Nurses maintain and enhance their competence through daily practice reflection, lifelong learning and by integrating that learning into their practice. As practicing nurses, QA is integral in ensuring the public receives safe, quality and ethical care.

The Regulated Health Professions Act, 1991 requires CNO to establish and administer a QA Program that assists nurses in maintaining competence and continually evaluating their practice.

CNO’s QA Program consists of three components:

1. QA Everyday
2. QA Assessment
3. Remedial support 

All nurses are expected to participate in QA by reflecting daily on their practice and participating in learning activities to maintain their continuing competence.

CNO selects a random number of nurses at various times throughout the year to complete QA Assessment. More information can be found on our Quality Assurance Assessment webpage

Reflective questions can be found in the Practice Reflection section on our QA Everyday webpage.

Yes. Reflection can take place in a group setting. Group reflection provides opportunities to learn from each other, identify common goals and inform your own assessment.

Yes. All components of QA require a Learning Plan. It is your accountability under the Regulated Health Professions Act, 1991 to complete a Learning Plan every year. You can do this however you choose. Some nurses use CNO’s Learning Plan template, while other nurses prefer using a notebook to record their plans for the year. CNO requires the Learning Plan identify two learning goals. If you are selected for QA Assessment, you will be required to submit your learning plan to CNO. You should keep a copy of your Learning Plan for two years.

As reflective practitioners, nurses reflect on their practice every day, to identify opportunities for continuous improvement and support professional learning and growth.

Yes. All nurses registered in the General or Extended Class are expected to participate in QA activities, except for nurses in the Non-Practising Class. For more information about the Non-Practising Class, visit the Registration Classes section of this website.

Even if you are not currently working, you can still reflect on your nursing practice experiences to determine your strengths, areas for improvement and learning needs. These experiences can include previous formal employment, or student placements if you are a new graduate.

You can also reflect on relevant new information and think about how it might influence your practice. For example, is there new evidence or legislation that may change how you would deliver care?

Part of practice reflection is getting feedback from peers. You can get peer feedback from a colleague who is familiar with your recent nursing roles, or include feedback from a previous clinical evaluation.

Once you have identified your learning needs from this reflection, you can plan your learning goals, and the activities you need to do to achieve them in your learning plan.

Updates to CNO’s QA program will be available on our website. We also will notify you of any changes in The Standard, and on our Facebook, X (formerly Twitter), LinkedIn and Instagram pages.