseLdqyj CykWÇdx ,tsVa ½ • xSj&vkS"kèkh; çcaèku[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 25 • VªkalD;wVsfu;l byfsDVªdy uoZ fLVeqys'ku (TENS) III 15 • ,uLs FksfVd tksf[ke o ,uLs Fksfl;k ls lacafèkr e`R;q vkSj #X.krk nj o tksf[ke çcaèku • ,uLs Fksfl;k es a xq.koÙkk lqèkkj vkSj jksxh lqj{kk o lajpuk] çfØ;k vkSj ifj.kke o ,uLs Fksfl;k es a ifj.kke eki es a varj o xq.koÙkk lqèkkj ,oa jksxh lqj{kk eas la;qDr vk;ksx dh vko';drk o vLirky vkSj LokLF; lsok ds fy, jk"Vªh; çR;k;u cksMZ o oSdfYid Hkqxrku ekWMy vkSj çn'kZu ds fy, Hkqxrku • O;kolkf;drk • n;s rk o VksVZ flLVe o drZO; dk mYy?a ku o dkj.k o {kfr o n[s kHkky dk ekud • ,uLs Fksfl;k ls lacafèkr eqdneks a ds dkj.k • dkuuw h ekeyks a dk çcaèku IV 10 • cqfu;knh çfrj{kkRed fl)kar • vfrlaosnu'khyrk çfrfØ;k,a • ,ukfQyfsDVd çfrfØ;k • ,ytÊ okys jksxh dk isfjvkWijfsVo çcaèku V 10 • xgu ns[kHkky bdkbZ eas ukslksdksfe;y laØe.k( feFkkby jsftLVsVa LVSfQyksdksdl vkWfj;l (MRSA) vkSj gky gh es a igpku s x, vU; ejksM+ ¼LVªus ½ • dhVk.kq'kksèku] thok.kq’kksèku • ekud lqj{kk mik;

• deZpkfj;ks a ds fy, çksfQySfDll • jksxk.kqjksèkh fpfdRlk & leh{kk VI 10 • flfoy eqdnesckth dks c<k+ok nus s oky s eqís • Hkkjr es a lacafèkr dkuwu • fpfdRlh; fujFkZdrk • ç'kklfud dkuwu% O;kolkf;d fofu;eu • VksVZ ykW% ykijokgh] is'ksoj dnkpkj] tkucw>dj fd, x, dnkpkj] xyr rjhds ls e`R;q] ekugkfu] geyk vkSj ekjihV • laoSèkkfud dkuuw % jksxh }kjk fu.kZ; yus k • f’k"Vkpkj vkSj uSfrdrk ds chp varj • uSfrd fl)kar] xHa khj ns[kHkky es a uSfrd fu.kZ; yus k] uSfrd fu.kZ; dks c<k+ok nus s okyh j.kuhfr;ka • ,uLs Fksfl;k es a ,uih ls lacafèkr uSfrd eqís% mipkj jksduk vkSj can djuk • efLr"d e`R;q ¼czsu MSFk½] vax nku vkSj ijke'kZ VII 15 • OR/ICU dk fMtkbu • vkWijsÇVx :e ij ykxw xq.koÙkk vk’oklu ekWMy • ekud] çksVksdkWy] uhfr;ka] çfØ;k,a • laØe.k fu;a=.k uhfr;ka vkSj çksVksdkWy • ekud lqj{kk mik;

• ulZ ,usLFksfl;k ls lacafèkr uÉlx laijh{k.k • LVkÇQx • fj&,DlIyksjs’ku vkWQ MSFk vkWu Vcs y26 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] VIII 11 • ,uLs Fksfl;k dk;ZLFky ekud vkSj ,uLs Fksfl;k e'khu rFkk dk;ZLFky ds fy, ekud • midj.kks a dh foQyrk • u, ,uLs Fksfl;k dk;ZLFky dh lqj{kk fo'ks"krk,a • ,uLs Fksfl;k dk;ZLFky s ckgj fudyuk • osc csLM ,uLs Fksfl;k lkW¶+Vos;j fleqy's ku • opqZvy ,usLFksfl;k e'khu osiksjkbtj • ,uLs Fksfl;k czhfnax lÆdV • dkcZu MkbvkWDlkbM vo'kks"kd • ,uLs Fksfl;k osfaVysVj • ,uLs Fksfl;k dk;ZLFky fofoèkrk,a • vif'k"V xSl dk lQkbZ ra= • fo|qr vkSj vfXu lqj{kk ¼48 ?kaVs es aladk; }kjk çn'kZu vkSj Nk=ks a}kjk vH;kl 'kkfey gS½ a. fofHkUu 'kY;&fpfdRlkvks a ds fy, jksfx;ks a dks fLFkj djuk b. nnZ] csgk's kh] cspSuh vkSj çyki dk vkS"kèkh; çcaèku i. ekWÆQu] QsVa us kby] feMktksye] yksjktsie] Mk;tsie] çksiksQksy] DyksfuMkbu] MsDlesMsVksfeMkbu] gsyksisfjMksy dh x.kuk] yksÇMx vkSj bu¶;wtu ii. ,fiMîwjy ,uYtsfl;k & lsaljh vkSj eksVj CykWd vlsleasV] fpfdRlk can djus ds ckn ,fiMîwjy dSFksVj dks gVkuk] ,fiMîwjy dSFksVj lkbV dh MªsÇlx cnyuk] ,uYtsfld ç'kklu ds fy, mipeZ iksVZ yxkuk vkSj gVkuk] ,fiMîwjy ,uYtsfl;k@ihlh, ij jksfx;ks a ds fy, e=w çfrèkkj.k ds fy, baVjfeVasV dSFkhVjkbts'ku] ,fiMîwjy bU¶;wtu ds fy, [kqjkd vuqekiu] ,fiMîwjy dSFksVj lek;kstu] dSFksVj ds [kqyis u dh tkap djus ds fy, vkSj ,uYtsfl;k ds fy, Hkh ,fiMîwjy vkS"kfèk;ks a dk ifj"dj.k c. TENS dk mi;ksx d. LØÇcx] xkmÇux vkSj XyksÇox e. LVsjkby rduhd i. LVsjkby iSd [kksyuk ii. Ropk dh rS;kjh iii. LVsjkby çfØ;kvks a ds fy, jksfx;ks a dks yisVuk f. jksxfujksèkh ,aVhck;ksfVd vkS"kfèk;ks a dk ç'kklu g. bdkb;ks a ds fy, çksVksdkWy rS;kj djuk h. osfaVys'ku i. ekMuZ baVhxzsVsM ,uLs Fksfl;k odZLVs'ku ii. áfwefMQk;j iii. ucs qykbtj & tsV] vYVªklksfud iv. bugsy's ku Fksjsih & ehVMZ Mkst bugsyj ¼,eMhvkbZ½] MªkbZ ikmMj bugsyj ¼MhihvkbZ½ v. byDs VªkWfud ¶+yksehVj vi. osfaVysVj lsÇVx i. bZlhth eas cnyko] funku vkSj mfpr çcaèku j. ân; dh èofu;ka & igpku vkSj funku k. QsQM+ksa dh èofu;ka & igpku vkSj funku VIII. I 1- jksfx;ks a dk ,usLFksfl;k&iwoZ vkadyu djukA 2- ,uLs Fksfl;k es a ewyHkwr rduhdks a vkSj n{krkvks a dk vuqç;ksx djukA 3- csgk's k vkSj ,usLFksfl;k fn, x, jksxh dh ns[kHkky djukA 4- ¶Y;wM vkSj byDs VªksykbV Fksjsih ds fl)karks a dk vH;kl djukA 5- ,uLs Fksfl;k ls lacafèkr midj.kks a dh dk;Z&ç.kkyh dks le>ukA 6- ,uLs Fksfl;k ç'kklu eas ckèkk Mkyus okyh lkekU; fpfdRlh; fLFkfr;ks a dks mtkxj djukA I 20[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 27 • xaHkhj :i ls chekj jksfx;ks a dk vkadyu • ok;qekxZ dh n[s kHkky • QsYM baVîcw s'ku • ,sl s jksxh dh ns[kHkky ftldh ’okl de py jgh gks • ifjlapj.k dk çcaèku • mipkj ds çHkkoks a dk vkadyu • xaHkhj :i ls chekj jksfx;ks a dk ifjogu • iqutÊou ifjR;kx • xaHkhj :i ls ?kk;y jksxh II 15 • lkekU; çcaèku • ,uLs Fksfl;k fn, x, jksfx;ks a eas ’olu fØ;k • dkÆM;ksoLdqyj flLVe • dkÆM;ks jsfLijVs jh vjLs V dk çcaèku III 10 • 'kjhj ds ¶Y;Mw daikVZesVa ~l • ¶Y;wM Fksjsih • ¶Y;wM dh fLFkfr dk uSnkfud vkadyu • 'kY;&fpfdRlk ds nkSjku jDr dh gkfu dk vuqeku vkSj jDrkèkku dh vko';drk • fof'k"V gkfu vkSj çfrLFkkiu • baVªkohul mi;ksx ds fy, thok.kqghu {ks= rS;kj djuk IV 10 • jksxh dh tkap • vkWijs'ku ls igy s miokl vkSj ¶Y;wM~l • ,uLs Fksfl;k vkSj 'kY;&fpfDrlk ls igys dh vkS"kfèk;ka V 15 • midj.k vkSj psd lwph rS;kj djuk • daVhU;wvl ¶yks e'khu • xSl vkiwÆr • U;wure ,uLs FksfVd midj.k • midj.kks a dk HkaMkj.k vkSj j[kj[kko VI 20 • ,uhfe;k • gheksXyksfcuksiSFkh • dkÆM;ksoLdqyj daMh’kal • ’olu lacaèkh jksx • eèkqegs • eksVkik • dqiks"k.k • Øksfud jhuy QsY;j • ,uLs Fksfl;k vkSj 'kY;&fpfdRlk ds nkSjku laØe.k dk lapj.k VII 3 • ,uLs Fksfl;k fjdkWMZ vkSj psd fyLV • ,uLs Fksfl;k fjiksVZ VIII 3 • ,uLs Fksfl;k dk lgh fodYi pquu s eas jksxh vkSj ifjokj dks ijke’kZ ¼48 ?kaVs eas ladk; }kjk çn'kZu vkSj Nk=ks a}kjk vH;kl 'kkfey gS½ • lhihvkj ¼ch,y,l vkSj ,lh,y,l½ & uotkr] o;Ld vkSj ckyd • ok;qekxZ çcaèku o ,aMksVªSfp;y baVîcw s'ku o yÇsjft;y ekLd ,;jos o QkbcjvkWfIVd baVîcw s'ku o dQ bU¶y's ku ,aM ,adfjxa n Vîwc28 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] o vksjy ,aM ,aMksVªSfp;y lD'kÇux vksiu@DyksTM rjhds o fØdksFkk;jksVkWeh o vkWDlhesVªh & iYl vkWDlheVs ªh] ohul vkWDlhesVªh o ,chth fo'ys"k.k o dSiuksxzkQh & O;k[;k vkSj çcaèku o ukWu&buosfto osfaVys'ku ✓ de çokg ifjorZuh; çn'kZu fMokbl% uts y dSFksVj@dSU;wyk@Mcy uts y çksxa ] Qsl ekLd] Qsl ekLd fon fjtjok;j cSx ✓ mPp çokg fuf'pr çn'kZu fMokbl% ,uVªus esVa ¼ospa qjh½ fMokbl] ,uvkbZoh@lhih,ih@,usLFksfVd ekLd] Vh ihl] czhfnax lÆdV • ,uLs Fksfl;k xlS ka s dk vuqekiu • ldwZy’sku ,aM ij¶;wtu ¼gseksMk;ukfed fu:i.k vkSj rjax xzkfQDl lfgr½ o buosfto chih ekWfuVfjax o ukWu&buosfto chih ekWfuVfjax o ohul çslj ¼ifjèkh;] dsæa h; vkSj Qq¶Qqlh; èkeuh vojksèk ncko½ o vkfVZfj;y ykbu yxkuk vkSj gVkuk o lsaVªy ykbu yxkuk vkSj gVkuk o iYl baMsDl daVhU;wvl dkÆM;d vkmViqV (PiCCO) o byDs VªksdkÆM;ksxzkQh (ECG) o osoQkWe Z • ¶Y;wM~l vkSj byDs VªksykbV~l o æo dh x.kuk vkSj ç'kklu ¼fØLVykW;M vkSj dksykW;M½ o jDr vkSj jDr mRiknks a dk ç'kklu o buksVªksi x.kuk] vuqekiu vkSj ç'kklu o byDs VªksykbV djsD’ku ¼lksfM;e] iksVsf'k;e] dSfY'k;e] QkLQksjl] eSXuhf'k;e½ o ¶Y;wM fMLisla j vkSj bU¶;wtu iai dk mi;ksx o IV dSuqys'ku • Xykblsfed fu;a=.k] Xykblsfed vlarqyu okys jksxh dh ns[kHkky o ekWfuVfjxa GRBS o balqfyu Fksjsih ¼LykbÇMx Ldsy vkSj bu¶;wtu½ o gkbijXykblsfe;k dk çcaèku & IV ¶Y;wM~l] balqfyu Fksjsih] iksVsf'k;e lIyhesVa ’sku o gkbiksXykblsfe;k dk çcaèku & MsDlVªkst IV • ,uLs Fksfl;k dk lgh fodYi pquu s eas jksfx;ks a vkSj ifjokj dk s ijke'kZ nsuk • 'olu volkn dk çcaèku • vkWu Vcs y dkÆM;d vjsLV dk çcaèku • xaHkhj :i ls chekj dk vkadyu • xaHkhj :i ls chekj dks ys tkuk IX. II 1- ,uLs Fksfl;k ds fofHkUu çdkjks a dks le>us vkSj çnku djus eas QkekZdksFksjsI;fwVDl vkSj QkekZdksMk;ufseDl dh tkudkjh dks ykxw djrk gSA 2- ekud lapkyu çfØ;kvks a ds vuqlkj ,uLs FksfVd ;kstuk] midj.k vkSj vkS"kfèk;ka rS;kj djrk gS vkSj mudk mi;ksx djus es a i;kZIr lqj{kk lkoèkkfu;ka cjrrk gSA 3- buosftu vkSj ukWu&buosfto fuxjkuh fofèk;ks a dk p;u] lfEeyu] çcaèku vkSj fuxjkuh djrk gSA 4- ,uLs FksfVLV dh ns[kjs[k es a lHkh 'kY;&fpfdRlk vkSj fpfdRlk ls lacafèkr çfØ;kvks a ds fy, lHkh jksfx;ks a dks tujy vkSj yksdy ,uLs Fksfl;k nus s dh rS;kjh djrk gS] nsrk gS vkSj@;k nus s eas Hkkxhnkjh fuHkkrk gSA 5- tujy] jhtuy vkSj yksdy ,uLs Fksfl;k] csgks'k djus dh fØ;k vkSj nnZ çcaèku tSlh ,uLs FksfVd rduhdks a ls lacafèkr n[s kHkky dh jksxh&fof'k"V ;kstuk çnku djrk gSA 6- çlwfr] cky fpfdRlk vkSj vU; rhoz nnZ çcaèku ds fy, {ks=h; rduhdks a dk mi;ksx djds ,uLs Fksfl;k vkSj ,uYtsfl;k çnku djrk gSA 7- jksfx;ks a dks isjhvkWijsfVo vuHq ko ds ekè;e ls enn djus ds fy, euksoSKkfud lgk;rk çnku djrk gSA 8- jksxh dh fLFkfr dk Rofjr vkadyu djds] mls fLFkj djds vkSj ;fn vko';d gks rks ACLS çnku djds ,uLs Fksfl;k çnku djus ds nkSjku gksus okyh tfVyrkvks a dh igpku djuk vkSj lg;ksxkRed :i ls mudk çcaèku djrk gSA 9- n[s kHkky ds vxy s Lrj ij tkus ds fy, jksxh dh fLFkfr vkSj çfrfØ;kvks a dk vkadyu vkSj ewY;kadu djrk gSA[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 29 I 10 • bugsy’sku ,tsVa • baVªkohul ,uLs FksfVDl • csta ksMk;tsikbu • vksfi;sV MªXl • ukWu&LVsjkW;My ,aVh&ba¶yes sVjh MªXl (NSAIDS) • ekalisf'k;ks a dks vkjke nsus okyh vkS"kfèk;ka II 15 • ,uLs Fksfl;k nsus ls igys • baVªkohul baMD’ku • baVªkeLdwyj baMD’ku • bugsy’skuy baMD’ku III 10 • ,uLs Fksfl;k lsokvks a ds Lrj • dsVkekbu ,usLFksfl;k • tujy bugsy’skuy ,uLs Fksfl;k • VksVy baVªkohul ,uLs Fksfl;k dh rduhdsa • vkikrdkyhu ekeyks a ds fy, tujy ,uLs Fksfl;k IV 15 • Likbuy ,uLs Fksfl;k vkSj ,fiMîjw y ,uYtsfl;k ds fy, jksfx;ks a dh rS;kjh • Likbuy ,uLs Fksfl;k nus s dh rduhdsa • ,fiMîwjy dSFksVj yxkuk • Likbuy ,uLs Fksfl;k ds fy, mi;ksx dh tku s okyh vkS"kfèk;ka • ,fiMîwjy ,uYtsfl;k ds fy, mi;ksx dh tku s okyh vkS"kfèk;ka • jksfx;ks a dh Likbuy ,usLFksfl;k ds ckn dh n[s kHkky • ,fiMîwjy ,uYtsfl;k ij jksfx;ks a dh n[s kHkky • lac) tfVyrk, a vkSj tksf[ke V 15 • ekWfyD;wyj edsfuTe vkWQ uoZ CykWd • uoZ CykWd ds çdkj • uoZ CykWd ds fy, bLrseky dh tku s okyh vkS"kfèk;ka vkSj mudh VkWfDldksdkbusfVd • uoZ CykWd ds ckn dh ns[kHkky • tfVyrk, a vkSj tksf[ke VI 10 • yksdy ,uLs FksfVd vkS"kfèk;ks a dh fo"kkDrrk vkSj lqj{kk • daVªkbaMhds’kal vkWQ daMD’ku ,uLs Fksfl;k • lkekU; lkoèkkfu;ka vkSj cqfu;knh midj.k • daMD’ku ,usLFksfl;k ds nkSjku csgk's kh • uewuk rduhd VII 7 • fdlh fo'ks"k vkWijs'ku ds fy, ,uLs FksfVd rduhd dk pquko • tujy ,uLs Fksfl;k dh ;kstuk cukuk • tujy vkSj daMD’ku rduhdks a dh lqj{kk VIII 7 • cPpks a ds fy, ,usLFksfl;k IX 7 • xHkkZoLFkk vkSj çlo ds nkSjku ,uLs Fksfl;k30 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] ¼48 ?kaVs eas ladk; }kjk çn'kZu vkSj Nk=ks a}kjk vH;kl 'kkfey gS½ • osfaVysVj lsÇVx • dkÆM;d ekWfuVÇjx • isfjQsjy IV&ykbu ,Dlsl • vksjy@uts y@,aMksVªSfp;y lD'ku • bZlhth dh O;k[;k • ,chth ifj.kkeks a dh O;k[;k • pLs V ,Dl&js dh jhÇMx • lhohih ekWfuVÇjx • iYl vkWDlheVs ªh • bU¶;wtu iai • vkWDlhtu ,MfefuLVª's ku o uts y çksXa l o Qsl ekLd o ospa qjh ekLd • vkbuksVªksIl dks yksM djuk vkSj ç'kkflr djuk • ukjdksfVd ,uYtsfld dks yksM djuk vkSj ç'kkflr djuk • jksfx;ks a dks çsfjr djuk ¼baMîwflax is’ksaV~l½ • jksfx;ks a dks myVuk vkSj ckgj fudkyuk ¼fjolZy ,aM ,DlVîwcs’ku vkWQ is’ksaV~l½ • Likbuy ,uLs Fksfl;k] ,fiMîwjy dSFksVj bul'kZu vkSj uoZ CykWd ds fy, jksfx;ks a dks fLFkj djuk • ih,lh;w jksfx;ks a dh n[s kHkky • ySc eas daMD'ku ,usLFksfl;k nsuk • vkbZlh,u ¼2020½ xkbMykbal vkWu ,MokaLM çSfDVl uÉlx] https://www.icn.ch/system/files/ documents/2020-4/ICN_APN%20Report_EN_WEB.pdf ls fy;k x;k • cjk'k ih-th-] dqysu vkj-ch-] LVksÇYVx vkj-d-s] fe'ksy ds-] dgyu ,e-] fØLVhu ,l-] vksVsZxk vkj-] lSe vkj- 'kjkj ,aM urkyh ,Q-,p- ¼2023½ fDyfudy ,uLs Fksfl;k ¼9oka laLdj.k½] ;,w l,% oksYVlZ ,aM Dywoj • MkWClu ch- ekbdy ¼2020½ ,uLs Fksfl;k bu fMfLVªDV gkWfLiVy ¼nlw jk laLdj.k½] ftusok% MCY;w,pvks • u's kuy vkWxZukbts'ku vkWQ ulZ çSfDV'kuj QSdYVht ¼,uvks,uih,Q 2022½ ulZ çSfDV'kuj jksy dfEiVaslht]

