NURSES AND MIDWIVES ACT: SUBSIDIARY LEGISLATION (CHAPTER 300 )

3. Application to register nursing home or agency

5. Council to issue certificate of registration

6. Appeal to Minister

7. Council to suspend certificate of registration

SI 88 of 2002.

1. Title

These Regulations may be cited as the Nurses and Midwives (Nursing Homes and Agency) Regulations, 2002.

2. Interpretation

In these Regulations unless the context otherwise requires-

"Council" means the General Nursing Council of Zambia established under section 3 of the Act;

"inspector" means a person appointed inspector under section 38 of the Act;

"nursing agency" means a registered private organisation established for the purpose of providing quality nursing and midwifery care in any setting in a community at a cost to be determined by the agency;

"Registrar" means the person appointed as Registrar under section 5 of the Act.

3. Application to register nursing home or agency

(1) Any person-

(a) above 21 years; and

(b) without a criminal record,

may apply to the Registrar for registration of a nursing home or agency as set out in Form 1 of the First Schedule.

(2) On receipt of an application for registration under sub-regulation (1), the Registrar shall, forward the application to the Council which shall consider the application.

(3) The Council shall examine and consider the application in terms of the requirements under the Act including-

(a) the name of the applicant;

(b) the name of the proprietor;

(d) bank statements;

(e) the names and qualifications of the proposed management and professional staff;

(f) the details of available facilities; including building plan;

(g) list of directors, partners or trustees; the physical location of the nursing home or agency;

(h) that the management of the nursing home or agency has at least one member who is a nurse or midwife registered with the Council and who has a minimum of five years experience;

(i) that the nursing home or agency has a full time nurse or midwife registered with the Council who has a minimum of five years experience who shall supervise the daily professional nursing or midwifery services in a nursing home;

(j) that the nursing home or agency has a residence or visiting medical practitioner who is registered with the Medical Council of Zambia; provided that where there is a visiting medical practitioner; that person shall conduct a minimum of three weekly units of at least one hour each.

(4) In the case of a nursing home or agency, the physical and other infrastructure and requirements set out in the Second Schedule shall be complied with for the purpose of registration under these Regulations.

(5) Where the Council considers an application under sub-regulation (3) it shall, where necessary, require an inspection to produce relevant reports and other information to the Council for purposes of ascertaining the application.

5. Council to issue certificate of registration

(1) Where the Council is satisfied that the application meets the requirements specified in the Act and under these Regulations, and on payment of the fee set out in the Third Schedule, the Council shall issue a certificate of registration, to the nursing home or agency within 14 days of the approval of the application by the Council.

(2) The certificate of registration shall be as set out in Form 2 of the First Schedule and shall be renewed every year.

(3) Where the Council rejects an application of a nursing home or agency, it shall instruct the Registrar within 14 days of such rejection to notify the applicant of the refusal to register and furnish the grounds of such refusal.

(4) The notice of refusal to register a nursing Home or Agency shall be as set out in Form 3 of the First Schedule.

6. Appeal to Minister

A person aggrieved by any decision of the Council in respect of the registration of a Nursing Home or Agency may appeal to the Minister within 14 days of receipt of notification of that decision.

7. Council to suspend certificate of registration

(1) Where after a certificate of registration has been issued under these Regulations, it comes to the notice of the Council that a nursing home or agency is not complying with the conditions for registration, the council shall suspend the certificate of registration stating the grounds for suspension and request the nursing home or agency to exculpate itself in writing within 14 days from the receipt of the letter of suspension.

(2) After receipt of a statement of exculpation the Council may-

(a) decide to hear the nursing home or agency on the matter;

(b) revoke the suspension of the registration with or without condition to implement specified measures; or revoke the certificate of registration.

8. Penalty

A person who runs a nursing home or agency without registration commits an offence and shall be liable on conviction to a term of imprisonment not exceeding three months or to a fine not exceeding 1,000 penalty units.

FIRST SCHEDULE

[Regulations 3, 4 and 5]

FORM 1

REPUBLIC OF ZAMBIA

NURSES AND MIDWIVES ACT

APPLICATION FOR REGISTRATION OF NURSING HOME OR AGENCY

To the Registrar, General Nursing Council, Lusaka

1. (a) Name of applicant: ................................................................................

(b) Nationality: ..........................................................................

NRC/Passport No: ............................................................................

2. Name of the nursing home/agency: ...............................................................
.......................................................................................................................

3. Physical location: .......................................................................................

P.O. Box No. .........................................................................................

4. (a) Name of proprietor: ................................................................................

(b) Nationality: .......................................................................................

(d) NRC/Passport No. ............................................................................

(e) Address: ...........................................................................................

5. Legal status of nursing home/agency:

(a) Limited Company

(b) Firm

(d) Other (state)

* tick applicable

6. List

(a) Names of directors: ...............................................................
................................................................................................
..................................................................................................

(b) partners: .................................................................................
................................................................................................
.................................................................................................

(c) trustees: ....................................................................................
...................................................................................................
....................................................................................................

(d) board members: ..........................................................................
.......................................................................................................
.......................................................................................................

(e) Other (specify): ..........................................................................
....................................................................................................
...........................................................................................................

7. (a) Name of person in charge of operations: ..................................................

(b) Professional qualifications: .......................................................................

8. Services and facilities offered at by the nursing home or agency:

......................................................................................................................
......................................................................................................................
.......................................................................................................................

This .......................... day of .............................. 20 ..

Signature ................................	Signature ................................
Applicant	Registrar

FORM 2

REPUBLIC OF ZAMBIA

NURSES AND MIDWIVES ACT

THE GENERAL NURSING COUNCIL OF ZAMBIA

CERTIFICATE OF REGISTRATION OF NURSING HOME OR AGENCY

[Regulation 5]

I, HEREBY certify that ................................. has this day been registered under section 23 of the Nurses and Midwives Act as a Nursing Home/Agency.

Dated at ..................................... this .................... day of ..................... 20 ..

Signature ................................	Signature ................................
President General Nursing Council of Zambia	Registrar General Nursing Council of Zambia

FORM 3

REPUBLIC OF ZAMBIA

NURSES AND MIDWIVES ACT

THE GENERAL NURSING COUNCIL OF ZAMBIA

NOTIFICATION TO REGISTER A NURSING HOME OR AGENCY

[Regulation 5]

To: ............................................

I hereby give you notice that in exercise of the powers conferred on me by section 24 of the Nurses and Midwives Act, I have refused to register as a nursing home under this said Act on the grounds that:

.....................................................................................................................................................................................................................................................................................................................................................................................................................................................

Any appeal to the Minister against this refusal must be delivered to the Permanent Secretary, Ministry of Health within 21 days of receipt of this notice.

Dated at .......................... .this ..................... day of ................. 20 ..

Signature ................................	Signature ................................
President General Nursing Council of Zambia	Registrar General Nursing Council of Zambia

FORM 5

REPUBLIC OF ZAMBIA

NURSES AND MIDWIVES ACT

APPLICATION FOR RENEWAL OF CERTIFICATE OF REGISTRATION OF NURSING HOME/AGENCY

I, ................................ hereby apply for the renewal of the certificate of registration issued in respect of the undermentioned nursing home/agency.

Name of nursing home/agency: ______________________________________________

Address: ________________________________________________________________

Name of Administrator/Manager _____________________________________________

I certify that the particulars of the Nursing Home or Agency are the same as those submitted with the first application for certificate of registration in respect of this nursing home/agency with the exception of the changes and structural alterations set out in the attached statement.

Dated ............................... Signed .........................................

SECOND SCHEDULE

[Regulation 4]

Physical Structure

A proposed Nursing home shall include the following:

Strong and secure building

An alarm system

Adequate corridor space

Easy to clean and non slippery floor

Fire extinguisher

Adequate protection against insects, vectors and intruders for safety of patients, staff and equipment

Minimum of three toilets and two bathrooms clearly labelled male, female and staff or such other numbers as will be commensurate with the clientele

Laundry

Sluice room

Incinerator/Placenta pit, where applicable located in a site approved under the Town and Country Planning Act.

A Nursing Home shall have a minimum of the following rooms with adequate ventilation and lighting, equipment, furniture and waste bins:

Reception Room Size: 300 x 300cm

Furniture: Desk with three chairs/stools

Locable cupboards for patient's records

Sitting Room/Waiting Area

Minimum: 400 x 400 cm

Furniture: desk, chairs (number depending on staff), record storage, secure stationery and drup cupboards

Treatment Room

Minimum Size 300 x 250 cm width:

Hand basin (sink) with running water

Separate sink for washing equipment

Adequate storage space for equipment

Small fridge for drugs and vaccines

Separate cupboard for storage of controlled drugs, under the Laws of Zambia Act

Trolleys (Dressing, drug etc)

Resuscitation tray with the minimum requirements of the following drugs:

Hydrocortisone-2 ampules

Adrenaline-2 ampules

Aminophylline-2 ampules

Anti-Convulsant-2 ampules

Anti-Histamine-2 ampules

Sodium Bicarbonate 4

Syringes and needles

Recommended disinfectant

Surgical gloves

Cut down set

Laryngoscope

Metal spatula/Tongue depressor

Pair of sterile examination gloves

Multistix for urinalysis

Glucometer

Ambu bag (with various sizes of masks)

I.V. fluids-5% Dextrose, Normal saline, Darrows, Ringers lactate

50% Dextrose

Drip stand

Cannulae and giving sets

Oxygen cylinder with working gauge

Suction machine and suction catheters

Weighing scale

Clinical thermometers

Sphygmomanometer and stethoscope

Working steriliser or portable autoclave

Fire extinguisher

Instruments (Gynaecological and obstetric)

Oxygen masks and humidfier

Airway, Endotracheal tubes

Torniquet

Examination Room

Size: 300 x 300 cm

Furniture: table; two chairs; couch foot stool; examination tray

Wash hand basin with hot and cold running water

Pharmacy

Size: as specified by the Pharmacy and Poisons Board (the Proprietor is encouraged to obtain a copy of the Pharmacy and Poisons Board guide-lines if he/she wishes to have a pharmacy on site):

Kitchen/Kitchenette

Kitchen size: 250 x 300cm

Fridge/Freezer or Cold room for perishables

Cooker/Stove

Microwave oven (optional)

Adequate crockery

Sink (s) with running water

Storage Space

Bedroom (s)

(a)Single Room

300 x 300cm

Hospital bed and mattress in good condition

Bedside lockers

Bedside table

Wardrobe

Chairs

Sink and running water

(b) Double Room

Size: 400 x 400cm

2 hospital beds and mattresses in good condition

2 lockers

Wardrobes

2 bedside tables

Sink and running water

Labour Ward

Size: 300 x 300 cm

Lithoctomy bed

Baby crib (s) and mattress

Suction machine

Drip stand, IV sets and fluids

Resuscitation tray

Sphygmomanometer and stethoscope

Thermometer

Delivery packs

Trolley (s)

Incubator

Foetal scope

Torniquet

Forceps

Adults and baby scales

Resuscitaire

Postnatal Room

As above for both single room and double room plus baby cribs and mattresses

Laboratory

For specifications, refer to Medical Laboratory Policy Guidelines

Storage Room

Adequate storage room for various items

Stationery

A nursing Home shall have the following stationery:

Â§ Registers: patients; births; deaths

Â§ Obstetric Record book

Â§ Admission Forms

Â§ Continuation forms

Â§ Fluid balance charts

Â§ Observation charts

Â§ Evaluation charts

Â§ Patients satisfaction survey questionaire

Â§ Referral forms

Â§ Partograms

Â§ Antenatal cards/if applicable

Â§ Tetanus toxoid immunisation cards

Â§ Laboratory request forms

Â§ Radiological request forms

Â§ Prescription pads

Other important items

Adequate linen (bed sheets, blankets, counterpanes)

Pillows

Stretcher

Vaccine fridge where necessary

Communication facilities

- radio

- phone

- fax

- E-mail

THIRD SCHEDULE

[Regulation 5]

PRESCRIBED FEE

Fee Units

Registration fee for Nursing Home

1000

Registration fee for Nursing Agency

600

NURSES AND MIDWIVES (INFAMOUS CONDUCT) REGULATIONS, 2002

[Section 37]

Arrangements of Regulations

Regulation

3. Committee to hear cases

4. Offences that may constitute infamous conduct

5. Investigation of Complaint

6. Investigations Committee to interview witness, visit premises etc.

7. Charge to be made against Practitioner

8. Charge to be personally served on practitioner

9. Practitioner to exculpate self

10. Committee to set time, date and place of hearing

11. Practitioner to inform Registrar or presentation and witness

12. Conduct of hearing

13. Consideration of matter by Committee and ruling of Committee

14. Practitioner to appeal to High Court

SI 89 of 2002.

1. Title

These Regulations may be cited as the Nurses and Midwives (Infamous Conduct) Regulations, 2002.

2. Interpretation

In these Regulations, unless the context otherwise requires-

"Committee" means the Professional Conduct Committee constituted constituted under section 31 of the Act;

"Council" means the General Nursing Council established under section 3 of the Act;

"Legal Practitioner" means the legal practitioner appointed under section 31 of the Act;

"Practitioner" means nurse, midwife or specialist registered under the act and includes nursing student; and

"Registrar" means the person appointed Registrar under section 5 of the Act.

3. Committee to hear cases

The professional Conduct Committee may consider and hear cases of infamous conduct in a professional respect-

(i) brought before it in form of a complaint against a practitioner; or

(ii) resulting from proceedings in a court of law and brought to its attention.

4. Offences that may constitute infamous conduct

Acts or omissions that constitute infamous conduct in a professional respect are specified in the Schedule to these Regulations.

5. Investigation of Complaint

Where a complaint has been laid before the Council and the Council determines that the matter warrants an investigation, it shall instruct the Professional Conduct Committee to investigate the matter and make appropriate recommendations to it.

6. Investigations Committee to interview witness, visit premises etc.

(1) During the course of its investigations, the Committee shall have power to-

(a) interview witnesses;

(b) visit premises;

(d) do any other thing that may be relevant to the conduct of the investigation.

(2) At the conclusion of an investigation the Committee shall submit a report of its findings to the Council stating that-

(a) its preliminary investigations show that there is no prima facie case against a Practitioner alleged to have committed or omitted to do anything;

(b) there is a prima facie case against a Practitioner who has been alleged to have committed acts or omissions that constitute infamous conduct in a professional respect and that given the circumstances of the case it is recommending that an inquiry be conducted against the Practitioner; or

7. Charge to be made against Practitioner

Where the Committee recommends that an inquiry is necessary to be conducted against a Practitioner under the Act and the Council accepts the recommendation under Rule 6, the Committee shall make a charge against that Practitioner which shall contain-

(a) the name and age of the Practitioner;

(b) the physical address of the Practitioner; and

(i) the place and time when the acts or omissions occurred;

(ii) the persons present when the acts or omissions occurred; and

(iii) the facts of the incident.

8. Charge to be personally served on practitioner

The charge in Regulation 7 shall be served personally on the Practitioner.

9. Practitioner to exculpate self

(1) After the service of the charge to the Practitioner, the Practitioner shall within 14 days of the service submit an exculpatory statement.

(2) The Practitioner shall serve the exculpatory statement on the Registrar.

10. Committee to set time, date and place of hearing

After receipt of the exculpatory statement under regulation 9, the Committee shall set the time, date and place of hearing of the matter, which shall be communicated to the Practitioner at least seven clear days before the date of hearing.

11. Practitioner to inform Registrar or presentation and witness

(1) Where the Practitioner receives the notice of hearing, the Practitioner shall inform the Registrar, in writing, whether the Practitioner intends to appear in person or to be presented by an advocate of the Practitioner's choice.

(2) Where the Practitioner intends to call by an advocate, the Practitioner shall submit to the Registrar the name and the address of the advocate.

(3) The Practitioner shall submit the names of the names of the persons the practitioner intends to call as witnesses.

(4) The Practitioner shall submit any documents or things to the Registrar which the Practitioner intends to adduce as evidence.

12. Conduct of hearing

At the hearing of the matter, the committee-

(a) shall introduce the members of the Committee and read out the charge to the Practitioner;

(b) the Practitioner shall lead and call evidence against the Practitioner by viva voce which may include calling relevant witnesses, producing documents or other relevant things;

(c) the Practitioner shall be accorded an opportunity to cross examine the witnesses called by legal practitioner and the legal practitioner shall thereafter be given an opportunity to re-examine the witness;

(d) the Practitioner shall give a closing statement on the matter;

(e) the Practitioner shall be asked to state case viva voce, call witnesses and tender all relevant evidence;

(f) legal Practitioner shall cross examine the Practitioner and the witnesses for the Practitioner;

(g) the Practitioner may re-examine the witnesses called by the Practitioner; and

(h) the Practitioner and the legal practitioner shall give a closing statement on the matter.

13. Consideration of matter by Committee and ruling of Committee

(1) The Committee shall consider the evidence produce and submitted at the hearing and shall make a ruling on the case-

(a) finding the Practitioner not guilty of the charge; or

(b) finding the Practitioner guilty of infamous conduct in a professional respect.

(2) Where the Committee finds a Practitioner not guilty of the infamous conduct in a professional respect it shall recommend to the Council that the Practitioner-

(a) be censured;

(b) be ordered to pay an amount not exceeding six thousand penalty units;

(d) shall have the enforcement of the punishment of that Practitioner suspended for a period of not exceeding one year on security of good behaviour and conduct during that period;

(e) be ordered to pay to the Council any costs connected with or incidental to the proceedings; or

(f) be erased from the register.

14. Practitioner to appeal to High Court

Where the Practitioner is aggrieved by the decision of the Council, the Practitioner may within 30 days following the decisions of the Council appeal to the High Court.

SCHEDULE

[Regulation 4]

I. A. Nurses Acts or Omissions constituting infamous conduct in a professional respect.

1. falsely claiming nursing qualifications.

2. Obtaining nursing qualifications by fraud.

3. Making or giving any false statement or information in connection with the application for issuing of a practising licence.

4. Impersonating another licensed nurse, midwife, or specialist or permitting another person to use practitioner's certificate.

5. Nursing practice;

(a) incompetence;

(b) negligence;

(d) divulging professional confidence;

(e) procuring, siding, attempting, agreeing or offering to procure or assist at a criminal abortion.

6. Practising under the influence of alcohol.

7. Practising without a licence

8. Advertising a Practitioner's services

9. Issuing unauthorised press statement

II B. Drug acts or omissions

1. The preparation, consumption or self-administration of any drug included in the Dangerous Act or listed under the Schedule of the Pharmacy and Poisons Act.

2. Use of cannabis.

3. Alcoholism

III C. Patient Abuse

4. Negligence - causing death or deformity

5. Negligence - in the giving of prescribed drug treatments.

6. Abuse of patients physically, mentally or sexually.

7. Failure or refusing to offer assistance to a patient.

IV D. Theft and Other Dishonesty Acts

8. Theft of hospital property.

9. Other theft.

NURSES AND MIDWIVES (REGISTRATION OF PRIVATE NURSING COLLEGE) REGULATIONS, 2002

[Section 18]

Arrangements of Regulations

Regulation

3. Application for registration of private nursing college

4. Application to provide certain details

5. Registration of nursing college

SI 90 of 2002.

1. Title

These Regulations may be cited as the Nurses and Midwives (Registration of Private Nursing College) Regulations, 2002.

2. Interpretation

In these Regulations, unless the context otherwise requires-

"college" means a nursing college Registered under these Regulations;

"Council" means the General Nursing Council established under the Act;

"Registrar" means the person appointed as Registrar under section 5 of the Act;

3. Application for registration of private nursing college

(1) Any person-

(a) above the age of 21 years; and

(b) without criminal record,

may establish a private college and apply to the Council for the registration of the college as set out in Form I in the First Schedule.

4. Application to provide certain details

(1) The application in Regulation (3) shall state-

(a) the name of the nursing college;

(b) the physical location of business and the postal address;

(d) the names, qualifications and experience of the proposed tutors and lecturers of the college;

(e) the name of the proprietor;

(f) list of directors, partners or trustees; and

(g) the person in charge or to be in charge of the college.

(2) The applicant shall submit with the application-

(a) a certificate under the Public Health Act;

(b) any affiliation documents;

(d) Fire Inspection Certificate;

(e) Certificate of Incorporation or partnership articles, Trust Deed;

(f) Any other information or document which the Council may require.

5. Registration of nursing college

(1) If, on application the Council is satisfied that-

(a) the college meets the nursing or midwifery training requirements of the area in which it is proposed to be situated;

(b) the premises of the college, including any hostel or other buildings used or to be used in connection with the instruction or accommodation of persons attending the nursing college;

(d) the applicant is or has a suitable person to manage the college;

(e) the programme of instruction is of a nature or standard approved by the Council and in accordance with the Syllabus approved by the Council;

(f) the teaching staff employed or to be employed at the nursing college will have the qualifications set out in the Third Schedule; and

(g) the person in charge of the nursing college will be a registered nurse or midwife with the qualifications and experience as set out in the Third Schedule;

(h) proper compliance will be made with other provisions of the Act;

the Council shall, upon payment of a fee as set out in the Second Schedule, register the college for a period not exceeding one year and the Registrar will issue a certificate of Registration as in Form 2 set out in the First Schedule to these Regulations.

(2) The registration of a college shall be renewable each year.

