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Accréditation Sans Frontières

International Accreditation of Healthcare Facilities

Standards › ASF Health Standards v10 › Standard 53

Standard 53

Optical and Hearing

Optical and hearing care: eye and hearing examinations, staff qualifications, products, hygiene teaching, aftercare, complaints and same-day referral of urgent findings.

7
criteria
7
documents
9
e-learning courses
4
references

Criteria on this page

15.115.215.315.415.515.615.7

How to read the colours
Red: Must. Required in every setting. Criteria that protect life are always red.
Green: Medium. Required, adapted to what a transition setting can realistically do.
Yellow: Minimum. The lowest acceptable level in a humanitarian setting, where resources are very limited.

Each criterion is shown in three settings: Humanitarian settings, Transition and fragile, and Standard. In standard settings, every criterion is Must.

Reference, not a requirement. Every policy, SOP, form and course on this page is a draft to help you. Adapt it to your hospital, write your own, or upload your own documents. What the assessor checks is that the standard is met and that you can show how.
Training colours: red means essential, green recommended, yellow optional. Each course shows its level for each setting: humanitarian, transition and fragile, and standard.
15.1Eye and Hearing Examinations Are Clinically SoundHumanitarian settings: MediumTransition and fragile: MustStandard: Must

Sight and hearing tests use validated methods and equipment. The test equipment is maintained. Results are recorded, and any finding that needs medical review is referred.

Humanitarian settings
Medium
Transition
Must
Standard
Must

Why it matters. A sight or hearing test that uses an unvalidated method or poor equipment gives the wrong answer, and the patient is fitted with the wrong product. The test is the start of every correct fitting.

How the surveyor verifies this criterion

Sample. Review 30 sight and hearing test records in the last 6 months, and the calibration records for the equipment used.

1. Results are recorded, and any finding that needs medical review is referred.

Method. Check each record for the named method.

Evidence to show. Sight and hearing test record (OPT-FRM-001).

Pass when. Every test names a validated method.

2. Test equipment is in calibration on the day of the test.

Method. Check the calibration date of the equipment used for each sampled test.

Evidence to show. Equipment inventory and service log (EQP-REG-001).

Pass when. Every test used equipment in calibration.

3. Each finding that needs referral is referred.

Method. Check each record with a referral finding for the referral made.

Evidence to show. Sight and hearing test record.

Pass when. Every finding that needs referral has a referral recorded.

Immediate fail (any one means the criterion is not met)

  • A test is given with an unvalidated method or with equipment past calibration.

Staff, training and documents

Read across each row to see who does each step. Click a document name for its full text.

Staff responsible

Which level applies to you: it depends on your setting. Humanitarian settings have the fewest essential courses; standard settings have the most. Check the colour for your setting in each criterion.

Role Why it applies Level Training Where to go
Doctor ISCO 2212
ASF proposal
Prescribes and reviews opioid treatment Humanitarian: Recommended
Transition: Recommended
Standard: Recommended
— —
Nurse ISCO 2221
ASF proposal
Uses or checks the equipment and falls controls at the bedside Humanitarian: Recommended
Transition: Recommended
Standard: Recommended
Emergency Medical Equipment & AED Readiness (MED-02) —
Manager ISCO 1342
ASF proposal
Runs the facility process this criterion measures Humanitarian: Recommended
Transition: Recommended
Standard: Recommended
Emergency Medical Equipment & AED Readiness (MED-02) —

Documents: who does each step

Document Writes Approves Fills in Checks and signs Files and uploads
OPT-FRM-001 · Sight and hearing test record PoliciesOPT-POL-001 · Clinical standards for sight and hearing tests Manager (ISCO 1342) Chief executive (ISCO 1120) Secretary (ISCO 3344) Manager (ISCO 1342) Secretary (ISCO 3344)

E-learning: who must take each course

E-learning course Who must take Who is recommended
Emergency Medical Equipment & AED Readiness (MED-02) In development Nurse Manager

References

  1. World Health Organization (2025). Vision and hearing screening for school-age children: implementation handbook. Used for: vision and hearing screening examinations for school-age children. https://news.gmj.ge/guideline/vision-and-hearing-screening-for-school-age-children-implementation-handbook/
15.2Staff Are Qualified for the Service They GiveHumanitarian settings: MediumTransition and fragile: MustStandard: Must

Sight testing, dispensing and hearing aid fitting are carried out only by staff with the qualification required for that task. Each person’s qualification for their task is verified and current, and their ongoing competency is evaluated.