https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/competencies/20220825_nonpf_np_role_co re_.pdf ls fy;k x;k • ikWy th- cjk'k] czwl ,Q- dqysu] jkWcV Z ds- LVksÇYVx] ekbdy ds- dgyu] ,e- fØLVhu LVkWd ,aM jkQys vkWVsZxk ¼2013½ gSaM cqd vkWQ fDyfudy ,uLs Fksfl;k ¼7oka laLdj.k½] oksYVlZ ,aM Dywoj] fyÇidkWV fofy;El ,aM foÇYdl • jkWcVZ vkj-ds-] xzsosuLVhu ,u-] yksckVks bZ-ch- ,aM xzsosuLVhu ts- ¼2002½ fDyfudy ,usLFksfl;k] lsVa yqbl] felkSjh% lkWUMlZ ,Ylsfo;j I II 1- ABG ,ukykbtj 2- ,uLs Fksfl;k çfØ;k VªkWyh 3- ,uLs Fksfl;k dk;ZLFky 4- cSu lÆdV 5- daI;Vw j 6- ØS'k dkVZ 7- fMfQfczyVs j[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 31 8- MkWiyj e'khu 9- QkbcjvkWfIVd czksda ksLdksi 10- XywdksehVj 11- baVîcw sÇVx ohfM;ksLdksi 12- IV LVSaM 13- vkWijsÇVx :e Vscy 14- vkWjksQsfjfUt;y ,;jost 15- vksojgsM ,ybZMh ykbV~l 16- vkWDlhtu] 4 ckj esfMdy ,;j vkSj oSD;we & ikbi ykbu 17- ejht VªkalQj jksyj@ih,Vh LykbM 18- jksxh okÉex ;wfuV ¼cSj gxj½ 19- iksft'ku vkÆVdy 20- lD'ku tkj 21- flÇjt iai ç'u&i= o ç'uksÙkjh% 10 vad fyf[kr dk;Z@vkofèkd ç'u&i= ¼oSf'od vkSj jk"Vªh; LokLF; lsok ds #>ku o uhfr;ka½% 10 vad uSnkfud lsfeukj ¼fof'k"V uSnkfud fLFkfr es a uSnkfud@n[s kHkky ekxZ@fof'k"V uÉlx fl)kar dk vuqç;ksx½% 5 vad ç'u&i=% 20 vad fyf[kr dk;Z ¼lkfgR;d leh{kk@'kksèk midj.k dh rS;kjh½% 5 vad tuZy Dyc ¼,usLFksfl;k uÉlx n{krkvks a ds fy, 'kksèk lk{; dk fo'y"sk.k½% 5 vad ç'u&i=% 15 vad tuZy Dyc ¼urs `Ro@çcaèku@f'k{k.k eas #>ku½% 5 vad fyf[kr dk;Z ¼vksvkj dk;ZLFky fgalk½% 5 vad lw{e f'k{k.k% 5 vad ç'u&i= vkSj ç'uksÙkjh% 20 vad ¼iSFkksfQft;ksykWth & 10] QkekZdksykWth & 10½ vkS"kfèk vè;;u ¼vkS"kfèk vè;;u ,oa çLrqfr½% 5 vad ekey s dh çLrqfr vkSj ekeys dh vè;;u fjiksVZ ¼iSFkksfQft;ksykWth½% 5 vad ç'u&i=% 20 vad fyf[kr dk;Z ¼uSnkfud@tkap fjiksVZ & fu"d"kks± dh O;k[;k vkSj fo'y"sk.k½% 10 vad uSnkfud çn'kZu vkadyu% 10 vad inLFkkiu i'pkr ijh{kk ¼vks,llhbZ½% 10 vad ekey s dh çLrqfr vkSj ekeys dh vè;;u fjiksVZ% 5 vad32 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] vkarfjd vks,llhbZ% 25 vad ¼inLFkkiu i'pkr ijh{kk dk vk;kstu fdlh Hkh ih,lh eas fd;k tk ldrk gS½ ç'u&i= vkSj ç'uksÙkjh% 20 vad fyf[kr dk;Z ¼,uLs Fksfl;k dk;ZLFky es a laØe.k fu;a=.k çksVksdkWy@ekud½% 10 vad uSnkfud çn'kZu vkadyu% 20 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@ns[kHkky ekxZ dk vuçq ;ksx½% 5 vad inLFkkiu i'pkr ijh{kk ¼vks,llhbZ½% 10 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 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 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 ¼inLFkkiu i'pkr ijh{kk dk vk;kstu fdlh Hkh ih,lh@ih,lh;w@vkbZlh;w es a fd;k tk ldrk gS½ O;kogkfjd% 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 ¾ 30 vad] laf{kIr mÙkj 5×6 ¾ 30 vad] vfry?kq mÙkj 5×2 ¾ 10 vadÀ[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 33 I.

1- o;Ld jksxh dk ,usLFksfl;k iwoZ bfro`Ùk ysuk rFkk 'kkjhfjd tkap djuk 2- cky jksxh dk ,uLs Fksfl;k iwoZ bfro`Ùk yus k rFkk 'kkjhfjd tkap djuk 3- fu"d"kks± vkSj ifj.kkeks a dh O;k[;k djuk 4- uSnkfud ekinMa kas dh fuxjkuh djuk × 1- o;Ld jksxh dk ldsfaær bfro`Ùk yus k 2- o;Ld jksxh dh ldsfaær 'kkjhfjd tkap djuk 3- cky jksxh dk ldsfaær bfro`Ùk yus k 4- cky 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 × I.