(3) Where the Council is of the opinion that the nursing college applying for registration does not meet any of the requirements referred to in sub-regulation (1), it shall reject the application stating the grounds for refusal to register and inform the applicant in writing within 14 days of making that decision.

NURSES AND MIDWIVES (RECORDS AND RETURNS) REGULATIONS, 2002

[Section 42]

Arrangements of Regulations

Regulation

3. Nursing home college or agency to submit records and returns

SI 91 of 2002.

1. Title

These By-laws may be cited as the Nurses and Midwives (Records and Returns) Regulations, 2002.

2. Interpretation

In these Regulations unless the contexts otherwise requires-

"Council" means General Nursing Council of Zambia established under section 3 of the Act;

"nursing college" means any premises used or intended to be used for the training of nurses or midwives including the premises used for the reception of and the provision of nursing or midwifery care to persons with reproductive health needs or suffering from any disease, injury or infirmity;

"Registrar" means the person appointed Registrar under section 5 of the Act.

3. Nursing home college or agency to submit records and returns

A nursing home, nursing agency or nursing college registered under the Act shall at the beginning of each year submit records and returns contained in the Schedule to these Regulations to the Registrar of the Council.

SCHEDULE

[Regulations 2]

Type of Institution	Records and Returns to be Submitted
1. Nursing College	(a) Student returns
(b) Examination results
(c) Index of students
(d) Staffing levels
(e) Infrastructure-
- schools
- hostels
- clinical area available
(f) Financial records
(g) Copies of curriculum
(h) Teaching and learning schedules
(i) Registration and renewal of college licence
2. Nursing Homes	(a) Patients register
(b) Register of births and deaths (maternal and infant included)
(c) Staffing levels
(d) Financial records
(e) Audit reports
(f) Records of disciplinary cases
(g) Admission and discharge records
(h) Bed capacity
(i) Referred records
(j) Records of inventory
(k) Regular sources of supplies
(l) Records of service offered
3. Nursing Agencies	(a) Staff register
(b) Record of services provided
(c) Inventory of equipment
(d) Financial records
(e) Records of audit reports-
- staff
- services
(f) Records of practising licences for professional of members of staff-
- curriculum vitae
- practising licence
- qualifications
(g) Records of disciplinary cases
(h) Records of disciplinary cases and procedures
(i) Evidence of registration with Registrar of Companies.

NURSES AND MIDWIVES (CONDUCT OF EXAMINATIONS) RULES, 2002

[Section 20]

Arrangements of Rules

Rule

3. Appointment of examiner

4. Eligibility selection of examiner

5. Examinations to take place at designated places

6. Examiners to work as group

7. Council to appoint panel of examiners

8. Colleges to set questions

9. Question to show allotted marks

10. Examiners to be provided with model answer

11. Examiners to ensure scripts are secure

12. Examiners to draw up master list

13. Council to verify results

14. Examiners to travel to venue of examination

15. Examiner to observe candidate perform procedure

SI 92 of 2002.

1. Title

These rules may be cited as the Nurses and Midwives (Conduct of Examination) Rules, 2002.

2. Interpretation

In these Regulations unless the context otherwise requires-

"Council" means the General Nursing Council of Zambia established under section 5 of the Act; and

"Registrar" means the person appointed as Registrar under section 5 of the Act.

3. Appointment of examiner

(1) The Registrar shall each year request a hospital or group of hospitals to submit to the Council names of persons suitable to conduct nurses and midwives written and practical examination in the following-

(a) general nursing;

(b) operating theatre nursing;

(d) and any other courses that may be specified by the council.

(2) The Council shall select names of examiners from those submitted by hospitals and respective nursing college under sub-rule (1).

(3) Where the Council selects a person as examiner, the Registrar shall inform that person of this fact in writing and require that person to notify the council in reasonable time on whether or not that person has accepted the selection.

(4) The Registrar shall coordinate all examinations conducted by the Council.

4. Eligibility selection of examiner

(1) Subject to the other provisions of this rule, a person may be eligible for selection as an examiner under these Regulation if that person-

(a) is a medical practitioner;

(b) is a nurse or midwifery tutor;

(c) is a registered nurse with specialisation in midwifery, operating theatre nursing, mental health nursing or other areas; or

(d) has at least three years clinical experience.

(2) A person may qualify to be-

(a) a theory examiner if that person is a nurse or midwifery tutor with a minimum of a Bachelor of science degree and is currently a practising nurse, midwife or specialist;

(b) a practical examiner if that person is a nurse, midwife or specialist and is currently practising as such.

(3) A person shall be appointed as an examiner under sub-rule (2) for a period of three years subject to renewal for another like term.

(4) An examiner's appointment may be revoked by the Council for-

(a) unsatisfactory performance of his duties as an examiner;

(b) negligence of duty as examiner;

(d) other forms of misconduct affecting his duties as examiner; or

(e) mental or physical incapacity to discharge the function as an examiner.

5. Examinations to take place at designated places

Examinations will take place at times and places to be designated by the council.

6. Examiners to work as group

Examiners shall work as a group and shall enter the examination room together and leave it together at the same time.

7. Council to appoint panel of examiners

(1) The Council shall appoint a panel of examiners from the list of those who have qualified under Rule 3.

(2) The selected panel of examiners shall elect a Chairperson from amongst themselves for that particular panel.

8. Colleges to set questions

(1) The Council shall request individual nursing colleges to set a number of examination questions and submit them to the council.

(2) The Council shall select examination questions from the questions submitted by the college under sub rule (1) for the examinations each year.

9. Question to show allotted marks

Every set of examination question shall specify the marks allotted for that question.

10. Examiners to be provided with model answer

The panel of examiners appointed under Rule 7 shall provide a model answer to the Registrar or Registrar's agent for every question before marking examinations scripts.

11. Examiners to ensure scripts are secure

(1) Examiners shall ensure that the examination scripts are secured in sealed envelopes which shall be opened in the presence of all panel members under the supervision of an officer from the Council.

(2) The Chairperson of each panel of examiners shall-

(a) ensure that examination scripts of all candidates are accounted for;

(b) allocate to each examiner examination papers to mark using a Council list of candidates examination numbers.

12. Examiners to draw up master list

At the end of marking examination all examination scripts, examiners will draw up a master list of examination results will shall indicate-

(a) candidates examination number;

(b) questions attempted by each candidates and marks scored; and

13. Council to verify results

The Council shall verify all the result compiled by the examiners and shall, after approval by the Minister, publish the results.

14. Examiners to travel to venue of examination

(1) All examiners for practical subject examinations coming from outside the centre where the examination is conducted shall travel, upon notification by Council, to the venue of practical examination a day before the sitting of the examinations and prepare, in consultation with nursing college, the conduct of examination.

(2) The exercise in sub-rule (1) shall include familiarisation of the examiners with clinical areas where examinations will be conducted.

15. Examiner to observe candidate perform procedure

(1) During practical examinations, an examiner shall observe very candidate perform a procedure, at least one of which shall involve the interaction between a patient and nurse.

(2) Prior to assessment the examiner will check every candidate's practical work record book to ascertain-

(a) if all learning experience have been covered for the candidate's level of training; and

(b) if the candidate has achieved proficiency in the specified areas.

NURSES AND MIDWIVES (PROFESSIONAL PRACTICE) RULES, 2002

[Section 22]

Arrangements of Rules

Rule

4. Registered nurse, midwife or specialist to provide care and treatment

3. Application

5. Assessment of condition of patient

6. Diagnosis

7. Reference of patient to another level of care

8. Nurse, midwife or specialist to have a certificate

9. Nurse, midwife or specialist to follow formulary

10. Nurse, midwife or specialist provide information

SI 93 of 2002.

1. Title

These Rules may be cited as the Nurses and Midwives (Professional Practice) Rules, 2002.

2. Interpretation

In these Rules unless the context otherwise requires-

"Council" means the General Nursing Council;

"Registrar" means the person appointed under section 5 of the Act;

"Specialist" means a person registered as specialist under section 11 of the Act.

3. Application

These Rules shall apply to the care and treatment of patients and clients in nursing and midwifery practice in a registered health institution or in school, community, workplace, private and public health facilities.

4. Registered nurse, midwife or specialist to provide care and treatment

The care and treatment of patients and clients referred to in Rule 3 shall be provided by nurses, midwives and specialists registered with the Council under the Act.

5. Assessment of condition of patient

In the course of attending to a patient or client, a nurse, midwife or specialist shall assess the general condition of the patient which may include-

(a) history taking;

(b) physical examination; or

6. Diagnosis

Where a nurse, midwife or specialist makes an assessment under rule 5, the nurse, midwife or specialist shall make a diagnosis and undertake appropriate and necessary therapeutic interventions which may include-

(a) insertion;

(b) removal of devices;

(d) resuscitation;

(e) infusions; or

(f) vacuum extraction.

7. Reference of patient to another level of care

Where in the course of attending to a patient or client, a nurse, midwife or specialist is of the opinion that the condition of the patient or client needs care and attention at another appropriate level, the nurse, midwife or specialist shall refer the patient or client to that level of care as soon as the circumstances may reasonably allow.

8. Nurse, midwife or specialist to have a certificate

(1) The Council shall issue a certificate to a nurse, midwife or specialist registered with the Council who has obtained appropriate and recognised training in prescription of drugs.

(2) A nurse, midwife or specialist issued with a certificate under sub rule (1) my prescribe and administer drugs.

(3) The certificate referred to in this rule shall be as set out in Form I of the Schedule.

9. Nurse, midwife or specialist to follow formulary

When prescribing drugs under rule (7) the nurse, midwife or specialist shall follow the established practice in Zambia Nurses and Midwives Formulary, approved by the Pharmacy and Poisons Board established under the Pharmacy and Poisons Act.

10. Nurse, midwife or specialist provide information

A nurse, midwife or specialist, where necessary, may provide information or do any other necessary interventions to prevent disease, illness or disability.

SCHEDULE

FORM 1

[Regulation 8]

REPUBLIC OF ZAMBIA

THE GENERAL NURSING COUNCIL

CERTIFICATE OF COMPETENCE IN DRUG PRESCRIPTION AND ADMINISTRATION

[Rule 9]

It is hereby certified that .........................having attended and successfully completed a prescribed training, is competent in prescribing and administering drugs under the National Drug Formulary pursuant to Cap. 299.

Date_______________

Signature ................................	Signature ................................
President General Nursing Council of Zambia	Registrar General Nursing Council of Zambia

NURSES AND MIDWIVES (DIPLOMA AND CERTIFICATES) RULES, 2003

[Section 20]

Arrangements of Rules

Rule

3. Council to issue diplomas and certificates

4. Form of diploma and certificate

5. Council to withdraw diploma or certificate

6. Council to investigate the grant of diploma or certificate

7. Loss or misplacement of diploma or certificate

8. Person to pass continuous assessment and examinations

9. Requirements for entry into nursing college

{mprestriction ids="2,3,5"}

10. Qualification of lecturers and nurse tutors

11. Nursing college to follow Council approved curriculum

12. Lecturer, nurse tutor, clinical teacher and professional supervise students

13. Examiners to be drawn from a list

14. Eligibility to write examination

15. Disqualification of a candidate

16. Examinations to be published

SI 33 of 2003.

1. Title

These Rules may be cited as the Nurses and Midwives (Diploma and Certificates) Rules, 2003.

2. Interpretation

In these Rules, unless the context otherwise requires-

"nursing college" means any premises used for the training of nurses including the premises used for the reception of and the provision of nursing care to persons suffering from any disease, injury or infirmity;

"Council" means the General Nursing Council of Zambia established under section 3 of the Act;

"President" means the person elected as President under paragraph 1 of the Schedule of the Act;

"Registrar" means the person appointed Registrar under section 5 of the Act.

3. Council to issue diplomas and certificates

The Council shall issue-

(a) a diploma signed by the Registrar and the President to a person who has successfully completed an approved programme of training for a period of three years or more; or

(b) a certificate signed by the Registrar and the President to a person who has successfully completed an approved programme of training of less than three years.

4. Form of diploma and certificate

The diploma and certificates to be issued under rule 3 shall be in the forms set out in the First Schedule to these Regulations.

5. Council to withdraw diploma or certificate

Where the Council is of the opinion that there are irregularities in the manner a person obtained a diploma or certificate, the Council may withhold or withdraw such diploma or certificate from the person to whom it was awarded.

6. Council to investigate the grant of diploma or certificate

Where the Council withholds or withdraws a diploma or certificate under Rule 5, it will investigate the circumstances regarding the grant of such diploma or certificate and-

(a) revoke the diploma or certificate; or

(b) reinstate the diploma or certificate on payment of a prescribed fee by the affected person.

7. Loss or misplacement of diploma or certificate

(1) Where a person has lost or misplaced a diploma or certificate, that person shall produce to the Registrar an affidavit deposing to the circumstances leading to the loss or misplacement of such diploma or certificate and a similar report from the police.

(2) Where the Council is satisfied that the circumstances deposed to in the affidavit in sub rule (1) establish the probability of genuine loss or misplacement of a diploma or certificate, the Registrar shall issue a duplicate of such diploma or certificate on payment of a prescribed fee by the affected person.

8. Person to pass continuous assessment and examinations

A person pursing a diploma or certificate under the Council shall successfully complete prescribed continuous assessment, written and practical examinations.

9. Requirements for entry into nursing college

A person may be admitted to a nursing college if that person-

(a) is between the ages of 16 and 45 years;

(b) has a full school certificate with "˜O' levels in subjects prescribed by the Council; and

10. Qualification of lecturers and nurse tutors

The minimum qualification for lecturers and nurse tutors in a college shall be as specified in the Second Schedule.

11. Nursing college to follow Council approved curriculum

Every college shall follow the course content prescribed in the nursing and midwifery curriculum approved by the Council and where applicable the University of Zambia School of Medicine.

12. Lecturer, nurse tutor, clinical teacher and professional supervise students

Lecturers, nurse tutors, Clinical teachers and designated nursing and other health care professionals shall provide clinical supervision in nursing colleges.

13. Examiners to be drawn from a list

(1) The Council shall appoint examiners from a list of practising nurses, midwives, tutors and lecturers in colleges submitted to it by individual schools, colleges and hospitals.

(2) The examiners in sub-rule (1) shall serve as examiners for a period of three years and shall be eligible for reappointment on expiry of the term of office.

(3) All set examinations for a nursing college shall be approved by the Council.

14. Eligibility to write examination

(1) Eligibility of a person to write an examination shall be recommended by a college after that person has fulfilled all requirements set by the Council.

(2) A person who is eligible to sit for an examination in a nursing college shall pay a fee to the Council as set out in the Third Schedule.

15. Disqualification of a candidate

(1) A candidate for an examination in a nursing college may be disqualified from sitting for examinations on disciplinary grounds and on the recommendation of a college to the Council.

(2) A person who is disqualified under sub-rule (1) shall be notified in writing of the disqualification before the date set for examinations.

(3) A person disqualified during the examination shall be notified in writing within 30 days of writing the examination.

16. Examinations to be published

Results of examinations shall be published within 90 days of the conduct of such examinations in at least one national newspaper of wide circulation.

SCHEDULE

[Regulation 4]

LIST OF FORMS

1. Zambia Registered Nurse Diploma

2. Zambia Registered Midwife Certificate

3. Zambia Operating Theatre Nurse Certificate

4. Diploma in Mental Health Nursing

5. Zambia Enrolled Nurse Certificate

6. Zambia Enrolled Midwife Certificate.

LOGO

GENERAL NURSING COUNCIL OF ZAMBIA

DIPLOMA

Zambia Registered Nurse

AWARDED TO ........................................................................................................ for having satisfied the Diploma requirements of the General Nursing Council of Zambia at ...................................................................in ................................... (Month) ....................................(Year)

................................... REGISTRAR

.............................. PRESIDENT

......................................... SEAL

DATE ....................... DIPLOMA No. ...................

LOGO

GENERAL NURSING COUNCIL OF ZAMBIA

DIPLOMA

Zambia Registered Mental Health Nurse

AWARDED TO ........................................................................................................for having satisfied the Diploma requirements of the General Nursing Council of Zambia at .....................................................................................in ........................................... (Month).................................... (Year)

.................................................. REGISTRAR

.................................................... PRESIDENT

......................................... SEAL

DATE ............................ DIPLOMA No. ............

LOGO

GENERAL NURSING COUNCIL OF ZAMBIA

CERTIFICATE

Zambia Registered Midwife

THIS IS TO CERTIFY THAT...............................................................................................................has passed the qualifying examinations for Zambia Registered Midwife held by the General Nursing Council of Zambia at.....................................................in .......................................(Month) ........................................(Year)

........................... REGISTRAR

............................................ PRESIDENT

.............................................. SEAL ......................................

DATE ....................... CERTIFICATE No. ..............................

LOGO

GENERAL NURSING COUNCIL OF ZAMBIA

CERTIFICATE

Zambia Operating Theatre Nurse

THIS IS TO CERTIFY THAT ............................................................................................................... has passed the qualifying examinations for Zambia Operating Theatre Nurse held by the General Nursing Council of Zambia at...................................... ................................................................in .......................................(Month) ........................................(Year)

.......................... REGISTRAR

......................................... PRESIDENT

.............................................. SEAL

DATE ...................... CERTIFICATE No. ....................

LOGO

GENERAL NURSING COUNCIL OF ZAMBIA

CERTIFICATE

Zambia Enrolled Nurse

THIS IS TO CERTIFY THAT ...............................................................................................................has passed the qualifying examinations for Zambia Enrolled Nurse held by the General Nursing Council of Zambia at..................................................... ....................................in .......................................(Month) ........................................(Year)

......................................... REGISTRAR

........................................ PRESIDENT

.............................................. SEAL

DATE ....................... CERTIFICATE No. ......................................

LOGO

GENERAL NURSING COUNCIL OF ZAMBIA

CERTIFICATE

Zambia Enrolled Midwife

THIS IS TO CERTIFY THAT...............................................................................................................has passed the qualifying examinations for Zambia Enrolled Midwife held by the General Nursing Council of Zambia at........................................................ ................................................................................in .......................................(Month) ........................................(Year)

...................................... REGISTRAR

..................................... PRESIDENT

.............................................. SEAL

DATE .................................. CERTIFICATE No. .....................

ZAMBIA REGISTERED NURSES (TRAINING) RULES

[Sections 17 and 18]

[RETAINED AS PER SECTION 15 OF THE INTERPRETATION AND GENERAL PROVISIONS ACT]

Arrangement of Rules

Rule

4. Institution of Zambia Registered Nurse's Certificate

3. Training needs

5. Nursing schools

6. Training to be at nursing schools

7. Admission to nursing schools

8. Training period for student nurse admitted under paragraph (a) (i) of Third Schedule

9. Training period for student nurse admitted under paragraph (a) (ii) of Third Schedule

10. Instruction of nurses

11. Nurse's Practical Work Record Book

12. Institution of examinations

13. Intermediate Examination

14. Entry to Intermediate Examination

15. Conduct of Intermediate Examination

16. Tests comprising Intermediate Examination

17. Entry to Final Examination

18. Tests comprising Final Examination

19. Passing in Final Examination

20. Examiners for Final Examination

21. Publication of examination results

22. Registration as nurse

Act 13 of 1994,

SI 106 of 1972,

SI 41 of 1976,

SI 44 of 1979,

SI 45 of 1979.

[Rules by the General Nursing Council of Zambia with the approval of the Minister]

1. Title

These Rules may be cited as the Zambia Registered Nurses (Training) Rules and shall apply to the training of Zambia Registered Nurses.

2. Interpretation

(1) In these Rules, unless the context otherwise requires-

"clinical instructor" means a registered nurse who is experienced in the teaching of bedside nursing and who is part of the nursing school staff;

"matron" means-

(a) in relation to a nursing school which consists of one hospital, the matron of that hospital;

(b) in relation to a nursing school which consists of a group of hospitals, the matron of one of those hospitals designated by the Council as the matron of that nursing school;

"medical superintendent" means-

(a) in relation to a nursing school which consists of one hospital, the medical superintendent of that hospital;

(b) in relation to a nursing school which consists of a group of hospitals, the medical superintendent of one of those hospitals designated by the Council as the medical superintendent of that nursing school;

"nurse tutor" means a qualified nurse tutor registered on the Register of Nurse Tutors kept by the Council;

"nursing school" means a hospital or group of hospitals recognised or deemed to have been recognised under rule 5 as a nursing school for the purposes of these Rules;

"principal tutor" means a qualified nurse tutor registered on the Register of Nurse Tutors kept by the Council and appointed to administer a nursing school;

"student nurse" means a person undergoing the course of training prescribed by these Rules;

"training period" means the periods prescribed by rule 8 (1) or 9 (1) for the course of training of a student nurse;

"ward" means a ward of a nursing school;

"ward sister" means a registered nurse in charge of a ward in a hospital associated with a nursing school.

(2) Save where the context otherwise requires, a reference in these Rules to the feminine gender shall be construed as including a reference to the masculine gender.

3. Training needs

(1) The training needs of students shall not be allowed to suffer by service needs in hospitals; all students shall be wholly supernumerary and may be removed entirely from the hospital environment at any time,night or day.

(2) The principal tutor shall be wholly in charge of the training programme and responsible only to the Council in implementing the programme.