Humanitarian settings
Medium
Transition
Must
Standard
Must

Why it matters. Sight testing, dispensing and hearing aid fitting each need their own qualification. A person without the right one can give a patient the wrong product with the wrong advice.

How the surveyor verifies this criterion

Sample. Review the qualification register for all staff who test sight, dispense or fit hearing aids, and the records of work done by each in the last 12 months.

1. Each person is qualified for each task they carry out.

Method. Check each task in the records against the person’s qualification for that task.

Evidence to show. Qualification register (OPT-REG-002).

Pass when. Every task is carried out by a person qualified for it.

2. Each qualification is verified and current.

Method. Check each entry for verification date and expiry.

Evidence to show. Qualification register.

Pass when. Every qualification is verified and current.

3. Staff without a qualification for a task are supervised.

Method. Check the supervision entry for any person without a qualification for a task.

Evidence to show. Qualification register.

Pass when. Every such task is supervised and recorded.

Immediate fail (any one means the criterion is not met)

  • A person without the qualification tests sight or fits a hearing aid alone.

Staff, training and documents

Read across each row to see who does each step. Click a document name for its full text.

Staff responsible

Which level applies to you: it depends on your setting. Humanitarian settings have the fewest essential courses; standard settings have the most. Check the colour for your setting in each criterion.

Role Why it applies Level Training Where to go
Doctor ISCO 2212
ASF proposal
Prescribes and reviews opioid treatment Humanitarian: Recommended
Transition: Recommended
Standard: Recommended
— —
Nurse ISCO 2221
ASF proposal
Uses or checks the equipment and falls controls at the bedside Humanitarian: Recommended
Transition: Recommended
Standard: Recommended
Credentialing, Competence and the Training Matrix (T-14)
Personnel competence, training and health (L-02)
—
Manager ISCO 1342
ASF proposal
Runs the facility process this criterion measures Humanitarian: Recommended
Transition: Recommended
Standard: Recommended
Credentialing, Competence and the Training Matrix (T-14)
Personnel competence, training and health (L-02)
—

Documents: who does each step

Document Writes Approves Fills in Checks and signs Files and uploads
OPT-REG-002 · Qualification register for sight testing, dispensing and hearing aid fitting Secretary (ISCO 3344) Chief executive (ISCO 1120) Secretary (ISCO 3344) Manager (ISCO 1342) Secretary (ISCO 3344)

E-learning: who must take each course

E-learning course Who must take Who is recommended
Credentialing, Competence and the Training Matrix (T-14) In development Nurse Manager
Personnel competence, training and health (L-02) In development Nurse Manager

References

  1. World Health Organization (2022). Guide to applying the WHO Eye Care Competency Framework. Used for: competencies and training of eye care staff. https://news.gmj.ge/guideline/guide-to-applying-the-who-eye-care-competency-framework/
  2. World Health Organization (2023). Primary Ear and Hearing Care: Training Manual. Used for: training of health workers in ear and hearing care. https://news.gmj.ge/guideline/primary-ear-and-hearing-care-training-manual/
15.3Products Are Fitted and CheckedHumanitarian settings: MediumTransition and fragile: MustStandard: Must

Spectacles, contact lenses and hearing aids are fitted to the individual’s measured need. The fit is checked with the patient before they leave.

Humanitarian settings
Medium
Transition
Must
Standard
Must

Why it matters. A spectacle, contact lens or hearing aid that does not fit correctly causes headache, damage or loss of benefit. Fitting and checking each product is what makes it safe to wear.

How the surveyor verifies this criterion

Sample. Review 30 fittings in the last 6 months, including spectacles, contact lenses and hearing aids.

1. Each product is fitted to the measured need.

Method. Check each fitting record for the measurement and the product.

Evidence to show. Fitting and fit check record (OPT-FRM-002).

Pass when. Every fitting has a measured need recorded.

2. The fit is checked with the patient before they leave.

Method. Check each fitting for the fit check and its time.

Evidence to show. Fitting and fit check record.