1- ldfsaær bfro`Ùk ysuk vkSj 'kkjhfjd tkap djuk rFkk fu"d"kks± ,oa ifj.kkeks a dh O;k[;k djuk 2- buosfto rFkk ukWu&buosfto n{krkvks a dh fuxjkuh djuk 3- fpfdRlh; eè;orZu ¼vkikrdkyhu çfØ;kRed n{krk,a½] ftleas vkS"kfèk ç'kklu 'kkfey gS 4- vkWijs'ku Vscy rS;kj djuk 5- 'kY;&fpfdRlk ds fy, fLFkj djuk 6- ikfjokfjd f'k{kk vkSj ijke'kZ 7- laØe.k fu;a=.k vH;kl ×34 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- cky jksxh dk ldsfaær bfro`Ùk yus k] 'kkjhfjd tkap djuk rFkk ifj.kkeks a dh O;k[;k djuk 3- buosfto rFkk ukWu&buosfto n{krkvks 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;k,a½] ftles a vkS"kfèk ç'kklu 'kkfey gS 7- vkWijs'ku Vscy rS;kj djuk 8- 'kY;&fpfdRlk ds fy, fLFkj djuk 9- laØe.k fu;a=.k vH;kl × II & III. I II 1- ldfsaær bfro`Ùk ysuk vkSj 'kkjhfjd tkap djuk rFkk fu"d"kks± ,oa ifj.kkeks a dh O;k[;k djuk 2- buosfto rFkk ukWu&buosfto n{krkvks a dh fuxjkuh djuk 3- n[s kHkky ;kstuk@ns[kHkky ekxZ fodflr djuk 4- ikfjokfjd f'k{kk ,oa ijke'kZ 5- fpfdRlh; eè;orZu ¼vkikrdkyhu çfØ;kRed n{krk,a½] ftleas vkS"kfèk ç'kklu 'kkfey gS 6- laØe.k fu;a=.k vH;kl × 1- o;Ld jksxh dk ldsfaær bfro`Ùk yus k] 'kkjhfjd tkap djuk rFkk ifj.kkeks a dh O;k[;k djuk 2- cky jksxh dk ldsfaær bfro`Ùk yus k] 'kkjhfjd tkap djuk rFkk ifj.kkeks a dh O;k[;k djuk 3- buosfto rFkk ukWu&buosfto n{krkvks a dh fuxjkuh djuk 4- ikfjokfjd f'k{kk ,oa ijke'kZ 5- n[s kHkky ;kstuk fodflr djuk@ns[kHkky ekxZ 6- vkS"kfèk ç'kklu 7- fpfdRlh; eè;orZu ¼vkikrdkyhu çfØ;k,a½ ftles a vkS"kfèk ç'kklu 'kkfey gS 8- laØe.k fu;a=.k vH;kl ×[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 35 3 * I 1 'kksèk midj.k dh rS;kjh ih 2 çdk'ku ds fy, ikaMqfyfi rS;kj djuk ih 3 O;ofLFkr leh{kk@lkfgR;d leh{kk ys[ku ih 4 'kksèk fucaèk@bZchih ifj;kstuk ¼f}rh; o"kZ½ ih fo"k;% II 1 midj.k vkSj vkiwÆr çcaèku ih 2 laØe.k fu;a=.k fuxjkuh] vkadyu vkSj mlls lacafèkr ih fjiksVZ y[s ku 3 jksxh çf’k{k.k ds fy, f'k{k.k ;kstuk rFkk ehfM;k ih rS;kj djuk III ih 2-1 'olu r=a ¼jis fLijVs jh flLVe½ ih 2-2 ân; r=a ¼dkfMZ;ksoLdqyj flLVe½ ih 2-3 tBjkU= ¼xSLVªksbuVSfLVuy flLVe½ ih 2-4 Luk;fod ra= ¼U;wjksykWftdy flLVe½ ih 2-5 tuukax&ew= ra= ¼tsfuVks;wjhujh flLVe½ ih 2-6 var%lzkoh ra= ¼,aMksØkbu flLVe½ ih 2-7 gsesVksykWftdy flLVe ih 2-8 eLdqyksLdsyVs y flLVe ih 2-9 baVhxqeasVjh flLVe ih 2-10 laosnh vax ¼lsla jh vkWxZUl½ ih 3-1 uotkr f'k'kq ih 3-2 ckyd ih 3-3 O;Ld ih 3-4 cqtqxZ ih ih IV 1-1 ck;ksdSfeLVªh ih 1-2 Dyhfudy iSFkksykWth ih 1-3 ekbØksck;ksykWth@ok;jksykWth ih 1-4 ,chth ih 2-1 QkbcjvkWfIVd czksda ksLdksih , 2-2 ohfM;ks vflLVMs ySfjaxksLdksih , 3-1 vYVªklkmaM ih 3-2 bZlhth ih36 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] * V ih ih IV ih ih ih 6-1 Lqikbu ih 6-2 yVs jy ih 6-3 çksu ih 6-4 fyFkksVkWeh ih 6-5 tSd&ukbQ ih 6-6 VªsMa sysucxZ ih 6-7 jkst ih 7-1 ,uLs Fksfl;k odZLVs'ku ih 7-2 dkÆM;d ekWfuVj ih 7-3 ETCO2 çksc Iyls esVa es a lgk;rk djuk ih 7-4 iYl vkWDlhehVj ih 7-5 lhDosfa’k;y daçflax fMokbl ih 7-6 12&yhM bZlhth ekWfuVj ih 7-7 flÇjt iai ih 7-8 bU¶;wtu iai ih 7-9 vkWijsÇVx :e Vscy ih 8-1 vkfVZfj;y CyM xSl (ABG) ih 8-2 iYl vkWDlheVs ªh ih 8-3 dSiuksxzkQh ih 8-4 lsaVªy ohul çslj ekWfuVfjax ih 8-5 byDs VªksdkÆM;ksxzke (ECG) ih 8-6 baVªkØSuhy ncko ¼(ICP) ih 8-7 PiCCO ¼iYl baMsDl daVhU;wvl dkÆM;d ih vkmViqV½ 8-8 Xyklxks dksek Ldksj ih 8-9 lhMs’ku Ldksj ih 8-10 isu Ldksj ih 8-11 czSMsu Ldksj ih 8-12 ,YMªsV Ldksj ih 8-13 thvkjch,l ih 8-14 pLs V ,Dljs ih 8-15 ,evkjvkbZ@lhVh ih 9-1 buosflo chih ekWfuVÇjx ih 9-2 ukWu&buosflo chih ekWfuVÇjx ih 9-3 isfjQsjy oSLdqyj LVVs l ih[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 37 * , ih *Nk= ds dkS'ky çn'kZu es a l{ke ik, tkus ij] ml ij çhlsIVj }kjk gLrk{kj fd, tk,axsA ls vis{kk dh tkrh gS fd os lwphc) dkS'ky@n{krkvksa dks rc rd dbZ ckj djsxa s tc rd fd os Lrj 3 n{krk rd ugÈ igqap tkr]s ftlds ckn çhlsIVj çR;sd n{krk ds le{k gLrk{kj fd, tk,axsA }kjk ;g lqfuf'pr fd;k tkuk pkfg, 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, Nk= i;Zos{k.k ds fcuk ml n{krk dk laiknu djus es a l{ke gS • 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 gS • 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 gS * 1-1 tujy ih 1-2 Likbuy ih 1-3 daMD’ku ih 1-4 uoZ CykWd ih 2-1 baMîfwlax ,tsVa ih 2-2 bugsy's ku ,tsVa ih 2-3 fjolZy ,tsVa ih 2-4 U;wjkseLdqyj CykWÇdx ,tsVa ih 2-5 çksfQySfDVd ,aVhck;ksfVDl ih 2-6 ukjdksfVDl ih ih ih 5-1 o;Ld ih 5-2 uotkr f'k'kq ih 5-3 ckyd ih ih 7-1 gSaM&vkWQ Ýkse vksvkj Vq ih,lh;w ih 7-2 gSaM&vkWQ Ýkse vksvkj Vq vkbZlh;w ih 8-1 LVsjkby iSd dks [kksyuk ih 8-2 çfØ;kvks a ds fy, Ropk dh rS;kjh ih 8-3 LVsjkby çfØ;k ds fy, jksfx;ks a dks yisVuk ih38 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] * ih a. lsaljh ,aM eksVj CykWd vkadyu ih b. ,fiMîwjy dSFksVj dks gVkuk ih c. ,fiMîwjy dSFksVj dh MªsÇlx cnyuk ih d. ,ukYtsfld ,MfefuLVªs’ku ds fy, lcD;wVsfu;l ih iksVZ yxkuk vkSj gVkuk e. ,fiMîwjy bU¶;wtu ds fy, [kqjkd vuqekiu ih f. ,fiMîwjy dSFksVj dks lgh djuk ih g. ,fiMîwjy vkS"kfèk;ks a dk ifj"dj.k ih ih a. ukyksDlksu b. ,u ,flVkby flLVhu c.

d. e.

12-1 baVªkohul ¶Y;wM ,MfefuLVª’sku ih ¼dksykW;M@fØLVykW;M½ 12-2 VhbZMh LVkWÇdx dk vuçq ;ksx ih 12-3 lhohih ykbu dh ns[kHkky vkSj gVkuk ih 12-4 vkfVZfj;y ykbu dh n[s kHkky vkSj gVkuk ih 12-5 isleds j okys jksxh dh n[s kHkky ih 12-6 vkfVZfj;y ykbu ls jDr laxzg ih 13-1 balqfyu Fksjsih ¼LykbÇMx Ldsy ,aM bu¶;wtu½ x.kuk] ih vuqekiu vkSj ç'kklu 13-2 LVsjkW;M ih 14-1 ET ,DlVîcw s'ku ih 14-2 LMA ,DlVîcw s'ku ih 14-3 uts y ,DlVîcw s'ku ih 15-1 ECG ih 15-2 ABG ih 15-3 Nkrh dk ,Dl&js ih 15-4 vYVªklkmaM ih 15-5 csfld ck;ksdsfeLVªh tkap ih 15-6 csfld ekbØksck;ksykWth tkap ih *Nk= ds dkS'ky çn'kZu es a l{ke ik, tkus ij] ml ij çhlsIVj }kjk gLrk{kj fd, tk,axsA ls vis{kk dh tkrh gS fd os lwphc) dkS'ky@n{krkvksa dks rc rd dbZ ckj djsxa s tc rd fd os Lrj 3 n{krk rd ugÈ igqap tkr]s ftlds ckn çhlsIVj çR;sd n{krk ds le{k gLrk{kj fd, tk,axsA[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 39 }kjk ;g lqfuf'pr fd;k tkuk pkfg, 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, Nk= i;Zos{k.k ds fcuk ml n{krk dk laiknu djus es a l{ke gS • 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 gS • 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 gS 5&10% nqyZHk çfØ;kvks a dk vH;kl dkS'ky ç;ksx'kkyk eas fd;k tkuk pkfg, vkSj Lrj 3 n{krk çkIr dh tkuh pkfg,A * 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% * ulZ çSfDV’kuj bu ,uLs Fksfl;k n{krkvks a gsrq lk{; dh [kkst ¼uSnkfud dkUÝsla @tuZy Dyc½ fo"k; dk 'kh"kZd% * urs `Ro@çcaèku@f'k{k.k ¼tuZy Dyc½ mnkgj.k% Vhe fuekZ.k eas #>ku fo"k; dk 'kh"kZd% ¼uSnkfud çLrqfr½ uSnkfud fLFkfr dk uke% ¼uSnkfud çLrqfr½ ekey s dk vè;;u ¼fyf[kr fjiksVZ½ uSnkfud fLFkfr dk uke% vkS"kfèk vè;;u ¼LFkk;h vkns'kks a ds rgr lwphc) vkS"kfèk;ka½ & 5 çLrqfr;ks a dh fyf[kr fjiksVZ ¼csMlkbM çLrqfr;ka½ 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 2-3-8 2-3-9 2-3-10 ¼fyf[kr fjiksVZ tek djus gsrq gSa½ ¼o;Ld½ & bfro`Ùk vkSj 'kkjhfjd tkap ¼nks fyf[kr fjiksVZ½ ¼ckyd½ & bfro`Ùk vkSj 'kkjhfjd tkap40 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] ¼,d fyf[kr fjiksVZ½ 3-2-1 3-2-2 3-2-3 ¼xHkZorh efgyk½ ¼,d fyf[kr fjiksVZ½ ç;ksx'kkyk ijh{k.kks a ds fy, jDr ds ueuw s ,d= djuk ¼ck;ksdsfeLVªh] fDyfudy iSFkksykWth] ekbØksck;ksykWth@ok;jksykWth] ,chth½ & çR;sd ds fy, 10 uewus fç&,usLFksfl;k vkadyu & 20 ,aMksVªSfp;y baVîcw s'ku & 10 ckj yÇsjft;y ekLd bVa îwcs'ku & 10 ckj *mUur vH;klh; uÉlx & ,ih,u( 'kkès k vuqç;ksx & vkj,( usr`Ro] çcaèku rFkk f'k{k.k & ,y],e,aMVh ¼uSnkfud dkUÝsla ½[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 41 fo"k; dk 'kh"kZd% I ¼uSnkfud lsfeukj½ fo"k; dk 'kh"kZd% I ¼tuZy Dyc½ fo"k; dk 'kh"kZd% II ¼uSnkfud lsfeukj½ fo"k; dk 'kh"kZd% II ¼tuZy Dyc½ fo"k; dk 'kh"kZd% ¼fyf[kr fjiksVZ tek djus ds fy, gSa½ ¼uSnkfud@n[s kHkky ekxZ½ 'kh"kZd dk uke% I ¼uSnkfud çLrqfr½ uSnkfud fLFkfr dk uke% I ¼ekey s dh vè;;u fjiksVZ½ uSnkfud fLFkfr dk uke% II ¼uSnkfud çLrqfr½ uSnkfud fLFkfr dk uke% II ¼ekey s dh vè;;u fjiksVZ½ uSnkfud fLFkfr dk uke% ¼ikap fyf[kr fjiksVZ½ 2-6-1 vkS"kfèk dk uke% 2-6-2 vkS"kfèk dk uke% 2-6-3 2-6-4 2-6-5 2-6-6 2-6-7 2-6-8 2-6-9 2-6-10 I uSnkfud fLFkfr dk uke% ¼ekey sdh vè;;u fjiksVZ½ II ¼ekey sdh vè;;u fjiksVZ½42 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] fyf[kr fjiksVZ¼fodflr uSnkfud@ns[kHkky ekxZ½ tujy ,uLs Fksfl;k nsuk & ,,l, xszM I jksfx;ks a ds fy, 50 ckj Likbuy ,uLs Fksfl;k nus k & xHkZorh fL=;ks a ds fy, 50 ckj ¼vkikrdky ds nkSjku de ls de 15 ckj½ uoZ CykWd nsuk & 50 ckj ,fiMîwjy dSFksVj bul’kZu & 30 ckj daMD’ku ,usLFksfl;k nsuk & 50 ckj ,uLs FksfVd ,tsVa rS;kj djuk vkSj nsuk & çR;sd ,uLs FksfVd ,tsVa & 40 ckj ekeys dh vè;;u fjiksVZ ds fy, uSnkfud çLrqfr fy[kh tk ldrh gSA ulZ çSfDV'kuj fdlh Hkh ,usLFksfl;k n[s kHkky lek;kstu eas jksfx;ks a dh n[s kHkky djus gsrq ftEens kjh o mÙkjnkf;Ro yus s ds fy, rS;kj vkSj ;ksX; gksrs gSaA os mPp n{krk dh vko’;drk oky s jksfx;ks a ds fy, lVhd mipkj lqfuf'pr djus ds fy, baVsfalfoLV] fQftf'k;u] ltZu vkSj fo'ks"kKks a ds lg;ksx ls dk;Z djrs gSaA dk;ZØe iwjk gksus ij] ,uih dks laLFkkxr LFkk;h vkn's kks a ds vuqlkj LFkk;h vkn's 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 vkns'k nus s dh Hkh vuqefr gksxhA[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 43 vkikrdky ds nkSjku fdlh Hkh ,uLs Fksfl;k n[s kHkky lek;kstu ¼vkWijÇsVx :e@ih,lh@ih,lh;w@vkbZlh;w vkfn½ eas ulZ çSfDV'kuj }kjk fuEufyf[kr baVªkous l batsD'ku ;k bU¶;wtu fn, tk ldrs gSa% 1- ,fMªufsyu 2- ukWj,fMªufsyu 3- Mksikekbu 4- MkscqVkekbu 5- ,Msukslkbu 6- ,fe;ksMsjksu 7- fyMksdsu@tkbyks dkMZ 8- ,QsfMªu 9- ,feuksQkbfyu 10- MsfjQkbfyu 11- ,VªkD;wfj;e ¼osD;wjksfu;e] iSu D;wfj;e½ 12- ,Vªksfiu lYQsV 13- ,foy 14- Dyksfufhu 15- fXyljhu VªkbukbVsªV 16- vkblkfsIVu 17- gkbMªksdkÆVlksu 18- MsDlkehFkklkus 19- yfsoVªslVs e 20- fQukbVksbu 21- oSfy;e 22- feMktksye 23- ekWÆQu lYQsV 24- isVa ktkslhu ySDVVs ¼QksVZfou½ 25- isfFkMhu gkbMªksDyksjkbM 26- çksiksQksy 27- lksMk ckbdkcksZusV 8-4% 28- lksMk ckbdkcksZusV 7-5% 29- eSXuhf'k;e lYQsV 30- iksVsf'k;e DyksjkbM • buMîfwlax ,tsVa ~l • ely fjysDlasV~l ¼ekalisf'k;ks a dks vkjke nsus okyh vkS"kfèk;ka½ • fjolZy ,tsVa ~l • ukyksDlksu •44 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] • ECG • ucs qykbts'ku • ABG • pSLV fQft;ksFksjsih • pSLV ,Dl&js • fMLVy dksyksLVkWeh ok’k • eyw tSojlk;fud tkap & Hb, PCV, TIBC, WBC • efgyk jksfx;ks a dks ;wfjujh dSFksVj yxkuk vkSj gVkuk VksVy] WBC fMQjasf'k;Yl] ESR, byDs VªksykbVl~ ] • VSLV QhM~l IyVs ysV~l] PT, aPTT, CyhÇMx ,aM DykWÇVx Vkbe] • TEDS çksdSfYlVksfuu] D-dimer, fØ,fVukbu] HbA1C, AC, • 'kY;&fpfdRlh; ejge&iêh PC, HDL, LDL, TIG, dksysLVªkWy VksVy] HIV, • Mk;fyfll 'kq# djuk vkSj can djuk HBsAg, HCV • ,Iyhds’ku vkWQ bPFkkeksy fXyljhu@eSXuhf'k;e lYQsV MªsÇlx QkWj FkzksEcksf¶yfcfVl@,DlVªkokls'ku • eyw ekbØksck;ksykWth tkap & CyM lsaiYl QkWj dYpj ,aM lsfalfVfoVh] fVIl vkWQ oLdwyj ,Dlsl • ckgjh fQDlsVlZ ij jksfx;ks a ds fy, fiu lkbV ns[kHkky ,aM bZVh Vîwc QkWj dYpj • vkblkes fsVªd ,aM vkblkVs ksfud ,Dljlkbt 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, Lukrdks a ds fy, fn'kkfunsZ'kks a ds :i eas miyCèk djk, tk ldrs gSaA ,uih Nk=ks a dks bu vkS"kfèkvks a dks nus s ds fy, çhlsIVlZ@,uih ladk; dh n[s kj[s k es a nus s ds fy, çf'kf{kr fd;k tk,xkA p;fur tkap ds vkns'k nus s vkSj fof'k"V fpfdRlh; çfØ;kvks a dks djus ds çksVksdkWy Hkh ,uih, Nk=ks a dks çf'kf{kr djus okys çR;sd vLirky es a miyCèk gks ldrs gSaA [जवज्ञापन-III/4/असा./900/2024-25] INDIAN NURSING COUNCIL

