Addressing the gaps in the standards of nursing education globally: Comparing the accreditation systems across countries and regions - A case study from Macao

Background: Professional accreditation is an importation measure for higher education quality assurance as it helps analyze and enhance the quality of education within nursing programs. Current literature indicates that accreditation is largely determined by national and regional institutions and lacks coherent international academic standards which causes a lack of consistency in nurse education around the world. Objectives: The purpose of this paper is to analyze the policy, standards and operation of professional accreditation amongst a sample of countries and regions around the world. It explores the strategies and improvement measures of accreditation and provides a useful reference for nursing education accreditation in terms of the operation and reformation of nurse education standards. Methodology: The study combined quantitative and qualitative methods through the search of websites and electronic data bases and the consultation of experts. The sources were 2 organizations, 5 countries, and 2 regions. Medical, health and nursing related databases such as CINAHL Plus, EBSCO MEDLINE, Journals@Ovid were utilized. In addition, four experts from the United States, the United Kingdom, Mainland China and Hong Kong were consulted and a case study from Macau was used to illustrate and share experience. The updated literature, related documents and expert feedback were analyzed. Results: The results indicated that the procedures and requirements for professional accreditation were similar, but were generally non-mandatory. There were differences in frequency, form and focus, and there were also variations amongst accrediting bodies, in term of terminology, jargon used as well as assessment indicators and standards. Conclusions and Recommendations: There were differences and variations between countries and regions regarding accreditation, according to their conditions and context. Practice could vary but the focus and core standards tended to be consistent. In order to promote more consistency in nurse education in the future, a strategy for accreditation should consider: 1. establishing mutual recognition of accreditation systems; 2. developing an international accreditation system; 3. recruiting international external examiners and experts to oversee standards; 4. the ICN to develop international accreditation services.