(3) Clinical instructors shall be employed in the ward situation to teach practical skills and associated underlying theory; and they shall not be utilised as classroom teachers. The principal tutor shall be wholly responsible for the delegation of clinical instructor's duties and their supervision.

4. Institution of Zambia Registered Nurse's Certificate

(1) For the purpose of enabling persons to become qualified to carry on the calling of a nurse, the Council may grant a certificate of competency, to be styled the Zambia Registered Nurse's Certificate, to such persons as have qualified under these Rules for the grant thereof.

(2) Every Zambia Registered Nurse's Certificate shall be in the form prescribed in the First Schedule.

5. Nursing schools

(1) Subject to the provisions of this rule, the Council may, on application being made to it, recognise any hospital or group of hospitals within the Republic as a nursing school for the purposes of these Rules if, in the opinion of the Council, it provides the facilities necessary for the training of student nurses.

(2) The Council shall not recognise a hospital or group of hospitals as a nursing school for the purposes of these Rules unless requirements as specified in the Second Schedule are, in the opinion of the Council, substantially complied with.

(3) The Kitwe School of Nursing, the Lusaka School of Nursing and the Mufulira School of Nursing are hereby deemed to have been recognised by the Council as nursing schools for the purposes of these Rules as from the commencement of the Act.

6. Training to be at nursing schools

Every person wishing to qualify for the Zambia Registered Nurse's Certificate shall undergo the course of training prescribed by these Rules at one or more nursing schools.

7. Admission to nursing schools

A candidate shall be eligible for admission to a nursing school for the purpose of undergoing the course of training prescribed by these Rules if, and only if, she conforms with the requirements specified in the Third Schedule.

8. Training period for student nurse admitted under paragraph (a) (i) of Third Schedule

(1) The training period of a student nurse admitted to a nursing school under the provisions of paragraph (a) (i) of the Third Schedule shall be as prescribed in this rule.

(2) The course of training of a student nurse shall extend over a period of not less than three years inclusive of-

(a) periods of vacation leave not exceeding four weeks per year; and

(b) periods of sick leave not exceeding six weeks during the whole period of the course of training.

(3) Save for the periods of vacation and sick leave specified in sub-rule (2) or any period recognised by the Council under sub-rule (4), the training of a student nurse shall be continuous throughout the whole period of the course of training and, on any interruption thereof, no recognition shall be accorded to the student nurse in respect of any period of the course of training undergone prior to such interruption.

(4) Where the course of training of a student nurse is interrupted for a period not exceeding two years, and the Council considers that the reasons for such interruption are sufficient, having regard to all the circumstances of the case, it may recognise the whole or any part of the period of training undergone by the student nurse prior to such interruption as counting towards the period of three years prescribed in sub-rule (2).

(5) The Council may allow a candidate to enter training at any stage of the training course if it is satisfied that the candidate has sufficient previous training or experience to exempt her from the requirements of these Rules.

9. Training period for student nurse admitted under paragraph (a) (ii) of Third Schedule

(1) The training period of a student nurse admitted to a nursing school under the provisions of paragraph (a) (ii) of the Third Schedule shall be as prescribed in this rule.

(2) The course of training of a student nurse shall extend over a period of not less than eighteen months inclusive of-

(a) a period of vacation leave not exceeding six weeks during the course of training;

(b) a period of sick leave not exceeding three weeks during the course of training.

(3) Save for the periods of vacation and sick leave specified in sub-rule (2), the training shall be continuous throughout the whole period of the course of training.

10. Instruction of nurses

(1) During her course of training, a student nurse shall receive theoretical and practical instruction in every subject prescribed by these Rules for an examination.

(2) Without derogation from the generality of the provisions of sub-rule (1), a student nurse shall be instructed according to the syllabus set out in the Fourth Schedule and shall attend not less than the minimum number of lectures in the subjects as set out in the Fifth Schedule.

(3) Every lecture given to student nurses on a subject prescribed by these Rules for an examination shall be delivered by a medical practitioner, a nurse tutor, a registered nurse or midwife or a person who, in the opinion of the Council, is sufficiently qualified to teach that particular subject. The teaching staff of a nursing school shall, subject to the approval of the Council, be appointed by the body responsible for the administration of that school.

(4) The instruction of every student nurse shall be generally supervised by a qualified nurse tutor.

11. Nurse's Practical Work Record Book

(1) Every student nurse shall, at the commencement of her course of training, be furnished with a practical work record book supplied by the Council in a form approved by the Examinations Committee, to be styled a Nurse' Practical Work Record Book, on which the teaching of practical nursing to such student nurse shall be recorded by a ward sister or a clinical instructor in charge of that part of the training in the manner prescribed in the Practical Work Record Book.

(2) The entries on a Nurse's Practical Work Record Book shall be checked by the nurse tutor at regular intervals not being less frequently than once in each month.

(3) A student nurse shall produce her Nurse's Practical Work Record Book to the examiner whenever she undergoes an examination held under these Rules.

12. Institution of examinations

For the purposes of these Rules, examinations, to be styled the Intermediate Examination and the Final Examination, shall be held from time to time as directed by the Council.

13. Intermediate Examination

The Intermediate Examination shall be held-

(a) in the case of a student nurse admitted to a nursing school under the provisions of paragraph (a) (i) of the Third Schedule, at the end of twelve months of training; and

(b) in the case of a student nurse admitted to a nursing school under the provisions of paragraph (a) (ii) of the Third Schedule, at the end of eight months of training;

and shall be in such form as the Examinations Committee shall from time to time direct.

[Am by SI 41 of 1976.]

14. Entry to Intermediate Examination

(1) A student nurse shall be eligible to be entered for the Intermediate Examination if, and only if, by the date fixed for the Intermediate Examination she will have satisfactorily completed not less than eighteen months or nine months of her training period, as the case may be.

(2) Every application for entry to the Intermediate Examination shall be in the form set out in the Sixth Schedule, as adapted, and shall be accompanied by a certificate in the form set out in the Eighth Schedule issued by the head of the nursing school stating that the applicant is suitable and eligible to be entered for the Intermediate Examination.

15. Conduct of Intermediate Examination

The Intermediate Examination of student nurses at a nursing school will be conducted by the staff of the nursing school at which they study. The head of the nursing school shall forward to the Examinations Committee the examination papers of the Intermediate Examination, the provisional results of the Intermediate Examination and the comments of the examiners. The Examinations Committee shall be the final moderator in respect of the Intermediate Examination.

16. Tests comprising Intermediate Examination

(1) The Intermediate Examination shall be based on the study of the systems covered during the training period and shall include pharmacology, microbiology, radiology and shall consist of-

(a) Written Paper One, in general medicine, based on the study of the systems covered during the training period and on the study of integrated subjects;

(b) Written Paper Two, in general surgery, based on the study of the systems covered during the training period and on the study of integrated subjects;

(c) practical examination, which shall be conducted in suitable areas of the hospital by internal examiners appointed by the principal tutor and shall last not more than one hour and not less than forty minutes; two examiners shall examine each candidate; the examination shall be conducted under normal working conditions, and every effort shall be made to ensure that there is no artificiality or unnecessary strain on the candidate; oral questions shall be centred on the nurse's day-to-day activities in the ward, and shall be at a realistic level for her stage of training.

(2) In this rule, "systems" means the alimentary system, the respiratory system, the cardio vascular system, the urinary system, the nervous system and the special senses, the endocrine system, the locomotor system, and the reproductive system.

[Am by SI 41 of 1976.]

17. Entry to Final Examination

(1) A student nurse shall be eligible to be entered for the Final Examination if, and only if-

(a) she has either passed or been exempted from the Intermediate Examination; and

(b) by the date fixed for the commencement of the Final Examination-

(i) she will have completed not less than-

A. three years of training period, if she was admitted to a nursing school under the provi- sions of paragraph (a) (i) of the Third Schedule; or

B. eighteen months of training period if she was admitted to a nursing school under the provi- sions of paragraph (a) (ii) of the Third Schedule;

(ii) she will have attended courses of lectures and demonstrations extending over the whole syllabus and will have attended not less than the minimum number of class hours prescribed; and

(iii) she will have undergone the practical instruction in the wards necessary for the completion of her Nurse's Practical Work Record Book; and

(c) her conduct during her training period has been satisfactory and she has obtained a certificate mentioned in sub-rule (2) (b); and

(d) she is the holder of a certificate issued by a medical practitioner stating that he has medically examined her and declaring that her health is such that no danger to her patients would be involved by her engaging in the duties of a nurse.

(2) Every application for entry to the Final Examination shall be in the form set out in the Sixth Schedule, as adapted, and shall be accompanied by-

(a) the appropriate examination fee prescribed in the Seventh

Schedule;

(b) a certificate in the form set out in the Ninth Schedule issued by the head of the nursing school stating that the applicant is in every way suitable and eligible to be entered for the Final Examination; and

18. Tests comprising Final Examination

(1) The Final Examination shall consist of-

(a) Written Paper One, containing eight questions which shall include-

(i) three questions in general medicine and medical nursing, of which candidates shall be required to answer two questions;

(ii) two questions in tropical medicine, of which candidates shall be required to answer one question;

(iii) three questions in paediatrics, of which candidates shall be required to answer two questions, one of which shall be a compulsory question in paediatrics infectious diseases;

and for which the time allowed shall be three hours;

(b) Written Paper two containing eight questions which shall include-

(i) three questions in surgery and surgical nursing, of which candidates shall be required to answer two questions;

(ii) two questions in gynaecology and obstetrics, of which candidates shall be required to answer one question;

(iii) three questions in orthopaedics, ENT, and opathalmology, of which candidates shall required to answer two questions;

and for which the time allowed shall be three hours;

(i) practical examination in suitable areas of the hospital; the practical examination shall last not more than one hour and not less than forty minutes; two examiners shall examine each candidate; the examination shall be conducted under normal working conditions, and every effort shall be made to ensure that there is no artificiality; oral questions shall be about the nurse's day-to-day activities in the ward;

(ii) health teaching by the candidate during the practical examination and which shall be observed by the examiners.

(2) Where possible the following subjects shall be integrated in both Written Paper One and Written Paper Two;

(a) pharmacology;

(b) psychology and sociology;

(d) nutrition and dietetics;

(e) physiotherapy;

(f) radiology;

[As amended by S.I. No. 41 of 1976.]

(ii) practical examination in health teaching to be conducted in the hospital or clinic; the practical shall last no more than thirty minutes, and no less than twenty minutes.

(2) Where possible, public health aspects shall be included in all questions.

19. Passing in Final Examination

(1) To satisfy the examiners in the Final Examination, it shall be necessary for a candidate to obtain-

(a) not less than fifty per centum in every written test; and

(b) not less than fifty per centum in every practical test.

(2) No candidate shall be credited with passing the Final Examination unless on the same occasion she satisfies the examiners in both the requirements specified in sub-rule (1).

20. Examiners for Final Examination

Every examiner appointed by the Examinations Committee shall be either a qualified medical practitioner, a qualified registered tutor or a qualified registered nurse.

21. Publication of examination results

(1) The list of successful candidates in the Final Examination shall be published in alphabetical order, classified into two divisions, to be designated the Honours Division and the Pass Division.

(2) Honours shall be awarded to candidates who obtain seventy-five per centum or more in every written and practical test.

22. Registration as nurse

A student nurse who has-

(a) completed the course of training to the satisfaction of the Examinations Committee; and

(b) satisfied the examiners in the Final Examination; and

shall be qualified for and shall be entitled to be registered on the

FIRST SCHEDULE

[Rule 4]

ZAMBIA REGISTERED NURSES' CERTIFICATE

Registration as nurse

This is to certify that......................................................................................................................................... has passed the qualifying examination for Zambia Registered Nurses held by the General Nursing Council of Zambia on............................. ................................................................................,20......., at......................................................

Date.......................................................

.............................................................................

Registrar,

General Nursing Council of Zambia

SECOND SCHEDULE

[Rule 5]

PART A

CONDITIONS UNDER WHICH SCHOOLS OF NURSING ARE APPROVED FOR THE TRAINING OF STUDENT NURSES FOR ADMISSION TO THE REGISTER OF ZAMBIA REGISTERED NURSES

The authorities of any school of nursing for which approval is sought are required to submit to the Council full particulars of the facilities available for training.

In every case a visit by the Council's Inspectors of Training Schools to the school making such application will be carried out before approval is granted.

1. The Teaching Department shall comprise-

(a) at least two spacious classrooms;

(b) one large demonstration room;

(d) a large hall to accommodate the entire student body;

(e) one large office for the principal tutor;

(f) one office for each registered nurse tutor;

(g) a communal office for clinical instructors;

(h) a small clinical laboratory;

(i) a small kitchen;

(j) toilet facilities; and

(k) 120 -150 students who would be the smallest unit which will be economic.

2. The Hostel shall comprise-

(a) separate bedrooms with wardrobe and dressing table cum desk;

(b) sitting and recreation rooms;

(d) a large room for storage of student's trunks and other luggage;

(e) toilet and bathroom/showers, 1:6;

(f) one linen room or linen cupboards;

(g) a room or rooms for cleaner's materials;

(h) accommodation for housekeepers or wardens;

(i) tutor's accommodation;

(j) visitor's room near front entrance;

(k) housekeeper's or warden' office;

(l) dining and kitchen facilities; and

(m) outdoor recreational facilities.

3. There must be at least one registered nurse tutor to organise and carry out the classroom teaching with sufficient teaching staff in relation to the number of students. The minimum overall ratio of tutors to students should be 1:40. It is considered that clinical instructors are a valuable addition to the trained staff in general and children's hospitals, but although they should be attached to the teaching department they should not be appointed in place of tutors. There must also be adequate secretarial and clerical assistance in the teaching department.

4. There should be an Education Committee whose membership, in addition to representatives of the Board of Governors or Management Committee, should include the Matron, Chief Male Nurse, or Principal Nursing Officer, representatives of the tutorial staff, clinical instructors, ward and departmental sisters and/or charge nurses, members of the medical staff participating in the teaching of student nurses, and a representative from the public health service and from the field of general education. There should also be a Ward Affairs Committee consisting of the Matron, Chief Male Nurse, or Principal Nursing Officer, representatives of the tutorial staff, clinical instructors and ward and departmental sisters and/or charge nurses in the hospital or group of hospitals, which should meet regularly to discuss methods of procedure in order to co-ordinate ward and classroom teaching.

5. The health care of the students should be under the care of a doctor appointed by the Medical Superintendent of the hospital to which the school is attached. Provision should be made for a complete pre-admission medical examination, annual X-ray and a complete medical examination at the end of training. Students should be allowed six statutory holidays with an average working week of 35 - 37 hours. Provision should also be made for suitably trained and experienced counsellors to be available to students needing advice on personal matters.

PART B

CONDITIONS UNDER WHICH HOSPITALS ASSOCIATED WITH TRAINING SCHOOLS FOR STUDENT NURSES FOR ADMISSION TO THE REGISTER OF ZAMBIA REGISTERED NURSES ARE APPROVED

The authorities of any hospital, or group of hospitals, for which approval as a training hospital is sought are required to submit to the Council full particulars of the clinical experience available for training and of the arrangements which will be made to ensure systematic practical and theoretical instruction of the student nurses in the subjects prescribed for admission to the appropriate part of the Register of Nurses.

In every case a visit by the Council's Inspectors of Training Schools to the hospital, or group of hospitals, making such application will be carried out before approval is granted.

The following are the general requirements relating to the practical and theoretical instruction of student nurses:

1. The hospital, or group of hospitals, must satisfy the Council that adequate clinical experience is available for the training.

2. Satisfactory arrangements must be made for the supervision and teaching of the student nurses by registered nurses in all wards and departments, both by day and night.

3. The standards of nursing practice, the equipment and facilities in the wards and departments of the hospital or hospitals must be such as to permit the teaching of good nursing care and allow the principles taught to be put into practice. It is essential that adequate domestic services (including domestic supervision) be available.

Training in General Nursing

A hospital involved in the training of nurses for admission to the Register kept for Zambia Registered Nurses is required to have a minimum of 300 beds and the necessary departments including Casualty/Accident Centre, Out-Patient Clinics and Operating Theatres. Such a group may comprise one or more hospitals. A hospital ward unit should ideally comprise not more than 30 beds and there should be one clinical room for student nurses attached to each ward or two-ward units.

I. The hospital, or group of hospitals, must be able to provide the following experience:

(a) General medical nursing of men and women. General surgical nursing of men and women, including gynaecological and genito-urinary nursing. Nursing of children (see below). Operating theatre. Casualty/Accident Centre, Out-Patient Clinics and Health Clinics. Ear, nose and throat, ophthalmic and orthopaedic conditions.

(b) Specialisation in paediatric nursing is required together with- One or more speciality, such as- Obstetric nursing. Psychiatric nursing. Neuro-surgical nursing. Thoracic surgical nursing. Infectious diseases nursing.

II. Every student is required to complete the following minimum clinical experience before entry to the final examination:

A. In the case of a student nurse admitted to a nursing school under the provisions of paragraph (a) (i) of the Third Schedule:

General medical nursing (male wards)-10 weeks

General medical nursing (female wards)-10 weeks

General surgical nursing (male wards)-10 weeks

General surgical nursing (female wards)-10 weeks

Paediatric nursing-12 weeks

Gynaecological nursing- 6 weeks

Obstetric nursing- 6 weeks

Operating theatre- 6 weeks

Out-Patient department/Casualty- 6 weeks

Public health nursing- 6 weeks

B. In the case of a student nurse admitted to a nursing school under the provisions of paragraph (a) (ii) of the Third Schedule:

Medical nursing (male or female)- 6 weeks

Surgical nursing (male or female)- 6 weeks

Paediatrics- 6 weeks

Out-Patient department or Casualty- 6 weeks

Operating theatre- 6 weeks

Ophthalmology- 6 weeks

Public and community nursing- 6 weeks

Gynaecology- 6 weeks

Psychiatric nursing- 6 weeks

Practical experience in public health nursing includes-

Follow-up study of two patients discharged from the hospital. Individual health teaching in the wards and out-patient department.

Planned group health teaching in the wards and out-patient department, out-patient clinics and under-five clinics.

Organisation of under-five clinics.

Home visits to follow up babies and mothers who need more care, such as under weight babies, babies with diarrhoea, malnourished babies, babies with common upper respiratory tract infections, etc.

Six week's experience in one or more of the following specialties, such as:

Psychiatric nursing.

Infectious diseases nursing.

Neuro-surgical nursing.

Thoracic surgical nursing.

Orthopaedic nursing.

Ophthalmic nursing.

Night duty not exceeding eight weeks during the second and third year of training (four weeks each year).

Male Nurses

In general the foregoing conditions should apply. Midwifery and gynaecological experience may be replaced by an obligation to undertake genito-urinary, casualty or venereology experience for similar periods as those required for the relevant subjects of female nurses.

The number of weeks gained in each type of clinical experience will need to be entered in the student nurse's record of practical experience for presentation to the examiners at the final examination.

A minimum number of students should be about 100 and the ratio of students to beds shall be 1:4.

The number of student nurses accepted must be related to the clinical experience available and no school should undertake the training of more student nurses than the number for whom the hospital can provide a planned programme of practical instruction.

THIRD SCHEDULE

[Rule 7]

REQUIREMENTS FOR ADMISSION TO NURSING SCHOOLS

A candidate shall be eligible for admission to a nursing school if, and only if-

(a) the candidate satisfies the following educational requirements:

(i) applicants must be in possession of a Cambridge or equivalent Certificate with a pass in English and four other subjects at GCE "O" level, three of them being General Science, Mathematics and Biology; or

(ii) the candidate is the holder of a certificate to the effect that she had been a medical assistant for three years and has been working as such continuously for at least one year immediately prior to the commencement of the course of student nurse;

(The Council may, however, use its discretion in cases of applicants with lower qualifications.)

(b) the candidate must have attained the age of 17 years on the last day of the month in which the course commences;

(d) the candidate must be prepared to be resident.

FOURTH SCHEDULE

[Rule 10 (2)]

SYLLABUS OF SUBJECTS FOR EXAMINATION FOR THE CERTIFICATE OF GENERAL NURSING (Z.R.N.)

A. PRINCIPLES AND PRACTICE OF NURSING

1. The Hospital and the Health Services:

an outline of the history and background of nursing and medical services, with particular reference to Zambia; the Health Services of Zambia; hospitals, their various departments and functions, and their relation to other health services.

2. The Nurse:

personal qualities and attitudes required;

standards of ethical conduct;

relationships between nurse, patient and relatives;

the place of the nurse in the hospital team;

her relationship with medical staff and other hospital workers;

responsibilities for leadership.

3. The Ward:

the plan of the ward routine and the patient's day;

elimination of noise;

ventilation, heating and lighting;

cleanliness of the ward as it affects the safety and comfort of the patient;

care of linen, disposal of soiled infected linen;

care and use of equipment;

care, storage and handling of food.

4. The Patient:

reception and admission of patients;

transfer and discharge of patients;

recording necessary particulars;

care of the patient's clothing and other belongings, including valuables;

observing and reporting on the patient's general condition and behaviour;

the nurse's responsibility for the patient's general cleanliness and hygiene;

prevention and treatment of infestation;

bedmaking, moving and lifting patients, helping patients to get in and out of bed;

care of patients confined to bed; care of ambulant patients; serving meals;

feeding patients; measuring and recording fluid intake and output;

recording weight;

taking and charting the temperature, pulse, respiration and blood pressure;

observing and reporting on urine, faeces, vomit and sputum;

giving and receiving reports.