NOTIFICATION New Delhi, the 26th December, 2024 INDIAN NURSING COUNCIL {NURSE PRACTITIONER IN ANESTHESIA (NPA) - POSTGRADUATE RESIDENCY PROGRAM} REGULATIONS, 2024 F.No. 11-1/2024-INC (IX):—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 Anesthesia (NPA) - 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[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 45 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 ANESTHESIA (NPA) - 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. It emphasizes human resource development in the areas of education and training alongside regulation and legislation. It is highly significant that the healthcare professionals require advanced educational and clinical training in healthcare settings for specialized services. The Government of India recognizes significant expansion in all healthcare settings both in public and private sectors. There is a felt need to have specialist nurses and nurse practitioners with advanced preparation to support healthcare services in our country.

Nurse Practitioners will be able to meet this demand provided they are well trained and empowered to practice in the area of need. With establishment of new cadres at 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 relevant settings in India. Nurse Practitioner in critical care/acute care, oncology, emergency care, neuro-care, cardiovascular care, anesthesia and other specialties can be prepared to function in all levels of relevant settings. Rigorous educational training will enable them to assess and participate in managing patients undergoing various procedures and surgeries both for prevention of complications and promotion of health.

A curricular structure/framework is proposed by the Council towards preparation of Nurse Practitioner in Anesthesia (NPA) at master’s level. The special feature of this program is that it is a clinical residency program emphasizing a strong clinical component with 15% theoretical instruction and 85% practicum. Competency based training is the major approach and NP education is based on competencies adapted from National Organization of Nurse Practitioner Faculties (NONPF) competencies (2022), International Council of Nurses (ICN, 2021), American Association of Colleges of Nursing (2021), American Association of Nurse Anesthesiology (AANA, 2023). Every course is based on the achievement of competencies.

The provision of adequate surgical cover is a prerequisite to accomplishing local and global health goals {Lancet Commission on Global Surgery (LCoGS), 2019}. A large section of people seeking surgical care cannot afford the financial burden of medical treatment. About 66% of patients in low- and lower-middle-income countries do not have access to primary surgical care. Safe anesthetic care is essential to ensure safe outcomes of surgery. Five billion people across the world have no access to safe anesthetic care. Law T.J. et al. (2019) spell out various issues and barriers in the path to achieve safe and accessible anesthesia care.

The LCoGS suggests an average minimum threshold of 5000 surgical procedures per 100,000 population by

2030. Sufficient trained anesthesia care providers are needed to cater for such large surgical volumes, and the workforce gap must be filled up by well-trained non-physician anesthesia care providers (NPAPs).

Narrowing the gap becomes the priority according to the Sustainable Development Goals, 2030, that focuses on Global Health Equity. The Nurse Practitioner in Anesthesia (NPA) Program is the way forward to close down the gap.

The NPA Program is intended to train registered B.Sc. Nurses at the master’s level to provide peri-anesthesia care to patients and to carry out critical care procedures in various anesthesia relevant settings. NPA focuses on assessing patients and their medical fitness for anesthesia and surgery, preventing, and treating acute complications if any and stabilizing them during the peri-anesthesia period.

These NPAs are required to practice in the operating rooms, pre-anesthesia clinics, post-anesthesia recovery rooms, ICUs, outpatient and in patient surgery units, emergency rooms, labor and delivery rooms, endoscopy suites, radiological centers, psychiatric units, including Community Health Centers (CHCs).

The program consists of various courses of study that are based on strong scientific foundations including evidenced based practice and management of complex health systems. These are built upon theoretical and practice competencies of B.Sc. Nursing. On completion of the program and registration with the respective SNRC, they are permitted to practice all competencies listed in the logbook of the Council syllabus. They will be able to provide general, regional and local anesthesia with supervision by anesthesiologists. They will also be able to administer drugs relevant to the scope of anesthesia care, order diagnostic tests, procedures, medical equipment, and therapies as per institutional protocols/standing orders. They will be permitted to manage post-operative patients in the Post Anesthesia Care Unit (PACU) and discharge them based on specific criteria. The NPAs when exercising this authority are accountable for the following competencies - a) Preanesthetic assessment b) Preparing, administering and terminating regional anesthesia with supervision c) Patient safety d) Monitoring vital signs e) Handling of equipment f) Basic and advanced cardiac life support46 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] g) Post operative care h) Pain management i) Risk prevention j) Documentation k) Health advocacy l) Professionalism The said postgraduate degree will be registered as an additional qualification by the SNRC.

Vision Nurse Practitioner in Anesthesia (NPA) program seeks to cater to the surgical, anesthesia, and obstetrics needs of underserved population, thereby minimizing the gap in healthcare delivery system and promoting the health profile of the country.

Philosophy The Council believes that there is a great need to establish a postgraduate program titled Nurse Practitioner in Anesthesia to meet the challenges and demands of healthcare services in India which is reflected in the National Health Policy, 2017 and to provide safe, quality care to patients undergoing anesthesia in specific healthcare settings.

The Council believes that postgraduates from a residency program will focus on strong clinical component, using competency-based training. They will be able to demonstrate clinical competence based on sound theoretical and evidence-based knowledge. The teaching-learning approach will concentrate on adult learning principles, competency-based education, collaborative learning, preceptorship, experiential learning, simulation based learning and self-directed learning. Education providers/preceptors/mentors can be operating room nurses and anesthesiologists. They will be subject experts and will possess high competence.

The Council also believes that a variety of educational strategies can be used in the clinical settings to address the deficit of qualified personnel. It is hoped to facilitate developing policies towards registration/licensure and create cadre positions for appropriate placement of these postgraduate Nurse Practitioners in Anesthesia.[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 47 II. Program Description This program is designed to assist students in developing expertise and in-depth understanding in the field of anesthesia nursing. It will enable the student to function as Nurse Practitioner in Anesthesia. It will further enable the student to function as educator, manager and researcher in the field of anesthesia nursing.

The NPA program is a Post Graduate Nursing residency program with a focus on competency based training. The duration is of two years with the curriculum consisting of theory that includes core courses, advanced practice courses and clinical courses besides clinical practicum which is a major component (Refer Curricular Framework).

III. Aim The Nurse Practitioner in Anesthesia (NPA) Program prepares registered B.Sc. nurses for advanced practice roles as clinical experts, educators and consultants leading to M.Sc. Nursing (Nurse Practitioner in Anesthesia) IV. Objectives On completion of the program, the Nurse Practitioner in Anesthesia (NPA) will be able to -

1. Assume responsibility in pre-anesthetic assessment of patients in various healthcare settings.

2. Demonstrate clinical competence in preparing, administering, and terminating anesthesia with supervision.

3. Assume responsibility for patient safety throughout the peri-anesthesia period.

4. Demonstrate skill in monitoring vital signs and interpreting values.

5. Describe the functioning of various equipment used in anesthesia.48 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4]

6. Assume responsibility in managing patients in anesthesia relevant settings to stabilize and restore patient’s health either independently or collaboratively with the team.

7. Manage pain and prevent peri-anesthesia related complications.

8. Liaise between patients, family and relevant team.

V. Minimum requirements to start the Nurse Practitioner in Anesthesia (NPA) Program The institution must accept the accountability for the NPA 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 Anesthesia program shall obtain an Essentiality Certificate/Government Order from the State. b. The following institutions are exempted from obtaining an 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 center with a minimum of 200 beds and with fully functional Operating Rooms & ICUs. b. It is preferable to have a medical college/nursing college attached to the parent hospital.

3. Operating Rooms & ICU Beds The hospital should have a minimum of 10 Operating Beds/Tables with a minimum of two tables for major surgeries and corresponding ICUs

4. Operating Room staffing a. The Operating Room complex should have a Charge Nurse/Nurse Manager preferably with B.Sc. Nursing or M.Sc. Nursing qualification. b. For Major OR: 2 Staff nurses for every functional operation table.

c. For Minor OR: 1 Staff nurse for every functional operation table. d. For Post Anesthesia Care Unit (PACU), the nurse patient ratio should be 1:1 for pediatric patients and 1:2 for adult patients for every shift.

e. There must be provision of additional 40-45% trained nursing staff towards leave reserve.

5. Faculty/Staff resources a. Clinical area: i. Nursing Preceptor: Full-time qualified GNM with 6 years of experience in Operation Theatre (preferably with Post Basic Diploma in Operating Room Nursing and Management) or B.Sc. Nursing with 2 years of experience in Operation Theatre or M.Sc. (Medical Surgical Nursing) with one year experience in Operation Theatre.

ii. Medical Preceptor: DA/MD Anesthesiologist/MD Intensivist with 2 years of experience. 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. (Medical Surgical Nursing/NPA)} (One faculty for every 10 students) ii. Assistant Professor: 1 {Teaching experience: 3 years post M.Sc. Nursing} iii. The above faculty shall perform dual role or be a senior nurse with M.Sc. Nursing in the same Specialty with the required qualification and experience, employed in OT/ICU in the same hospital iv. Guest Lecturers for Pharmacology, Pathophysiology, Critical Care

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 journal d. E-learning facilities[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 49

7. List of equipment for Operating Rooms and ICU (enclosed in Appendix 1)

8. Student Recruitment/Admission Requirements a. The applicants must be a registered B.Sc./P.B.B.Sc. nurse with a minimum of one-year clinical experience in Operation Theatres/ICUs prior to enrollment.

b. Must have undergone the B.Sc. Nursing in an institution found suitable by the Council and have been registered in any SNRC. c. Must have scored not less than 55% aggregate marks in the B.Sc. Nursing program.

d. Must be physically fit.

Number of candidates to be recruited: 1 Candidate for 2 Major Operating Tables.

Salary

1. In-service candidates (candidates who have been working in the same institution) will get regular salary.

2. Stipend/salary for the other candidates must be provided 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 the 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 reappear 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 - Refer OSCE Guidelines found in Appendix 2.

Maximum number of students per day will be 10 students.

Examination should be held in the 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 Nurse Practitioner in Anesthesia program/M.Sc. faculty (Medical Surgical Nursing preferable) with 5 years of post PG experience}, one external examiner (same as above) and one anesthesiologist as internal examiner who should be preceptor for NPA program.

Dissertation/EBP Project

Research Guides: Main guide: Nursing faculty (3 years post PG experience) teaching NPA program Co-guide: Medical preceptor

Submission of Research Proposal: 6 to 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: It must be obtained by the Institutional Review Board/Hospital Ethics Committee since it involves clinical research.

Topic Selection: The topic should be relevant to anesthesia nursing that will add knowledge or evidence for nursing intervention. The research should be conducted in OR/PACU/ICU 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 to 9 months in second year.

Submission of Dissertation Final: 3 months before completion of the second year.50 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] 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 can be conducted in place of dissertation and report submitted for evaluation.

VII. Assessment (Formative and Summative) • Quiz • Seminar • Written assignments/Term papers • Case/Clinical presentation • Clinical or care pathway/Case study report • Clinical performance evaluation • Logbook (Procedural competency list and clinical requirements) countersigned by the medical/nursing faculty preceptor • Objective Structured Clinical Examination (OSCE) • Test papers • 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 2 hours 50 Nursing 2 Research Application and Evidence Based 3 hours 30 70 Practice in Anesthesia Care 3 Advanced Skills in Leadership, Management 3 hours 30 70 and Teaching Advanced Practice Courses 4 Advanced Pathophysiology and 3 hours 30 70 Pharmacology applied to Anesthesia Care 5 Advanced Health/Physical Assessment 3 hours 30 70 50 50 IInd year Specialty Courses 1 Foundations of Anesthesia Nursing Practice 3 hours 30 70 100 100 2 Anesthesia Nursing I 3 hours 30 70 100 100 3 Anesthesia Nursing II 3 hours 30 70 100 100 4 Dissertation and Viva 50 50 VIII. Courses of Instruction Theory Lab/Skill Lab Clinical

(hours) (hours) (hours) Ist year Core Courses I Theoretical Basis for Advanced Practice Nursing 40[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 51 Theory Lab/Skill Lab Clinical

(hours) (hours) (hours) II Research Application and Evidence Based Practice in 56 24 336 (7 weeks) Anesthesia Care III Advanced Skills in Leadership, Management and 56 24 192 (4 weeks) Teaching Advanced Practice Courses IV Advanced Pathophysiology applied to Anesthesia Care 60 336 (7 weeks) V Advanced Pharmacology applied to Anesthesia Care 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 Anesthesia Nursing Practice 96 48 576 (12 weeks) VIII Anesthesia Nursing I 96 48 576 (12 weeks) IX Anesthesia Nursing II 96 48 624 (13 weeks) TOTAL = 2208 hours 288 (6 weeks) 144 (3 weeks) 1776 (37 weeks) No. 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-Skill Lab-Clinical) [Theory = 15%, Practicum (Skill Lab & Clinical) = 85%]

IInd year: 288-144-1776 hours (Theory-Skill Lab-Clinical) [Theory = 15%, Practicum (Skill Lab & Clinical) = 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 one per week.

