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

Chronic Disease Management

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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. (3rd Ed.). Toronto, ON: Author. Retrieved from https://rnao.ca/sites/rnao-ca/files/AssessAndManagementOfPain_15_WEB-_FINAL_DEC_2.pdf
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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.

    Registered Nurses’ Association of Ontario. (2014). Care transitions. Toronto, ON, Canada: Author. https://rnao.ca/sites/rnao-ca/files/Care_Transitions_BPG.pdf

    French translation - Transitions des soins https://rnao.ca/sites/rnao-ca/files/TransitionsDesSoins-RNAO.pdf

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    For the purpose of this document, Interprofessional is defined as: Multiple health disciplines with diverse knowledge and skills who share an integrated set of goals and who utilize interdependent collaboration that involves communication, sharing of knowledge and coordination of services to provide services to patients/clients and their care-giving systems.

    This best practice guideline, Developing and Sustaining Interprofessional Health Care: Optimizing patients/clients, organizational, and system outcomes is intended to foster healthy work environments. The focus in developing this guideline was identifying attributes of interprofessional care that will optimize quality outcomes for patients/clients, providers, teams, the organization and the system.

    This guideline identifies best practices to enable, enhance and sustain teamwork and interprofessional collaboration, and to enhance positive outcomes for patients/clients, systems and organizations. It is based on the best available evidence; where evidence was limited, the recommendations were based on the consensus of expert opinion.

    Registered Nurses’ Association of Ontario. (2013). Developing and sustaining interprofessional health care: Optimizing patients/clients, organizational, and systems outcomes. Toronto, ON: Author. Retrieved from https://rnao.ca/sites/rnao-ca/files/DevelopingAndSustainingBPG.pdf
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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. Retrieved from https://rnao.ca/sites/rnao-ca/files/End-of-Life_Care_During_the_Last_Days_and_Hours_0.pdf
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    Effective nursing practice is dependent on an effective therapeutic relationship between the nurse and the client. This guideline addresses the qualities and capacities of an effective therapeutic relationship, the state of knowledge, and the knowledge needed to be effective. To implement a therapeutic relationship successfully, an organization's characteristics and workplace values must be supportive and in place. An organization readiness assessment based on the best practice recommendations is provided. Supplement: 2006

    Registered Nurses’ Association of Ontario. (2002). Establishing therapeutic relationships. Toronto, ON, Canada: Author. Retrieved from https://rnao.ca/sites/rnao-ca/files/Establishing_Therapeutic_Relationships.pdf
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    The purpose of this best practice guideline is to provide evidence-based recommendations related to nurses and other health care professionals providing effective client centred learning. This guideline will address the following areas: • How can nurses effectively facilitate client centred learning? • What are effective teaching delivery methods/ strategy for client centred learning? • How do nurses assess client learning? This guideline will be applicable to all domains of nursing including clinical, administration, and education.

    Registered Nurses’ Association of Ontario. (2012). Facilitating client centred learning. Toronto, ON: Author. Retrieved from https://rnao.ca/sites/rnao-ca/files/BPG_CCL_2012_FA.pdf
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    The Person-and Family-Centred Care best practice guideline can be used to enhance the quality of partnerships between health-care providers with individuals accessing care, ultimately improving clinical outcomes. It is important to acknowledge that person- and family-centred care focuses on the whole person as a unique individual and not just on their illness or disease. By viewing the individual through this lens, health-care providers come to know and understand the person’s life story, experience of health, the role of family in the person’s life, and the role they may play in supporting the person to achieve health. This guideline provides best practice recommendations in three main areas: •Practice recommendations are directed primarily to those who provide direct care to persons in health-system settings and in the community. •Education recommendations are directed to those responsible for staff and student education. •System, organization, and policy recommendations apply to managers, administrators, policy-makers, nursing regulatory bodies, academic institutions, and government bodies. Recommendations in these three areas are most effective when implemented together. This guideline replaces the previous BPG Client Centred Care.

    Registered Nurses’ Association of Ontario. (2015). Person-and family-centred care. Toronto, ON, Canada: Author. Retrieved from https://rnao.ca/sites/rnao-ca/files/FINAL_Web_Version_0.pdf
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    Chronic diseases are unlike any acute illness, in that they require considerable professional self-management support over the client’s lifetime, related life management skills, and long term regular follow-up with healthcare professionals. Over the last decade, a dramatic rise in the prevalence of chronic health conditions has emerged, altering the way in which care is sought, managed, delivered and received. The purpose of this guideline is to provide evidence-based recommendations for Registered Nurses and Registered Practical Nurses across the continuum of care in self-management support. These recommendations identify strategies and interventions that enhance an individual’s ability to manage their chronic health condition.

    Registered Nurses’ Association of Ontario. (2010). Strategies to support self-management in chronic conditions: Collaboration with clients. Toronto, ON: Author. Retrieved from https://rnao.ca/sites/rnao-ca/files/Strategies_to_Support_Self-Management_in_Chronic_Conditions_-_Collaboration_with_Clients.pdf