Pass when. At least 95% of fittings have the fit checked before the patient leaves.

3. A product that does not fit is adjusted or not given.

Method. Check each recorded misfit for the adjustment or the decision.

Evidence to show. Fitting and fit check record.

Pass when. Every misfit is adjusted or not given.

Immediate fail (any one means the criterion is not met)

  • A product is given before its fit has been checked with the patient.

Staff, training and documents

Read across each row to see who does each step. Click a document name for its full text.

Staff responsible

Which level applies to you: it depends on your setting. Humanitarian settings have the fewest essential courses; standard settings have the most. Check the colour for your setting in each criterion.

Role Why it applies Level Training Where to go
Doctor ISCO 2212
ASF proposal
Prescribes and reviews opioid treatment Humanitarian: Recommended
Transition: Recommended
Standard: Recommended
— —
Nurse ISCO 2221
ASF proposal
Uses or checks the equipment and falls controls at the bedside Humanitarian: Recommended
Transition: Recommended
Standard: Recommended
Patient Identification, Informed Consent and Patient Rights (T-07) —
Manager ISCO 1342
ASF proposal
Runs the facility process this criterion measures Humanitarian: Recommended
Transition: Recommended
Standard: Recommended
Patient Identification, Informed Consent and Patient Rights (T-07) —

Documents: who does each step

Document Writes Approves Fills in Checks and signs Files and uploads
OPT-FRM-002 · Fitting and fit check record PoliciesOPT-POL-002 · Fitting and checking products Manager (ISCO 1342) Chief executive (ISCO 1120) Secretary (ISCO 3344) Manager (ISCO 1342) Secretary (ISCO 3344)

E-learning: who must take each course

E-learning course Who must take Who is recommended
Patient Identification, Informed Consent and Patient Rights (T-07) In development Nurse Manager

References

In process of development. Will be available soon.

15.4Contact Lens and Hearing Aid Hygiene Is TaughtHumanitarian settings: MinimumTransition and fragile: MediumStandard: Must

Patients who wear contact lenses or hearing aids are taught hygiene and care for their device, and the teaching is recorded. The teaching is checked with the patient.

Humanitarian settings
Minimum
Transition
Medium
Standard
Must

Why it matters. Contact lenses and hearing aids can cause infection if they are not cleaned and cared for correctly. Patients taught the right care keep themselves safe between visits.

How the surveyor verifies this criterion

Sample. Review the hygiene teaching records for 20 contact lens and hearing aid users in the last 6 months.

1. Each user is taught hygiene and care for the device.

Method. Check each user record for the teaching.

Evidence to show. Device hygiene teaching record (OPT-FRM-003).

Pass when. At least 95% of users have the teaching recorded.

2. The teaching is checked with the patient.

Method. Check each record for the patient showing or saying back the steps.

Evidence to show. Device hygiene teaching record.

Pass when. At least 90% of records show the check.

3. The teaching is repeated at each review.

Method. Check the review records for a repeat of the teaching.

Evidence to show. Device hygiene teaching record.

Pass when. At least 90% of reviews include the repeat teaching.

Immediate fail (any one means the criterion is not met)

Staff, training and documents

Read across each row to see who does each step. Click a document name for its full text.

Staff responsible

Which level applies to you: it depends on your setting. Humanitarian settings have the fewest essential courses; standard settings have the most. Check the colour for your setting in each criterion.

Role Why it applies Level Training Where to go
Doctor ISCO 2212
ASF proposal
Prescribes and reviews opioid treatment Humanitarian: Recommended
Transition: Recommended
Standard: Recommended
— —
Nurse ISCO 2221
ASF proposal
Uses or checks the equipment and falls controls at the bedside Humanitarian: Recommended
Transition: Recommended
Standard: Recommended
Hand Hygiene and Standard Precautions (T-06) —
Manager ISCO 1342
ASF proposal
Runs the facility process this criterion measures Humanitarian: Recommended
Transition: Recommended
Standard: Recommended
Hand Hygiene and Standard Precautions (T-06) —

Documents: who does each step

Document Writes Approves Fills in Checks and signs Files and uploads
OPT-SOP-001 · Hygiene teaching for contact lens and hearing aid users FormsOPT-FRM-003 · Device hygiene teaching record Manager (ISCO 1342) Chief executive (ISCO 1120) Manager (ISCO 1342) Chief executive (ISCO 1120) Secretary (ISCO 3344)

E-learning: who must take each course

E-learning course Who must take Who is recommended
Hand Hygiene and Standard Precautions (T-06) In development Nurse Manager

References

In process of development. Will be available soon.