Clinical Placements

Ist year: 44 weeks (excludes 2 weeks of introductory block classes and workshop) Clinical Postings* No. of weeks Pre-Anesthesia Clinic (PAC)/PAC in wards (General Surgery, Orthopedics, Eye, ENT, Head and 10 Neck, Neuro, Cardiothoracic, Urology, GI/HPB, Pediatric Surgery, Respiratory, Endosurgery, OBG, Elderly, Adult & Children) Intensive Care Unit Surgical 2 Neonatal 2 Pediatric 252 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] Clinical Postings* No. of weeks Cardiothoracic 2 Neurosurgical 2 Day Care OR 1 General Surgery OR 2 Obstetrics and Gynecology 2 Orthopedic Surgery 1 Post Anesthesia Care Unit (PACU) Obstetrics and Gynecology 1 Pediatric 1 General Surgery 2 ENT 1 Eye 1 Vascular 1 Day Care 1 Trauma 1 Urology 1 Neuro 1 Pain Clinic 2 Oncology Wards/Palliative Care Unit 1 Secondary Care Hospital/CHCs 2 District Hospital 2 TOTAL WEEKS 44

IInd year: 45 weeks (excludes one week of block classes) Clinical Postings* Tertiary Care Centers & including PAC/PACU/OR/ICU/CCU Community Health Center (CHC)/Secondary Care Hospital (weeks) General surgery 7 Obstetrics & Gynecology 7 Orthopedics & Trauma 5 Pediatric Surgery 2 Ophthalmology 3 Urology 2 ENT 2 Plastic surgery 2 Cardiothoracic 1 Neurosurgery 1 Dental 2 Emergency Surgery 2[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 53 Clinical Postings* Tertiary Care Centers & including PAC/PACU/OR/ICU/CCU Community Health Center (CHC)/Secondary Care Hospital (weeks) Radio Diagnosis 2 Endoscopy Room 1 ICUs 6 TOTAL WEEKS 45 C. Methods of Teaching Theory • Lecture cum discussion • Seminar • Workshops Practice • Clinical conference • Case/clinical presentation • In depth drug study, presentation, and report • Case study/Clinical or care pathway Presentation • Nursing rounds • Journal clubs • Directed reading • Assignments and projects • Case study analysis • Simulation based learning • Problem based learning • Experiential learning • Reflective learning D. Procedures/Logbook At the end of each clinical posting, clinical logbook (Specific Procedural Competencies/Clinical Skills) (Appendix 3) and clinical requirements (Appendix 4) have to be signed by the preceptor/faculty.

E. Nurse Practitioner in Anesthesia Competencies (Adapted from ICN, 2020)

1. Acquires knowledge related to comprehensive assessment, diagnostic procedures, management of peri-anesthesia complications.

2. Applies and adapts advanced skills and competencies in patient safety while they are in complex and/or unstable environments.

3. Applies sound advanced clinical reasoning and decision making in peri-anesthetic management.

4. Uses critical thinking in assessment, management and evaluation of patient care.

5. Documents assessment, diagnosis, management and monitors treatment and follow-up care in partnership with the patient.

6. Administer drugs and treatments according to institutional protocols.

7. Uses applicable communication, counseling, advocacy and interpersonal skills to initiate, develop and discontinue therapeutic relationships.

8. Refers to and accepts referrals from other healthcare professionals to maintain continuity of care.

9. Practices independently wherever authorized.

10. Consults with and is consulted by other healthcare professionals and others.

11. Works in collaboration with the OR personnel and the surgical team members in the interest of the patient.

12. Develops a practice that is based on current scientific evidence and incorporated into the health management of patients, families and communities.

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 using 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.54 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4]

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.

F. Institutional Protocol/standing orders-based administration of drugs & ordering of investigations and therapies The students will be trained to both assist and administer appropriate anesthesia, 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 anesthesiologist and endorsed later by written orders.

Implementation of Curriculum - A tentative plan Ist year courses Introductory Workshop Theory integrated in Methods of teaching classes clinical practicum (Topic can be specified)

1. Theoretical 8 hours 1×32 = 32 hours • Seminar/Theory application Basis for Advanced • Lecture (faculty) Practice Nursing (40)

2. Research 8 hours 40 (5 days) 1×24 = 24 hours • Research study analysis Application and + 8 hours • Exercise/Assignment (lab) Evidence Based Practice in Anesthesia Care (56+24)

3. Advanced 12+2 hours 1×26 = 26 hours • Clinical conference Skills in Leadership, 2.5×16 = 40 hours • Seminar Management and • Exercises/Assignment (lab) Teaching (56+24)

4. Advanced 1.5×40 = 60 hours • Case presentation Pathophysiology applied • Seminar to Anesthesia Care (60) • Clinical conference

5. Advanced 10 hours 1×44 = 44 hours • Nursing rounds Pharmacology applied to • Drug study presentation Anesthesia Care (54) • Standing orders/presentation

6. Advanced 8 hours 2×26 = 52 hours • Clinical demonstration (faculty) Health/ Physical 1.5×18 = 27 hours • Return demonstration Assessment (70+48) 1×15 = 15 hours • Nursing rounds 2×6 = 12 hours • Physical assessment (all systems) 2×2 = 4 hours • 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

7. Foundations of 9×16 = 144 hours • Demonstration (lab) Anesthesia Nursing Practice • Return demonstration (lab) (96+48 hours) = 144 hours • Clinical teaching • Case study • Seminar • Clinical conference • Faculty lecture

8. Anesthesia 9×16 = 144 hours • Demonstration (lab) Nursing I • Return Demonstration (lab) (96+48 hours) = 144 hours • Clinical conference/journal club • Seminar • Case presentation • Drug study (including drug interaction) • Nursing rounds • Faculty lecture[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 55 IInd year courses Theory and skill lab integrated Methods of teaching 1 week Block classes (48 hours) into clinical practicum

9. Anesthesia 9×16 = 144 hours • Demonstration (lab) Nursing II • Return Demonstration (96+48 hours) = 144 hours • Nursing rounds • Clinical conference/journal club • Seminar • Faculty lecture

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 after 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 Anesthesia Nursing.

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 anesthesia 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 donors and the recipients.

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 Systems 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: Role of politics & economics in healthcare delivery 4 (Competency-4)

5. Digital transformation in health care: Trends & Opportunities (Competency-5) 4 Advanced Practice Nursing (APN)

6. APN - Definition, Scope, Philosophy, Accountability, Roles & Responsibilities (Collaborative 3 practice and Nurse Prescribing roles) (Competency-6 & 7)

7. Regulation (accreditation of training institutions and credentialing) & Ethical Dimensions of 3 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

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 prescribing56 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] S.No. Topic Hours policies in India with relevance to these policies in other countries?

3. Examine the nursing protocols relevant to NP practice found in anesthesia care units 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 • AANA (2023) Scope of Nurse Anesthesia Practice, Illinois, USA: AANA • DeNisco & Barkers A.M. (2015) Advanced Practice Nursing: Essential Knowledge for the Profession (3rd ed.),

Massachusetts: Jones & Bartlett Publishers • 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. Retrieved from https://www.icn.ch/system/files/ documents/2020-4/ICN_APN%20Report_EN_WEB.pdf • National Organization of Nurse Practitioner Faculties (NONPF 2022) Nurse practitioner role competencies.

Retrieved from https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/competencies/20220825_nonpf_ np_role_core_.pdf. • 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 Anesthesia Care COMPETENCIES

1. Applies sound research knowledge and skills in conducting independent research in anesthesia care setting.

2. Participates in collaborative research to improve in quality of patient care.

3. Interprets and uses research findings to produce EBP.

4. Tests/evaluates current practice to develop best practices and health outcomes and quality care.

5. Analyses the evidence for nursing interventions carried out in anesthesia nursing practice to promote safety and effectiveness of care.

6. Develops skill in writing scientific research reports.

Hours of Instruction: Theory: 56 + Lab/Skill Lab: 24 = 80 hours S.No. Topic Hours

1. Research and Advanced Practice Nursing: Significance of research and inquiry related to 2 advanced nursing role (Competency-1)

2. Research Agenda for APN Practice: Testing current practice to develop best practice, health 5 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 steps - Integrating EBP to anesthesia care environment - Areas of evidence in anesthesia care - Barriers to implement EBP - Strategies to promote EBP (Competency-3,4,5)[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 57 Total 56 hours Lab/Skill Lab & Assignments: 24 hours • Identifying research priorities • Writing exercises on research question, objectives and hypothesis • Writing research proposal/EBP project proposal • Scientific paper writing - preparation of manuscript for publication • Writing Systematic review/Literature review: Analyze the evidence for a given nursing intervention in anesthesia unit 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 III. Advanced Skills in Leadership, Management and Teaching COMPETENCIES

1. Applies principles of leadership and management in anesthesia care units.

2. Manages stress and conflicts effectively in anesthesia 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 anesthesia care setting.

5. Builds teams and motivates others in anesthesia care setting.

6. Develops unit budget, manages supplies and staffing effectively.

7. Participates appropriately in times of innovation and change.

8. Uses effective teaching methods, media and evaluation based on sound principles and trends of teaching.

9. Develops advocacy role in patient care, maintains quality and ethics in peri-anesthesia units in hospital and community settings.

10. Provides counselling to families and patients in crisis situations particularly on table emergencies.

Hours of Instruction. Theory: 56 + Lab/Skill Lab: 24 = 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 anesthesia care settings 4

4. Stress management and conflict management - principles and application to anesthesia care 4 environment, effective time management

5. Quality improvement and audit 4

6. Problem solving, critical thinking and decision making, communication skills applied to anesthesia 5 nursing practice

7. Team building, motivating and mentoring within OR set up 2

8. Budgeting and management of resources including human resources - OR budget, material 5 management, staffing, assignments

9. Change and innovation 2

10. Staff performance, and evaluation (performance appraisals) 6

11. Teaching-learning theories and principles applied to Anesthesia Nursing 2

12. Competency based education and outcome-based education 2

13. Teaching methods/strategies - experiential, reflective, scenario based, simulation etc., 8

Media: educating patients and staff in anesthesia care settings58 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] S.No. Topic Hours

14. Staff education and use of tools in evaluation 4

15. APN - Roles as a teacher 2

16. Advocacy roles in anesthesia care environment 2 Total 56 hours Lab/Skill Lab: 24 hours COMPETENCIES

1. Preparation of staff patient assignment

2. Preparation of unit budget

3. Preparation of staff duty roster

4. Patient care audit

5. Preparation of nursing care standards and protocols

6. Management of equipment and supplies

7. Monitoring, evaluation, and writing report of infection control practices

8. Development of teaching plan

9. Micro teaching/patient education sessions

10. Preparation of teaching method and media for patients and staff

11. Planning and conducting OSCE/OSPE

12. Construction of tests

Assignment: Operation Room work place violence Bibliography • Bastable S.B. (2019) Nurse as educator: Principles of teaching and learning for nursing practice (5th ed.), New

Delhi: Jones & Bartlett Publishers • 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 • Liebler J.G. & McConnel C.R. (2008) Management principles for health professionals, Sudbury, MA: Jones & Bartlett Publishers • Roussel L. & Swansburg, R.C. (2010) Management and leadership for nurse administrators (5th ed.), New Delhi:

Jones & Bartlett Publishers ADVANCED PRACTICE COURSES IV. Advanced Pathophysiology applied to Anesthesia Care COMPETENCIES

1. Integrates the knowledge of pathophysiology while performing pre-anesthesia assessment, intra-anesthesia monitoring and post-anesthesia care.

2. Manages symptoms related to peri-anesthesia related complication using the knowledge of pathophysiology.

3. Analyzes changes relevant to peri-anesthesia patient care.

IV. A. Advanced Pathophysiology applied to Anesthesia Care

Hours of Instruction: Theory: 30 hours Unit Hours Content I 6 Cardiovascular System Pathophysiology of cardiovascular conditions • Hypertension • Hypotension • Coronary artery diseases • Ischemic heart disease • Heart failure • Hypertrophic cardiomyopathy • Valvular heart disease • Congenital heart disease[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 59 Unit Hours Content • Pericardial disease • Cardiovascular risks related to anesthetic agents • Effect of positioning on cardiovascular system II 6 Pulmonary System Pathophysiology of pulmonary conditions • Pulmonary function • Pathophysiology of lung conditions • Obstructive pulmonary disease • Restrictive pulmonary disease • Pulmonary Embolism • Pulmonary Edema • Pulmonary Hypertension • Aspiration • Atelectasis • Cor pulmonale • Pulmonary risks related to anesthetic agents • Effect of positioning on pulmonary system III 6 Central Nervous System and Peripheral Nervous System Pathophysiology of Neurological Disorders • Intracranial hypertension • Brain stem injury • Stroke • Traumatic brain injury • Venous air embolism • Cerebral aneurysms • Arterio-venous malformations • Cerebrovascular accident • Intracranial mass lesions • Seizures • Degenerative neurological diseases • Neuromuscular disease • Spinal cord injury • Neurological trauma • Psychiatric disorders - Depression, Bipolar disease, Schizophrenia, Neuroleptic malignant syndrome, Substance abuse • Neurological risks related to anesthetic agents • Effect of positioning on Neurological system IV 4 Renal System Pathophysiology of Renal conditions • Benign Prostatic Hyperplasia • Tumors • Bladder trauma • Renal failure • Renal risks related to anesthetic agents V 4 Gastrointestinal and Hepatobiliary System Pathophysiology of Gastrointestinal and Hepatobiliary conditions • GI bleed • Abdominal injury • Intestinal obstruction • Perforated appendix • Acute pancreatitis • Abdominal aorta aneurysm • Hepatitis - acute, chronic60 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] Unit Hours Content • Cirrhosis • Hepatic failure • Gastrointestinal and Hepatobiliary risks related to anesthetic agents VI 4 Endocrine System Pathophysiology of Endocrine Functions • Diabetes mellitus • Hyperthyroidism, Hypothyroidism • Hyperparathyroidism, Hypoparathyroidism • Mineralocorticoid excess, Mineralocorticoid deficiency, Glucocorticoid excess, Glucocorticoid deficiency, Catecholamine excess • Obesity • Carcinoid syndrome • Endocrinological risks related to anesthetic agents Total 30 hours IV. B. Advanced Pathophysiology applied to Anesthesia Care

Hours of Instruction: Theory: 30 hours Unit Hours Content I 4 Musculoskeletal System (MS) Pathophysiology of MS conditions • Spine Fractures • Ankylosing Spondylitis • Dislocations • Ligamental injuries • Inflammatory conditions • Intervertebral disc prolapses, Potts disease • Congenital - Kyphosis, Lordosis, Scoliosis • MS risks related to anesthetic agents • Effects of position on MS System II 8 Eye, Ear, Nose and Throat Pathophysiology of ear, nose & throat conditions • Conditions of the ear • Conditions of the eyes • Conditions of the nose • Conditions of the throat III 6 Multisystem dysfunction Advanced pathophysiological process of the following conditions • Shock - Hypovolemic - Cardiogenic - Distributive • Trauma - Thoracic - Abdominal - Musculoskeletal - Maxillofacial IV 4 Specific infections Advanced pathophysiological process of specific infections • HIV • Tetanus • SARS • Rickettsiosis • Leptospirosis • Dengue[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 61 Unit Hours Content • Malaria • Chikungunya • Rabies • Avian flu • Swine flu • COVID-19 V 8 Reproductive system Advanced pathophysiological process of reproductive conditions • Pregnancy - Normal, Umbilical cord prolapse, Dystocia & abnormal fetal presentations and positions, Multiple gestations, Pregnancy induced hypertension, Obstructed labour, Ruptured uterus, Preterm labour • Antepartum hemorrhage - Placenta previa, Abruption placentae, Uterine rupture • Premature rupture of membranes • Chorioamnionitis • Amniotic fluid embolism • Post partum hemorrhage • HELLP (Hemolysis, Elevated Liver enzymes, Low Platelet Count) • Trauma 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 • Huether S.E. & McCance K.L. (2012) Understanding Pathophysiology (5th ed.), St. Louis, Missouri: Elsevier • Nagelhout J.J. & Elisha S. (2018) Nurse Anaesthesia, St. Louis, Missouri: Elsevier • Norris T.L. (2020) Porth’s Essentials of Pathophysiology (5th ed.), Walters Kluwer • Porth C.M. (2007) Essentials of Pathophysiology: Concepts of altered health states (4th ed.), Philadelphia:

Lippincott Williams & Wilkins • Porth C.M. (2007) Essentials of Pathophysiology: Concepts of altered health states (2nd 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.), Philadelphia: Lippincott Williams & Wilkins V. Advanced Pharmacology applied to Anesthesia Care COMPETENCIES

1. Applies the pharmacological principles in providing various types of anesthesia and in the care of post-anesthesia patients.

