Laboratory quality regulations and accreditation standards in Canada

ObjectivesTo review the current status of laboratory quality regulations and accreditation standards in Canada.Design and methodsThe review is written based on information collected by survey questionnaires, a comprehensive review of available websites, and personal communications.ResultsAccreditation of medical laboratories in Canada is regulated by provincial health authorities. Out of the ten provinces of Canada, five have provincial accreditation bodies, while in the other five provinces, medical laboratories are accredited by Canadian Counsel on Health Service Accreditation (CCHSA). Each of these accreditation bodies has developed their own standards, implementing the International Organization for Standardization (ISO) documents to variable extent. Canadian Coalition for Quality in Laboratory Medicine (CCQLM) has recently been incorporated to provide a national structure for harmonizing quality management in medical laboratories across Canada.ConclusionsAlthough provincially regulated, implementation of ISO in accreditation standards and coalition of accreditation bodies have been promoting the harmonization of quality regulations in Canada.     

Quality assessment of interpretative commenting in clinical chemistry

BACKGROUND: Clinical interpretation of laboratory results is an integral part of clinical chemistry. However, the performance goals for assessing interpretative commenting in this discipline have not been as well established as for the quality of analytical requirements. METHODS: We present a review of the 10 case reports circulated in the 2002 Patient Report Comments Program by the Royal College of Pathologists of Australasia (RCPA) and the Australasian Association of Clinical Biochemists Chemical Pathology Group of RCPA-Quality Assurance Programs Pty Ltd. Participants were expected to add an interpretative comment to a set of results accompanied by brief clinical details. Comments received were broken down into components that were translated into key phrases. An expert panel evaluated the appropriateness of the key phrases and proposed a suggested composite comment. A case summary/rationale was also returned to participants. RESULTS: There was considerable diversity in the range of interpretative comments received for each case report. Although the majority of comments received were felt to be acceptable by the expert panel, some comments were felt to be inappropriate, misleading, or in a few instances, dangerous. CONCLUSION: The golden rule in medicine is "do no harm". Although there is no objective evidence that interpretive comments help to improve patient outcomes, if comments are added to reports it is important that they reflect accepted practice and current guidelines. It is of concern that a large proportion of comments returned were considered to be inappropriate and/or misleading. The Patient Report Comments Program has highlighted the need to consider limiting commenting to persons with clear expertise.     

护理部在推动医院评审标准落实中的做法与体会

等级医院评审标准为医院管理带来了新的理念。为适应评审标准的要求,达到评审的目的,护理部通过解读标准、强化培训、反复自查整改等措施,逐步使各级人员落实标准的意识不断增强,各项工作的落实更加规范,持续质量改进的理念不断强化,逐步形成了按照标准良性运行的有效机制。     

Interprofessional education accreditation standards in the USA: A comparative analysis

Recent legislation has made it a legal requirement for schools' contribution to their pupils' spiritual development to be inspected as part of the school inspection process. However, some confusion exists about the meaning of the term ‘spiritual development’. The first part of this article reviews some of the meanings ascribed to the term by educationalists and theologians while the second part examines headteachers' perceptions of the meaning of the term within the context of primary schools.     

我国本科护理学专业教育标准构建的研究

目的 构建既符合我国国情,又顺应国际环境的本科护理学专业教育标准,为开展本科护理学专业认证提供依据和科学的评价工兵.方法 考察我国护理本科教育现状,并组织专家小组会议构建本科护理学专业教育标准草案.运用德尔菲法,从全国开办护理本科护理教育的院校中选择98所进行两轮函询,根据专家意见修订草案,同时对标准进行验证.结果 确立的本科护理学专业教育标准包括本科护理学毕业生应达到的基本要求(32项)和本科护理学专业教育办学标准(10个领域40项).专家意见的集中程度和对各级指标评价的一致性程度均较高.结论 形成的本科护理学专业教育标准科学、全面地规定了我国护理本科教育的人才培养和办学条件要求,符合我国本科护理教育的发展现状,并融入了我国护理专业发展特色,体现了当前护理教育发展的国际趋势.     

Nursing duties and accreditation standards and their impacts: The nursing perspective

BackgroundMedical advances and increasingly complex patients presenting to the Emergency Department (ED) make nursing challenging. Gaining new knowledge and skills is a perpetual requirement. New quality initiatives to improve patient safety and care are being constantly introduced and create significant work and time pressures for healthcare providers involved.Study questionDo ED nurses support the introduction of new quality standards, in addition to their current heavy workload?Study designA cross-sectional survey.MethodsAll ED nurses in the Edmonton zone were invited to complete a survey on nursing beliefs regarding various accreditation standards and their impacts. The survey was developed iteratively, involving study investigators, the Health Authority Management Team, and Nursing Managers. Response options included a 7-point Likert scale of agreement. Median ratings and interquartile ranges were determined for each survey statement.ResultsA total of 433/1241 (34.9%) surveys were completed. Respondents were RNs (91.4%), female (88.9%), with 0–5 years ED experience (43.7%). Overall, respondents ‘agreed’ or ‘strongly agreed’ with the statements, indicating favourable attitudes towards Accreditation Canada standards and other quality initiatives. They were neutral towards universal domestic violence screening, and the differentiation between a Best Possible Medication History and medication reconciliation.ConclusionsDespite their heavy workload, nurses strongly agreed on the importance of medication reconciliation, falls risk, and skin care, but felt that improved documentation forms could support efficiency. This nursing perspective is valuable in informing attempts to standardize and simplify documentation, including the design and implementation of a provincial clinical information system.