Patient safety is at the heart of nursing. As the nursing regulator in Ontario, CNO’s role is to make sure nurses are maintaining their knowledge and skills throughout their careers so the public receives safe, quality nursing care. One way we do this is through our quality assurance program.

The Regulated Health Professions Act, 1991 requires that all health care regulators in Ontario establish and administer a quality assurance (QA) Program.

QA is a process where nurses are required to reflect on their practice, identify gaps in their knowledge and take action to fill those gaps. CNO supports this process by providing tools and resources to assist nurses in completing their annual QA requirements.

QA is important because it keeps nurses accountable in making sure they are staying up to date with the evolving health care environment, for instance, changes in nursing scope of practice, increasing client care needs, and advances in health care technology.

Nurses must declare they engage in QA activities every year when renewing their CNO membership. When nurses complete their QA requirements, they demonstrate to the public their commitment to lifelong learning and continued competence. The public can have confidence in the nursing profession and be assured that nurses are providing safe, quality care.

All practicing nurses are accountable, under legislation, to self-assess their nursing practice every year. This includes reflecting on current practice, identifying learning needs, and completing a learning plan which clearly outlines activities to improve competence. We call this QA Everyday.

Each year, CNO randomly selects nurses for QA Assessment. There are two parts to QA Assessment: Part A: Knowledge Assessment and Part B: Practice Assessment. In Part A, nurses complete a set of learning modules about nursing practice and complete a knowledge check. In Part B, nurses are to submit their Learning Plan and other activities for review. Once submitted, a CNO trained QA Peer Coach reviews the submission and provides feedback. Nurses will have an opportunity to work individually with the QA Peer Coach to understand and apply their feedback to improve future practice, including strengthening their understanding and application of the Code of Conduct.

If a nurse chooses not to participate or does not demonstrate adequate knowledge skill and judgment, they may be directed by CNO’s QA Committee to complete additional activities.