2. Analyzes and apply pharmaco-therapeutics and pharmacodynamics in anesthesia.

3. Practices safe drug administration based on principles and institutional protocols.

4. Documents accurately and provides appropriate care in case of drug allergies, anaphylaxis, and drug overdose.

5. Applies sound knowledge of drug interactions while providing anesthesia.

Hours of Instruction: Theory: 54 hours Unit Hours Content I 2 Introduction to pharmacology • History • Classification of drugs and schedules II 4 Pharmacokinetics and Pharmaco-dynamics • Introduction • Absorption, Distribution, Metabolism and Excretion in critical care • Plasma concentration, half life • Loading dose and maintenance dose • Therapeutic index and drug safety62 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] Unit Hours Content • 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 4 Inhalation anesthetics • Introduction • Pharmacokinetics • Clinical overview of current inhalation treatment • Neuropharmacology of invasive anesthesia on cardiovascular, pulmonary, hepatic, neuromuscular, general effects, obstetrics, and effects of fetal development • Anesthesia degradation by carbon dioxide • Clinical utility of volatile anesthesia • Standing Orders/Institutional Protocols IV 5 Intravenous anesthetics • Introduction • Pharmacokinetics • General principles of intravenous anesthesia • Pharmacokinetics, pharmacodynamics, clinical uses and side effects of o Propofol o Etomidate o Ketamine o Dexmedetomidine o Benzodiazepines o Barbiturates • New intravenous anesthetics • Standing Orders/Institutional protocol V 4 Opioids • Introduction • Pharmacokinetics and pharmacodynamics of opioids • Opioid mechanism • Opioid induced respiratory depression • Other opioid related side effects • Remifentanil for labor pain • Genetic differences • Opioid induced immunomodulation and cancer recurrence • Acute pain management in opioid dependent patients VI 6 Neuromuscular blocking agents • Introduction • Pharmacokinetics and pharmacodynamics • Pharmacological characteristics • Depolarizing neuromuscular blocking drugs • Non-depolarizing neuromuscular blocking drugs • Drug interaction • Alternates to neuromuscular blocking agent • Monitoring neuromuscular blockade • Reversal of neuromuscular blockade VII 4 Cholinesterase inhibitors & other pharmacological antagonists to neuromuscular blocking agents • Introduction • Pharmacokinetics and pharmacodynamics of o Neostigmine o Pyridostigmine o Edrophonium o Physostigmine[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 63 Unit Hours Content o Sugammadex o L-cysteine VIII 2 Anticholinergic drugs • Introduction • Pharmacokinetics & pharmacodynamics of o Atropine o Scopolamine IX 4 Adrenergic agonists • Introduction • Pharmacokinetics and pharmacodynamics of o Phenylephrine o Alpha 2 agonists o Epinephrine o Ephedrine o Norepinephrine o Dopamine o Isoproterenol o Dobutamine o Dopexamine o Fenoldopam X 4 Adrenergic antagonists • Introduction • Pharmacokinetics and pharmacodynamics of o Alpha blockers - Phentolamine o Mixed antagonists - Labetalol o Beta blockers - Esmolol, Metoprolol, Propranolol, Nebilol, Carvedilol XI 4 Adjuncts to anesthesia • Introduction • Pharmacokinetics and pharmacodynamics of o Histamine receptor antagonists - H1 receptor antagonists, H2 receptor antagonists o Antacids - Metoclopramide, Proton pump inhibitors, 5 HT3 receptor antagonists o Butyrophenones o Dexamethasone o Neurokinin 1 receptor antagonist XII 4 Other drugs used as adjuvants • Introduction • Pharmacokinetics and pharmacodynamics of o Ketorolac o Clonidine o Dexmedetomidine o Doxa pram o Naloxone o Naltrexone o Flumazenil XIII 3 Hypotensive agents Introduction • Pharmacokinetics and pharmacodynamics of o Nitro vasodilators - Sodium Nitroprusside, Nitroglycerine, Hydralazine o Non-Nitro vasodilators - Fenoldopam, Calcium antagonists XIV 4 Local anesthetics • Introduction • Pharmacokinetics and pharmacodynamics • Mechanism of action of local anesthetics • Pharmacology and pharmacodynamics • Pharmacokinetics of local anesthesia • Clinical use of local anesthesia64 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] Unit Hours Content • Toxicity of local anesthesia • New local anesthetics • Future therapeutics and modalities Total 54 hours Bibliography • 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 • Phillips N.M. (2013) Berry & Kohn’s Operating room technique, Elsevier: New Delhi • Wynne A.L., Woo T.M. & Olyaei A.J. (2007) Pharmacotherapeutics for nurse practitioner prescribers (2nd ed.),

Philadelphia: Davis VI. Advanced Health/Physical Assessment COMPETENCIES

1. Applies the principles of system-wise physical assessment and develop appropriate examination skills.

2. Uses advanced health assessment skills to differentiate between 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 the anesthesiology team in making the right choice of anesthesia.

5. Documents assessment, diagnosis, and management and monitor follow up care in partnership with healthcare team members, patients, and families.

Hours of Instruction: Theory: 70 + Lab/Skill Lab: 48 = 118 hours Unit Hours Content I 4 Introduction • History collection • Physical examination II 6 Cardiovascular (CVS) system • Anatomy & physiology of CVS - review o Structure of the heart o Blood flow through the heart o Conduction system of the heart o Arteries and Veins • Common symptoms of CVS: Chest Pain, Dyspnea, Palpitations, Syncope, Calf pain • Cardiac history collection • Physical assessment: Inspection: Skin Color, Jugular Vein Distension, Edema • Physical assessment: Auscultation: Heart Sounds, Carotid Sounds • Physical assessment: Palpation: Pulses, Capillary Refill, Edema, Heaves or Thrills • Other assessments: Blood Pressure, Jugular Venous Pressure • Cardiac laboratory studies: biochemical markers, hematological studies • Cardiac diagnostic studies: Electrocardiogram, echocardiography, transesophageal echocardiography, stress testing, Holter monitoring, Myocardial perfusion scans, Coronary angiography, Transcranial Doppler, Valve area & transvalvular gradient, Regurgitant fraction • Arterial blood pressure: Mean arterial pressure III 6 Respiratory system • Anatomy and physiology of the Respiratory system - review • Common symptoms of the respiratory system • Respiratory system History Collection • Physical examination: Inspection: Assess Level of Consciousness, Respiratory Rate, Breathing Pattern, Skin Color of the lips, face, hands, and feet, Chest for symmetry and configuration, Clubbing • Physical examination: Auscultation: Lung Sounds • Physical examination: Percussion: Dull sounds, Clear Low-pitched Sounds, Hollow Sounds • Respiratory monitoring: Arterial blood gases, pulse oximetry, end-tidal carbon dioxide monitoring[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 65 Unit Hours Content • Respiratory diagnostic tests: Chest radiography, ventilation perfusion scanning, pulmonary angiography, bronchoscopy, thoracentesis, sputum culture, pulmonary function test • Assessment of elastic resistance: Compliance, Lung volumes, Functional residual capacity, Vital capacity • Assessment of non-elastic resistance: Airway resistance to gas flow, Tissue resistance • Assessment of Alveolar, Arterial & Venous gas tensions o Oxygen - Alveolar oxygen tension, Pulmonary end capillary oxygen tension, arterial oxygen tension, Mixed venous oxygen tension o Carbon dioxide - Mixed venous carbon dioxide tension, alveolar carbon-dioxide tension, Pulmonary end capillary carbon dioxide tension, arterial carbon dioxide tension, End Tidal carbon dioxide tension IV 6 Nervous system • Neurological history • General physical examination: Communication, Cognition, Perception (Mental Status), Cranial Nerve Examination, Sensory Examination, Motor Examination, Range of Motion, Muscle Strength, Muscular Endurance, Reflexes, Balance, Gait • Neurodiagnostic studies - Electroencephalography, Evoked potential, CT scan, MRI, PET Scan V 5 Renal system • History • Physical examination • Assessment of renal function - Blood urea nitrogen, Serum creatinine, creatinine clearance, creatinine ratio • Assessment of electrolytes and acid base balance • Assessment of fluid balance VI 6 Gastrointestinal and hepatic system • History • Physical examination • Assessment of GI tract • Assessment of Liver function - Serum bilirubin, Serum transferases, Serum alkaline phosphatase, Serum albumin, Blood ammonia, Prothrombin time test • Diagnostic studies - radiological and imaging studies, endoscopic studies VII 5 Endocrine system • History • Physical examination • Assessment of endocrinal glands and their activity - Hormonal levels, Electrolyte levels • Laboratory studies - Electrolyte levels, Blood sugar • Diagnostic tests - Radiological and imaging studies, ECG VIII 4 Musculoskeletal system • History • Physical examination - gait assessment, joint assessment • Laboratory studies - blood parameters (inflammatory enzymes, uric acid) • Diagnostic studies - Radiological and imaging studies IX 5 Reproductive system (Male & Female) • History • Physical examination • Laboratory studies • Diagnostic studies X 5 Sensory Organs • History • Physical examination • Laboratory studies • Diagnostic studies - Radiological and imaging studies, endoscopic studies XI 4 Assessment of children • Growth and development • Nutritional assessment • Specific system assessment66 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] Unit Hours Content XII 4 Assessment of peripheral vascular system • History • Physical examination • Laboratory studies • Diagnostic studies - Radiological and imaging studies XIII 4 Assessment of Neonates • History • Physical examination • Screening tests for newborn • Breast feeding • Nutrition XIV 3 Assessment of Integumentary system • History • Physical examination • Laboratory studies • Diagnostic - Skin smear, Skin swab, Skin biopsy, Allergen test XV 3 Assessment of Elderly • History • Physical Examination • Laboratory studies • Geriatric assessment tools - Clinical Dementia Rating Scale, Mini-Mental State Examination, Criteria for Alzheimer's Disease, Global assessment of functioning scale, Geriatric depression scale, stroke assessment scale Total 70 hours List of skills to be practiced in the skill lab (48 hours include demonstration by the faculty and practice by the students) Lab/Skill Lab: 48 hours • Comprehensive history taking • Focused history taking (system wise) • Comprehensive physical examination • Focused physical examination (system wise) • Monitoring clinical parameters (system wise) • Assessment of children undergoing Anesthesia o neonate and child • Assessment of older adults undergoing Anesthesia • Assessment of pregnant women undergoing Anesthesia • Pre-anesthesia assessment of patients undergoing various surgeries under different types of anesthesia • Ordering and interpretation of lab/diagnostic tests as per institutional protocols Bibliography • Barash P.G., Cullen R.B., Stoelting R.K., Michel K., Cahalan M., Christine S., Ortega R., Sam R. Sharar & Natallie F.H. (2023) Clinical Anesthesia (9th ed.), USA: Wolters & Kluwer • 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 • Robert R.K., Gravenstein N., Lobato E.B. & Gravenstein J. (2002) Clinical Anesthesia, St. Louis, Missouri:

Saunders Elsevier • Wilson S.F. & Giddens J.F. (2006) Health assessment for nursing practice (4th ed.), St. Louis, Missouri: Saunders Elsevier SPECIALTY COURSES (Foundations of Anesthesia Nursing Practice, Anesthesia Nursing I and Anesthesia Nursing II)[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 67 VII. Foundations of Anesthesia Nursing Practice COMPETENCIES

1. Applies advanced concepts of anesthesia.

2. Collaborates with multidisciplinary team and prepares care/clinical pathways in assessment and management of patients undergoing anesthesia.

3. Provides care related to health protection, anesthesia management, anticipatory guidance, and counseling.

4. Applies ethical principles in peri-anesthesia care.

5. Practices principles of infection control relevant to peri-anesthesia environment.

6. Practices independently within the legal framework of the country towards the interest of patients, families, and communities.