5. Nursing Procedures:

(a) Associated with general care of the patient:

special positions used in nursing care;

bed and cot making with modification of method required in special conditions;

methods of warming the bed;

methods of relieving pressure;

prevention and treatment of pressure sores;

disposal and/or disinfection of urine, faeces, sputum and vomit;

care of incontinent patients;

care of the unconscious patient;

last offices;

bathing of infants and children;

feeding of infants and children.

(b) Prevention of spread of infection (or surgical technique):

prevention of spread of infection in a ward;

principles of asepsis;

aseptic technique;

methods of cleansing, sterilisation and disinfection;

preparation of lotions;

conduct of surgical dressings and other sterile procedures;

methods of securing dressings;

methods of disposal of soiled dressings.

weights and measures (Metric System);

rules for the storage of drugs and poisons;

rules for and method of the administration of drugs.

(d) Associated with specialised conditions:

care of the patient before and after anaesthesia; general pre- and post-operative nursing care; inhalations.

administration of oxygen; and oxygen and carbon dioxide;

nursing of patients requiring artificial respirators;

intravenous and subcutaneous infusions;

artificial feeding;

gastric aspiration and washout;

preparation and administration of enemas of various types;

passing of flatus tube;

colonic and rectal washouts;

vaginal irrigations, perineal care, insertion of pessaries;

catheterisation and irrigation of urinary bladder-in the case of male patients, the nurse should be prepared to carry out these procedures ONLY when no male nurse is available;

treatment of the eye, bathing, irrigation, instillation of drops, application of ointments and

dressings;

treatment of the ear, swabbing, instillation of drops, insufflation, syringing, application of

ointments and dressings;

treatment of the mouth and throat by gargling, irrigation and painting; uses and applications of heat, cold and medicated preparations; principles and methods of treatment by baths and sponging.

(e) Clinical procedures:

collection of specimens of blood, blood slides, urine, faeces, vomit, sputum and discharge;

urine testing;

preparation and care of patient and preparation of apparatus for-

(i) examination of ear, nose, mouth, throat, of respiratory, alimentary, urinary and genital tracts, neurological examination;

(ii) procedures including the examination of body fluids, gastric analysis, renal and liver efficiency test, estimation of basal metabolic rate, X-ray examination, lumbar puncture, cisternal puncture, bone marrow puncture, venepuncture and venesection, aspirating the pleural cavity;

(iii) drainage of peritoneal cavity and subcutaneous tissues;

(iv) advanced procedures, as follows, and subject to notes below:

simple suturing of skin wounds;

application of simple splint, Plaster of Paris splints;

all methods of artifical respiration, including mechanical external massage in cardiac failure:

inoculations and vaccinations, all types;

intravenous procedures:

the taking of blood for all diagnostic purposes or from a donor;

the introduction of drugs of fluids other than blood.

IMPORTANT NOTES:

1. Methods of resuscitation-the nurse needs to appreciate the indications for various methods in varying circumstances, to understand their use and be able to carry them out effectively.

2. Inoculations and vaccinations-these are restricted to the execution as directed, and specifically exclude subsequent assessment.

3. Intravenous procedures-while it is to be clearly understood that the delegation to the nurse of these procedures normally carried out by the doctor or by specially trained technicians may on occasions or in certain circumstances be deemed necessary, any doctor thus delegating this responsibility must be prepared to satisfy himself that the nurse concerned is competent to carry out the procedure efficiently; to accept full responsibility should the patient suffer ill effects; and to ensure the awareness of the employing body or bodies that such delegation is taking place.

(f) Operating theatre techniques:

preparation and use of theatre annexes;

preparation and sterilisation of instruments, ligatures, sutures, needles and equipment;

observation and care of patients during anaesthesia and operation;

management of theatre table and lighting;

management of diathermy and suction apparatus;

positions used in operations;

general preparation of anaesthetic apparatus;

scrubbing for minor operations.

6. First-Aid and Treatment in Emergencies:

aims of first-aid treatment;

general principles and rules to be observed;

improvisation of equipment;

methods of moving and carrying injured persons;

use of triangular and roller bandages and splints;

haemorrhage;

shock; asphyxia;

fractures;

burns and scalds;

poisoning;

bites and stings;

fits;

emergencies, e.g., fire and accidents in the ward.

B. STUDY OF THE HUMAN INDIVIDUAL

1. Human Biology:

the living cell as the unit of life; characteristics of living organisms; man as a complex organism with differing structure of cells according to function; a simple outline of body tissues;

the requirements for life, e.g., nutrition, fluids, oxygen; elimination, movement, control of activity, awareness of environment; protection from harm;

reproduction;

how these requirements are met anatomically and physiologically:

(a) General structure of the body:

anatomical parts of body as a whole;

body cavities;

position and relation of main organs;

skin as protecting organ;

(b) How the body moves:

skeleton, joints, muscles and their relationship to movement (no detailed anatomy to be given);

the heart; circulation, composition and functions of blood and lymph (no detailed anatomy of heart);

(d) Food:

(basic requirements given in section on nutrition);

simple outline of digestive system;

digestion; absorption;

(e) Respiration:

how and why it is carried out;

simple outline of air passages; lungs;

muscles of respiration and action;

(f) Elimination:

general outline of urinary system; function of kidneys;

micturition; composition of urine; colon and elimination;

lungs and elimination;

skin and effect of its function on elimination;

fluid balance;

(g) Control of activity and awareness of environment:

general arrangements and outline of function of nervous system and special senses;

simple description of hormonal activity;

regulation of body temperature;

(h) Reproduction:

outline of organ's function.

2. Elementary Psychology and Mental Health:

a brief outline of normal development from birth, through childhood, adolescence to maturity and old age;

mental hygiene and adolescence;

personality-its development, its changes;

learning; remembering; forgetting and perceiving;

behaviour in illness;

nurse-patient relationship;

value of mental health;

influence of body on mind;

emotional needs;

common reactions to unmet emotional needs;

psychology of working with individual groups;

mental defectives-causes, prevention and treatment;

juvenile delinquency-causes, prevention and treatment; mental health in relation to nursing practice;

qualities of an emotionally matured person and how to be a useful citizen.

C. SOCIOLOGY

1.The Individual in Society:

structural organisation of community life as a means of meeting basic human needs;

the health of the individual;

meaning of health in our society;

epidemiology of health;

promotion of health in various cultures and societies.

2. Patterns of Community Life:

(a) Family:

organisation of the family;

changes in family life;

family breakdown;

problems arising from family breakdown;

dependence of families on community services;

(b) Community:

factors influencing development and characteristic of the community;

development of community services;

external factors influencing community life;

(d) social problems, social disorganisation;

social pathology in Zambia.

3. Nursing and the Social Organisation:

development of nursing in relation to social changes;

social legislation and activities of social welfare department;

sociology in relation to nursing practice.

D. PROMOTION OF HEALTH

1. Personal and Communal Hygiene:

(a) Personal health:

eating and drinking, smoking, work, exercise and games, rest and relaxation, sleeping, personal cleanliness, clothing, shoes;

(b) Air and Ventilation:

composition, air pollution, principles of ventilation, effects of inefficient ventilation;

composition, sources, uses, domestic and communal purification, contamination, water-borne diseases;

(d) Housing:

minimum requirements for health;

accident prevention;

(e) Sanitation:

general principles of collection and disposal of sewage and refuse;

(f) Pests, Vermin, Parasites:

simple description of common types, methods of destruction, adverse effect on health.

2. Microbiology:

(a) history of microbiology;

(b) the part micro-organisms play in health and disease, simple classification, growth and production, spore-bearing organisms;

modes of entry and transmission of infection, reaction of the body to infection, prevention of cross-infection in hospital wards;

(d) the microscope;

(e) normal flora of the human body;

(f) bactericides;

(g) microbiology applied to nursing procedures.

3. Nutrition:

basic principles of feeding patients and nutritional needs in sickness and health;

classification of foodstuffs with the functions of each;

effects of cooking on foodstuffs;

the calorie- as a unit of heat;

dietary requirements of individuals at different ages and living under different conditions of physical activity;

effects of inadequate diet;

composition of common articles of diet (percentage composition not required);

milk-percentage composition;

comparative value of cow's milk and human milk;

protection of food and milk from contamination and adulteration;

care in the home and hospital;

diseases spread by milk and other foods.

4. Public Health Nursing, Including Health Education:

the role of the nurse as a health educator;

public health services;

principles of community health nursing;

methods of teaching various levels groups; health teaching lesson plan;

audio-visual aids;

home visit-follow-up care;

principles in the use of a nursing bag;

the care of pre-scholars-nutrition;

immunisation;

school health;

industrial health;

statistics- their place in public health;

national, voluntary and international organisations which contribute to development of public health services in the country.

E. NATURE AND CAUSES OF DISEASES AND PRINCIPLES OF TREATMENT

1. Nature and Causes of Disease (not already covered):

hereditary conditions;

congenital abnormalities and birth trauma;

nutritional and metabolic disorders-deficiencies or excesses in the diet-failure in absorption;

endocrine disorders;

psychosomatic conditions;

trauma-types of injury and processes of healing;

infections and infestations;

new growths; types and characteristics;

degeneration;

poisons-common types only;

undetermined origin.

NOTE:- These general headings setting out in the broadcast possible lines the nature and cause of disease should be applied in the study of all types of conditions, which include general and specialised medical and surgical conditions, affecting all age groups and all systems and organs in the body.

The study of any conditions from which a patient may be suffering either of a general or specialised character should include-

applied anatomy and physiology;

causes;

symptoms and the well-known signs;

reasons for investigation;

treatment;

nursing care to include observation and records;

normal course of the disease;

complications;

social aspects and rehabilitation.

2. Tropical Medicine:

(public health aspects are to be integrated in all the subjects) nutritional disorders;

malaria;

African trypanosomiasis-sleeping sickness;

schistosomiasis-bilharzia;

ankylostomiasis-hookworms;

ascariasis-round worms;

tape worm taenia solium;

taenia saginata;

thread worms;

filariasis;

leprosy;

tropical ulcer;

yellow fever;

yaws;

poisonous bites-snakes; insects.

3. Infectious Diseases:

(public health aspects are to be integrated in all the subjects)

dysentery;

infantile gastro-enteritis;

food poisoning;

cholera;

enteric fever (typhoid fever and paratyphoid fever);

tuberculosis;

diphtheria;

measles;

rubella (German measles);

whooping cough;

meningococcal fever (meningitis);

poliomyelitis;

rabies;

chickenpox;

smallpox;

mumps;

gonorrhoea;

syyphilis;

influenza.

4. Dermatology:

scabies;

eczema;

ringworm;

impetigo;

viral warts.

5. General Principles of Medical and Surgical Nursing (not already covered): (special emphasis to be placed on diseases and conditions prevalent in Central Africa)

(a) alimentary system:

abnormalities and disorders of appetite, swallowing, digestion, absorption, metabolism and defaecation;

types of vomiting, diarrhoea and constipation; diseases of the alimentary tract and its associated organs;

(b) respiratory system:

abnormalities of respiration; types of cough and sputum;

diseases of the respiratory tract, lungs and pleura;

abnormalities of pulse, cardiac action and blood pressure;

diseases affecting the heart, blood, blood vessels and blood-forming organs, lymphatic vessels and nodes;

(d) urinary system:

abnormalities of urine; disorders of micturition;

diseases of the urinary tract;

(e) nervous system and special senses:

disorders and diseases of the brain, spinal cord and peripheral nerves. Assessment of level of consciousness, sensory changes and types of paralysis. Abnormalities and disorders of sight, hearing, smell, taste and touch;

diseases of the eye, ear, nose, tongue and skin;

(f) endocrine system:

effects of disordered function of endocrine glands;

(g) locomotor system:

abnormalities and diseases of bones, joints and muscles-traumatic and inflammatory conditions only;

(h) reproductive system:

(i) female-

A. gynaecology:

abortion and ectopic pregnancy;

disorders of menstruation; infertility;

infection of the genital tract;

displacements of the genital organs;

benign tumours of the genital tract including ovarian tumours;

carcinoma of the genital tract; urinary and rectal fistulae; contraception;

B. obstetrics, maternal and child care:

importance of mother and child care;

maternal and child health problems in Zambia;

signs and symptoms, diagnosis of pregnancy;

principles of ante-natal care;

growth and development of foetus;

diet for the pregnant mother and general care;

stages of normal labour;

care of mother during labour;

post-natal care of mother and child;

prematurity, care of the premature baby;

feeding problems in Zambia;

under-five clinic and its activities;

accidents in home and prevention;

(ii) male-prostation, infections and neoplastic conditions only;

(i) psychiatric disorders:

interrelation of mental and physical processes;

elementary psychopathology;

psychosis and neurosis compared and nursing management;

special treatments and drugs;

(j) paediatrics:

diseases of infancy and childhood (not already covered);

protein deficiency-kwashiorkor;

immunisation;

adaptation of usual nursing measures to care of children, with special reference to drugs and administration of parenteral fluids;

(k) ophthalmology:

optics, squints;

disorders of lacrymal apparatus and eyelids;

conjunctivitis;

trachoma;

glaucoma, uveitis;

cataract;

local treatments;

(l) ear, nose and throat:

diseases of the nose;

diseases of the paranasal sinuses;

diseases of the throat;

diseases of the larynx;

diseases of the ear-external, middle and inner.

6. Treatment of Disease (relevant items from previous sections should be studied in relation to the nursing care required in the treatment of any condition from which patients may be suffering):

Other aspects of treatment:

(a) rest:

general rest of mind and body;

psychological principle of patient care;

the therapeutic climate;

importance of environment and planning the patient's programme to include adequate rest;

physiological rest of affected organ or area;

complications associated with prolonged local or general immobilisation;

(b) dietetics:

ward meals;

modification of the normal diet in the treatment of various conditions;

preparation of normal and special diets;

Dangerous Drugs Act (Chapter 95);

rules under the Pharmacy and Poisons Act (Chapter 299);

the use, dosage, action and side effects of drugs commonly ordered in diseases of-

cardiovascular system;

alimentary system;

endocrine system;

nervous system;

genito-urinary system;

respiratory system;

locomotor system;

preparations of vitamins and hormones;

anti-histamines;

chemo- and bio-therapeutic agents;

(d) radiotherapy:

principles of treatment by X-ray and radioactive substances;

(e) physiotherapy:

principles and practices of treatment;

(f) occupational and industrial therapy:

principles and use of occupational industrial therapy as a means of return to health and working capacity.

F. WARD ADMINISTRATION

(a) qualities of a good ward sister;

(b) patient's needs;

(d) running and supervision of the ward;

(e) the principles of ordering stores for the ward;

(f) ward teaching and the importance of good relationship with the tutorial staff;

(g) how to prepare for a doctor's ward round;

(h) how to write off duties;

(i) how to write nursing reports;

(j) how to write confidential reports;

(k) care of equipment and inventory.

FIFTH SCHEDULE

[Rule 10 (2)]

MINIMUM CLASS HOURS

(including demonstrations but excluding practice sessions)

	Student nurse admitted under paragraph (a)(i) of Third Schedule	Student nurse admitted under paragraph (a) (ii) of Third Schedule
Anatomy and physiology	50	20
Psychology and mental health	10	12
Microbiology	12	6
Sociology	10	10
Personal hygiene and public health nursing, including health education	40	20
Obstetrics	3	6
Maternal and child care	7	14
Nutrition and dietetics	8	16
First-aid	12	6
Principles and practice of nursing	40	90
General principles of medical and surgical nursing	30	60
General surgery	24	12
General medicine	24	12
Paediatrics	10	12
Gynaecology	8	10
Tropical medicine	10	12
Infectious diseases	6	12
Pharmacology	12	8
Ear, nose, throat and eye diseases	6	10
Psychiatry	6	10
Dermatology	4	2
Ward administration	6	6
Orthopaedics	6	-
TOTAL hours over three year's training	248	462

SIXTH SCHEDULE

[Rules 14 (2) and 17 (2)]

ZAMBIA REGISTERED NURSES' EXAMINATION

.................................................., 20.....

ENTRY FORM

Candidates for examination are asked to enter all details requested below and return the form immediately to the General Nursing Council of Zambia together with the examination fee of .........................

Surname (in BLOCK CAPITALS) .............................

................................................................................................. Other names .....

...................................................................................................................................................

Age.......................... ......... Day.................................. Month................................... Year..............................

Place of Birth...........................

............................................................................................................................. Permanent Address ...............

............................................................................................................................... Training School .......................

............................................................................................................................ Date of Commencement of Training .......

............................................................................................................ Amount of Fee ........................................................

............................................................................................. How sent (cheque, money order or postal order): Nos .....

...................................................................................

To the best of my knowledge this is a true statement

Date.............................................

.................................................

Signature of Candidate

SEVENTH SCHEDULE

[Rule 17 (2))]

PRESCRIBED FEE

Final Examination

[As amended by Act No. 13 of 1994]

EIGHTH SCHEDULE

[Rule 14 (2)]

CERTIFICATE OF TUTOR AS TO PROGRESS OF TRAINING PRIOR TO SITTING INTERMEDIATE EXAMINATION FOR ZAMBIA REGISTERED NURSES

Name of Applicant .............................................

.................................................................................................

Age of Applicant ....................................................

.............................................................................................

Date of Entry into Training ......................................

...........................................................................................

Comments of Tutor as to progress of candidate and suitability of candidate as a Zambia Registered Nurse. Tutor should certify that the candidate has satisfactorily undergone the course of training as set out in the first part of the syllabus.

........................................................................................

Tutor in charge of Applicant's Training

Date.....................................................

NINTH SCHEDULE

[Rule 17 (2)]

CERTIFICATE OF TUTOR AS TO PROGRESS OF TRAINING PRIOR TO SITTING FINAL EXAMINATION FOR ZAMBIA REGISTERED NURSES

Name of Applicant ................................................................

Age of Applicant ...................................................................

Date of Entry into Training ...................................................

Has the Pupil passed the Intermediate Examination? .............

If so, give the date of passing .............................................

Comments of Tutor as to progress of candidate and suitability of candidate as a Zambia Registered Nurse. Tutors should certify that the candidate has satisfactorily undergone the full course of training as set out in the syllabus and that the candidate is suitable in every way to practise as a Registered Nurse. The Tutor will be required to provide for the perusal by the Examiners of the Nurse's Practical Work Record Book.

..............................................................

Tutor in charge of Applicant's Training

Date...................................................

NURSES AND MIDWIVES (APPEALS) RULES

[Sections 11 and 30]

[RETAINED AS PER SECTION 15 OF THE INTERPRETATION AND GENERAL PROVISIONS ACT]

Arrangement of Rules

Rule

3. Appeals to Supreme Court

2. Appeals to High Court

SI 10 of 1984.

[Rules by the Chief Justice]

1. Title

These Rules may be cited as the Nurses and Midwives (Appeals) Rules.

2. Appeals to High Court

Subject to any specific provisions of the Act, the High Court (Appeals) (General) Rules, shall apply to any appeal to the High Court brought pursuant to the provisions of the Act.

3. Appeals to Supreme Court

Subject to any specific provisions of the Act, the Supreme Court Rules shall apply to any appeal to the Supreme Court brought pursuant to the provisions of the Act.

ZAMBIA ENROLLED NURSES (TRAINING) RULES

[Sections 17 and 18]

[RETAINED AS PER SECTION 15 OF THE INTERPRETATION AND GENERAL PROVISIONS ACT]

Arrangement of Rules

Rule

3. Institution of Zambia Enrolled Nurse's Certificate

4. Training schools

5. Supervisor

6. Training to be at training school

7. Admission to training schools

9. Instruction of pupil nurse

10. Institution of examination

11. Syllabus for examinations

12. Entry to examination

13. Tests comprising the examination

14. Examiner for Examination

15. Marking of Examination

17. Conditions under which students may be allowed to re-sit

18. Grant of Zambia Enrolled Nurse's Certificate

Act 13 of 1994,

SI 73 of 1974.

[Rules by the General Nursing Council of Zambia]

1. Title

These Rules may be cited as the Zambia Enrolled Nurses (Training) Rules.

2. Interpretation

In these Rules, unless the context otherwise requires-

"Act" means the Nurses and Midwives Act;

"Committee" means the Examinations Committee of the Council;

"Council" means the General Nursing Council of Zambia established under section 3 of the Act;

"matron" means-

(a) in relation to a training school which consists of one hospital, the matron of that hospital;

(b) in relation to a training school which consists of a group of hospitals such one of the matrons of such hospitals as is designated by the Council to be the matron of the training school;

"pupil nurse" means a person undergoing training in a training school;

"training period" means the period prescribed by sub-rule (1) of rule 8 for the course of training of pupil nurses;

"training school" means a hospital or group of hospitals recognised or deemed to have been recognised under rule 4 to be a training school for the purposes of these Rules;

"ward" means a ward of a training school.

3. Institution of Zambia Enrolled Nurse's Certificate

(1) For the purpose of enabling a person to become qualified to carry on the calling of a nurse, the Council may, subject to the other provisions of these Rules, grant a certificate of competency, to be styled the Zambia Enrolled Nurse's Certificate.

(2) Every Zambia Enrolled Nurse's Certificate shall be in the form set out in the First Schedule to these Rules.

