Implementing and sustaining evidence-based practices in long-term care.

All Clinical Resources

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    This best practice guideline is focused on preventing and addressing abuse and neglect of older adults throughout various health-care institutions and community settings in Canada. It outlines recommendations for nurses and other health-care providers, educators, health-care organizations, advocacy groups, nursing regulatory bodies and governments. Implementation resources in development include an e-learning course, a health education fact sheet, and a personal digital assistant (PDA) version of the guideline.

    This guideline is part of an initiative funded by the Government of Canada’s New Horizons for Seniors Program and builds on a collaborative project between the Canadian Nurses Association (CNA) and RNAO, titled Promoting the Awareness of Elder Abuse in Long-Term Care.

    Registered Nurses’ Association of Ontario (2014). Preventing and Addressing Abuse and Neglect of Older Adults: Person-Centred, Collaborative, System-Wide Approaches. Toronto, Canada: http://rnao.ca/bpg/guidelines/abuse-and-neglect-older-adults

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    It will provide direction to all nurses and the interprofessional team who provide care in all health-care settings to people (>15 years of age) with type 1 and/or type 2 diabetes and who have established diabetic foot ulcers. This best practice guideline provides evidence-based recommendations that will assist interdisciplinary teams with assessment and management of clients who are over the age of fifteen with established diabetic foot ulcers.

    Registered Nurses’ Association of Ontario (2013). RNAO Assessment and Management of Foot Ulcers for People with Diabetes. Toronto, ON: Author. This work is funded by the Ontario Ministry of Health and Long-Term Care. Retrieved from: http://rnao.ca/bpg/guidelines/assessment-and-management-foot-ulcers-people-diabetes-second-edition
     

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    The guideline contains recommendations for best nursing practices in the assessment and management of pain for Registered Nurses (RNs) and Registered Practical Nurses (RPNs). It is acknowledged that the individual competency of nurses varies between nurses and across categories of nursing professionals (RNs and RPNs) and is based on knowledge, skills, attitudes, critical analysis and decision making which is enhanced over time by experience and education. This guideline is endorsed by the International Association for the Study of Pain.

    © Registered Nurses’ Association of Ontario (2013). Assessment and Management of Pain Third Edition.  Toronto, ON: Author. http://ltctoolkit.rnao-dev.org/node/326/edit?destination=clinical-topics/pain-assessment

     

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    The purpose of this Guideline is to present evidence-based recommendations that apply to the decisions and best practices of interprofessional teams working to assess and manage existing pressure injuries in people 18 years of age and above. This Best Practice Guideline (BPG) replaces the RNAO BPG Assessment and Management of Stage I to IV Pressure Ulcers (2007). It provides evidence-based practice, education and policy recommendations for interprofesssional teams across all care settings who are assessing and providing care to people with existing pressure injuries. Moreover, this Guideline refers to “pressure ulcers” as “pressure injuries.” This new terminology aligns with the National Pressure Ulcer Advisory Panel (NPUAP).

    This Guideline provides best practice recommendations in three main areas:

    • Practice recommendations are directed primarily to the front-line interprofessional teams who provide care for people with existing pressure injuries across all practice settings.
    • Education recommendations are directed to those responsible for interprofessional team and staff education, such as educators, quality improvement teams, managers, administrators, and academic institutions.
    • System, organization, and policy recommendations apply to a variety of audiences, depending on the recommendation. Audiences include managers, administrators, policy-makers, health-care professional regulatory bodies, and government bodies.

    Registered Nurses’ Association of Ontario. (2016). Assessment and Management of Pressure Injuries for the Interprofessional Team, Third Edition. Toronto, ON: Author. Retrieved from: http://rnao.ca/bpg/guidelines/pressure-injuries

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    This new guideline is designed to apply to all domains of nursing practice, including clinical, administration, and education, to assist nurses to become more comfortable, confident and competent when caring for clients undergoing care transitions. It is important that nurses, working in collaboration with the interprofessional team promote safe and effective care transitions. Care transitions depends on effective communication and coordination of client care by all interprofessional team members and with the client, their family and caregivers.

    Reference: Registered Nurses’ Association of Ontario (2014). Care Transitions. Toronto, ON, Canada: Author. http://rnao.ca/bpg/guidelines/care-transitions

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    This nursing Best Practice Guideline (BPG) is intended to replace the RNAO (2010) BPGs Screening for Delirium, Dementia and Depression in Older Adults and Caregiving Strategies for Older Adults with Delirium, Dementia and Depression. It is to be used by nurses and other members of the interprofessional health-care team to enhance the quality of their practice pertaining to delirium, dementia, and depression in older adults, ultimately optimizing clinical outcomes through the use of evidence-based practices.

    Registered Nurses’ Association of Ontario. (2016). Delirium, Dementia, and Depression in Older Adults: Assessment and Care. Toronto, ON, Canada: Author. Retrieved from http://rnao.ca/bpg/guidelines/assessment-and-care-older-adults-delirium-dementia-and-depression

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    This guideline focuses on recommendations for adults, aged 18 years and older, who have reached the part of the illness trajectory that includes the last days and hours of life. This guideline will provide evidence- based recommendations for Registered Nurses and Registered Practical Nurses on best nursing practices for end-of-life care during the last days and hours.

    Registered Nurses’ Association of Ontario (2011). End-of-Life Care During the Last Days and Hours. Toronto, ON: Author. 

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    This guideline provides evidence-based recommendations for RNs and RPNs on best nursing practices for oral health care. This guideline focuses on recommendations for assessing oral health, and strategies and interventions related to oral care. 

    Registered Nurses’ Association of Ontario (2008). Oral Health: Nursing Assessment and Intervention. Toronto, ON: Author. Website: http://rnao.ca/bpg/guidelines/oral-health-nursing-assessment-and-intervention      

    This work is funded by the Ontario Ministry of Health and Long-Term Care.

    Translations for this Guideline: Igiene del cavo orale - Valutazione e interventi infermieristici (Italian).

     

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    Reduce the frequency and severity of constipation among older adults through the use of adequate hydration and dietary fibre, regular consistent toileting and physical activity. Achieving and maintaining a pattern of normal bowel elimination will prevent constipation, decrease the use of laxatives, and improve the quality of life for older adults. Published: 2005 Supplement: 2005 Revised: 2011

    Registered Nurses’ Association of Ontario. Prevention of Constipation in the Older Adult Population. (2011). Toronto, ON: Author.  Retrieved from: http://rnao.ca/bpg/guidelines/prevention-constipation-older-adult-population.

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    Increase your confidence, knowledge, skills and abilities in the identification of adults within health care facilities at risk of falling and to define interventions for the prevention of falling. The guideline does not include interventions for the prevention of falls and fall injuries in older adults living in community settings. The guideline has relevance to areas of clinical practice including acute care and long-term care, and will assist nurses to apply the best available research evidence to clinical decisions, and to promote the responsible use of health care resources. Revised: 2005 Supplement: 2011

    Registered Nurses’ Association of Ontario.  (2011).  RNAO Prevention of Falls and Fall Injuries in the Older Adult Best Practice Guideline. (Rev. Ed.).  Toronto, ON: Registered Nurses’ Association of Ontario.  (Original work published 2002)

    http://rnao.ca/sites/rnao-ca/files/Prevention_of_Falls_and_Fall_Injuries_in_the_Older_Adult.pdf