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

Professionalism in Nursing

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    Professionalism in nursing is an essential ingredient in achieving a healthy work environment and is enabled by the context of practice.

    Overall Goals of the BPG:

    1. To identify the concept of professionalism as a guiding tenet that enhances outcomes for nurses, patients, organizations and systems.
    2. To define the attributes of professionalism.
    3. To identify and discuss the evidence related to each attribute of professionalism.
    4. To provide strategies for success.

    The key areas addressed by this guideline are:

    • Identification of a set of attributes that signify professionalism of the nurse
    • Evidence from the Joanna Briggs Institute systematic review and other literature
    • Knowledge, competencies and behaviors of effective nurses who exhibit professional practices in their workplace
    • Organizational structures, key elements and processes that support development of effective nursing professional practices
    Registered Nurses’ Association of Ontario. (2007). Professionalism in nursing.  Toronto, ON, Canada: Author. Retrieved from https://rnao.ca/sites/rnao-ca/files/Professionalism_in_Nursing.pdf

     

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    In a 48 minute interview, two executive nurse leaders discuss the concepts of critical inquiry and evidence-informed practice and how they apply to nursing.  The regulatory requirements for evidence based informed practice along with how critical inquiry supports a safe practice are discussed by way of examples.

    College of Nurses of Ontario. (2015).  Critical inquiry and evidence-informed practice webcast. Retrieved from http://www.cno.org/fr/exercice-de-la-profession/educational-tools/webcasts/critical-inquiry-and-evidence-informed-practice-webcast/

     

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    A webcast that reviews the standards for documentation outlined by the College of Nurses of Ontario.

    College of Nurses of Ontario. (2012). Documentation: An overview webcast.

    Retrieved from http://www.cno.org/en/learn-about-standards-guidelines/educational-tools/webcasts/documentation-webcast/

     

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    This webinar provides information to assist nurses who have been selected for a Guided Reflection meeting, as part of the College's Professional Conduct process. Nurses learn how to prepare for the meeting with College staff, and what will happen when they come to the College for the meeting.

    College of Nurses of Ontario. (n.d.). Guided reflection: What to expect. Retrieved from http://www.cno.org/en/learn-about-standards-guidelines/educational-tools/webcasts/practice-reflection-videos/guided-reflection-what-to-expect/

     

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    A short discussion emphasizing the importance of self-reflection in every nurse’s practice; facilitated by Anne Coghlan, Executive Director of the College of Nurses of Ontario.

    College of Nurses of Ontario. (n.d.). Practice reflection: Learning from practice. Retrieved from http://www.cno.org/en/learn-about-standards-guidelines/educational-tools/webcasts/practice-reflection-videos/practice-reflection-videos-intro/

     

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    This document explains the purpose of mandatory reporting, how the College of Nurses addresses reports, and what outcomes you can expect from making a report to the College.

    College of Nurses of Ontario. ( 2018). Mandatory Reporting : A Process guide for employers, facility operators and nurses. Retrieved from https://www.cno.org/en/protect-public/employers-nurses/

     

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    A webcast that reviews the medication practice standard as outlined by the College of Nurses of Ontario.

    College of Nurses of Ontario. ( 2019). Medication practice standard: An overview webcast. Retrieved from: http://www.cno.org/en/learn-about-standards-guidelines/educational-tools/webcasts/medication-practice-standard-an-overview-webcast/

     

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    This Nurse Practitioner (NP) practice standard describes the accountabilities specific to NPs in Ontario (also known as Registered Nurses in the Extended Class). NPs are also accountable for complying with relevant laws and other College standards and guidelines as applicable.

    College of Nurses of Ontario. ( 2019). Nurse practitioner practice standard. Retrieved from http://www.cno.org/globalassets/docs/prac/41038_strdrnec.pdf
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    This presentation provides a discussion on the professional and regulatory requirements of practice reflections and its benefits. There is an explanation on how regulated nurses can reflect on their practice. Two examples of practice reflection are shared.

    College of Nurses of Ontario (2015). Practice reflection: Learning from practice [PDF file]. Retrieved from http://www.cno.org/globalassets/4-learnaboutstandardsandguidelines/prac/learn/teleconferences/practice-reflection--learning-from-practice.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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    Gain an overview of the most compelling evidence about diversity; understanding it, accepting the differences it brings to work settings, and finally, to seeking and embracing diversity.

    This panel has been developing guidelines that recommend a congruent set of work place behaviours, management practices and institutional policies within a practice setting resulting in an organizational environment that is respectful and inclusive of cultural and other forms of diversity.

    Registered Nurses’ Association of Ontario. (2007). Embracing cultural diversity in health care: Developing cultural competence. Toronto, ON: Author. Retrieved from https://rnao.ca/sites/rnao-ca/files/Embracing_Cultural_Diversity_in_Health_Care_-_Developing_Cultural_Competence.pdf

     

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     The goal of this best practice guideline is to strengthen collaborative practice among nurses, because effective collaborative practice is essential for working in health-care organizations. In this guideline, we focus on collaborative practice amongst three types of nursing professionals – registered nurse (RN), registered practical nurse (RPN) and nurse practitioner (NP) – and explore what fosters healthy work environments for them, aware that collaboration must align with the needs of the patient or client. This best practice guideline was developed to assist nurses, nursing leaders, other health professionals and senior managers to enhance positive outcomes for patients/clients (individual/family/group/community), nurses, and the organization through intra-professional collaborative practice. This guideline was based on the best available evidence and where evidence was limited, the best practice recommendations were based on the consensus of expert opinion. This guideline identifies:

    • best practices for intra-professional practice; and
    • the organizational culture, values and relationships, and the structures and processes required, for developing and sustaining effective intra-professional nursing practice among nurses.
    Registered Nurses’ Association of Ontario. (2016). Intra-professional collaborative practice among nurses. Toronto, ON, Canada: Author. Retrieved from https://rnao.ca/sites/rnao-ca/files/bpg/Intra-professional_Collaborative_Practice_042017.pdf
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    Cette ligne directrice sur les pratiques exemplaires en soins infirmières et infirmiers est un document détaillé comportant les ressources nécessaires au soutien de la pratique basée sur des données probantes. Un milieu de travail sain, c’est un milieu de pratique qui maximise la santé et le bien-être des infirmières, des résultats de qualité chez le patient ou client, le rendement de l’organisation et du système, et les retombées sociales, y compris des collectivités en meilleure santé.

    Association des infirmières et infirmiers autorisés de l’Ontario. (2013). Lignes directrices sur le développement et le maintien du leadership infirmier (2em Ed). Toronto, ON, Canada: Auteur. Récupérée de https://rnao.ca/sites/rnao-ca/files/LeadershipBPG_FR.pdf

     

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    Gain knowledge in leadership practices that result in healthy outcomes for nurses, patients/clients, organizations and systems. This guideline addresses:

    • System resources that support effective leadership practices and behaviours for formal leaders and nurses at the point of care
    • Organizational culture, values and resources that support effective leadership practices and behaviours at all levels
    • Personal resources that support effective leadership practices across the continuum of care
    • Anticipated outcomes of effective nursing leadership

    This guideline provides evidence-based recommendations for RNs and RPNs on best nursing practices for developing and sustaining nursing leadership.

    Registered Nurses’ Association of Ontario. (2013). Developing and sustaining nursing leadership Best Practice Guideline (2nd Ed.). Toronto, ON, Canada: Author. Retrieved from https://rnao.ca/sites/rnao-ca/files/LeadershipBPG_Booklet_Web_1.pdf

     

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    This Best Practice Guideline focuses on nursing teams and processes that foster healthy work environments. The focus for the development of this guideline was managing conflict among nursing and healthcare teams with the view that while some conflict is preventable, healthy conflict can also be beneficial.

    The BPG was developed to assist nurses in all roles and all settings, other health professionals and management teams to enhance positive outcomes for patients/clients, nurses and Health-care teams, and the organization itself.

    This BPG identifies:

    • Knowledge, competencies and behaviours for effective conflict management;
    • Best practices that effectively recognize, address, mitigate and manage conflict;
    • Educational requirements and strategies;
    • Policy changes at both the organizational and system levels needed to support and sustain an environment that understands, prevents, mitigates and manages conflict;
    • Implementation strategies and tools; and,
    • Future research opportunities.

    For the purpose of this document, conflict is defined as: a phenomenon occurring between interdependent parties as they experience negative emotional reactions to perceived disagreements and interference with the attainment of their goals (Barki & Hartwick, 2004)

    Registered Nurses’ Association of Ontario. (2012). Managing and mitigating conflict in health-care teams. Toronto, ON: Author. Retrieved from https://rnao.ca/sites/rnao-ca/files/Managing-conflict-healthcare-teams_hwe_bpg.pdf

     

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    A short video profiling different nurses discussing reflective practice and getting feedback about their practice.  The clip highlights questions nurses can ask themselves and how they can get feedback from their peers.

    College of Nurses of Ontario. (n.d.). The value of reflective practice. Retrieved from http://www.cno.org/en/learn-about-standards-guidelines/educational-tools/webcasts/practice-reflection-videos/the-value-of-practice-reflection/