4. Training schools

(1) Subject to the provisions of this Rule, the Council may on application being made to it recognise any hospital or group of hospitals within the Republic to be a training school for the purposes of these Rules if, in the opinion of the Council, it provides adequate facilities for the training of nurses.

(2) The Council shall not recognise any hospital or group of hospitals as a training school unless requirements specified in the Second Schedule to these Rules have been substantially complied with.

(3) The Council shall before recognising any hospital or group of hospitals as a training school inspect or cause to be inspected such hospital or hospitals for the purpose of ascertaining that they are a fit and proper place for the training of nurses.

(4) The hospitals set out in the Third Schedule to these Rules shall be deemed to have been recognised by the Council as training schools.

5. Supervisor

(1) Every training school shall be in the charge of a Supervisor to be approved by the Council:

Provided that no person shall be qualified to be approved as a Supervisor of a training school unless she is a Registered Nurse.

(2) The Supervisor of a training school shall be responsible for ensuring that the pupil nurses admitted to the training school are trained in accordance with the provisions of these Rules and shall designate one or more experienced sisters or charge nurses as teachers of the training school.

6. Training to be at training school

Every person wishing to qualify for Zambia Enrolled Nurse's Certificate shall undergo the course of training prescribed by these Rules at one or more training schools.

7. Admission to training schools

A person shall not be eligible for admission to a training school as a pupil nurse unless she fulfils the requirements set out in the Fourth Schedule hereto.

8. Period of training

(1) The course of training of a pupil nurse shall extend over a period of not less than twenty-four calendar months inclusive of-

(a) periods of vacation leave not exceeding eighteen days per year;

(b) public holidays not exceeding six days per year;

(2) Save for the period of vacation leave or sick leave specified in sub-rule (1) or any period recognised by the Council under sub-rule (3), the training of a pupil nurse shall be continuous throughout the whole period of the course of training and, on any interruption thereof, no recognition shall be accorded to the pupil nurse in respect of any period of the course of training undergone by her prior to such interruption.

(3) Where the course of training of a pupil nurse is interrupted for a period not exceeding two years, the Council may, if having regard to all the circumstances of the case it considers the reasons for such interruption to be adequate and justified, recognise the whole or any part of the period of training undergone by the pupil nurse before such interruption as counting towards the period of twenty-four calendar months prescribed by sub-rule (1).

9. Instruction of pupil nurse

(1) During the course of her training a pupil nurse shall receive theoretical and practical instruction and clinical experience in every subject contained in the syllabus.

(2) For each pupil nurse there shall be kept a record to be known as the Pupil Nurse's Record of Practical Instruction; wherein the Supervisor of the training school shall enter the number of weeks for which each type of clinical experience is undergone by the pupil nurse.

10. Institution of examination

For the purposes of these Rules examinations to be styled the Zambia Enrolled Nurse's Examination, shall be held from time to time but not less frequently than twice in each year.

11. Syllabus for examinations

The syllabus for the Zambia Enrolled Nurse's Examination shall be as prescribed in the Fifth Schedule to these Rules.

12. Entry to examination

(1) A pupil nurse shall be eligible to be entered for Zambia Enrolled Nurse's Examination if, and only if, by the date fixed for the commencement of the examination-

(a) she will have completed not less than twenty months of her training to the satisfaction of the person in charge of the training school;

(b) she will have attended courses in the theoretical and practical instruction and clinical experience extending over the whole syllabus;

(2) Every application for entry to the Zambia Enrolled Nurse's Examination shall be in the form set out in the Sixth Schedule to these Rules and shall be accompanied by-

(a) examination fee of forty fee units; and

(b) a certificate in the form set out in the Seventh Schedule to these Rules by the Supervisor of the training school certifying that the applicant has fulfilled the conditions mentioned in rule 12 (1) and that she is eligible to be entered for the Zambia Enrolled Nurse's Examination.

[As amended by Act No. 13 of 1994]

13. Tests comprising the examination

Subject to any modifications which the Examinations Committee may, from time to time, prescribe the Zambia Enrolled Nurse's Examination shall consist of the following-

(a) written test of 2G hours duration, consisting of-

(i) Paper A. Comprising thirty short answer questions; and

(ii) Paper B. Comprising three essay questions of which the candidate shall be required to answer two questions;

(b) a practical examination which shall be conducted by two external examiners appointed by the Council and which shall-

(i) last for not more than 1 hour nor less than 40 minutes;

(ii) be conducted in suitable areas of the hospital under normal working conditions; and

(iii) comprise practical tests and oral questions which questions shall relate to the nurse's day-to-day activities in the ward.

14. Examiner for Examination

Every examiner shall be appointed by the Examinations Committee for the purposes of the Zambia Enrolled Nurse's Examination and shall be either a qualified registered nurse or registered nurse tutor.

15. Marking of Examination

To satisfy the examiner in any examination it shall be necessary for a candidate to obtain not less than fifty per cent in all parts of the examination.

16. Publication of examination results

A list of successful candidates in an examination shall be published, classified into two divisions to be designated the Honours Division and the Pass Division and in each such division the successful candidate's names shall appear in alphabetical order.

17. Conditions under which students may be allowed to re-sit

Subject to the approval of the Council a pupil nurse who has failed in part of the examination may be permitted to re-sit that part on not more than two occasions:

Provided that the pupil nurse may not re-sit for a part of an examination unless she shall have been in continuous training up to the time of such re-sit.

18. Grant of Zambia Enrolled Nurse's Certificate

A pupil nurse who has-

(a) completed the course of training prescribed by these Rules to the satisfaction of the Examinations Committee; and

(b) passed the examination; and

shall be qualified for and shall be entitled to be granted the Zambia Enrolled Nurse's Certificate.

19. Savings

Any period of training undergone at the hospitals set out in the Third Schedule hereto and any examination held prior to the coming into operation of these Rules shall be deemed to have been undergone or passed in terms of these Rules.

FIRST SCHEDULE

[Rule 3 (2)]

ZAMBIA ENROLLED NURSES' CERTIFICATE

This is to certify that. ............................................................................... has passed the qualifying examination for Zambia Enrolled Nurses held by the General Nursing Council of Zambia on ...................................., 20.........at................................ ............................................................................................

Date................................................

................................................................................

Registrar,

General Nursing Council of Zambia

SECOND SCHEDULE

[Rule 4 (2)]

CONDITIONS UNDER WHICH HOSPITALS MAY BE APPROVED AS TRAINING SCHOOLS FOR PUPIL NURSES FOR ADMISSION TO THE ROLL OF NURSES

The authorities of any hospital or group of hospitals for which approval as a training school is sought, shall submit to the Council full particulars of the clinical experience available for training and of the arrangements which will be made to ensure systematic practical and theoretical instruction of the pupil nurses in the subjects prescribed for admission to the Roll of Nurses.

In every case before a hospital, or group of hospitals, is recognised as a training school inspection of such hospital or hospitals shall be carried out by the Council's inspectors.

The following are the general requirements relating to the practical and theoretical instruction of pupil nurses:

1. The hospital, or group of hospitals, must satisfy the Council that adequate clinical experience is available for the training.

2. Satisfactory arrangements must be made for the supervision and teaching of the pupil nurses by registered nurses in all the wards and departments, both by day and night.

3. An experienced sister or charge nurse interested in teaching and preferably having attended a recognised course for teachers of pupil nurses for the Roll, should be responsible for teaching the students. The minimum overall ratio of nurse teachers to pupils should be one to thirty. A total strength of registered nurses in the training school should not be less than eight at any one time for a 150-bed hospital. Where suitable arrangements can be made teaching should be under the overall guidance of a registered nurse tutor. There must also be adequate secretarial and clerical assistance in teaching departments.

4. A teaching department should comprise as follows-

(a) one spacious lecture room;

(b) one large demonstration room to accommodate one or two beds;

(d) a tutor's office;

(e) a clerk's office;

(f) cooking facilities for demonstration;

(g) teaching aids which should include a skeleton, anatomical charts, slides, film strips, slide and film strip projector and a 16 mm projector.

This department should be in close proximity to the hospital, in order to facilitate integration of teaching and practice.

5. The standards of nursing practice, the equipment and facilities in the wards and departments of the hospital must be such as to permit the teaching of good nursing care and the principles taught to be put into practice on the wards. It is essential that adequate domestic services (including domestic supervision) be available.

6. There should be an Education Committee whose membership should include the Matron and/or Chief Male Nurse, representatives of the teaching staff, ward and departmental sisters and/or charge nurses, members of the medical staff participating in the teaching of the pupil nurses and, where possible, a member from the field of general education. The Education Committee should meet regularly to discuss methods of procedure, in order to co-ordinate ward and classroom teaching. There should be co-operation between hospital administrators and teaching staff with regard to allocation of duties and the teaching programme.

7. Accommodation of the following standards should be available-

(a) pupils can be accommodated in two, four or six-bedroomed units with individual wardrobe and dressing table facilities;

(b) a sitting and recreation room;

(d) a dining room;

(e) adequate kitchen facilities;

(f) a laundry room;

(g) a linen room or linen cupboards;

(h) toilets and bathrooms/showers, 1:6 not less than 1:8;

(i) outdoor recreational facilities such as netball, tennis, etc.;

(j) housekeeper's accommodation.

Training for the Pupil Nurses in General Nursing

A training school for admission to the general part of the Roll of Nurses is required to have a minimum of 150 beds (of which not less than ninety beds are acute general beds) and the necessary departments including Casualty/Accident Centre, Out-Patient Clinics and Operating Theatres.

Every pupil nurse is required to complete the following minimum clinical experience before entry to the final examinations:

Preliminary Training School- 4 - 6 weeks

Male Medical-8 weeks

Female Medical-8 weeks

Male Surgical-8 weeks

Female Surgical-8 weeks

Paediatrics-12 weeks

Theatre-4 weeks

Public Health, Child Health Clinics-4 weeks

Casualty and/or O.P.D.-4 weeks

Gynaecology or Obstetrics-4 weeks

Experience in one or more of the following:

Orthopaedic, E.N.T. Ophthalmic-4 weeks

Night duty not less than 16 weeks and not more than 24 weeks.

Such experience may be consecutively or intermittently gained during the course of the nurse's training.

Hours of duty, not exceeding 42 hours per week. Lecture periods should be counted as duty.

THIRD SCHEDULE

[Rule 4(4)]

The following hospitals are recognised by the Council as Zambia Enrolled Nurse's Training Schools:

1. Chitambo Hospital, P.O. Kanona

2. Kalene Hills Hospital, P.O. Ikelenge

3. Lewanika Hospital, P.O. Box 147, Mongu

4. Livingstone Hospital, P.O. Box 91, Livingstone

5. Macha Mission Hospital, Private Bag 11XC, Choma

6. Mbereshi Hospital, P.O. Box 94, Kazembe

7. Monze Mission Hospital, P.O. Box 29, Monze

8. Mukinge Mission Hospital, P.O. Kasempa

9. Mwami Mission Hospital, P.O. Box 169, Chipata

10. Nchanga North Hospital, P.O. Box 63, Chingola

11. Our Lady's Hospital, Chilonga, P.O. Mpika

12. Roan Antelope Hospital, P.O. Box 98, Luanshya

13. Ronald Ross Hospital, P.O. Box 197, Mufulira

14. Salvation Army Hospital, Chikankata, Private Bag S2, Mazabuka

15. St Francis Hospital, P.O. Box 16, Katete

16. Wusikili Hospital, P.O. Box 1900, Kitwe

FOURTH SCHEDULE

[Rule 7]

A candidate shall be eligible for admission to a training school if, and only if-

(a) the candidate meets the following educational requirements-

(i) Form II or equivalent up to 1970;

(ii) Form III from 1970 with passes in English, one Science subject and two other subjects;

(b) the candidate shall have attained the age of seventeen years on the last day of the month in which the course commences;

(c) the candidate should have passed a medical examination and received a certificate from a registered medical practitioner stating that she is free from disease and is medically fit to undergo training.

FIFTH SCHEDULE

[Rule 11]

SYLLABUS OF SUBJECTS FOR EXAMINATION FOR ADMISSION TO THE ROLL OF NURSES (Z.E.N.)

1st Year

1. INTRODUCTORY

Section I:

Hospital and Health Services

Nurse

Ward

Patient

Nursing Procedure and Other Procedures

Care of the Sick Child

Medicine and Poisons

First-Aid

Section II:

1. Personal Development

2. Anatomy and Physiology

3. (a) Personal Hygiene

(b) Communal Hygiene

4. Nutrition and Simple Cookery

5. Microbiology

2nd Year

Section I:

Advanced Nursing Procedures

Section II:

Public Health and Health Education

Section III:

1. General Medical and Surgical Conditions

2. Tropical, Parasitical and Infectious Diseases

3. Nutritional Conditions

Section IV:

Ward Management

SECTION I

PRINCIPLES AND PRACTICE OF NURSING

1. The Hospital and Health Services:

Brief history of nursing

The health services of Zambia

Hospital departments and functions

The role of the enrolled nurse

2. The Nurse:

Personal qualities

Professional attitude in relation to patients, relatives, visitors and staff

Ethical conduct

Uniform

3. The Ward:

Ward routine, and its general management

The environment of the patient

Cleanliness, ventilation, heating and lighting

Elimination of noise

Safety measures within the hospital

Care of rubber goods

Economy

Care, storage and handling of food

Disposal of refuse

4. The Patient:

Admission, transfer and discharge

Care of patient's clothes, property and valuables Observations of the patient's condition, weighing of patients

Bed making

Positions

Bed accessories

Care of mouth

Special beds

Bathing in bed or bathroom

Lifting and moving patients

Total nursing care of ambulant and bed patients

The use of urinals and bedpans

Care of infants and children

5. Nursing Procedures:

A. Routine Nursing Care of Patient

Temperature, pulse and respiration

Observation, disposal and disinfection of urine, faeces, vomit and sputum

Measuring and recording fluid intake and output

Preparation for serving of meals

Urine testing

Care of the hair

Treatment of verminous patients

Feeding helpless patients

Preparation for and assisting in routine medical examination

Collection of specimen

Simple dressing

B. Other Nursing Procedures

Ward dressings

Administration of oxygen

Inhalation and steam tents

Simple enemas and suppositories

Rectal and colonic lavage

Barrier nursing and isolation care

Taking and recording of blood pressure

Local application including linaments, ointments, poultices and compresses

Sponging of patient-Tepid sponging

Eye treatment-Swabbing, irrigation and instillation of drops and ointments

Preparation for ear syringing

Ear treatment

Preparation for assisting in special examination of eye, ear, nose, throat, rectum and vagina

Preparation of patient for X-ray

Care of patient with continuous bladder drainage

Giving, receiving and writing of ward reports

Care of the dying and last offices

C. Advanced Nursing Procedures

Preparation for and maintenance of infusion

Preparation for operation, anaesthetic and pre- and post-operative care Preparation for and the administration of hypodermic, intramuscular and sub-cutaneous injection

Preparation for (only) intravenous injection

Preparation for and catheterisation of patient

Preparation for lumbar puncture Preparation for abdominal paracentesis Preparation for aspiration

Preparation for and care of tracheostomy

Preparation for and care of patient with skin traction

Care of patient with underseal drainage

Naso-gastric feeding

Surgical dressing

Vulval swabbing

Taking of blood slides

Simple suturing

6. Care of the Sick Child:

Bathing, feeding and general care including sleep, play, dietary intake

Routine observations for children

Safety precautions for children

Care of scalp vein and intra-peritoneal infusion

Care of premature baby and maintenance of incubators

7. Medicine and Poisons:

Introduction of Metric System

Calculation of solution and dilutions

The Dangerous Drugs Act

Storage and safe custody of medicines and drugs

Methods of administration of drugs

Rules for giving medicines

Uses and side effects of drugs in common use

Disinfectants and antiseptics

8. First-Aid:

Aims of first-aid treatment

General principles and rules to be observed

Improvisation of equipment

Methods of moving and carrying injured persons

Use of triangular and roller bandages and splints

Treatment of the following emergencies:

Haemorrhage

Shock

Asphyxia-resuscitation

Fracture

Burns and scalds

Poisoning-carbon monoxide from charcoal fires, and the gases formed in the mining industry

Bites and stings

Fits

Fainting

Fire and accidents

Foreign bodies

SECTION II

THE HUMAN INDIVIDUAL AND HIS ENVIRONMENT

1. Personal Development of the Individual:

The patient as a person, his relationship to family, community

The effect of illness and separation from familiar background on the behaviour of child and adult

The child; its normal growth and development

2. The Structure and Function of the Human Body:

The body and how it works

A simple outline and function of all body systems

3. The Promotion of Individual and Communal Health:

A. Personal Hygiene

B. Communal Hygiene; water supply, sanitation, housing, pests, vermin and parasites

The factor which causes breakdown of health, welfare and other social services

4. Public and Health Education:

The nurse in relation to the teaching of health participation in National, Provincial or

District Programmes which contributes to the promotion of public health-

(a) Vaccinations

(b) Child Health Clinics (Under Fives Clinic)

5. Nutrition and Simple Cookery:

(a) Basic principles of nutrition:

1. Constituents of food

2. Body requirements

3. Balanced diet

(b) Effects of inadequate or unsuitable diet

(d) Invalid cookery

6. Micro-Organisms (Microbiology):

Bacteria

Body defence mechanism

Immunisation

Infection-its spread and prevention

Sterilisation

SECTION III

AN OUTLINE OF CAUSE, COURSE AND TREATMENT OF DISEASE

1. General Medical and Surgical Conditions:

Respiratory: Upper respiratory tract disorders, asthma, bronchitis, pneumonia, tuberculosis, pleural effusion (mentron)

Circulatory: Anaemia, heart disease, hypertension, haemorrhoids, varicose veins, thrombosis, embolism, gangrene, congenital heart disease

Digestive: Ulcer, obstruction, cholecystitis, cirrhosis of the liver, gastroenteritis, jaundice, dysentery, carcinoma and appendicitis

Urinary: Nephritis, pyelitis, renal failure, uraemia, calculi, trauma, cystitis, prostatic hypertension, urethral strictures

Skin: Eczema, scabies, dermatitis, boils, psoriasis, styes, urticaria, ring-worm Skeletal/Muscular: Fractures, arthritis, amputations, dislocations, osteomyelitis, sprains, rickets

Nervous: Epilepsy, meningitis, cerebro-vascular, accident, Parkinson's disease, congenital conditions, peripheral neuritis

Endocrine: Diabetes mellitus, thyroxicosis, simple goitre

Reproduction: Abortions, pelvic infections, ectopic pregnancy, traumatic conditions, tumours, menstrual abnormalities, infertility, venereal diseases, emergency midwifery Ophthalmic: Trachoma, conjunctivitis, spring catarrh, cataract, glaucoma

2. Tropical Parasitical and Infectious Diseases:

Bilharzia (Schistosomiasis); malaria; leprosy; cholera; rabies; typhoid; measles; smallpox; mumps; whooping cough; diphtheria; poliomyelitis; chickenpox; trypanosomiasis; hookworm; threadworm; roundworm; tetanus

3. Nutritional:

Kwashiorkor, marasmus, P.C.M. malnutrition, vitamin deficiencies

SECTION IV

WARD MANAGEMENT

4. A. Responsibility towards patients and other ward staff

B. Running and the supervision of the ward

C. The principles of ordering stores for the ward

D. Preparation for a doctor's ward round

E. Care of equipment and inventory

5. Conduct of Normal Labour:

Signs and symptoms of pregnancy

Aims of antenatal care (briefly)

Complications of pregnancy (briefly)

Brief outline of normal labour

Conduct of normal delivery

HOURS OF TEACHING IN EACH DEPARTMENT

Introductory Course:	Hours
Nursing Theory and Demonstration	24
Personal Hygiene and Communal Health	16
Nutrition and Diabetics	7
First-Aid Theory and Practice	5
Anatomy and Physiology	22
Visits	5
Practice	41
TOTAL	120 hours

1st Year:

Hours

Nursing

Microbiology

Pharmacology

Nutrition

Anatomy and Physiology

Paediatrics

Public Health and Health Education

TOTAL

112 hours

2nd Year

Hours

Surgery

Medicine

Paediatrics

Other Specialities

TOTAL

88 hours

GRAND TOTAL

320 hours

SIXTH SCHEDULE

[Rule 12 (2)]

ZAMBIA ENROLLED NURSES' EXAMINATION

......................................................................., 20.......

ENTRY FORM

Candidates for examination are asked to enter all details required below and to return the form immediately to General Nursing Council of Zambia together with the examination fee.

Surname (IN BLOCK LETTERS): ......................................................................................................................

Other Names: ............................................................... .........................

Age: ............................. day ............................ month ............................ year.................................................................

Place of Birth : ........................................................

Training School: ...........................................................

Permanent Address: .........................................................

Date of Commencement of Training: ..............................................................

To the best of my knowledge this is a true statement.

.............................................................

Signature of Candidate

Date...............................................

SEVENTH SCHEDULE

[Rule 12 (2) (a) and (b)]

Examination Fee

40 fee units

CERTIFICATE OF TUTOR AS TO PROGRESS OF TRAINING PRIOR TO SITTING OF THE EXAMINATION FOR ZAMBIA ENROLLED NURSES' ........................................................ ENTRY*

Name of Applicant: ........................................................................................... Age of Applicant: ............................................................................................