7. Understands the function of anesthesia workstation.

8. Creates and maintains a safe therapeutic environment using risk management strategies and quality improvement.

Hours of Instruction: Theory: 96 + Lab/Skill Lab: 48 = 144 hours Unit Hours Content I 15 Introduction to Anesthesia Nursing Practice • Introduction to the course • Review of anatomy and physiology of vital organs (Brain, Spinal Cord, Lungs, Heart, Kidney, Liver, Pancreas, Thyroid, Adrenal and Pituitary gland) • Historical review - Anesthesia • Concepts in Anesthesia Nursing • Principles of Anesthesia Nursing • Scope of NP in Anesthesia • Operating rooms and critical care unit set up (including types of OR and ICU, equipment, supplies, OR tables and accessories, use and care of various type of monitors & ventilators, Flow sheets, supply lines and the environment) • OR personnel o Nursing staff (Nurse Managers, Charge Nurses, Scrub Nurses, Circulating Nurses, PACU Nurses) o Anesthesiologists o Surgeons o Anesthesia technicians o Ancillary staff • Technology in Anesthesia • Healthy work environment • Future challenges in NPA II 10 Pain Management • Pain in critically ill patients • Pain - Types, Theories • Physiology, systemic responses to pain and psychology of pain - Review • Acute pain services • Pain assessment - pain scales, behavior and verbalization • Pain management - pharmacological (opioids, benzodiazepines, propofol, alpha agonist, tranquilizers, neuromuscular blocking agents) • Nonpharmacological management • Transcutaneous electrical nerve stimulation (TENS) III 15 Anesthetic risk, quality improvement and liability • Anesthetic risk o Mortality and morbidity related to anesthesia o Risk management • Quality improvement and patient safety in anesthesia o Structure, Process and Outcome o Difference in outcome measurement in anesthesia o Joint Commission requirements in quality improvement and patient safety o National Accreditation Board for hospital and health care o Alternative payment models and pay for performance • Professionalism • Liability68 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] Unit Hours Content o Tort system o Breach of duty o Causation o Damages o Standard of care • Causes of anesthesia related lawsuits • Management of legal cases IV 10 Allergic Response • Basic immunological principles • Hypersensitivity responses • Anaphylactic reaction • Perioperative management of patient with allergies V 10 Infection control in Operating Rooms • Nosocomial infection in intensive care unit; methyl resistant staphylococcus aureus (MRSA) and other recently identified strains • Disinfection, Sterilization • Standard safety measures • Prophylaxis for staff • Antimicrobial therapy - review VI 10 Legal and ethical issues in Anesthesia Nursing Practice - Nurse’s role Legal issues • Issues giving raise to civil litigation • Related laws in India • Medical futility • Administrative law: Professional regulation • Tort law: Negligence, professional malpractice, intentional torts, wrongful death, defamation, assault and battery • Constitutional Law: Patient decision making Ethical Issues • Difference between morals and ethics • Ethical principles, ethical decision making in critical care, strategies for promoting ethical decision making • Ethical issues relevant to NP in Anesthesia: withholding and withdrawing treatment • Brain death, Organ donation & Counseling VII 15 Quality assurance • Design of OR/ICU • Quality assurance models applicable to Operating Rooms • Standards, Protocols, Policies, Procedures • Infection control policies and protocols • Standard safety measures • Nursing audit relevant to Nurse Anesthesia • Staffing • Re-exploration and Death on Table VIII 11 Anesthesia workstation and development systems for anesthetics • Anesthesia workstation standards and standards for anesthesia machine and workstation • Failure of equipment • Safety features of new anesthesia workstation • Check out of anesthesia workstation • Web based anesthesia software simulation • Virtual anesthesia machine vaporizers • Anesthesia breathing circuits • Carbon dioxide absorbers • Anesthesia ventilators • Anesthesia workstation variations • Waste gas scavenging systems • Electrical and Fire Safety[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 69 Unit Hours Content Total 96 hours List of skills to be practiced in the skill lab (48 hours include demonstration by the faculty and practice by the students) a. Positioning of patients for various surgeries b. Pharmacological management of pain, sedation, agitation, and delirium i. Calculation, loading and infusion of - Morphine, Fentanyl, Midazolam, Lorazepam, Diazepam, Propofol, Clonidine, Dexmedetomidine, Haloperidol ii. Epidural analgesia - sensory and motor block assessment, removal of epidural catheter after discontinuing therapy, change of epidural catheter site dressing, insertion and removal of subcutaneous port for analgesic administration, intermittent catheterization for urinary retention for patients on epidural analgesia/PCA, dose titration for epidural infusion, epidural catheter adjustment, purging epidural drugs to check patency of catheter and also for analgesia c. Use of TENS d. Scrubbing, Gowning and Gloving e. Sterile Techniques i. Opening of Sterile packs ii. Skin preparation iii. Draping of patients for sterile procedures f. Administration of Prophylactic Antibiotics g. Drafting Protocols for units h. Ventilation i. The Modern integrated Anesthesia Workstation ii. Humidifiers iii. Nebulizers - jet, ultrasonic iv. Inhalation therapy - metered dose inhalers (MDI), dry powder inhalers (DPI) v. Electronic Flowmeter vi. Ventilator Settings i. ECG Changes, Diagnosis and Appropriate Management j. Heart Sounds - Identification and Diagnosis k. Lung sounds - Identification and Diagnosis VIII. Anesthesia Nursing I COMPETENCIES

1. Performs pre-anesthesia assessment of patients.

2. Applies fundamental techniques and skills in anesthesia.

3. Provides care for unconscious and anesthetized patient.

4. Practices principles of fluid and electrolyte therapy.

5. Understands the function of anesthesia related equipment.

6. Elicits common medical conditions that interfere with anesthesia administration.

Hours of Instruction: Theory: 96 + Lab/Skill Lab: 48 = 144 hours Unit Hours Content I 20 Fundamental techniques & skills • Assessment of critically ill patients • Care of the airway • Failed intubation • Care of the patient whose breathing is inadequate • Management of circulation • Assessing the effects of treatment • Transportation of critically ill patients • Resuscitation abandonment • Severely injured patients II 15 Care of unconscious and anesthetized patients • General management • Respiratory function in the anesthetized patients • Cardiovascular system70 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] Unit Hours Content • Management of cardio respiratory arrest III 10 Principles of fluid and electrolyte therapy • Fluid compartments of the body • Fluid therapy • Clinical assessment of fluid status • Estimation of blood losses during surgery and the need for blood transfusion • Specific losses and replacement • Production of sterile fields for intravenous use IV 10 Assessment of patients before anesthesia • Examining the patient • Preoperative fasting and fluids • Premedication for anesthesia and surgery V 15 Clinical use of anesthesia equipment, Oxygen gas supplies, equipment and maintenance • Draw over apparatus and check list • Continuous flow machines • Gas supplies • Minimum anesthetic equipment • Storage and maintenance of equipment VI 20 Important medical conditions for anesthesia • Anemia • Haemoglobinopathies • Cardiovascular conditions • Respiratory diseases • Diabetes mellitus • Obesity • Malnutrition • Chronic renal failure • Transmission of infection during anesthesia and surgery VII 3 Documentation • Anesthesia records and check lists • Anesthesia reports VIII 3 Counseling • Patients and families in making right choices of anesthesia Total 96 hours List of skills to be practiced in the skill lab (48 hour include demonstration by the faculty and practice by the students) • CPR (BLS and ACLS) - Neonates, Adult and Pediatrics • Airway Management o Endotracheal Intubation o Laryngeal mask airway o Fiberoptic intubation o Cuff inflation and anchoring the tube o Oral and Endotracheal Suctioning open/closed methods o Cricothyrotomy o Oximetry - Pulse oximetry, Venous oximetry o ABG Analysis o Capnography - Interpretation and Management o Noninvasive ventilation ✓ Low flow variable performance devices: nasal catheters/cannulas/double nasal prongs, face mask, face mask with reservoir bags ✓ High flow fixed performance devices: Entrainment (Venturi) devices, NIV/CPAP/Anesthetic masks, T pieces, breathing circuits • Titration of Anesthesia Gases • Circulation and perfusion (including hemodynamic evaluation and waveform graphics) o Invasive BP monitoring[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 71 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 Pulse index Continuous Cardiac output (PiCCO) o Electrocardiography (ECG) o Waveforms • 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 Electrolyte correction (sodium, potassium, calcium, phosphorus, magnesium) o Use of fluid dispenser and infusion pumps o IV Cannulation • 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 patients and family in making the right choice of anesthesia • Management of Respiratory Depression • Management of on table Cardiac Arrest • Assessment of critically ill • Transportation of critically ill IX. Anesthesia Nursing II COMPETENCIES

1. Applies the knowledge of pharmacotherapeutics and pharmacodynamics in understanding and providing various types of anesthesia.

2. Prepares anesthetic plans, equipment, and drugs according to standard operating procedures and takes adequate safety precautions in using them.

3. Selects, inserts, manages and monitor invasive and non-invasive monitoring modalities.

4. Prepares, administers and/or participates in the administration of general and regional anesthesia to all patients for all surgical and medically related procedures under the supervision of anesthetists.

5. Provides patient-specific plan of care relevant to anesthetic techniques such as general, regional and local anesthesia, sedation and pain management.

6. Provides anesthesia and analgesia using regional techniques for obstetric, pediatric and other acute pain management.

7. Provides psychological support to help patients through the perioperative experience.

8. Identifies and collaboratively manages complications that occur during the provision of anesthesia by rapid assessment of patient’s condition, stabilizing and providing ACLS if required.

9. Assesses and evaluates the patient’s condition and responses for readiness to move to next level of care.

Hours of Instruction: Theory: 96 + Lab/Skill Lab: 48 = 144 hours Unit Hours Content I 10 Drugs used in General Anesthesia (Review) • Inhalation agents • Intravenous anesthetics • Benzodiazepines • Opiate drugs • Non-steroidal anti-inflammatory drugs (NSAIDS) • Muscle relaxants II 15 General Anesthesia • Before induction of anesthesia • Intravenous induction • Intramuscular induction • Inhalational induction III 10 Specimen General Anesthetic Techniques • Levels of anesthetic services72 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] Unit Hours Content • Ketamine anesthesia • General inhalational anesthesia • Techniques of total intravenous anesthesia • General anesthesia for emergency cases IV 15 Spinal Anesthesia & Epidural Analgesia • Preparation of patients for Spinal Anesthesia and Epidural Analgesia • Techniques of providing Spinal Anesthesia • Insertion of Epidural Catheter • Medications used for Spinal Anesthesia • Medications used for Epidural Analgesia • Post Spinal Anesthesia Care of patients • Care of Patients on Epidural Analgesia • Complications & Risks involved V 15 Nerve Block Anesthesia • Molecular Mechanism of Nerve Block • Types of Nerve Blocks • Drugs used for Nerve Blocks and their Toxicokinetic • Post Nerve Block Care • Complications and Risks VI 10 Conduction Anesthesia • Toxicity and safety of local anesthetic drugs • Contraindications to conduction anesthesia • General precautions and basic equipment • Sedation during conduction anesthesia • Specimen techniques VII 7 Choosing & planning your anesthetic technique • Choice of anesthetic technique for a particular operation • Planning general anesthesia • Safety of general and conduction techniques VIII 7 Pediatric Anesthesia • Anesthesia for children IX 7 Obstetric Anesthesia • Anesthesia during pregnancy and delivery Total 96 hours List of skills to be practiced in the skill lab (48 hours include demonstration by the faculty and practice by the students) • Ventilator settings • Cardiac monitoring • Peripheral IV-line access • Oral/Nasal/Endotracheal suction • Interpretation of ECG • Interpretation of ABG results • Reading of Chest X-ray • CVP monitoring • Pulse oximetry • Infusion Pump • Oxygen administration o Nasal prongs o Face mask o Venturi mask • Loading and administering inotropes • Loading and administering narcotic analgesics[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 73 • Inducing patients • Reversal and extubation of patients • Positioning patients for Spinal anesthesia, Epidural catheter insertion & Nerve Blocks • Care of PACU patients • Providing conduction anesthesia in lab Bibliography • ICN (2020) Guidelines on Advanced Practice Nursing, retrieved from https://www.icn.ch/system/files/ documents/2020-4/ICN_APN%20Report_EN_WEB.pdf • Barash P.G., Cullen R.B., Stoelting R.K., Michel K., Cahalan M., Christine S., Ortega R., Sam R. Sharar & Natallie F.H. (2023) Clinical Anesthesia (9th ed.), USA: Wolters & Kluwer • Dobson B. Michael (2020) Anesthesia at the District Hospital (2nd ed.), Geneva: WHO • National Organization of Nurse Practitioner Faculties (NONPF 2022) Nurse Practitioner Role Competencies,

retrieved from https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/competencies/20220825_nonpf_ np_role_core_.pdf • Paul G. Barash, Bruce F. Cullen, Robert K. Stoelting, Michael K. Cahalan, M. Christine Stock & Rafael Ortega

(2013) Hand Book of Clinical Anesthesia (7th ed.), Wolters & Kluwer, Lippincott Williams & Wilkins • Robert R.K., Gravenstein N., Lobato E.B. & Gravenstein J. (2002) Clinical Anesthesia, St. Louis, Missouri:

Saunders Elsevier The skills listed under the Specialty courses such as Foundations of Anesthesia Nursing Practice, Anesthesia Nursing I and Anesthesia 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 anesthesia care relevant settings (e.g. Operating rooms and ICUs). The log book specifies all the requirements to be completed and the list of skills that are to be signed by the preceptor/faculty once the students develop proficiency in doing the skills independently.

Appendix 1 EQUIPMENT LIST FOR ANESTHESIA

1. ABG Analyzer

2. Anesthesia procedure trolley

3. Anesthesia Workstation

4. Bain Circuit

5. Computer

6. Crash Cart

7. Defibrillator

8. Doppler Machine

9. Fiberoptic Bronchoscope

10. Glucometer

11. Intubating Videoscope

12. IV Stand

13. Operating Room Table

14. Oropharyngeal Airways

15. Overhead LED Lights

16. Oxygen, 4 Bar Medical Air and Vacuum - Pipe lines

17. Patient Transfer Roller/PAT Slide

18. Patient warming unit (Bair Hugger)

19. Position Articles

20. Suction Jars

21. Syringe Pump 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 and Quiz: 10 marks Written assignment/term paper (Global and National Healthcare Trends & Policies): 10 marks74 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] Clinical seminar (Clinical/Care pathway in specific clinical condition/Application of specific nursing theory): 5 marks

Final theory exam: 25 marks

Total: 50 marks

2. Research Application and Evidence Based Practice in Anesthesia Care

Theory:

Test papers: 20 marks Written assignment (Literature review/Preparation of research instrument) : 5 marks Journal club (Analysis of research evidence for anesthesia nursing competencies) : 5 marks

Total: 30 marks

3. Advanced Skills in Leadership, Management and Teaching

Theory:

Test papers: 15 marks Journal club (Trends in Leadership/Management/Teaching) : 5 marks Written assignment (OR workplace violence) : 5 marks

Microteaching: 5 marks

Total: 30 marks

4. Advanced Pathophysiology & Advanced Pharmacology applied to Anesthesia Care

Theory:

Test papers and Quiz: 20 marks (Pathophysiology - 10, Pharmacology - 10) Drug studies (Drug study and presentation) : 5 marks Case presentation and case study report (Pathophysiology) : 5 marks

Total: 30 marks

5. Advanced Health/Physical Assessment

Theory:

Test papers: 20 marks Written assignment (Diagnostic/investigatory reports - interpretation and analysis of findings) : 10 marks

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 can be conducted in any PAC) IInd year

1. Foundations of Anesthesia Nursing Practice

Theory:

Test papers and Quiz: 20 marks Written assignment (Infection control protocols/Standards in Anesthesia workstation) : 10 marks

Total: 30 marks

Practicum:

Clinical performance evaluation: 20 marks Drug studies (Drug study and presentation): 10 marks Case presentation and case study report (Family education/counselling): 5 marks Case presentation (Application of Clinical/Care Pathway): 5 marks End of posting exam (OSCE): 10 marks

Internal OSCE: 50 marks

Total Internal practical: 100 marks

2. Anesthesia 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[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 75

Case study report: 10 marks

Internal OSCE: 50 marks

Total Internal practical: 100 marks

3. Anesthesia Nursing II

Theory:

Test papers: 20 marks

Clinical Seminar: 10 marks

Total: 30 marks

Practicum:

Clinical performance evaluation: 20 marks End of posting (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 can be conducted in any PAC/PACU/ICU)

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 = 30 marks, Short answers 5×6 = 30 marks, Very short answer 5×2 = 10 marks} OSCE GUIDELINES FOR INTERNAL AND EXTERNAL PRACTICAL EXAMINATION Ist year I. AVANCED HEALTH/PHYSICAL ASSESSMENT INTERNAL

OSCE: 25 marks CORE COMPETENCY DOMAINS TO BE EXAMINED

1. Pre-anesthesia history taking and physical examination of an adult patient

2. Pre-anesthesia history taking and physical examination of a child patient

3. Interpretation of findings and results

4. Monitoring of clinical parameters

Number of stations: 5 (4+1 Rest stations)

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.76 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] IInd year I. FOUNDATIONS OF ANESTHESIA 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. Preparation of operation table

5. Positioning for surgeries

6. Family Education and counseling

7. Infection control practices

Number of stations: 5 (4+1 Rest stations)

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 procedures) including drug administration

7. Preparation of operation table

8. Positioning for surgeries

9. Infection control practices

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 II & III. ANESTHSIA 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. Development of plan of care/care pathway

4. Family education and counseling

5. Therapeutic interventions (emergency procedural competencies) including drug administration

6. Infection control practices

Number of stations: 5 (4+1 Rest stations)

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[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 77

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. Family education and counseling

5. Development of plan of care/care pathway

6. Drug administration

7. Therapeutic interventions (emergency procedures) including drug administration

8. Infection control practices

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 .

Appendix 3 CLINICAL LOG BOOK FOR NURSE PRACTITIONER IN ANESTHESIA (NPA) - POSTGRADATE RESIDENCY PROGRAM (Specific Procedural Competencies/Clinical Skills) Ist year S.No. Specific Competencies/Skills Number Performed/ Date Signature of the Observed/Assisted Preceptor*/Faculty I CLINICAL RESEARCH PROJECT APPLICATION AND EVIDENCE BASED PRACTICE 1 Preparation for research instrument P 2 Preparation of a manuscript for publication P 3 Writing systematic review/literature review P 4 Dissertation/EBP project (II Year) P

Topic:

II LEADERSHIP, MANAGEMENT AND TEACHING SKILLS 1 Management of equipment and supplies P 2 Monitoring, evaluating, and writing report P related to infection control 3 Preparation of teaching plan and media for P patients’ education III HEALTH ASSESSMENT 1 Focused history taking (system wise) P 2 Focused Physical Examination (system wise) - 10 each system

2.1 Respiratory system P

2.2 Cardiovascular system P

2.3 Gastrointestinal system P

2.4 Neurological system P

2.5 Genitourinary system P

2.6 Endocrine system P

2.7 Hematological system P

2.8 Musculoskeletal system P

2.9 Integumentary system P78 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] S.No. Specific Competencies/Skills Number Performed/ Date Signature of the Observed/Assisted Preceptor*/Faculty

2.10 Sensory organs P 3 Age Specific History & Physical Examination

3.1 Neonate P

3.2 Child P

3.3 Adult P

3.4 Geriatric P 4 History & Physical Examination of a P Pregnant Woman IV DIAGNOSTIC PROCEDURES 1 Collecting Blood Sample for Laboratory Tests

1.1 Biochemistry P

1.2 Clinical Pathology P

1.3 Microbiology/Virology P

1.4 ABG P 2 Assisting Invasive Procedures

2.1 Fiberoptic Bronchoscopy A

2.2 Video Assisted Laryngoscopy A

3. Non-Invasive Procedures

3.1 Ultrasound P

3.2 ECG P V. BASIC COMPETENCIES 1 Pre-anesthesia Assessment P 2 Scrubbing, Gowning and Gloving P 3 IV Cannula Insertion P 4 Endotracheal Intubation P 5 Laryngeal Mask Intubation P 6 Positioning Patients for Surgery

6.1 Supine P

6.2 Lateral P

6.3 Prone P

6.4 Lithotomy P

6.5 Jack-Knife P

6.6 Trendelenburg P

6.7 Rose P 7 Setting up, use and maintenance of basic equipment

7.1 Anesthesia Workstation P

7.2 Cardiac Monitor P

7.3 Assisting in ETCO2 Probe Placement P

7.4 Pulse Oximeter P

7.5 Sequential compressing device P

7.6 12-lead ECG monitor P

7.7 Syringe Pump P

7.8 Infusion Pump P[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 79 S.No. Specific Competencies/Skills Number Performed/ Date Signature of the Observed/Assisted Preceptor*/Faculty

7.9 Operating Room Table P 8 Interpretation of critical parameters and Radiological images

8.1 Arterial Blood Gas (ABG) P

8.2 Pulse Oximetry P

8.3 Capnography P

8.4 Central Venous Pressure Monitoring P

8.5 Electrocardiogram (ECG) P

8.6 Intracranial pressure (ICP) P

8.7 PiCCO (Pulse index Continuous Cardiac P Output)

8.8 Glasgow Coma Score P

8.9 Sedation Score P

8.10 Pain Score P

8.11 Braden Score P

8.12 Aldrete’s Score P

8.13 GRBS P

8.14 Chest Xray P

8.15 MRI/CT P 9 Monitoring

9.1 Invasive BP monitoring P

9.2 Noninvasive BP monitoring P

9.3 Peripheral vascular status P 10 Assisting with Administration of Blood A 11 Preparation of a Drug book with all P medications relevant to anesthesia *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 NPA 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 IInd year S.No. Specific Competencies/Skills Number Performed/ Date Signature of the Observed/Assisted Preceptor*/Faculty ADVANCED COMPETENCIES 1 Assisting/Providing Anesthesia

1.1 General P

1.2 Spinal P

1.3 Conduction P

1.4 Nerve Block P 2 Preparation and Administration of

2.1 Inducing Agents P80 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] S.No. Specific Competencies/Skills Number Performed/ Date Signature of the Observed/Assisted Preceptor*/Faculty

2.2 Inhalation Agents P

2.3 Reversal Agents P

2.4 Neuromuscular Blocking Agents P

2.5 Prophylactic Antibiotics P

2.6 Narcotics P 3 Triaging Surgeries P 4 Family Education and Counseling P 5 BLS

5.1 Adult P

5.2 Neonate P

5.3 Child P 6 ACLS P 7 Hand-off

7.1 Hand-off from OR to PACU P

7.2 Hand-off from OR to ICU P 8 Infection Control Practices in OR

8.1 Opening of Sterile Packs P

8.2 Skin preparation for procedures P

8.3 Draping of patients for sterile procedure P 9 Preparation of policies/standards/protocols in P peri-anesthesia settings 10 Epidural analgesia a. Sensory and motor block assessment P b. Removal of epidural catheter P c. Change of epidural catheter dressing P d. Insertion and removal of subcutaneous port P for analgesic administration e. Dose titration for epidural infusion P f. Epidural catheter adjustment P g. Purging epidural drugs P

11. Administration of Additional drugs specific to P Anesthesia a. Naloxone b. N Acetyl Cysteine c. d. e.

12 Performing the following vital procedures

12.1 Intravenous fluid administration P (Colloid/Crystalloid)

12.2 Application of TED stocking P

12.3 Care and removal of CVP line P

12.4 Care and removal of arterial line P

12.5 Care of Patient with Pacemaker P

12.6 Blood collection from arterial line P 13 Administration of[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 81 S.No. Specific Competencies/Skills Number Performed/ Date Signature of the Observed/Assisted Preceptor*/Faculty

13.1 Insulin therapy (sliding scale & infusion) P Calculation, titration and administration

13.2 Steroids P 14 Extubation

14.1 ET Extubation P

14.2 LMA Extubation P

14.3 Nasal Extubation P 15 Ordering investigations

15.1 ECG P

15.2 ABG P

15.3 Chest X-ray P

15.4 Ultrasound P

15.5 Basic biochemistry investigations P

15.6 Basic microbiology investigations P *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 NPA 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 PRACTIONER IN ANESTHESIA (NPA) - POSTGRADATE RESIDENCY PROGRAM 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 Nurse Practitioner in Anesthesia competencies (Clinical conference/Journal club)

Title of the topic:

1.3 *L,M&T - Leadership/Management/Teaching (Journal club) Ex. Trends in Team Building

Title of the topic:

2 Clinical Rounds (with nursing staff, faculty, students) - Case/Clinical presentation

2.1 Pathophysiology (Clinical conditions)

Name of clinical condition:

2.2 Pathophysiology (Clinical conditions) 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)

Name of the drug:82 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] S.No. Clinical Requirement Date Signature of the Preceptor/Faculty

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 Anesthesiologists) - Case/Clinical Presentation (Written reports are for submission)

3.1 Health Assessment (Adult) - History & Physical Examination (Two written reports)

3.2 Health Assessment (Pediatric) - History & Physical Examination (One written report)

3.2.1

3.2.2

3.2.3

3.3 Health Assessment (Pregnant woman) (One written report) 4 Collecting blood samples for laboratory tests (Biochemistry, Clinical pathology, Microbiology/Virology, ABG) - 10 samples each 5 Pre-anesthesia assessments - 20 6 Endotracheal intubation - 10 times 7 Laryngeal mask intubation - 10 times *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 the Clinical Area Clinical Condition Number of days Signature of care given Faculty/Preceptor[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 83 Name of the Clinical Area Clinical Condition Number of days Signature of care given Faculty/Preceptor Signature of the Program Coordinator/Faculty Signature of the HOD/Principal CLINICAL REQUIREMENTS FOR NURSE PRACTIONER IN ANESTHESIA (NPA) - POSTGRADATE RESIDENCY PROGRAM IInd year S.No. Clinical Requirement Date Signature of the Preceptor/Faculty 1 Clinical Seminar/Journal Club/Clinical Conference

1.1 Foundations of Anesthesia Nursing Practice (Clinical Conference)

Title of the topic:

1.2 Anesthesia Nursing I (Clinical Seminar)

Title of the topic:

1.3 Anesthesia Nursing I (Journal Club)

Title of the topic:

1.4 Anesthesia Nursing II (Clinical Seminar)

Title of the topic:

1.5 Anesthesia Nursing II (Journal Club)

Title of the topic:

2 Clinical Rounds (With Nursing staff, faculty, students) - Clinical/Case presentation (Written reports are for submission)

2.1 Foundations of Anesthesia Nursing Practice (Clinical/Care Pathway)

Name of topic:

2.2 Anesthesia Nursing I (Clinical Presentation)

Name of clinical condition:

2.3 Anesthesia Nursing I (Case Study Report)

Name of clinical condition:

2.4 Anesthesia Nursing II (Clinical Presentation)

Name of clinical condition:

2.5 Anesthesia Nursing II (Case Study Report)

Name of clinical condition:

2.6 Drug studies (drugs listed under Standing Orders) Bedside presentation (Five written reports)

2.6.1 Name of drug:

2.6.2 Name of drug:

2.6.3

2.6.4

2.6.5

2.6.684 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] S.No. Clinical Requirement Date Signature of the Preceptor/Faculty

2.6.7

2.6.8

2.6.9

2.6.10 3 Interdisciplinary Clinical Rounds (with ICU doctors) - Clinical/Case Presentation

3.1 Anesthesia Nursing I

Name of clinical condition:

3.2

3.3

3.4

3.5 (Case Study Report)

3.6 Anesthesia Nursing II

3.7

3.8

3.9 (Case Study Report)

3.10 Written Report (Developed Clinical/Care Pathway) 4 Providing General Anesthesia - 50 times for ASA grade I patients 5 Providing Spinal Anesthesia - 50 times for pregnant women (15 at least during emergency) 6 Providing Nerve Block - 50 times 7 Epidural Catheter Insertion - 30 times 8 Providing Conduction Anesthesia - 50 times 9 Preparation and Administration of Anesthetic agents - each anesthetic agent - 40 times

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 the Clinical Area Clinical Condition Number of days Signature of care given Faculty/Preceptor[भाग III—खण् ड 4] भारत का रािपत्र : असाधारण 85 Name of the Clinical Area Clinical Condition Number 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 PRACTIONER IN ANESTHESIA (NPA) - POSTGRADATE RESIDENCY PROGRAM Nurse Practitioners are prepared and qualified to assume responsibility and accountability for the care of patients in any anesthesia care setting. They collaborate with intensivists, physicians, surgeons and specialists to ensure accurate therapy for patients with high acuity needs. On completion of the program, the NPs 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 any of the Anesthesia Care Settings (Operating Rooms/PACs/PACUs/ICUs etc.) Catecholamines

1. Adrenaline

2. Noradrenaline

3. Dopamine

4. Dobutamine Antidysrhythmic

5. Adenosine

6. Amiodarone

7. Lidocaine/Xylo card Adrenergic agent

8. Ephedrine Bronchodilators

9. Aminophylline

10. Deriphylline Non depolarizing skeletal muscle relaxant

11. Atracurium (Vecuronium, Pan curium) Anticholinergic

12. Atropine sulphate Antihistamine

13. Avil Antihypertensive

14. Clonidine

15. Glycerin trinitrate

16. Isoptin86 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4] Corticosteroid

17. Hydrocortisone

18. Dexamethasone Antiepileptic

19. Levetiracetam

20. Phenytoin Sedatives & relaxants

21. Valium

22. Midazolam

23. Morphine Sulphate

24. Pentazocine Lactate (Fortwin)

25. Pethidine Hydrochloride

26. Propofol Electrolytes & acid base correction agents

27. Soda bicarbonate 8.4%

28. Soda bicarbonate 7.5%

29. Magnesium sulphate

30. Potassium chloride

Additional drugs that can be administered specific to Operating Rooms are as follows: • Inducing agents • Muscle relaxants • Reversal agents • Naloxone The following investigations and therapies may be ordered by the NPs Ordering Investigations Ordering Therapies • ECG • Nebulization • ABG • Chest physiotherapy • Chest X ray • Distal colostomy wash • Basic Biochemistry investigations - Hb, PCV, • Insertion and removal of urinary catheter for female patients TIBC, WBC Total, WBC differentials, ESR, • Test feeds electrolytes, platelets, PT, aPTT, bleeding and • TEDS clotting time, procalcitonin, D-dimer, creatinine, • Surgical dressing HbA1C, AC, PC, HDL, LDL, TIG, cholesterol • Starting and closing dialysis total, HIV, HBsAg, HCV • Application of Ichthammol Glycerin/Magnesium Sulphate • Basic Microbiology investigations - blood dressing for thrombophlebitis/extravasation samples for culture and sensitivity, tips of • Pin site care for patients on external fixators vascular access and ET tube for culture • Isometric and isotonic exercises 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 NPA 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 NPA students.

Dr. T. DILEEP KUMAR, President [ADVT.-III/4/Exty./900/2024-25] 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.