15.5Aftercare and Follow-Up Are ArrangedHumanitarian settings: MediumTransition and fragile: MustStandard: Must

Each patient has a defined follow-up for adjustment, review and problems, and a named contact.

Humanitarian settings
Medium
Transition
Must
Standard
Must

Why it matters. A product that is fitted once is not finished. Adjustment, review and follow-up after the fitting are where most problems are found and fixed.

How the surveyor verifies this criterion

Sample. Review the aftercare records for 20 product fittings in the last 6 months, and each problem reported.

1. Each patient has a follow-up booked for adjustment and review.

Method. Check each fitting for the follow-up booked.

Evidence to show. Aftercare and follow-up record (OPT-FRM-004).

Pass when. At least 95% of fittings have a follow-up booked.

2. Each patient has a named contact for problems.

Method. Check each record for the named contact given.

Evidence to show. Aftercare and follow-up record.

Pass when. Every patient has a named contact recorded.

3. A reported problem is seen within the set time.

Method. Check each reported problem for the time of response.

Evidence to show. Aftercare and follow-up record.

Pass when. At least 90% of problems are seen within the set time.

Immediate fail (any one means the criterion is not met)

  • A patient is given a product with no follow-up booked and no named contact.

Staff, training and documents

Read across each row to see who does each step. Click a document name for its full text.

Staff responsible

Which level applies to you: it depends on your setting. Humanitarian settings have the fewest essential courses; standard settings have the most. Check the colour for your setting in each criterion.

Role Why it applies Level Training Where to go
Doctor ISCO 2212
ASF proposal
Prescribes and reviews opioid treatment Humanitarian: Recommended
Transition: Recommended
Standard: Recommended
— —
Nurse ISCO 2221
ASF proposal
Uses or checks the equipment and falls controls at the bedside Humanitarian: Recommended
Transition: Recommended
Standard: Recommended
Aftercare & Follow-up: Closing the Loop After Every Visit (AMB-06) —
Manager ISCO 1342
ASF proposal
Runs the facility process this criterion measures Humanitarian: Recommended
Transition: Recommended
Standard: Recommended
Aftercare & Follow-up: Closing the Loop After Every Visit (AMB-06) —

Documents: who does each step

Document Writes Approves Fills in Checks and signs Files and uploads
OPT-SOP-002 · Aftercare and follow-up for products FormsOPT-FRM-004 · Aftercare and follow-up record Manager (ISCO 1342) Chief executive (ISCO 1120) Manager (ISCO 1342) Chief executive (ISCO 1120) Secretary (ISCO 3344)

E-learning: who must take each course

E-learning course Who must take Who is recommended
Aftercare & Follow-up: Closing the Loop After Every Visit (AMB-06) In development Nurse Manager

References

In process of development. Will be available soon.

15.6Complaints About Products Are Recorded and Acted OnHumanitarian settings: MinimumTransition and fragile: MediumStandard: Must

Complaints about products and services are recorded, reviewed, and acted on, including returns and replacements. The handling of complaints is set out in the complaints and records rule, which applies to every provider; this criterion adds the product-specific steps for returns and replacements.

Humanitarian settings
Minimum
Transition
Medium
Standard
Must

Why it matters. A complaint about a product or a service is information about what is going wrong. Recording and acting on it, and telling the patient what was done, improves the service.

How the surveyor verifies this criterion

Sample. Review every complaint about a product or service in the last 12 months.

1. Each complaint is recorded.

Method. Compare the complaints log with the complaints received in the period.

Evidence to show. Product complaint record (OPT-FRM-005).

Pass when. No complaint is missing from the record.

2. Each complaint is reviewed and acted on.

Method. Check each complaint for the review and the action.

Evidence to show. Product complaint record.

Pass when. Every complaint has a review and an action recorded.

3. The patient is told the outcome.

Method. Check each complaint for the outcome told and its date.

Evidence to show. Product complaint record.