Date of Entry into Training: ...................................................................................

Number of Days Absent (casual leave and sickleave):....................................

Comments of Tutor as to progress of candidate during training and suitability of candidate to pratise as a Zambia Nurse: ............................................... ..................................................................................

.....................................................................................

Tutor in Charge of Applicant Training

Date..............................................

[As amended by Act No. 13 of 1994]

_______________________________

*State whether 1st, 2nd or 3rd entry.

ZAMBIA ENROLLED MIDWIVES (TRAINING) RULES

[Sections 32 and 33]

[RETAINED AS PER SECTION 15 OF THE INTERPRETATION AND GENERAL PROVISIONS ACT]

Arrangement of Rules

Rule

3. Institution of Zambia Enrolled Midwive's Certificate

4. Midwifery schools

5. Supervisor of midwifery school

6. Training to be at midwifery school

7. Admission to midwifery school

9. Instruction of pupil midwife

10. Institution of examination

11. Syllabus for examination

12. Entry to examination

13. Tests comprising examination

14. Marking of examination

15. Examiners for examination

17. Grant of Zambia Enrolled Midwive's Certificate

Act 13 of 1994,

SI 61 of 1970,

[Rules by the Medical Council of Zambia with the approval of the Minister]

1. Title

These Rules may be cited as the Zambia Enrolled Midwives (Training) Rules.

2. Interpretation

In these Rules, unless the context otherwise requires-

"examination" means the Zambia Enrolled Midwive's Examination held in accordance with the provisions of these Rules;

"midwifery school" means a hospital recognised under rule 4 (1) or deemed to have been recognised under rule 4 (3) as a midwifery school for the purposes of these Rules;

"pupil midwife" means a person undergoing the course of training prescribed by these Rules;

"training period" means the period prescribed by rule 8 (1) for the course of training of a pupil midwife.

3. Institution of Zambia Enrolled Midwive's Certificate

(1) For the purpose of enabling persons to carry on the practice of a midwife, the Council may grant a certificate of competency, to be styled the Zambia Enrolled Midwive's Certificate, to such persons as have qualified under these Rules for the grant thereof.

(2) Every Zambia Enrolled Midwive's Certificate shall be in the form prescribed in the First Schedule.

4. Midwifery schools

(1) Subject to the provisions of this rule, the Council may, on application being made to it, recognise any hospital within the Republic as a midwifery school for the purposes of these Rules if, in the opinion of the Council, it provides the facilities necessary for training pupil midwives.

(2) The Council shall not recognise a hospital as a midwifery school for the purposes of these Rules unless the Council is satisfied that the requirements as specified in the Second Schedule have been substantially complied with.

(3) The hospitals set out in the Third Schedule shall be deemed to have been recognised by the Council as midwifery schools for the purposes of these Rules.

5. Supervisor of midwifery school

(1) The person in charge of a midwifery school (in these Rules referred to as the supervisor of the midwifery school) shall be a person who is registered both as a midwife and as a general nurse.

(2) The supervisor of a midwifery school shall be responsible for ensuring that pupil midwives admitted to that midwifery school are trained in accordance with the provisions of these Rules and shall designate one or more midwives as midwifery teachers for the purposes of these Rules.

6. Training to be at midwifery school

Every person wishing to qualify for the Zambia Enrolled Midwive's Certificate shall undergo the course of training prescribed by these Rules at a midwifery school.

7. Admission to midwifery school

A person shall be eligible for admission to a midwifery school for the purpose of undergoing the course of training prescribed by these Rules if, and only if, she complies with the requirements specified in the Fourth Schedule.

8. Period of training

(1) The course of training of a pupil midwife shall extend over a period of not less than-

(a) one year in case of a pupil midwife who holds the Zambia Enrolled Nurse's Certificate; or

(b) two years in the case of any other pupil midwife.

(2) The period prescribed in sub-rule (1) shall be inclusive of vacation leave not exceeding two weeks per year and sick or compassionate leave not exceeding two weeks per year.

(3) Subject to the provisions of sub-rules (2), (4) and (5), the training period of a pupil midwife shall be continuous throughout the whole period of the course of training and, on any interruption thereof, no recognition shall be accorded to the pupil midwife in respect of any period of the course of training undergone by her prior to such interruption.

(4) If the period of training of a married pupil midwife is interrupted by reason of her pregnancy-

(a) during the first six months of commencement of training, she may be re-admitted to recommence her training period;

(b) during the second six months, she may be re-admitted to undertake nine months of further training at the end of which she will be deemed to have completed one year of her training period;

(c) during the third six months, she may be re-admitted to undertake fifteen months of further training at the end of which she will be deemed to have completed two years of her training period;

(d) during the fourth six months, she may be re-admitted to undertake nine months of further training at the end of which she will be deemed to have completed two years of her training period:

Provided that in all cases mentioned in paragraphs (a) to (d)-

(i) re-admission shall be at the discretion of the supervisor of the midwifery school;

(ii) the period of interruption shall not be longer than one year; and

(iii) there is evidence of proper provision having been made for the child of such pregnancy.

(5) Where the course of training of a pupil midwife is interrupted for a period not exceeding two years, and the Council considers that the reasons for such interruption are sufficient having regard to all the circumstances of the case, it may recognise the whole or any part of the period of training undergone by the pupil midwife prior to such interruption as counting towards the period of the course of training prescribed by sub-rule (1).

9. Instruction of pupil midwife

(1) During the course of her training, a pupil midwife shall receive theoretical and practical instruction in the syllabus prescribed for the examination.

(2) Without derogation from the generality of the provisions of sub-rule (1), every pupil midwife shall, during her course of training-

(a) attend lectures on the syllabus prescribed for the examination, including lectures on the infant; and

(b) attend not less than forty-four clinical teaching sessions; and

(c) conduct ante-natal examinations on not less than fifty pregnant women and receive instruction in the care and supervision of women during the course of pregnancy, including the booking of the cases and the keeping of the records; and

(d) receive clinical instruction in the conduct of labour, including the witnessing of not less than ten labours; and

(e) perform not less than ten vaginal examinations and be taught the procedure for rectal examination; and

(f) attend not less than twenty labours, under the supervision of a person trained in midwifery, in each case making a full examination during the course of labour, personally delivering the infant and the after-birth and keeping records of each case; and

(g) attend and nurse puerperal women and their infants during the period that the patients are in the hospital; and

(h) attend not less than ten infant welfare clinics which may include post-natal examination; and

(i) attend a number of lectures on mothercraft and health education.

(3)The instruction of every pupil midwife shall be generally supervised by a midwifery teacher and be conducted throughout training in the maternity and associated departments of a midwifery school.

10. Institution of examination

For the purposes of these Rules, examinations, to be styled the Zambia Enrolled Midwives as Examination, shall be held from time to time, not being less frequently than twice in each year.

11. Syllabus for examination

The syllabus for the examination shall be as prescribed in the Fifth Schedule.

12. Entry to examination

(1) A pupil midwife shall be eligible to be entered for the examination if, and only if, by the date fixed for the commencement of the examination-

(a) she will have completed not less than eleven months of her training period, if undergoing a one year course, or not less than twenty-two months if undergoing a two year course; and

(b) she will have attended courses of lectures and demonstrations extending over the whole syllabus prescribed for the examination; and

(c) the supervisor of the midwifery school is satisfied that her health is such that no danger to her patients would be involved by her engaging in the duties of a midwife.

(2) Application for entry to the examination shall be in the form set out in the Sixth Schedule and it shall be accompanied by-

(a) the appropriate examination fee prescribed in the Seventh Schedule; and

(b) a certificate in the form prescribed in the Eighth Schedule, issued by the supervisor of the midwifery school at which the applicant is undergoing her training, stating that the applicant is eligible to be entered for the examination.

13. Tests comprising examination

The examination shall consist of-

(a) a written test in accordance with current recommendations for which the time allowed shall be two hours; and

(b) an oral and practical test of one hour's duration, of which the candidate should spend twenty minutes with the patient, on the syllabus prescribed by rule 11 for the examination.

14. Marking of examination

(1) Marks for the tests forming part of the examination shall be allotted as follows-

(a) 100 marks shall be allotted to the written test;

(b) 100 marks shall be alloted to the oral and practical test.

(2) To satisfy the examiners in the examination, it shall be necessary for a candidate to obtain not less than fifty per centum of the aggregate of the marks allotted to both tests of the examination.

15. Examiners for examination

Every examiner appointed by the Examinations Committee for the purposes of the examination shall be a registered midwife and general nurse who is actively involved in midwifery training.

16. Publication of examination results

The list of successful candidates in the examination shall be published in alphabetical order.

17. Grant of Zambia Enrolled Midwive's Certificate

A pupil midwife who has-

(a) completed the course of training prescribed by these Rules; and

(b) passed the examination; and

shall be qualified for and shall be entitled to be granted the Zambia Enrolled Midwive's Certificate.

FIRST SCHEDULE

[Rule 3 (2)]

ZAMBIA ENROLLED MIDWIVES' CERTIFICATE

This is to certify that ............................... who has attained the age of nineteen years, has completed the course of training prescribed by the Zambia Enrolled Midwives (Training) Rzules, and has passed the Zambia Enrolled Midwive's Examination held by the Medical Council of Zambia on ............................................., 20........, at ..........................................

She is hereby granted the Zambia Enrolled Midwive's Certificate.

Date ...............................................................

Registrar, Medical Council of Zambia.

LUSAKA, ZAMBIA.

SECOND SCHEDULE

[Rule 4 (2)]

REQUIREMENTS TO BE FULFILLED BY A HOSPITAL TO BE APPROVED AS A MIDWIFERY SCHOOL

1. The permanent medical and midwifery staff employed at the hospital shall be satisfactory in the opinion of the Council and, without derogation from the generality of the foregoing, such staff includes-

(a) a medical practitioner with special experience in obstetrics; and

(b) experienced midwives in relation to the size of the hospital.

2. The annual average of confinements taking place in the hospital amounts to not less than 130.

3. The hospital-

(a) contains ante-natal beds associated with an ante-natal clinic and a post-natal department; and

(b) contains satisfactory accommodation for lectures and demonstrations and the equipment, models and facilities necessary for the proper instruction of pupil midwives; and

THIRD SCHEDULE

[Rule 4 (3)]

HOSPITALS RECOGNISED AS MIDWIFERY SCHOOLS

The following hospitals are recognised by the Council as midwifery schools:

1. Batoka Hospital, P.O. Box 91, Livingstone.

2. St Franci's Hospital, P.O. Katete.

3. Our Lady's Hospital, Chilonga, P.O. Mpika.

4. Mbereshi Hospital, P.O. Kawambwa.

5. Salvation Army Hospital, Chikankata, Private Bag S.2, Mazabuka.

6. Wusikili Hospital, P.O. Box 1900, Kitwe.

7. Nchanga North Hospital, P.O. Box 63, Chingola.

8. Monze Mission Hospital, P.O. Box 29, Monze.

FOURTH SCHEDULE

[Rule 7]

REQUIREMENTS FOR ADMISSION TO MIDWIFERY SCHOOL

A person shall be eligible for admission to a midwifery school if, and only if-

(a) she possesses the former Standard VI Certificate or a Form II Certificate;

(b) she shall have attained the age of seventeen years on the last day of the month in which the course commences;

(c) she shall have passed a medical examination and received a certificate from a registered medical practitioner stating that she is free from disease and infection and is medically fit to undergo training.

FIFTH SCHEDULE

[Rule 11]

SYLLABUS OF SUBJECTS FOR ADMISSION TO THE REGISTER OF ENROLLED MIDWIVES FOR CANDIDATES WITH NO PREVIOUS EXPERIENCE

FIRST YEAR

1. The Hospital and Health Services:

Health services of Zambia; hospitals and various departments and their functions.

2. The Nurse:

Personal qualities and attitudes; standards of ethical conduct; relationships between nurse, patient and relatives. The place of the Enrolled Midwife in the hospital team.

3. The Ward:

The environemnt of the patient.

Cleanliness, ventilation and the prevention of cross-infection; and heating.

Elimination of noise.

Safety measures, including fire precautions.

Care and use of ward linen and equipment.

4. Personal Hygiene:

The meaning of health; personal cleanliness; care of skin, hair, hands and feet; care of personal clothing; value of recreation, exercise, fresh air and sleep; excretory system.

5. The Structure of the Human Body:

The body as a whole.

Chief cavities and contents.

How it moves.

Simple outline of body systems.

Introduction to Midwifery.

6. Nursing Procedures:

Bedmaking-ordinary, admission and operation beds.

General care of patients:

Prevention of pressure sores.

Lifting and turning patients.

Positions commonly used in nursing.

Shaving.

Tepid sponging.

Feeding and preparation of meals.

Feeding of helpless patients.

Taking and recording of temperature, pulse and respiration.

Range of temperatures.

Normal and abnormal pulse and respiration.

Observation, disposal and disinfection of urine, faeces and sputum.

Collection of specimens; blood slides.

Intake and output charts.

Medicines, drugs and poisons-weights and measures; administration of medicine and dosages; methods of administering drugs; regulations regarding dangerous drugs and poisons; preparation and dilution of lotions in common use.

Preparation of equipment for and the care of the patient during a routine medical examination.

Enemata and suppositories.

Hypodermic and intramuscular injections.

Pre-operative care-general and skin preparation.

Post-operative care.

Simple ward dressings.

Removal of stitches and clips.

Catheterisation.

Preparation for sub-cutaneous and intra-peritoneal infusions, intravenous infusions and blood transfusions.

Prevention of cross-infection.

Last offices.

Emphasis must be placed at all times on bedside teaching.

7. The Principal Causes of Disease:

To be introduced with emphasis on recognition, implications for preventive measures and health education, avoiding all detail not absolutely essential to effective midwifery and child welfare.

Malnutrition, e.g. Kwashiorkor.

Infection and infestation, e.g.:

inflammation-cross-infection, causes and prevention.

tuberculosis.

pneumonia.

meningitis.

gastro-enteritis, dysentery.

measles, smallpox, mumps, whooping cough, diphtheria.

poliomyelitis.

malaria. trypanosomiasis. leprosy.

hook worm and other intestinal parasites.

bilharziasis (Schistosomiasis).

rabies.

tetanus.

SECOND YEAR

A. ANATOMY AND SPECIAL PHYSIOLOGY:

1. The Female Skeletal Pelvis:

Bones, joints-types and essential measurements in relation to the foetal skull.

2. The Female Generative Organs:

External, internal, Main ligaments, muscles, blood supply, nerve supply, pelvic floor.

3. The foetal skull.

4. Ovulation and Menstruation:

Puberty; amenorrhoea; dysmenorrhoea; menopause.

5. Development of Foetus:

Fertilisation; placenta; umbilical cord.

6. Physiology of Pregnancy:

Changes in mother-uterus, breast, skin, nervous system, respiratory system, circulatory system, urinary system, endocrine system.

B. NORMAL MIDWIFERY:

1. Normal Pregnancy:

Diagnosis-presumptive and positive signs.

History-age, date of last menstrual period, expected date of delivery, previous health, previous pregnancies and labours.

2. Ante-Natal Care:

Personal hygiene; diet; bowels; sleep; clothing; exercise; blood pressure; abdominal inspection; asoultation; presentation; head fitting; mothercraft.

3. Normal Labour:

Physiology of labour-1st, 2nd and 3rd stages; mechanism of labour; the feoetus as passenger-lie, presentation, position and engagement of head.

Management of normal delivery.

1st Stage- Admission of patient; prevention of infection; rest and sedation; nourishment; examination.

2nd Stage- Delivery; care of perineum; episiotomy; tears; immediate care of the infant.

3rd Stage- Prevention of post-partum haemorrhage; delivery of placenta; examination of placenta and membranes; suturing of perineum.

4. Normal Puerperium:

Physiology-involution, lochia.

Management-rest, sleep, cleanliness, bowels and bladder, fundal height. Anatomy of breasts; management of breast feeding.

5. Newborn Baby:

(a) care at birth.

(b) first bath and examination.

(d) daily care and observations.

(e) feeding.

C. ABNORMAL MIDWIFERY:

1. Abnormal Pregnancy:

(a) Minor disorders-morning sickness; constipation; nsomnia; varicose veins; mild oedema; indigestion; urinary infection; sacro-iliac strain.

(b) Haemorrhages:

Bleeding in early pregnancy.

Abortion-causes, diagnosis and treatment.

Ante-partum haemorrhage.

(Emergency treatment in the home, the rural health clinic and the hospital should be specially referred to.)

Hyperemesis gravidarum.

Pre-eclampsia and eclampsia.

(d) Displacement of gravid uterus: Retroversion and anteflexion-brief mention.

(e) Diseases associated with pregnancy:

Anaemias.

Vaginal discharges.

Urinary infection.

Malaria.

Veneral diseases.

German measles.

Heart disease.

Tuberculosis. Diabetes.

2. Abnormal Labour:

Prolonged labour; maternal and foetal distress.

(a) Disproportion.

(b) Abnormal uterine action:

Primary uterine inertia; secondary uterine inertia.

Tonic contraction; rigid cervix; constriction ring; hour-glass contraction. (Cause, recognition and management.)

Posterior positions.

Brow, face, breech, shoulder and transverse lie. (Causes, recognition, dangers and management.)

(d) Obstructed labour and uterine rupture.

(e) Multiple pregnancy.

(f) Accidents and emergencies of labour:

Prolapsed cord.

Perineal, vaginal and cervical tears.

(g) Emergencies of the third stage:

Post-partum haemorrhage.

Retained placenta.

Acute inversion of uterus. Obstetric shock.

3. Traumatic results of childbirth:

Cystocoele.

Rectococle.

Vulvo-vaginal fistula.

4. Abnormal puerperium:

(a) Uterine infection.

(b) Urinary infection.

(d) Secondary post-partum haemorrhage.

(e) Thrombosis, embolus and phlebitis-briefly.

(f) Puerperal insanity.

(g) Associated pyrexias.

D. DISORDERS OF THE NEWBORN CHILD:

Asphyxia.

Cerebral haemorrhage.

Birth injuries.

Infections.

Jaundice.

Blood disorders.

Malformations.

Tetanus.

Premature infant:

Definition; dangers; preparation for birth.

Feeding and general care.

Dysmaturity-briefly.

Postmaturity-briefly.

E. OBSTETRIC OPERATIONS:

Technique.

Induction of labour.

Vacuum extraction. Forceps delivery.

Version.

Caesarean section.

Manual removal of placenta.

Symphysiotomy.

F. DRUGS USED IN MIDWIFERY:

Drugs and their uses.

Dosages.

The Law.

Introduction to the Metric System.

Practical instruction in the following should be continued throughout training:

History-taking.

Giving and receiving reports.

Estimation of haemoglobin.

Sterilisation.

Infection.

Injections.

Blood pressure.

Catheterisation.

Enemata.

Urine testing.

Removal of stitches and clips.

Infusions and transfusions.

Skin preparations.

Collection of specimens; blood slides.

Oxygen administration.

Care of drugs.

Shock and haemorrhage.

Incubation management.

Inhalation analgesia.

SIXTH SCHEDULE

[Rule 12 (2)]

ZAMBIA ENROLLED MIDWIVES' EXAMINATION

..................................................., 20..........

ENTRY FORM

Candidates for examination are asked to enter all details requested below and return the form immediately to the Medical Council of Zambia together with the examination fee.

Surname (in BLOCK CAPITALS) Other Names .............................................

Date of Birth ..................................................................................................

Place of Birth ...............................................................................................

Permanent Address .......................................................................................

Training School ..............................................................................................

Date of Commencement of Training ................................................................

To the best of my knowledge this is a true statement.

..........................................................

Signature of Candidate

Date ...............................................................

SEVENTH SCHEDULE

[Rule 12 (2) (a))]

PRESCRIBED FEE

Examination Fee

60 fee units

[Am by Act 13 of 1994.]

EIGHTH SCHEDULE

[Rule 12 (2) (b)]

CERTIFICATE OF SUITABILITY TO ENTER ZAMBIA ENROLLED MIDWIVES' EXAMINATION

Name of Applicant ....................................................

Date of Entry into Training ........................................

Number of days absent (causal leave, sick leave and compassionate leave) ..................

Comments regarding suitability to practise as a midwife

I, ....................................................................................... being the supervisor in charge of the Midwifery School at ............................................................. ...............hereby certify that the applicant has fulfilled the requirements of the Zambia Enrolled Midwives (Training) Rules in every respect, and is eligible to be entered for the examination.

Date .....................................................................................

ZAMBIA ENROLLED PSYCHIATRIC NURSE (TRAINING) RULES

[Sections 32 and 33]

[RETAINED AS PER SECTION 15 OF THE INTERPRETATION AND GENERAL PROVISIONS ACT]

Arrangement of Rules

Rule

3. Institution of Zambia Enrolled Psychiatric Nurse's Certificate

4. Training school

5. Supervisor of training school

6. Training to be at training school

7. Admission to training school

9. Instruction of student nurse

10. Institution of examination

11. Syllabus for examination

12. Entry to examination

13. Tests comprising examination

14. Examiners for examination

15. Marking of examination

17. Grant of Zambia Enrolled Psychiatric Nurse's Certificate

18. Transitional provisions

SI 63 of 1970.

[Rules by the Medical Council of Zambia with the approval of the Minister]

1. Title

These Rules may be cited as the Zambia Enrolled Psychiatric Nurse (Training) Rules.

2. Interpretation

(1) In these Rules, unless the context otherwise requires-

"Council" means the Medical Council of Zambia;

"student nurse" means a person undergoing the training prescribed by these Rules;

"training period" means the period prescribed by rule 8 (1) for the course of training of a student nurse;

"training school" means a hospital or group of hospitals recognised or deemed to be recognised under rule 4 (4) as a training school for the purposes of these Rules;

"ward" means a ward of a training school.

(2) Save where the context otherwise requires, a reference in these Rules to the feminine gender shall be construed as including a reference to the masculine gender.

3. Institution of Zambia Enrolled Psychiatric Nurse's Certificate

(1) For the purpose of enabling persons to become qualified to carry on the calling of a nurse, the Council may grant a certificate of competency, to be styled the Zambia Enrolled Psychiatric Nurse's Certificate, to such persons as have qualified under these Rules for the grant thereof.

(2) Every Zambia Enrolled Psychiatric Nurse's Certificate shall be in the form set out in the First Schedule.

4. Training school

(1) The Zambia Enrolled Psychiatric Nurse's Training School will be situated at Chainama Hills Hospital, Lusaka.

(2) The Council shall not recognise a hospital or group of hospitals as a training school unless the requirements specified in the Second Schedule have been substantially complied with.

(3) The Council shall cause an inspection of the hospital or group of hospitals which make an application for recognition as a training school before any such application is approved.

(4) The hospital set out in the Third Schedule shall be deemed to have been recognised by the Council as a training school for the purposes of these Rules.

5. Supervisor of training school

(1) The person in charge of a training school (in these Rules referred to as the supervisor of the training school) shall be a person who is registered as a Registered Mental Nurse.

(2) The supervisor of a training school shall be responsible for ensuring that student nurses admitted to that training school are trained in accordance with the provisions of these Rules and shall designate one or more experienced sisters or charge nurses as teachers for the purposes of these Rules.

6. Training to be at training school

Every person wishing to qualify for the Zambia Enrolled Psychiatric Nurse's Certificate shall undergo the course of training prescribed by these Rules at one or more training schools.

7. Admission to training school

A person shall be eligible for admission to a training school for the purpose of undergoing the course of training prescribed by these Rules if, and only if, she fulfills the requirements specified in the Fourth Schedule.

8. Period of training

(1) The course of training of a student nurse shall extend over a period of not less than twenty-four calendar months inclusive of-

(a) periods of vacation leave not exceeding eighteen days per year; and

(b) periods of sick leave not exceeding four weeks during the whole course of training.

(2) Save for the period of vacation leave or sick leave specified in sub-rule (1), or any period recognised by the Council under sub-rule (3), the training of a student nurse shall be continuous throughout the whole period of the course of training and, on any interruption thereof, no recognition shall be accorded to the student nurse in respect of any period of the course of training undergone by her prior to such interruption.

(3) Where the course of training of a student nurse is interrupted for a period not exceeding two years, and the Council considers the reasons for such interruption are sufficient, having regard to all the circumstances of the case, it may recognise the whole or any part of the period of training undergone by the student nurse prior to such interruption as accounting towards the period of twenty-four calendar months prescribed by sub-rule (1).

9. Instruction of student nurse

(1) During the course of her training, a student nurse shall receive theoretical and practical instruction and clinical experience in every subject contained in the syllabus.

(2) For each student nurse there shall be kept a Student Nurse's Record of Practical Instruction and the supervisor of the training school shall enter therein the number of weeks undergone in each type of clinical experience by the student nurse.

10. Institution of examination

For the purposes of these Rules, examinations, to be styled the Zambia Enrolled Psychiatric Nurse's Examination, shall be held from time to time, not being less frequently than twice in each year.

11. Syllabus for examination

The syllabus for the Zambia Enrolled Psychiatric Nurse's Examination shall be as prescribed in the Fifth Schedule.

12. Entry to examination

(1) A student nurse shall be eligible to be entered for the Zambia Enrolled Psychiatric Nurse's Examination if, and only if, by the date fixed for the commencement of the examination-

(a) she will have completed not less than twenty months of her training period to the satisfaction of the person in charge of the training school;

(b) she will have attended courses in the theoretical and practical instructions and clinical experience extending over the whole syllabus;

(2) Every application for entry to the Zambia Enrolled Psychiatric Nurse's Examination shall be in the form prescribed in the Sixth Schedule and shall be accompanied by-

(a) the appropriate examination fee prescribed in the Seventh Schedule; and

(b) a certificate in the form set out in the Eighth Schedule by the supervisor of the training school certifying that the applicant has fulfilled the conditions mentioned in sub-rule (1) and that she is eligible to be entered for the Zambia Enrolled Psychiatric Nurse's Examination.

13. Tests comprising examination

The Zambia Enrolled Psychiatric Nurse's Examination shall consist of the following, subject to any modifications the Examinations Committee may from time to time prescribe-

(a) written tests consisting of-

(i) Paper A - comprising thirty short-answer questions; and

(ii) Paper B - comprising one long-answer question;

(b) an oral test;

on the syllabus prescribed in rule 11.

14. Examiners for examination

Every examiner appointed by the Examinations Committee for the purposes of the Zambia Enrolled Psychiatric Nurse's Examination shall be either a qualified registered nurse or a qualified nurse tutor.

15. Marking of examination

To satisfy the examiner in an examination, it shall be necessary for a candidate to obtain not less than fifty per centum in all parts of the examination.

16. Publication of examination results

The list of successful candidates in an examination shall be published in alphabetical order classified into two divisions, to be designated the Honours Division and the Pass Division.

17. Grant of Zambia Enrolled Psychiatric Nurse's Certificate

A student nurse who has-

(a) completed the course of training prescribed by these Rules to the satisfaction of the Examinations Committee; and

(b) passed the examination; and

shall be qualified for and shall be entitled to be granted the Zambia Enrolled Psychiatric Nurse's Certificate.

18. Transitional provisions

Any period of training, similar to the course of training prescribed by these Rules, undergone prior to the promulgation of these Rules, at the hospital mentioned in the Third Schedule, shall be deemed to have been a period of training undergone in terms of these Rules, and any examinations held prior to the promulgation of these Rules, in respect of such course of training, shall be deemed to have been the Zambia Enrolled Psychiatric Nurse's Examination held under the provisions of these Rules.

FIRST SCHEDULE

[Rule 3(2)]

ZAMBIA ENROLLED PSYCHIATRIC NURSES' CERTIFICATE

This is to certify that .............................................................

has satisfactorily completed the course of training prescribed by the Zambia Enrolled Psychiatric Nurse (Training) Rules, and has passed in ................................. Division the Zambia Enrolled Psychiatric Nurse's Examination held by the Medical Council of Zambia on ........................................, 20................ at .........................................

The said .............................................................................. is hereby granted the Zambia Enrolled Psychiatric Nurse's Certificate.

Date ...............................................................

Registrar, Medical Council of Zambia.

LUSAKA, ZAMBIA

SECOND SCHEDULE

[Rule 4 (2)]

CONDITIONS UNDER WHICH HOSPITALS ARE APPROVED AS TRAINING SCHOOLS FOR STUDENT NURSES FOR ADMISSION TO THE ROLL OF PSYCHIATRIC NURSES

The authorities of any hospital or group of hospitals, for which approval as a training school is sought, are required to submit to the Council full particulars of the clinical experience available for training and of the arrangements which will be made to ensure the systematic practical and theoretical instruction of the student nurses in the subjects prescribed for admission to the Roll of Psychiatric Nurses.

In every case, a visit by the Council's Inspectors of Training Schools to the hospital, or group of hospitals, making such application will be carried out before approval is granted.

The following are the general requirements relating to the practical and theoretical instruction of student nurses:

1. The hospital, or group of hospitals, must satisfy the Council that adequate clinical experience is available for the training.

2. Satisfactory arrangements must be made for the supervision and teaching of the student nurses by registered nurses in all the wards and departments, both by day and night.

3. An experienced sister or charge nurse interested in teaching and preferably having attended a recognised course for teachers of student nurses for the Roll, should be responsible for teaching the students. The minimum overall ratio of nurse teachers to students should be one to thirty. A total strength of registered nurses in the training school should not be less than eight at any one time for a 150-bed hospital. Where suitable arrangements can be made the teaching should be under the overall guidance of a registered mental nurse tutor. There must also be adequate secretarial and clerical assistance in teaching departments.

4. A teaching department should comprise-

(a) lecture room-large enough to accommodate one or two beds. Shelving and cupboards to house teaching aids;

(b) library to house 300 to 400 books and small tables and chairs;

(d) Clerk's office;

(e) cooking facilities for demonstration;

(f) teaching aids should include articulated skeleton, anatomical slides, film strips and projector and link projector.

This department should be in close proximity to the hospital, or one of the hospitals forming the training school, in order to facilitate integration of teaching and practice.

5. The standards of nursing practice, the equipment and facilities in the wards and departments of the hospital or hospitals must be such as to permit the teaching of good nursing care and allow the principles taught to be put into practice on the wards. It is essential that adequate domestic services (including domestic supervision) be available.

6. Where possible there should be an Education Committee whose membership, in addition to representatives of the Board of Governors or Management Committee, should include the Matron, Chief Male Nurse, or Chief Nursing Officer, representatives of the teaching staff, ward and departmental sisters and/or charge nurses, members of the medical staff participating in the teaching of the student nurses, a representative from the public health service and from the field of general education. There should also be a Ward or Chief Nursing Officer, representatives of the teaching staff, ward and departmental sisters and/or charge nurses in the hospital or group of hospitals, which should meet regularly to discuss methods of procedure in order to co-ordinate between hospital administrators and teaching staff with regard to the allocation of duties and the teaching programme.

7. The Council will require an assurance that accommodation of the following standard is available-

(a) students can be accommodated in two- , four- or six-bed-roomed units with individual wardrobe and dressing table facilities;

(b) sitting and recreation room;

(d) dining room;

(e) kitchenette facilities;

(f) laundry room;

(g) linen room or linen cupboards;

(h) toilets and bathrooms-showers, 1 to 6, not less than 1 to 8;

(i) outdoor recreational facilities such as netball and tennis.

8. Schemes of part-time training for the Roll may be approved by the Council.

TRAINING FOR STUDENT NURSES IN PSYCHIATRIC NURSING

A training school for admission to the Psychiatric part of the Roll is required to have a minimum of 150 beds (of which not less than 40 are acute beds) and the necessary departments including Out-Patient, Clinics, Occupational Therapy and Recreational. Such a school may comprise one or more hospitals.

Every student nurse is required to complete the minimum clinical experience to be gained in the following wards-

(a) wards for long stay patients;

(b) wards for acute patients;

(d) wards for psychopathic patients;

(e) wards for epileptic and subnormal patients;

(f) convalescent wards.

Long Stay patients:

Emphasis here is on the prevention of deterioration in patients who have been ill for a considerable time.

From this ward students will gain experience in accompanying patients to Occupational

Therapy, Social and Recreational Therapy.

Convalescent patients:

Experience will be in participating with patients in preparation for their discharge. It is planned that students working in this ward will make visits to patient's homes accompanied by the psychiatric social worker. They will also visit the Matero "Half Way House".

Mentally subnormal patients:

Students will gain valuable experience in this very special type of nursing care.

A planned programme of practical experience covering the main outline of the training period must be drawn up and submitted to the Council. The number of weeks gained in each type of clinical experience will need to be entered in the Student Nurse's Record of Practical Instruction.

The length of the introductory course shall not be less than four weeks.

THIRD SCHEDULE

[Rule 4 (4)]

HOSPITAL RECOGNISED AS TRAINING SCHOOL

The following hospital is recognised by the Council as a Zambia Enrolled Psychiatric Nurse's Training School:

Chainama Hills Hospital, P.O. Box 43, Lusaka.z

FOURTH SCHEDULE

[Rule 7]

REQUIREMENTS FOR ADMISSION TO TRAINING SCHOOL

A candidate shall be eligible for admission to a training school if, and only if-

(a) the candidate meets the following educationzal requirements-

(i) Standard VI, if obtained before 1965; or

(ii) Full Junior School Certificate;

(b) the candidate shall have attained the age of seventeen years on the last day of the month in which the course commences;

(c) the candidate shall have passed a medical examination and received a certificate from a Government Medical Officer stating that she is free from disease and infection and is fit to undergo training.

FIFTH SCHEDULE

[Rule 11]

SYLLABUS OF SUBJECTS FOR ZAMBIA ENROLLED PSYCHIATRIC NURSES' EXAMINATION

1. The Hospital and the Health Services:

The health services of Zambia.

Hospitals, their various departments and functions, and their relation to other health services.

2. The Nurse:

Personal qualities and attitudes required.

Standards of ethical conduct.

Relationships between nurse, patient and relatives.

The place of the enrolled nurse in the hospital team.

3. The Ward:

The environment of the patient.

Cleanliness, ventilation and the prevention of cross-infection; heating.

Elimination of noise.

Safety measures, including fire precautions.

Care and use of ward linen and equipment, including bed accessories, utensils and instruments in common use.

4. The Patient:

Admission, transfer and discharge.

General and regular observation of patient's condition and changes therein.

Routine washing and bathing in bed and bathroom.

Care and prevention of pressure sores; mouth toilet.

Use of urinals and commodes.

The nursing care of-

(a) the ambulant patient;

(b) the patient, mobile in bed;

(d) the patient at complete rest in the supine position;

(e) the patient being nursed upright;

(f) the febrile patient;

(g) the unconscious patient;

(h) the incontinent patient;

(i) the infectious patient;

(j) the paralysed patient;

(k) the mentally-disturbed patient;

(l) pre- and post-operative patients;

(m) patients in plaster and extension;

(n) the dying (plus last offices, care of relatives).

Special nursing of infants and children: bathing, feeding.

5. Nursing Procedures:

Observation, disposal and disinfection of urine, faeces, vomit and sputum-collection of specimens of these excretions.

Measuring and recording fluid intake and output.

Simple urine testing (clinitest range).

Taking and recording temperature, pulse and respiration.

Roller bandaging-application of strapping-elastoplast.

Preparing for and serving of meals.

Treatment of verminous patients.

Sponging the patient.

Simple enemas and suppositories.

Passing a flatus tube.

Local applications:

applications of cold compress and fomentations;

preparation and application of kaoline poultices, linaments and ointments; preparation of equipment for immobilising a limb-application of a Thomas's splint;

rectal and colonic lavage;

preparation for and examination of ears, nose, throat, eyes;

swabbing and bathing the eyes;

preparation for syringing the ears;

preparation for and examination of the vagina and rectum.

Medicines and poisons:

weights and measures;

storage and safe custody of medicines and drugs;

various methods of administering drugs into the body;

preparation for and giving medicines;

use and regulations regarding poisons and dangerous drugs;

preparation and dilution of lotions in common use.

Advanced nursing procedures:

preparation of equipment for and the care of the patient during a routine medical

examination;

taking and recording blood pressure;

preparation of patients for X-ray;

care of the patient after anaesthetics;

preparation for and the administration of hypodermic and intramuscular injections;

preparation for intravenous injections;

inhalations, dry and moist, use of steam kettles and steam tents;

preparation for and administration of oxygen.

Surgical techniques:

surgical cleanliness and surgical nursing care-asepsis and antiseptic;

sterilisation of articles in common use;

preparation and conduct of ward dressings;

preparation for lumbar puncture;

preparation for catheterisation;

preparation for taking blood specimens including blood slides;

preparation of equipment for intravenous infusion;

care of patients receiving intravenous infusion.

Other nursing procedures:

Physical methods of treatment in psychiatry including:

artificial feeding;

preparation for neurological examination;

preparation of patient before and care of patient after Electroplexy (E.C.T.);

modified insulin;

abreaction;

pre- and post-operative care of patient undergoing Leucotomy;

occupational and work therapy;

toxic and side effects of drugs used in psychiatry;

psychological methods of treatment.

6. First Aid:

The principles and practice of first aid in the street, the home and the hospital:

methods of moving and carrying the injured;

the use of triangular bandages;

first aid treatment of-

wounds and haemorrhages (internal and external);

simple fractures-sprains and dislocations;

burns and scalds;

asphyxia;

methods of artificial respiration;

poisoning;

loss of consciousness;

fits and convulsions;

bites and stings;

foreign bodies.

7. The Human Individual and his Environment:

(An elementary knowledge under all headings, avoiding all detail not absolutely essential to effective nursing.)

8. (a) Personal Development of the Individual:

The individual, his development and his relationship with the family and other people. The patient as an individual.

The effect of illness and separation from familiar background on the behaviour of children and adults.

The needs of the individual.

(b) The Structure and Function of the Human Body:

The body as a whole; general arrangement and how it moves; the cavities, with names and positions of principal contents.

A simple outline of the body systems.

Conception, foetal development and birth.

Physical development from birth to maturity.

The promotion and maintenance of good health.

The laws of healthy living as these affect the individual and the community, and as applied to the home.

The importance of good personal habits.

The factors which cause deterioration in health, and how these may be dealt with by the individual, in the family and in the community.

Infection and how it may be carried.

Parasites-internal and external.

The laws governing healthy living as these affect the individual and the community.

The maintenance of health and the importance of promoting good health.

Ventilation and the problems of overcrowding.

Control of epidemics within the community.

Nutrition: basic principles, nutritional needs of infants, children and adults in sickness and for the promotion of health; effects of inadequate or unsuitable diet.

Welfare and other social services.

9. The Principal Causes of Disease:

(To be taught with special emphasis on implications for preventive measures and health education.)

Malnutrition, e.g. kwashiorkor.

Infection and infestation, e.g.:

inflammation-cross infection causes and prevention;

tuberculosis;

pneumonia;

meningitis;

gastro-enteritis, dysentery;

measles;

malaria-tryposomiasis;

hook-worm and other intestinal parasites;

bilharziasis (schistosomiasis);

anaemias;

venereal disease.

10. Psychiatry:

Causation of psychiatric illness.

Preventive psychiatry, e.g.:

child guidance;

education of public;

early treatment.

(a) Disorders primarily due to failure of normal development:

(i) amentiae;

(ii) immaturities of personality;

(iii) anomalies of instinct.

(b) Disorders primarily due to abnormal development or reaction to internal stress:

(i) functional neuroses-hysterical reaction, obsessive-compulsive reaction;

(ii) affective disorders-anxiety states, depressive illness, mania, hypomania.

Schizophrenic psychoses.

Acute confusional states.

Puerperal psychoses.

Psychosomatic reactions.

Dementias.

SIXTH SCHEDULE

[Rule 12 (2)]

ZAMBIA ENROLLED PSYCHIATRIC NURSES' EXAMINATION

..................................................., 20..........

ENTRY FORM

Candidates for examination are asked to enter all details requested below and return the form immediately to the Medical Council of Zambia together with the examination fee.

Surname (in BLOCK CAPITALS) ...................................................

Other Names ................................................................................

Age .............................. Date of Birth ..................................................................

Place of Birth .......................................................

Permanent Address ................................................

Training School ..........................................................

To the best of my knowledge this is a true statement.

Date ...............................................................

.....................................................

Signature of Candidate

SEVENTH SCHEDULE

[Rule 12 (2) (a)]

PRESCRIBED FEE

Examination Fee

60 fee units

EIGHTH SCHEDULE

[Rule 12 (2) (b)]

CERTIFICATE OF TUTOR AS TO PROGRESS OF TRAINING PRIOR TO SITTING OF EXAMINATION FOR ZAMBIA ENROLLED PSYCHIATRIC NURSES

Name of Applicant .......................................................

Age of Applicant ...........................................................

Date of Entry into Training ............................................

Comments of tutor as to progress of candidate and suitability of candidate as a Zambia

Enrolled Psychiatric Nurse.

I certify that the candidate has fulfilled the conditions mentioned in rule 12 (1) of the Zambia Enrolled Psychiatric Nurse (Training) Rules, and that the candidate is eligible to be entered for the Zambia Enrolled Psychiatric Nurse's Examination.

Date ...............................................................

........................................

Supervisor of the Training School

[As amended by Act No. 13 of 1994.]

ZAMBIA REGISTERED MIDWIVES (TRAINING) RULES

[Sections 32 and 33]

[RETAINED AS PER SECTION 15 OF THE INTERPRETATION AND GENERAL PROVISIONS ACT]

Arrangement of Rules

Rules

3. Zambia Registered Midwive's Certificate

4. Registered midwifery schools

5. Supervisor of registered midwifery school

6. Training to be at registered midwifery school

7. Admission to registered midwifery school

9. Married student midwives

10. Instruction of student midwife

11. Institution of examination

12. Syllabus for examination

13. Tests comprising examination

14. Marks for examination

15. Examiners for examination

17. Grant of Zambia Registered Midwive's Certificate

Act 13 of 1994,

SI 62 of 1970,

SI 44 of 1979.

[Rules by the Medical Council of Zambia with the approval of the Minister]

1. Title

These Rules may be cited as the Zambia Registered Midwives (Training) Rules.

2. Interpretation

In these Rules, unless the context otherwise requires-

"Council" means the Medical Council of Zambia.

"examination" means the Zambia Registered Midwive's Examination held in accordance with the provisions of these Rules;

"registered midwifery school" means a hospital recognised under rule 4 (1) or deemed to have been recognised under rule 4 (3) as a registered midwifery school for the purposes of these Rules;

"student midwife" means a person undergoing the course of training prescribed by these Rules;

"training period" means the period prescribed by rule 8 for the course of training of a student midwife.

