The following resource is designed to assist Long-Term Care (LTC) homes with the implementation of the following Best Practice Gudielines:
Documents found in this resource are evidence-based, but it is not a program plan. Each LTC home is unique and each home is in various stages of guideline implementation. LTC homes are advised to use the resource at their discretion. For those resources that have copyright notations, it is recommended that LTC homes obtain permission from the primary author prior to implementing them within their setting. The Toolkit is a dynamic resource, and is being updated and revised on a regular basis by the LTC Best Practices Program team. Visit this site often to see what's new!
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A tool to assist with comparing your organization’s current practice with evidence-based RNAO best practice recommendations.
Registered Nurses Association of Ontario (2022). Gap Analysis- A Proactive Approach to Bladder and Bowel Management. Toronto. ON
The best practice guideline (BPG) A Proactive Approach to Bladder and Bowel Management in Adults, Fourth Edition replaces the RNAO BPGs Promoting Continence Using Prompted Voiding and Prevention of Constipation in the Older Adult Population, both of which were last updated in 2011. This BPG provides evidence-based recommendations for effective strategies to support adults (aged 18 years and older) who live with urinary incontinence, fecal incontinence and/or constipation that will improve quality of care and lead to positive health outcomes.
The BPG includes good practice statements on conducing a focused initial assessment and recommendation areas that address the following: toileting strategies, physical activity, adequate intake of fibre and/or fluids, interprofessional approach and bowel protocol.
This BPG can be used by nurses, members of the interprofessional team and caregivers across the continuum of care and in all domains of practice such as administration, clinical, education, policy and research. The evidence-based recommendations in this BPG are applicable to all practice settings where persons who live with urinary incontinence, fecal incontinence and/or constipation are accessing services (e.g., acute care, long-term care, primary and community care, and rehabilitation settings).
| Registered Nurses’ Association of Ontario (RNAO). A proactive approach to bladder and bowel management in adults. 4th ed. Toronto (ON): RNAO; 2020. |
A comprehensive list of physical, environmental, functional and other factors that contribute to fecal incontinence. Registered Nurses’ Association of Ontario (RNAO). A proactive approach to bladder and bowel management in adults. 4th ed. Toronto (ON): RNAO; 2020.
A systematic approach to encouraging incontinent people to become continent. Registered Nurses’ Association of Ontario (RNAO). A proactive approach to bladder and bowel management in adults. 4th ed. Toronto (ON): RNAO; 2020.
A list of the major drug groups that can contribute to urinary incontinence. Registered Nurses’ Association of Ontario (RNAO). A proactive approach to bladder and bowel management in adults. 4th ed. Toronto (ON): RNAO; 2020.
A comprehensive list of physical, emotional and other factors that contribute to urinary continence. Registered Nurses’ Association of Ontario (RNAO). A proactive approach to bladder and bowel management in adults. 4th ed. Toronto (ON): RNAO; 2020.
Appendix H from the RNAO A Proactive Approach to Bladder and Bowel Management in Adults — Fourth Edition is a systematic approach to dealing with constipation and fecal incontinence.
Registered Nurses’ Association of Ontario (RNAO). A proactive approach to bladder and bowel management in adults. 4th ed. Toronto (ON): RNAO; 2020. (p. 132).
Appendix G from the RNAO A Proactive Approach to Bladder and Bowel Management in Adults — Fourth Edition shows how the best practice guideline recommendations can be applied in the clinical setting.
Registered Nurses’ Association of Ontario (RNAO). A proactive approach to bladder and bowel management in adults. 4th ed. Toronto (ON): RNAO; 2020. (p.131).
Appendix S from the RNAO A Proactive Approach to Bladder and Bowel Management in Adults — Fourth Edition provides systematic approaches to decreasing constipation.
Registered Nurses’ Association of Ontario (RNAO). A proactive approach to bladder and bowel management in adults. 4th ed. Toronto (ON): RNAO; 2020. (p. 150-151).
Appendix Q from the RNAO A Proactive Approach to Bladder and Bowel Management in Adults — Fourth Edition shows pictures of stools to help improve assessment of constipation.
Registered Nurses’ Association of Ontario (RNAO). A proactive approach to bladder and bowel management in adults. 4th ed. Toronto (ON): RNAO; 2020. (p. 147).