Pass when. At least 95% of complaints have the outcome told.

Immediate fail (any one means the criterion is not met)

Staff, training and documents

Read across each row to see who does each step. Click a document name for its full text.

Staff responsible

Which level applies to you: it depends on your setting. Humanitarian settings have the fewest essential courses; standard settings have the most. Check the colour for your setting in each criterion.

Role Why it applies Level Training Where to go
Doctor ISCO 2212
ASF proposal
Prescribes and reviews opioid treatment Humanitarian: Recommended
Transition: Recommended
Standard: Recommended
— —
Nurse ISCO 2221
ASF proposal
Uses or checks the equipment and falls controls at the bedside Humanitarian: Recommended
Transition: Recommended
Standard: Recommended
Complaints Handling and Patient Feedback (T-12) —
Manager ISCO 1342
ASF proposal
Runs the facility process this criterion measures Humanitarian: Recommended
Transition: Recommended
Standard: Recommended
Complaints Handling and Patient Feedback (T-12) —

Documents: who does each step

Document Writes Approves Fills in Checks and signs Files and uploads
OPT-SOP-003 · Product complaints, returns and replacements FormsOPT-FRM-005 · Product complaint record Manager (ISCO 1342) Chief executive (ISCO 1120) Manager (ISCO 1342) Chief executive (ISCO 1120) Secretary (ISCO 3344)

E-learning: who must take each course

E-learning course Who must take Who is recommended
Complaints Handling and Patient Feedback (T-12) In development Nurse Manager

References

In process of development. Will be available soon.

15.7Urgent Eye and Ear Findings Are Referred the Same DayHumanitarian settings: MediumTransition and fragile: MustStandard: Must

Staff are trained to recognise sudden loss of vision or hearing, and other signs of an urgent eye or ear condition. Each such patient is sent the same day to emergency medical care through a written route that every member of staff knows.

Humanitarian settings
Medium
Transition
Must
Standard
Must

Why it matters. Sudden loss of vision or hearing can be a sign of a serious condition that needs care the same day. Staff who recognise it, and refer at once, can prevent permanent loss.

How the surveyor verifies this criterion

Sample. Review the urgent referral records for the last 12 months, and the staff training record for recognising urgent eye and ear conditions.

1. Staff are trained to recognise sudden loss of vision or hearing.

Method. Check the training record for each clinical member of staff.

Evidence to show. Training matrix register (WRK-REG-001).

Pass when. Every clinical member of staff has the training recorded.

2. Each urgent patient is sent the same day to emergency care.

Method. Check each urgent case for the referral on the same day.

Evidence to show. Urgent eye and ear referral record (OPT-FRM-006).

Pass when. Every urgent case is referred the same day.

3. The patient is confirmed to have reached care.

Method. Check each referral for the confirmation.

Evidence to show. Urgent eye and ear referral record.

Pass when. Every referral has the confirmation recorded.

Immediate fail (any one means the criterion is not met)

  • A patient with sudden loss of vision or hearing is not referred the same day.

Staff, training and documents

Read across each row to see who does each step. Click a document name for its full text.

Staff responsible

Which level applies to you: it depends on your setting. Humanitarian settings have the fewest essential courses; standard settings have the most. Check the colour for your setting in each criterion.

Role Why it applies Level Training Where to go
Doctor ISCO 2212
ASF proposal
Prescribes and reviews opioid treatment Humanitarian: Recommended
Transition: Recommended
Standard: Recommended
— —
Nurse ISCO 2221
ASF proposal
Uses or checks the equipment and falls controls at the bedside Humanitarian: Recommended
Transition: Recommended
Standard: Recommended
Medical Emergency Protocol Development (MED-01)
Safety & Emergency Preparedness (H-05)
—
Manager ISCO 1342
ASF proposal
Runs the facility process this criterion measures Humanitarian: Recommended
Transition: Recommended
Standard: Recommended
Medical Emergency Protocol Development (MED-01)
Safety & Emergency Preparedness (H-05)
—

Documents: who does each step

Document Writes Approves Fills in Checks and signs Files and uploads
OPT-FRM-006 · Urgent eye and ear referral record PoliciesOPT-POL-003 · Urgent eye and ear referral Manager (ISCO 1342) Chief executive (ISCO 1120) Secretary (ISCO 3344) Manager (ISCO 1342) Secretary (ISCO 3344)

