South African Nursing Council - Sanc

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SOUTH AFRICAN NURSING COUNCILNOTIFICATION OF COMPLETION OF TRAININGEDUCATION AND TRAINING OF A NURSE (GENERAL,PSYCHIATRIC AND COMMUNITY) AND MIDWIFE LEADINGTO REGISTRATIONGovernment Notice No. R425 of 19 February 1985 (as amended) This information must be provided by the Person in charge of the Nursing EducationInstitutionIncomplete and incorrect forms will not be processed1. DETAILS OF THE NURSING EDUCATION INSTITUTIONName ( as approved by Council)Correspondence Number (S- File No.)Accreditation certificate numberPhysical addressPostal addressPostcodePostcodeTelephone Number(s)Fax NumberE-mail Address2. DETAILS OF PERSON IN CHARGE OF NURSING EDUCATION INSTITUTIONName of Person In Charge of the NursingEducationSANC Reference NumberProfessional Qualifications (not academicqualifications)3. NAME OF UNIVERSITY OFAFFILIATION /ASSOCIATION (IN CASE OFCOLLEGE OR NURSINGSCHOOL)1 Page

4. LEARNER DETAILSSurnameGiven Names in full (according toID/Passport)SANC Reference NumberSA Identity Document NumberPassport NumberOR(ifCountry of issueforeign)Date of CommencementFOR OFFICE h)(Day)Date of Resumption (if applicable)Date of Completion5.RECORD OF EDUCATION AND TRAINING(N.B. TRANSLATE COUNCIL PERIOD TO HOURS)5.1 Total TheoryPrescribed Periods & HoursAchieved For office useHoursBy SANCNEI- Biological and Natural Sciences- Social Sciences- Fundamental Nursing Science- Ethos and Professional Practice- General Nursing Science- Psychiatric Nursing Science- Community Nursing Science- Midwifery- Pharmacology- Other (specify)Total5.2 PRACTICA5.2.1 GENERAL NURSING SCIENCE (INCLUDING ACUTE, CHRONIC/LONG TERM, IN/OUT OFHOSPITALPractice areaApprovedAchieved HoursTotalFor office useMinimum total 4000 hours for allthe disciplinesGeneral Nursing ScienceMedical WardsSurgical WardsPaediatric WardsCasualty & Out Patient DepartmentOperating TheatreOther (specify)Total2 PageDayNight

5.2.2PSYCHIATRIC NURSING SCIENCETherapy for the Mentally RetardedAdmission (Acute Care)Long-term and Security UnitsChildren and AdolescentsGeriatric NursingCommunity & RehabilitationOccupational & Recreational ServicesOther (specify)5.2.3MIDWIFERY NURSING SCIENCEMinimum total hours 1000Ante-natal ServicesLabour ward/delivery roomNeonatal CarePost-natal care servicesOther (specify)Requirement specificationsThese include but are not limited to examples set out below:Midwifery skillsPrescribedSupervision of Pregnant women (in numbers)Ante-natal patients with abnormal conditionsInternal examinationsNormal deliveries observedWomen progressed during the 1st stage oflabourDeliveries by a learnerConducting third and fourth stages of labourPerformance of episiotomiesSuturing of episiotomies and 1st and 2nd degreetears.Complicated deliveriesPost-partum care of mother and baby(including examinations)Breathing and relaxation techniqueAnte-natal and post-natal exercisesAdministration of local anaesthesia excludingpudendal blockOther (specify)3 PageAchievedFor office use

5.2.4COMMUNITY NURSING SCIENCEHealth EducationEnvironmental ControlMother & Child Services including preschool childSchool Health ServicesOccupational Health ServicesGeriatric Health ServicesPsychiatric Health ServicesNeonatal Care ServicesPrevention and control of communicable diseasesHealth Assessment Treatment and CareRehabilitationCommunity ResourceOther e.g. IMCI, PCTMT (specify)5.3 SUMMATIVE ASSESSMENT OUTCOMES/YEAR MARKTheoryFirst yearSecond yearThird yearFourth yearOther (specify)4 PagePracticaFor office use

6. APPROVED/ACCREDITED CLINICAL FACILITY USED FOR PLACEMENTName of Clinical FacilitiesFor officeOther (e.g. Day Visits)7. LEAVE GRANTEDTYPE OF LEAVE (vacation, sick, etc.)5 PageFor Office UseFROM (Full dates)TO (Full dates)

Declaration that a learner has met the educational requirements to be registered as a Nurse and MidwifeLearner detailsSurnameGiven names in fullSANC reference numberSouth African identity document numberOR Passport numberCountry of issueTraining details(*)Name of Institution:Date of commencementYear:Month:Date of completionYear:Month:Declaration by Person in charge of nursing education programmeDay:Day:I hereby declare that the aforementioned learner: Has complied with all the prescribed minimum education and training programme requirements for registration as a Nurse and Midwife interms of Government Notice No. R.425 of 19 February 1985; and Has been assessed and found to have the required competencies as per the prescribed teaching guide to practice in accordance with theprescribed scope of practice of a Nurse and Midwife.I further declare that: The information provided is accurate and based on the authentic education and training records of the said learner; All the education and training of the learner were accurately recorded for the duration of the programme; The nursing education institution has in its possession all the original education and training records, including but not limited to assessmentand clinical records; There is no evidence that such training records were tampered with or are in any way fraudulent; and In the event that any tampering of the record or fraudulent records are detected after this declaration is made, I undertake to immediatelynotify the Council thereof in writing.I fully understand the meaning and implications of this declaration(**)Full names (Print)DesignationSANC reference numberSignatureDateDeclaration by Person in charge of nursing education institutionI declare that the information provided is accurate and based on the authentic education and training records of the said learner.I fully understand the meaning and implications of this declaration(**)Full names (Print)DesignationSANC reference numberSignatureDateAffix Stamp of the Nursing Education Institutionhere(*) Any entry into the register made in error or through misrepresentation will be deleted/removed from the register.(**) Any person that makes a false declaration or misrepresents the facts or information given in this declaration may be charged with an offence interms of sections 46 and 54 of the Nursing Act, 2005 (Act No. 33 of 2005).6 Page

SOUTH AFRICAN NURSING COUNCIL NOTIFICATION OF COMPLETION OF TRAINING EDUCATION AND TRAINING OF A NURSE (GENERAL, PSYCHIATRIC AND COMMUNITY) AND MIDWIFE LEADING TO REGISTRATION Government Notice No. R425 of 19 February 1985 (as amended) This information must be provided by the Person in charge of the Nursing Education Institution

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