3. Zambia Registered Midwive's Certificate

For the purpose of enabling persons to carry on the practice of a midwife, the Council may grant a certificate of competency, to be styled the Zambia Registered Midwive's Certificate, to such persons as have qualified under these Rules for the grant thereof.

(2) Every Zambia Registered Midwive's Certificate shall be in the form prescribed in the First Schedule.

4. Registered midwifery schools

(1) Subject to the provisions of this rule, the Council may, on application being made to it, recognise any hospital within the Republic as a registered midwifery school for the purposes of these Rules if, in the opinion of the Council, it provides the facilities necessary for training student midwives.

(2) The Council shall not recognise a hospital as a registered midwifery school for the purposes of these Rules unless the Council is satisfied that the requirements as specified in the Second Schedule have been substantially complied with.

(3) The hospital set out in the Third Schedule shall be deemed to have been recognised by the Council as a registered midwifery school for the purposes of these Rules.

5. Supervisor of registered midwifery school

(1) The person in charge of a registered midwifery school (in these Rules referred to as the supervisor of the registered midwifery school) shall be a person who is in possession of the Midwife Teachers Diploma.

(2) The supervisor of a registered midwifery school shall be responsible for ensuring that student midwives admitted to that registered midwifery school are trained in accordance with the provisions of these Rules and shall designate one or more registered midwives as midwifery teachers for the purposes of these Rules.

6. Training to be at registered midwifery school

Every person wishing to qualify for the Zambia Registered Midwive's Certificate shall undergo the course of training prescribed by these Rules at a registered midwifery school.

7. Admission to registered midwifery school

A person shall be eligible for admission to a registered midwifery school if, and only if, she complies with the requirements specified in the Fourth Schedule.

8. Period of training

(1) The course of training shall extend over a period of not less than one year inclusive of-

(a) periods of casual leave not exceeding two weeks per year; and

(b) periods of sick leave or compassionate leave not exceeding two weeks per year.

(2) Subject to the provisions of rule 9 and save for periods of casual leave, sick leave or compassionate leave, the training of a student midwife shall be continuous throughout the whole period of the course of training and, on any interruption thereof, no recognition shall be accorded the student midwife in respect of any period of the course of training undergone by her prior to such interruption.

9. Married student midwives

Married student midwives whose training is interrupted owing to pregnancy-

(a) during the first six months, shall be re-admitted (at the discretion of the supervisor of the registered midwifery school) to recommence training;

(b) during the second six months, may be re-admitted to undertake nine months of further training.

In each of the above cases, the interval should be no longer than one year and there should be evidence of proper provision having been made for the child of such pregnancy.

10. Instruction of student midwife

(1) During the course of her training, a student midwife shall receive theoretical and practical instruction in the syllabus prescribed for the examination.

(2) Without derogation from the generality of the provisions of sub-rule (1), every student midwife shall, during the course of her training-

(a) attend lectures on the syllabus prescribed for the examination;

(b) receive concurrent clinical instruction;

(d) witness ten normal deliveries;

(e) perform not less than twenty vaginal examinations;

(f) conduct not less than twenty normal labours under the supervision of a registered midwife, in each case making a full examination during the course of labour, personally deliver the infant and after-birth and keep records of each case;

(g) attend and nurse puerperal women and their infants during the period that the patients are in hospital;

(h) visit not less than ten puerperal women and their babies in the women's own homes;

(i) attend not less than ten child welfare clinics;

(j) give not less than ten health education talks to pregnant or puerperal women and keep records of each.

(3) The instruction of every student midwife shall be generally supervised by a qualified midwifery tutor and be conducted throughout the period of training in the maternity and associated departments of a registered midwifery school.

11. Institution of examination

For the purposes of these Rules, examinations, to be styled the Zambia Registered Midwive's Examination, shall be held from time to time but not less frequently than twice in each year.

12. Syllabus for examination

The syllabus for the examination shall be as prescribed in the Fifth Schedule.

(1 ) A student midwife shall be eligible to be entered for the examination if, and only if-

(a) she will have completed not less than eleven months of her training period;

(b) she will have attended courses of lectures and completed experience under rule 10(2)(a) to (g);

(c) the supervisor of the registered midwifery school is satisfied that her health is such that no danger to her patients would be involved by her engaging in the duties of a midwife.

(2) Every application for entry to the examination shall be in the form prescribed in the Sixth Schedule and shall be accompanied by-

(a) the appropriate examination fee prescribed in the Seventh Schedule; and

(b) a certificate in the form prescribed in the Eighth Schedule, issued by the supervisor of the registered midwifery school at which the applicant is undergoing training, stating that the applicant is eligible to be entered for the examination.

13. Tests comprising examination

The examination shall consist of-

(a) a written test in accordance with current recommendations for which the time allowed shall be three hours;

(b) an oral and practical test of one hour's duration, of which the candidate shall spend twenty minutes examining the patient, twenty minutes with the Consultant Obstetrician examining and twenty minutes with the Midwifery Tutor examining.

14. Marks for examination

(1) Marks for the tests forming the examination shall be allotted as follows-

(a) 100 marks for the written part of the test;

(b) 100 marks for the oral and practical part of the test.

The marks shall be equally divided as follows-

(i) Consultant Obstetrician-50 marks;

(ii) Midwifery Tutor-50 marks.

(2) To satisfy the examiners, it shall be necessary for a candidate to obtain not less than fifty per centum of the marks allotted to each test of the examination.

[As amended by S.I. No. 44 of 1979]

15. Examiners for examination

Every examiner appointed by the Examinations Committee for the purposes of the examination shall be actively involved in midwifery training, that is to say-

(a) a practising obstetrician; or

(b) a qualified midwifery tutor.

16. Publication of examination results

The list of successful candidates in the examination will be published in alphabetical order.

17. Grant of Zambia Registered Midwive's Certificate

A student who has-

(a) completed the course of training prescribed by these Rules; and

(b) passed the examination;

shall be qualified for and shall be entitled to be granted the Zambia

FIRST SCHEDULE

[Rule 3 (2)]

ZAMBIA REGISTERED MIDWIVES' CERTIFICATE

This is to certify that

has completed the course of training prescribed by the Zambia Registered Midwives (Training) Rules, and has passed the Zambia Registered Midwive's Examination held by the Medical Council of Zambia on ................................................. 20.........., at .............

The said ........................................................................................... is hereby granted the Zambia Registered Midwives's Certificate.

Date .......................................

LUSAKA .......................................................

ZAMBIA, Registrar,

..............................................

Medical Council of Zambia.

SECOND SCHEDULE

[Rule 4 (2)]

REQUIREMENTS TO BE FULFILLED BY A HOSPITAL TO BE APPROVED AS A REGISTERED MIDWIFERY SCHOOL

(a) a medical practitioner with special experience in obstetrics; and

(b) a qualified midwifery tutor; and

2. The annual average number of confinements taking place in the hospital amounts to not less than 150.

3. The hospital-

(a) contains ante-natal beds associated with an ante-natal clinic;

(b) conducts a post-natal clinic;

(d) has satisfactory equipment, teaching aids and facilities necessary for the proper instruction of student midwives;

(e) is able to provide facilities for infant welfare and health education experience;

(f) has satisfactory accommodation for student midwives in training.

THIRD SCHEDULE

[Rule 4 (3)]

HOSPITAL RECOGNISED AS REGISTERED MIDWIFERY SCHOOL

The following hospital is recognised by the Council as a registered midwifery school:

University Teaching Hospital, Lusaka.

FOURTH SCHEDULE

[Rule 7]

REQUIREMENTS FOR ADMISSION TO REGISTERED MIDWIFERY SCHOOL

A candidate shall be eligible for admission to a registered midwifery school if, and only if-

(a) the candidate shall be in possession of the Zambia Registered Nurse's Certificate; or be in possession of a certificate recognised by the Council as being equivalent to the Zambia Registered Nurse's Certificate;

(b) the candidate shall have completed one year of experience as a Registered Nurse in Zambia, this may have been in-

(i) a Government hospital;

(ii) a Mine hospital; or

(iii) a Mission hospital;

(c) the candidate shall have passed a medical examination and received a certificate from a registered medical practitioner stating that she is free from disease and infection and is medically fit to undergo training.

FIFTH SCHEDULE

[Rule 12]

SYLLABUS OF SUBJECTS FOR THE ZAMBIA REGISTERED MIDWIVES' EXAMINATION

INTRODUCTORY TRAINING:

Two weeks prior to entry to wards and departments:

Theoretical and practical introduction to the following:

1. Normal pregnancy.

2. Normal labour.

3. Normal neonate.

4. Normal puerperium.

5. Danger signs in midwifery (briefly) to facilitate reporting.

TRAINING SYLLABUS:

Obstetric Anatomy and Physiology (includes pregnancy changes) (Midwifery Tutor):

1. The pelvis.

2. External genitalia and vagina.

3. The uterus.

4. Fallopian tubes and ovaries.

5. Menstrual cycle.

6. Fertilisation and, briefly, embryology.

7. The placenta-foetal circulation.

8. Pelvic floor.

9. Breasts.

10. Foetal skull and moulding.

11. Hormones.

Normal pregnancy (Midwifery Tutor):

1. Signs and symptoms (revise physiological changes).

2. Uterine changes.

3. Examination of ante-natal patient-

(a) booking and general examination;

(b) abdominal examination;

4. Ante-natal care.

5. Mothercraft and health education-

(a) nutrition;

(b) general health and hygiene;

6. Minor disorders of pregnancy.

Normal labour (Midwifery Tutor):

1. Physiology of labour-all stages.

2. Management of labour-all stages.

3. Care of newborn.

4. Mothercraft-

(a) labour talks;

(b) preparation for and care of newborn in the village;

5. Perineal laceration and repair.

The newborn (Midwifery Tutor):

1. Normal physiology.

2. Examination and cord treatment.

3. First bath and daily observations.

4. Breast feeding and problems of breast feeding.

5. Common infections and prevention.

6. Child welfare.

7. Immunisation and vaccination.

8. Artificial feeding.

The puerperium (Midwifery Tutor):

1. Physiology.

2. Routine observations.

3. Nursing care.

4. Breast care.

Abnormal pregnancty (Obstetrician):

1. Hyperemesis gravidarum.

2. Vaginal discharges.

3. Abortion and allied subjects.

4. Pre-eclampsia and eclampsia.

5. Diseases associated with pregnancy-

(a) anaemia;

(b) tuberculosis;

(d) cardiac;

(e) diabetes;

(f) veneral diseases.

6. Ante-partum haemorrhage.

7. Unstable lie.

Abnormal labour (Obstetrician):

1. Abnormal uterine action.

2. Prolonged labour-include maternal and foetal distress.

3. Posterior positions.

4. Breech presentation.

5. Face and brow presentations.

6. Shoulder and transverse lie.

7. Trial labour.

8. Cephalo-pelvic disproportion.

9. Obstructed labour.

10. Ruptured uterus.

11. Multiple pregnancy.

12. Hydramnios, cord presentation and prolapse.

13. Intra-uterine death.

14. Obstetric operations.

15. Post-partum haemorrhage.

16. Retained placenta and manual removal (abnormal placenta).

17. Obstetric shock.

18. Traumatic results of childbirth-

(a) third degree tear;

(b) cystocele, rectocele, uterine prolapse;

Abnormal neonate (Paediatrician):

1. Asphyxia neonatorum.

2. Abnormal moulding, caput, cephalhaematoma.

3. Prematurity.

4. Dysmaturity, postmaturity.

5. Cerebral injury.

6. Other birth injuries.

7. Infections of newborn.

8. Congenital abnormalities.

9. Blood disorders.

10. The diabetic baby.

11. Artificial feeding.

Abnormal puerperium (Obstetrician):

1. Puerperal sepsis.

2. Secondary P.P.H. (revision).

3. Emergencies of puerperium (embolus, etc.).

4. Puerperal insanity.

Other subjects (Midwifery Tutor):

1. Statutory Rules.

2. Midwives handbook.

3. Drugs in midwifery.

4. Responsibility of a midwife to teach.

SIXTH SCHEDULE

[Rule 12 (2)]

ZAMBIA REGISTERED MIDWIVES' EXAMINATION

..................................................., 20.............

ENTRY FORM

Candidates for examination are asked to enter all details requested below and return the form immediately to the Medical Council of Zambia together with the examination fee.

Surname (BLOCK CAPITALS) Other Names ..................................

Date of Birth .....................................

Place of Birth ....................................

Permanent Home Address .................................................................

Training School ...............................................................................

Date of Commencement of Training ...............................................

To the best of my knowledge this is a true statement.

Date ....................................

.....................................................

Signature of Candidate

SEVENTH SCHEDULE

[Rule 12 (2) (a)]

PRESCRIBED FEE

Examination Fee

60 fee units

EIGHTH SCHEDULE

[Rule 12 (2) (b)]

CERTIFICATE OF SUITABILITY TO ENTER ZAMBIA REGISTERED MIDWIVES' EXAMINATION

Name of Applicant ....................................................................

Date of Entry into Training ........................................................

Number of days absent (casual leave, sick leave and compassionate leave) .......

Comments regarding suitability to practise as a Registered Midwife

I, ............................................................... being the Supervisor in charge of the Registered Midwifery School at ......................................... hereby declare that the applicant has fulfilled the requirmements of the Zambia Registered Midwives (Training) Rules in every respect and is eligible to be entered for the Zambia Registered Midwive's Examination.

Date ...............................................................

Supervisor, Registered Midwifery School

[As amended by Act No. 13 of 1994]

NURSES AND MIDWIVES (SICK CHILDREN'S NURSES PRIMARY QUALIFICATIONS) REGULATIONS

[Section 17]

Arrangement of Regulations

Regulation

2. Primary qualifications of fully registered sick children's nurses

SI 247 of 1969.

[Regulations by the Minister after consultation with the Medical Council of Zambia]

1. Title

These Regulations may be cited as the Nurses and Midwives (Sick Children's Nurses Primary Qualifications) Regulations.

2. Primary qualifications of fully registered sick children's nurses

The certificates specified in the Schedule shall be primary qualifications for the purposes of registration on the register of fully registered sick children's nurses.

SCHEDULE

[Regulation 2]

SICK CHILDREN'S NURSES

A certificate of qualification as a sick children's nurse granted by any of the following examining authorities:

General Nursing Council for England and Wales.

General Nursing Council for Scotland.

An Bord Altranais (Republic of Ireland).

Joint Nursing and Midwives Council for Northern Ireland.

MEDICAL AND ALLIED PROFESSIONS (ENROLLED NURSES PRIMARY QUALIFICATIONS) REGULATIONS

[Section 17]

Arrangement of Regulations

Regulation

2. Primary qualifications of fully enrolled nurses

SI 283 of 1969.

[Regulations by the Minister after consultation with the Medical Council of Zambia]

1. Title

These Regulations may be cited as the Medical and Allied Professions (Enrolled Nurses Primary Qualifications) Regulations.

2. Primary qualifications of fully enrolled nurses

The certificates specified in the Schedule shall be primary qualifications for the purposes of registration on the register of fully enrolled nurses.

SCHEDULE

[Regulation 2]

ENROLLED NURSES

Examining Authority	Qualification
Medical Council of Zambia.	Zambia Enrolled Nurse's Certificate.
Department of Health, Republic of Zambia	Certificate of Zambian Enrolled Nurse Training.
Any of the Hospitals in the Third Schedule to the Zambia Enrolled Nurse (Training) Rules:	Certificates of training granted prior to Department of Health or Council recognition
Chitambo Hospital.	Female Nursing Assistant's Certificate.
Kaonde Hospital (now Mukinge).	Practical Nursing Certificate.
Batoka Hospital.	Hospital Assistant's Certificate.
Mbereshi Hospital (London Missionary Society).	Nursing Certificate. Medical Assistant's Certificate Orderly's Certificate.
General Nursing Council for England and Wales.	Enrolled Assistant Nurse Certificate (to August, 1961).
Enrolled Nurse Certificate (from August, 1961)
General Nursing Council for Scotland.	Enrolled Assistant Nurse Certificate (to August, 1961).
Enrolled Nurse Certificate (from August, 1961)
Professional College Schools for Nurses (Scuola Convitto Professionale per Infermiere) recognised by the Ministry of Health, Italy.	Diploma of Professional Nurse (Diploma di Infermiera Professionale).
Medical Department of the Seventh Day Adventist Church, Zambesi Union:
Kanye Hospital, Botswana	General Medical And Surgical Nurse Certificate.
Malamulo Hospital Training School, Malawi.	Medical Assistant Certificate.
Medical Council of Southern Rhodesia.	Enrolled Nurse's Certificate.
Hospitals recognised by the International Red Cross.	Assitant Nurse's Certificate.
Nurse's Certificate.
Department of Health of the Federal Republic of Germany.	Nursing Sister's Certificate.
Nurses and Midwives Council of Malawi.	Enrolled Nurse's Certificate.
Nurses and Midwives and Nursing Assistants Council of Uganda.	Nursing Assistant's Certificate
Nurses and Midwives Council of Tanzania.	Auziliary Nurse's Certificate.

MEDICAL AND ALLIED PROFESSIONS (MENTAL PRIMARY QUALIFICATIONS) REGULATIONS

[Section 17]

[RETAINED AS PER SECTION 15 OF THE INTERPRETATION AND GENERAL PROVISIONS ACT]

Arrangement of Regulations

Regulation

2. Primary qualifications of fully registered mental nurses

SI 310 of 1967.

[Regulations by the Minister after consultation with the Medical Council of Zambia]

1. Title

These Regulations may be cited as the Medical and Allied Professions (Mental Nurses Primary Qualifications) Regulations.

2. Primary qualifications of fully registered mental nurses

The certificates specified in the Schedule shall be primary qualifications for the purposes of registration on the register of fully registered mental nurses.

SCHEDULE

[Regulation 2]

MENTAL NURSES

A certificate of qualification as a mental nurse granted by any of the following examining authorities:

General Nursing Council for England and Wales;

General Nursing Council for Scotland;

An Bord Altranais (Republic of Ireland):

Joint Nursing and Midwives Council for Northern Ireland:

South African Nursing Council:

The "B" Certificate granted by the Medical Officer of Health The Hague;

Nursing Council of Nigeria.

MEDICAL AND ALLIED PROFESSIONS (NURSES AND MIDWIVES PRIMARY QUALIFICATIONS) REGULATIONS

[Section 17]

[RETAINED AS PER SECTION 15 OF THE INTERPRETATION AND GENERAL PROVISIONS ACT]

Arrangement of Regulations

Regulation

2. Primary qualifications of fully registered nurses

FIRST SCHEDULE

SECOND SCHEDULE

SI 14 of 1967.

[Regulations by the Minister after consultation with the Medical Council of Zambia]

1. Title

These Regulations may be cited as the Medical and Allied Professions (Nurses and Midwives Primary Qualifications) Regulations.

2. Primary qualifications of fully registered nurses

The certificates specified in the First Schedule shall be primary qualifications for the purposes of registration on the register of fully registered nurses.

3. ...

The certificates specified in the Second Schedule shall be primary qualifications for the purposes of registration on the register of fully registered midwives.

FIRST SCHEDULE

[Regulation 2]

NURSES

A certificate of qualification as a general nurse granted by any of the following examining authorities:

General Nursing Council for England and Wales.

General Nursing Council for Scotland.

Joint Nursing and Midwives Council for Northern Ireland.

An Bord Altranaias (Republic of Ireland).

Nurse's Registration Board of Australian Capital Territory.

Nurse's Registration Board of New South Wales.

Nurse's and Masseur's Registration Board of Queensland.

Nurse's Board of South Australia.

Nurse's Registration Board of Tasmania.

Victorian Nursing Council.

Nurse's Registration Board of Western Australia.

Nurse's and Midwive's Board of New Zealand.

Alberta Association of Registered Nurses.

Manitoba Association of Registered Nurses.

Saskatchewan Registered Nurse's Association.

Nurse's Board of Ghana.

Nurse's and Midwive's and Nursing Assistant's Council of Uganda.

Medical Council of Southern Rhodesia.

South African Nursing Council.

Nurse's and Midwive's Council of Kenya.

Association of Nurses of the Province of Quebec.

The "A" Certificate granted by the Medical Officer of Health-The Hague.

SECOND SCHEDULE

[Regulation 3]

MIDWIVES

A certificate of qualification as a midwife granted by any of the following examining authorities:

Central Midwives Board for England and Wales.

General Nursing Council for Scotland.

Joint Nursing and Midwives Council for Northern Ireland.

An Bord Altranais (Republic of Ireland).

Nurse's Registration Board of Australian Capital Territory.

Nurse's Registration Board of New South Wales.

Nurse's and Masseur's Registration Board of Queensland.

Nurse's Board of South Australia.

Nurse's Registration Board of Tasmania.

Victorian Nursing Council.

Nurse's Registration Board of Western Australia.

Nurse's and Midwive's Board of New Zealand.

Nurse's Board of Ghana.

Medical Council of Southern Rhodesia.

South African Nursing Council.

The "A" Certificate granted by the Medical Officer of Health-The Hague.

NURSES AND MIDWIVES ACT (COMMENCEMENT) ORDER

[Section 1]

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