E-learning: who must take each course

E-learning course Who must take Who is recommended
Medical Emergency Protocol Development (MED-01) In development Nurse Manager
Safety & Emergency Preparedness (H-05) In development Nurse Manager

References

  1. World Health Organization (2025). Vision and hearing screening for school-age children: implementation handbook. Used for: referral pathways for vision and hearing findings in children. https://news.gmj.ge/guideline/vision-and-hearing-screening-for-school-age-children-implementation-handbook/

Who is responsible for Standard 53

Each criterion names the positions responsible for it. Every position links to its own terms of reference.

Criterion Responsible Supports
15.1 Eye and Hearing Examinations Are Clinically Sound Optometrist
Ophthalmologist
Audiologist
15.2 Staff Are Qualified for the Service They Give Optometrist
Audiologist
Competency assessor
15.3 Products Are Fitted and Checked Hearing aid dispenser
Audiologist
Optometrist
15.4 Contact Lens and Hearing Aid Hygiene Is Taught Hearing aid dispenser
Audiologist
Optometrist
15.5 Aftercare and Follow-Up Are Arranged Optometrist
Audiologist
Patient services manager
15.6 Complaints About Products Are Recorded and Acted On Complaints and patient experience officer
Optometrist
Patient services manager
15.7 Urgent Eye and Ear Findings Are Referred the Same Day Ophthalmologist
ENT (otolaryngology) specialist
Head of emergency department

Role details: reporting, supervision and training

Training shown is the general recommendation. Role-specific training is set in the next improvement round.

Role Reports to Supervises Recommended training
Complaints and patient experience officer Quality manager None Facility induction; safeguarding adults (general recommendation)
Ophthalmologist Head of department (per specialty) None Facility induction; safeguarding adults (general recommendation)
ENT (otolaryngology) specialist Head of department (per specialty) None Facility induction; safeguarding adults (general recommendation)
Audiologist Head of department (per specialty) None Facility induction; safeguarding adults (general recommendation)
Optometrist Head of department (per specialty) None Facility induction; safeguarding adults (general recommendation)
Head of emergency department Medical director Triage nurse, Emergency nurse Facility induction; safeguarding adults (general recommendation)
Patient services manager Chief operating officer (COO) Admissions officer, Receptionist, Appointments clerk, Medical records manager, Bed manager / patient flow coordinator Facility induction; safeguarding adults (general recommendation)
Competency assessor Training and education manager None Facility induction; safeguarding adults (general recommendation)
Hearing aid dispenser Head of department (per specialty) None Facility induction; safeguarding adults (general recommendation)

Questions and answers

The criterion text is the authority. These answers summarise it.

What do the colours mean?

Red (Must) is required. Green (Medium) is recommended. Yellow (Minimum) is the minimum for humanitarian settings. Each criterion shows the level for each setting.

Do I have to use the documents on this page?

No. The policies, SOPs, forms and registers are drafts to help you. Adapt them to your facility, write your own, or upload your own. What the assessor checks is that the criterion is met and that you can show how.

Why does a criterion have no reference?

A grey note means no guideline in the GMJ library covers that criterion yet. A reference will be added once one is agreed.

Guidelines for this standard

9 guideline(s) are held in the GMJ Guidelines Library and listed here. Each link opens the full guideline on news.gmj.ge. The complete library, grouped by standard, is at Guidelines.

  1. WHO Guidelines on Hand Hygiene in Health Care (2009) (World Health Organization)
  2. World report on vision (2019) (World Health Organization)
  3. Guide to applying the WHO Eye Care Competency Framework (World Health Organization)
  4. Primary Ear and Hearing Care: Training Manual (World Health Organization)
  5. Infection prevention and control practices for care of patients in nontraditional settings with focus to the novel coronavirus (COVID-19) (Pan American Health Organization)
  6. Vision and hearing screening for school-age children: implementation handbook (World Health Organization)
  7. Development and implementation of national action plans for infection prevention and control: practical guide (World Health Organization)
  8. Clinical management and infection prevention and control for mpox: living guideline, May 2025 (World Health Organization)
  9. Guidelines on hand hygiene in community settings (World Health Organization)

Also relevant to this standard: