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, ON: Registered Nurses’ Association of Ontario. Retrieved from https://rnao.ca/sites/rnao-ca/files/Preventing_Abuse_and_Neglect_of_Older_Adults_English_WEB.pdf

     

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    This best practice guideline (BPG) Oral Health: Supporting Adults Who Require Assistance Second Edition replaces the RNAO BPG Oral Health: Nursing Assessment and Intervention, which was released in 2008. The purpose of this next edition BPG is to provide nurses, the interprofessional team and caregivers with evidence-based recommendations for the provision of oral care for adults (18 years of age and older) that will: (a) promote an interprofessional approach to providing oral care, (b) enhance the delivery of oral care interventions, and (c) ultimately lead to positive oral health outcomes for persons. 

    The BPG focuses on providing oral care across health settings to adults who require assistance with oral care in a continuum that ranges from the set-up of oral care supplies to full physical assistance with oral care. This BPG provides recommendations to support the delivery of oral care—including appropriate supervision, prompting and assistance—while still advocating for the person’s independence and autonomy. 

    Registered Nurses’ Association of Ontario (2020). Oral Health: Supporting Adults Who Require Assistance. (2nd ed.). Toronto, ON: Author. Retrieved from https://rnao.ca/sites/rnao-ca/files/bpg/RNAO_Oral_Health_Supporting_Adults_Who_Require_Assistance_Second_Edition_final.pdf 

    This work is funded by the Government of Ontario.

     

     

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    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.

     

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    Increase your comfort, confidence and competence in this practice area, in order to enhance safety for your clients and to lower the impact of suicide to society. The goal of this best practice guideline is to provide nurses with recommendations, based on the best available evidence, related to the assessment and care of adults at risk for suicidal ideation and behaviour.

    Registered Nurses’ Association of Ontario. (2009). Assessment and Care of Adults at Risk for Suicidal Ideation and Behaviour. Toronto, ON, Canada: Author. Retrieved from http://rnao.ca/bpg/guidelines/assessment-and-care-adults-risk-suicidal-ideation-and-behaviour

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

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

     

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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 caregiviers.

    This guideline is endorsed by Accreditation Canada.

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

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

     

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

     

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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. 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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    Preventing Falls and Reducing Injury from Falls (3rd ed.) replaces the RNAO (2011) BPG Prevention of Falls and Fall Injuries in the Older Adult, which was originally published in 2002 and then revised in 2005 and 2011. Whereas previous editions focused on older adults in hospital and long-term-care settings, the scope of this third edition has been expanded to include in all adults (>18 years) at risk for falls and receiving care from nurses and other health-care providers across the health-care continuum, including those living in the community.

    The purpose of this guideline is to outline evidence-based approaches for preventing falls and reducing fall injuries for adults. Recommendations are provided at the following three levels:

    • Practice recommendations are directed primarily toward nurses who provide direct clinical care to adults at risk for falls across the continuum of care, including (but not limited to): primary care, home care, hospital care, and long-term care settings. The secondary audience of the practice recommendations includes other members of the interprofessional team who collaborate with nurses to provide comprehensive care. All of the recommendations are applicable to the scope of practice of registered nurses and nurse practitioners (general and extended classes); however, many are also applicable to other health-care providers.
    • Education recommendations are directed at individuals and organizations responsible for the education of healthcare providers, such as educators, quality improvement teams, managers, administrators, academic institutions, and professional organizations.
    • Organization and policy recommendations are directed at those managers, administrators, and policy-makers responsible for developing policy or securing the supports required within health-care organizations that enable the implementation of best practices. For optimal effectiveness, recommendations in these three areas should be implemented together.
    Registered Nurses’ Association of Ontario.  (2017).  RNAO Prevention of Falls and Reducing Injury from Falls Best Practice Guideline. (4th Ed.).  Toronto, ON: Author.

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

    http://rnao.ca/bpg/guidelines/prevention-falls-and-fall-injuries

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    Nurses require knowledge and evidence on the use of alternative approaches to the use of restraints. The promotion of safe evidence based care is the goal to prevent the untoward incidents from the use of restraints. This guideline offers nurses a model which will help them to examine their approach to the use of restraints within their practice.

    Registered Nurses’ Association of Ontario. (2012). RNAO Promoting Safety: Alternative Approaches to the Use of Restraints. Toronto, ON: Author. Retrieved from https://rnao.ca/sites/rnao-ca/files/Promoting_Safety_-_Alternative_Approaches_to_the_Use_of_Restraints_0.pdf

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

    Source: https://rnao.ca/bpg/guidelines/promoting-safety-alternative-approaches-use-restraints?_ga=2.257239755.1702348378.1602485970-1685849072.1567072300 

     

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    This guideline focuses its recommendations on three areas: 1.Practice recommendations directed at the nurse 2.Education recommendations directed at the competencies required for practice 3.Organization and Policy recommendations addressing the importance of a supportive practice environment as an enabling factor for providing high quality nursing care, which includes ongoing evaluation of guideline implementation. Supplement: 2007

    This best practice guideline provides evidence-based recommendations for nurses who are not specialists in the area of Diabetes. These recommendations assist nurses to conduct risk assessments for foot ulcers, provide basic education for the prevention of foot ulcers and   implement the appropriate interventions when there is a high risk for ulcer or amputation present.
    Registered Nurses’ Association of Ontario (2007). RNAO Reducing foot Complications for People with Diabetes. Toronto, ON: Author. Retrieved from: http://rnao.ca/bpg/guidelines/reducing-foot-complications-people-diabetes

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    Supporting Adults who Anticipate or Live with an Ostomy is a best practice guideline (BPG) that provides nurses and the interprofessional team with evidence-based recommendations for the most effective strategies to support adults (18 years and older) who anticipate or live with an ostomy. The purpose of this BPG is to (a) promote self-management, (b) enhance access and delivery of care, and (c) lead to positive health outcomes in adults who anticipate or live with an ostomy.

    The BPG has 6 evidence-based recommendations that address the following: access to Nurses Specialized in Wound, Ostomy, and Continence (NSWOC) to support comprehensive care, the need for a standardized ostomy care program within health service organizations, guidance on the prevention of parastomal hernias, and quality of life assessments in adults who anticipate or live with an ostomy.

    This BPG can be used by nurses across the continuum of care and in all domains of practice—such as clinical, research, education, policy, and administration—and members of the interprofessional team. It can also be used by organizations in which they are employed. The evidence-based recommendations in this BPG are applicable to all practice settings where adults who anticipate or live with an ostomy are accessing services (such as, but not limited to, acute care, long-term care, community settings, and rehabilitation settings).

    Registered Nurses’ Association of Ontario. (2019). Supporting adults who anticipate or live with an ostomy. Toronto, ON: Author. Retrieved from https://rnao.ca/sites/rnao-ca/files/bpg/OSTOMY_FINAL_WEB.pdf 

     

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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- Assessment and Management of Foot Ulcers for People with Diabetes. Toronto, ON.

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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

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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-Adult Asthma Care- Promoting Control of Asthma. Toronto. ON

     

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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-Assessment and Care of Adults at Risk for Suicidal Ideation and Behaviour. Toronto. ON

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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-Assessment and Management of Pressure Injuries for the Interprofessional Team. Toronto. ON

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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-Care Transitions. Toronto. ON

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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-Delirium, Dementia and Depression in Older Adults . Toronto, ON.

     

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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-End-of-Life Care During Last Days and Hours. Toronto. ON

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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-Nursing Care of Dyspnea- The 6th Vital Sign in Individuals with Chronic Obstructive Pulmonary Disease. Toronto. ON

     

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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 -Oral Health Supporting Adults Who Require Assistance. Toronto, ON.

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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-Ostomy Care and Management. Toronto. ON

     

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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- Palliative Approach to Care in the Last 12 Months of Life. Toronto. ON

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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- Person and Family Centred Care. Toronto, ON.

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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 Preventing and Addressing Abuse and Neglect of Older Adults. Toronto, ON

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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- Preventing Falls and Reducing Injury from Falls. Toronto. ON

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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 Promoting Safety: Alternative Approaches to the Use of Restraints. Toronto, ON

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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-Reducing Foot Complications for People with Diabetes. Toronto, ON.

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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 Assessment & Management of Pain 3rd edition. Toronto, ON.

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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-Assessment and Management of Venous Leg Ulcers. Toronto, ON.

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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-Engaging Clients Who Use Substances. Toronto, ON

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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. https://rnao.ca/sites/rnao-ca/files/FINAL_Web_Version_0.pdf

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

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    A summary of the recommendations of RNAOs Best Practice Guideline on Preventing Falls and Reducing Injury from Falls (4th ed.).

    Registered Nurses’ Association of Ontario.  (2017).  RNAO Prevention of Falls and Reducing Injury from Falls Best Practice Guideline. (4th Ed.).  Toronto, ON: Author. (p.11-14).

     

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    This document contains sample program objectives, policy, procedures and staff training materials and tools that meet the minimum requirements of the LTCHA and regulation. It was developed by Advantage Ontario. Obtained with permission.

    Ontario Association of Non-Profit Homes and Services for Seniors. (December 2010).   Continence Care and Bowel Management Program - Policy, Procedures and Training Package.  Woodbridge, ON, Canada: Author.  Retrieved from http://www.oanhss.org/MediaCentre2/LTCHomesActCentralseeSiteNavigation/LTCHA_Resources.aspx.

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    This document contains sample program objectives, policy, procedures and staff training materials and tools that meet the minimum requirements of the LTCHA and regulation. It was developed by Advantage Ontario. Obtained with permission.

    Ontario Association of Non-Profit Homes and Services for Seniors. (January 2011).   Nutrition and Hydration Program - Policy, Procedures and Training Package.  Woodbridge, ON, Canada: Author.  Retrieved from http://www.oanhss.org/MediaCentre2/LTCHomesActCentralseeSiteNavigation/LTCHA_Resources.aspx.

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    Ontario Regulation 246/22 was made under the Fixing Long-Term Care Act (FLTCA), 2021 and proclaimed into force to regulate Ontario's long-term care home sector April 11, 2022. Government of Ontario (2022) Ontario Regulation 246/22. Toronto (ON).

    Retrieved from https://www.ontario.ca/laws/regulation/r22246#BK65 

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    This free to join Community of Practice contains Modules on such topics as how wounds heal, wound assessment and wound packing. The site also has links to Canadian association of Wound Care, Diabetic Foot Canada, and several YouTube webinars on a variety of related topics

    BC Patient Safety and Quality Council. (n.d.). elearning modules: Skin and wound care. Retreived from https://www.clwk.ca/

    Copyright 2016 BCPSQC. All Rights Reserved.

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    This presentation reviews strategies of sizing and distribution for improving continence product usage. Developed by Deb Jenkins, APN, Improving Continence Care Collaborative Co-lead, SHRTN Community of Practice. December 2011.

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    The case study and its accompanying discussion guide were developed for educational purposes in long-term care homes to promote use of the RNAO Delirium, Dementia, and Depression in Older Adults: Assessment and Care BPG. This resource provides the necessary instructions to hold a facilitated discussion with long-term care staff.  Overall goals of the case study and discussion guide are to:

    • Actively engage participants in discussions about delirium, dementia, and depression
    • Help long-term care staff identify the differences between delirium, dementia, and depression
    • Help long-term care staff become familiar with key resources they can use at the point-of-care to support identification of delirium, dementia, and depression
    • Reinforce best practices for the care of delirium, dementia, depression in older adults

    Reference: Registered Nurses’ Association of Ontario. (2017). 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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    The 4AT is a validated rapid assessment test for delirium and cognitive impairment. It is widely used in routine clinical practice in the UK and internationally. It is free for download and use.

    Reference: MacLullich, A., Ryan, T. and Cash, H. (2014). 4AT Rapid Assessment Test for Delirium. Retrieved from http://www.the4at.com/

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    This is a comprehensive guide for caregivers caring for a stroke survivor by March of Dimes program, Stroke Recovery Canada. It provides information and tips on stroke recovery for caregivers.

    Reference: March of Dimes. (n.d.). Stroke Recovery Canada. Caregivers guide to stroke recovery (2nd ed). Retrieved from SRC_Caregiver-s_Guide_to_Stroke_Recovery.pdf 
     


     

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    The Guide to Dressing Foot Wounds is found as Appendix R of the RNAO BPG, Assessment and Management of Foot Ulcers for People with Diabetes. Pg 147-149. The guide is adapted from the Canadian Association of Wound Care (CAWC) and was reprinted with permission in the BPG.

    Reference: Registered Nurses’ Association of Ontario. (2013). Appendix R of Assessment and Management of Foot Ulcers for People with Diabetes. Toronto, Canada: Author. pp. 147-149

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    This Guide summarizes the main points of The Substitute Decisions Act. It should not be used as a substitute for the legislation, and it is not a substitute for legal advice. To make the legislation easier to understand, the Guide avoids legal terminology wherever possible.

    Canadian Hospice Palliative Care Association. (2004). A Guide to Substitute Decisions Act. Retrieved from http://www.attorneygeneral.jus.gov.on.ca/english/family/pgt/pgtsda.pdf.


     

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    This handout features promising practices to help move long-term care homes towards becoming safe, welcoming and inclusive spaces for the 2SLGBTQI+ community. It was developed as a supplement to the presentation delivered at the AdvantAge Ontario Convention on “A Home for All: Making Long-Term Care Welcoming for 2SLGBTQI+ People” in May 2019. This work stems from the Ontario Centres for Learning, Research and Innovation in Long-Term Care (CLRI)’s Supporting Diversity and Inclusion Advisory Group.

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    A well illustrated presentation on improving continence care developed by the IC-5 project.

    Developed during IC5 and Women’s College Hospital – no references and no name on who developed the presentation

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    This model guides all activities related to hospice palliative care, and develop local standards of practice.  The model is built on an understanding of health, the illness and bereavement experiences, and the role hospice palliative care plays in relieving suffering and improving quality of life. 

    Canadian Hospice Palliative Care Association. (March 2002). A Model to Guide Hospice Palliative Care: Based on National Principles and Norms of Practice.  Ottawa, ON: Author.  Retrieved from https://www.chpca.ca/wp-content/uploads/2019/12/norms-of-practice-eng-web.pdf
     

    Copyright © 2002, Canadian Hospice Palliative Care Association. All Rights Reserved.

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    This guide was developed by Saint Elizabeth and Yee Hong Centre for Geriatric Care to share the experiences and insights after implementing person-centred care (PCC) workshops with personal support workers (PSWs) within the two organizations. Reference: Saint Elizabeth. (October 2013). A practical guide to implementing person-centred care education for PSWs in the home, community and long-term care sectors.

    Bender, D. (2013). A practical guide to implementing person-centred care education for PSWs in the home, community and long-term care sectors. Retrieved from https://www.saintelizabeth.com/getmedia/3b053be0-3313-45e5-8aea-872781c0b76d/Practical-Guide-for-Implementing-PCC-Education-for-PSWs-October-2013.pdf.aspx

     

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    Abbey Pain Scale is an assessment tool for the measurement of pain in people with dementia who cannot verbalize

    Abbey, J; De Bellis, A; Piller, N; Esterman, A; Giles, L; Parker, D and Lowcay, B. Funded by the JH & JD Gunn Medical Research Foundation 1998 – 2002 (This document may be reproduced with this acknowledgment retained). Retrieved from: http://www.wales.nhs.uk/sitesplus/documents/862/FOI-286f-13.pdf

    Source: Dementia Care Australia Pty Ltd. Website: www.dementiacareaustralia.com

     

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    This template is helpful in identifying and altering the antecedent and consequences to change behaviour.

    Registered Nurses’ Association of Ontario. (2012). Appendix L of Promoting Safety: Alternative Approaches to the Use of Restraints. Toronto, Canada: Author.  (p. 113). Retrieved from https://rnao.ca/sites/rnao-ca/files/Promoting_Safety_-_Alternative_Approaches_to_the_Use_of_Restraints_0.pdf

    Source: Omelan, C. (2006). CME: Approach to Managing Behavioural Disturbances in Dementia. Canadian Family Physician, February, 52, p. 193 Reprinted with permission from the Canadian Family Physician

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    Health HQ Neuropathic Pain Resources - This website provides access to resources related to neuropathic pain.

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    An assessment tool that uses the mnemonic OPQRSTUV to assist health care professionals systematically assess people who screen positively for the presence or risk of any type of pain and who can self report.

    Figure 1 (page 21) RNAO BPG Assessment and Management of Pain 3rd Edition (2012) http://rnao.ca/bpg/guidelines/assessment-and-management-pain

    Adapted from "Symptom Assessment Acronym "OPQRSTUV", in Fraser Health Authority, 2012, Hospice Palliative Care Program Symptom Guidelines. Retrieved from https://www.fraserhealth.ca/-/media/Project/FraserHealth/FraserHealth/Health-Professionals/Professionals-Resources/Hospice-palliative-care/SymptomAssessmentRevised_Sept09.pdf

     

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    Toolkit contains easy to use resources to support uptake of the guideline at practice, education, policy, organizational and systems levels. The toolkit includes a E-Learning course (4 modules) on Elder Abuse for leadership and staff with various knowledge-based activities and supplementary resources.

    Reference: Registered Nurses' Association of Ontario. (2015). Addressing Abuse of Older Adults: An RNAO Initiative-Best Practice Success Kit. Toronto, ON: Author. Retrieved from http://rnao.ca/bpg/initiatives/abuse-and-neglect-older-adults-pan-canadian-best-practice-guideline-initiative

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    This link takes you to the Health Canada website where you can access the guidance on hospital beds related to entrapment.

    Health Canada. (2006). Guidance Document: Adult Hospital Beds: Patient Entrapment Hazards, Side Rail Latching Reliability, and Other Hazards. Author. Retrieved from https://www.canada.ca/en/health-canada/services/drugs-health-products/medical-devices/application-information/guidance-documents/guidance-document-adult-hospital-beds-patient-hazards-side-rail-other-hazards.html

     

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    Canadian Centre for Effective Practice has developed resources for the care of adults living with mental health and addiction. Keeping Your Patients Safe: A Guide to Primary Care Management of Mental Health and Addictions-related Risks and Functional Impairments Tool is designed to assist primary care providers in identifying, assessing and managing risks in a patient with diagnosed, undiagnosed or changing mental health conditions.

    Reference: Canadian Centre for Effective Practice (2017). Adult Mental Health. Retrieved from https://thewellhealth.ca/mentalhealthrisk 

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    Learn how to participate in advance care planning process in Ontario. The Speak Up Ontario website provides in formation on Advance Care Planning as a process of thinking about and sharing your wishes for future health and personal care. It can help you tell others what would be important if you were ill and unable to communicate.

    Speak Up. (n.d.). homepage. Retrieved from https://www.speakupontario.ca/
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    This advanced planning framework is seen through a health lens recognizing and building on interaction with the legal and ethical framework across the country and professions. The new Framework builds on the 2012 National Framework with a focus partnerships, and promoting collaboration among different system levels: local, provincial/territorial and national.

    Canadian Hospice Palliative Care Association.  (2020). Advance Care Planning in Canada: A Pan-Canadian Framework. Retrieved from https://www.advancecareplanning.ca/news/2019-updated-national-framework-acp-now-released/

     

    © 2020 Advance Care Planning Canada. All rights Reserved.

    ACP in Canada is a national collaborative project led by CHPCA

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    Advance Care Planning, Goals of Care, and Treatment Decisions & Informed Consent- Frequently Asked Questions (FAQ)

    Copyright @ 2022 Canadian Palliative Care Network

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    This document contains sample program objectives, policy, procedures, staff training materials and tools related to fall prevention. (Member login is not required. The documents may be accessed by scrolling to the bottom of page.)

    Ontario Association of Non-profit homes and services for seniors. (2011). OANHSS LTCHA Implementation Member Support Project. Fall Prevention and Management Program: Policy, Procedures and Training Package.

    Copyright 2011.

     

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    This link takes you to the AdvantAge Ontario Website for implementation resources, you can scroll down to find a section on Minimizing Restraining and Use of Personal Assistance Services Devices (PASDs). Under this section there are documents related to: 1) Policy, procedure and training package and 2) Appendix materials, including: i) physical restraint monitoring, ii) restraint audit tool, and iii) least restraint, last resort training presentation.  

    AdvantAge Ontario. (2010). LTCHA Implementation resources. Retrieved from https://www.advantageontario.ca/MediaCentre2/LTCHomesActCentralseeSiteNavigation/LTCHA_Resources.aspx

    Copyright: AdvantAge Ontario 

    Website: www.advantageontario.ca   

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    This link will take you to the document developed by AdvantAge Ontario to support program objectives, policy, procedures and staff training materials and tools that meet minimum requirements of the LTCH Act and Regulation.

    Retrieved from www.advantageontario.com 

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    This document contains a sample policy and procedures to support compliance and meet the requirements of s. 20(1) and (2) of the Long-Term Care Homes Act, 2007 and its Regulation.

    AdvantAge Ontario Long-Term Care Homes Act (LTCHA) Implementation Member Support Project resources are confidential documents for AdvantAge members only. Any review, retransmission, dissemination or other use of, or taking of any action in reliance upon this information, by persons or entities other than the intended recipients is prohibited without the approval of AdvantAge.

    Reference: Ontario Association of Non-Profit Homes and Services for Seniors. (2012). Zero tolerance for abuse and neglect: Sample policies and procedures. Retrieved from http://www.oanhss.org/MediaCentre2/LTCHomesActCentralseeSiteNavigation/LTCHA_Resources.aspx?WebsiteKey=112387af-5c3c-42f5-bfce-85c542bee396
     

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    The ACE Website provides materials for public education on prevention of elder abuse. Materials include information on powers of attorney, consumer protection and legal issues affecting older persons.

    Advocacy Centre for the Elderly (ACE) (2013) Retrieved from http://acelaw.ca

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    This site describes elder abuse and provides a number of downloadable publications related to addressing and preventing elder abuse.

    Any use of information in the web site should be accompanied by an acknowledgment of WHO as the source, citing the uniform resource locator (URL) of the article.

    Reference: World Health Organization. Ageing and Life Course Elder Abuse. Retrieved from http://www.who.int/ageing/projects/elder_abuse/en/

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    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).

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    An algorithm to guide oral assessment and intervention. The algorithm summarizes the recommendations to help oral care teams to understand how to implement them into practice.

    Registered Nurses’ Association of Ontario. (2020). Appendix F of Oral Health: Supporting Adults Who Require Assistance (2nd ed.). Toronto, Canada: Author.  (page 110). Retrieved from https://rnao.ca/sites/rnao-ca/files/bpg/RNAO_Oral_Health_Supporting_Adults_Who_Require_Assistance_Second_Edition_final.pdf

     

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    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).

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    This heart-warming video shows how music can transform the life of a resident with dementia.

    Reference: Sundance Film Festival. (2014, January 7) Alive Inside: A Story of Music & Memory Featurette - Documentary HD. Retrieved from https://youtu.be/8HLEr-zP3fc

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    The Alternative Approaches List is a table with examples and suggested alternatives and patient behaviours.

    Registered Nurses’ Association of Ontario. (2012). Appendix J of Promoting Safety: Alternative Approaches to the Use of Restraints. Toronto, Canada: Author.  (pp. 104-107). Retrieved from https://rnao.ca/sites/rnao-ca/files/Promoting_Safety_-_Alternative_Approaches_to_the_Use_of_Restraints_0.pdf

    All request to adapt the Alternative Approaches to Restraint use must be directed to the Ottawa Hospital, Department of Nursing Professional Practice

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    This decision tree from The Ottawa Hospital provides a visual decision making guide to determine risk and restraint alternatives.

    Registered Nurses’ Association of Ontario. (2012). Appendix N of Promoting Safety: Alternative Approaches to the Use of Restraints. Toronto, Canada: Author. (page 116). Retrieved from https://rnao.ca/sites/rnao-ca/files/Promoting_Safety_-_Alternative_Approaches_to_the_Use_of_Restraints_0.pdf

    All requests to adapt the Alternative to Restraints Decision Tree must be directed to the Ottawa Hospital, Department of Nursing Professional Practice

  • Show description [+]

    This Alzheimer Canada website section provides resources for health care professionals on the following topics: Ambiguous Grief and Loss, Pain, End of Life and Culture Change

    Retrieved from http://www.alzheimer.ca/en/We-can-help/Resources/For-health-care-professionals

    2017 Alzheimer Society of Canada. All rights reserved.

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    This link takes you to the Alzheimer Society Canada publication which discusses types of restraints, least restraint for persons with dementia and what to do when restraint free strategies are ineffective.

    Alzheimer Society of Canada. (2007). Restraints. Toronto, Ontario, Canada: Author. Retrieved from http://www.alzheimer.ca/en/We-can-help/Resources/Alzheimer-Society-brochures-and-publications.

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    This organization provides support to families and clients affected by Alzheimer’s disease. Links are provided to a chapter near you. Web site is also available in French.  Website: www.alzheimer.ca/en/on.

    The Website is copyrighted by the Alzheimer Society of Canada.

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    A Successful story of a Falls Prevention Program.

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    Anxiety symptoms are extremely common. In the primary care setting, a major task is to determine whether the symptoms are a reaction to a distressing situation, indications of an anxiety or other psychiatric disorder such as depression, or signs of a non-psychiatric condition. This resource provides clinical tools for screening, assessment, diagnosis, and treatment.

    Reference: Centre for Addiction and Mental Health (2022). Anxiety Disorders. Retrieved from https://www.camh.ca/en/professionals/treating-conditions-and-disorders/anxiety-disorders

     

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    Appendix F - provides a summary of related approaches and tools for assessing fall risk. The tools are categorized as follows: gait and balance; general fall risk and fear of falls. It is important for the organization to review the findings to support selection of tools for settings and population(s) served noting that other tools are available that address specific risk factors.

    Registered Nurses’ Association of Ontario.  (2017).  Appendix F of RNAO Prevention of Falls and Reducing Injury from Falls Best Practice Guideline. (4th Ed.).  Toronto, ON: Author. (p.92-97)

     

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    An extensive list of validated assessment and screening tools. Tools not only assess for history of abuse but also assess for possibility of future abuse, and quality of care being given.

    Registered Nurses’ Association of Ontario. (2014). Appendix G of Preventing and Addressing Abuse and Neglect of Older Adults: Person-Centred, Collaborative, System-Wide Approaches. Toronto, Canada: Registered Nurses’ Association of Ontario. pp 105-110. http://rnao.ca/sites/rnao-ca/files/Preventing_Abuse_and_Neglect_of_Older_Adults.pdf

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    This resource describes two mnemonics for wound assessment. ‘NERDS’ is used to systematically assess for superficial critical colonization (localized infection) and STONEES to access deeper and surrounding infection (systemic infection) in people with pressure injuries. NERDS: N – non-healing wound; E – exudate; R – red and bleeding. D – debris; and S – smell. STONEES: S – size; T – temperature: O – os; N – new or satellite areas of breakdown: E – exudate; E – erythema and/or edema (cellulitis); and S – smell.

    Reference: Registered Nurses Association of Ontario (RNAO). 2016. Appendix K: Assessment for Infection. Assessment and Management of Pressure Injuries for the Interprofessional Team, Third Edition. Accessed July 28, 2016 http://rnao.ca/sites/rnao-ca/files/PI_BPG_FINAL_WEB_June_10_2016.pdf  pp. 135-136.

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    The following is not an exhaustive list of methods on assessing a person’s goals of care. This mnemonic has been suggested as an example identified within the systematic review, AGREE II appraised guidelines, by the expert panel or external stakeholder feedback. It is an example of how to identify the goals of symptom management in people for whom wound healing is not a clinical expectation and where maintaining the person’s comfort is key

    Reference: Registered Nurses 'Association of Ontario. (2016). Appendix P of Assessment and Management of Pressure Injuries for the Interprofessional Team. Toronto, Canada: Author. pp 139.

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    This table from Appendix K pages 152-153 of the BPG Delirium, Dementia and Depression in Older Adults: Assessment and Care (2016) helps us reflect on our own attitudes, skills and knowledge about dementia and provides tips for successful interpersonal skills with residents with dementia.

    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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    Practice guidelines are documents that help nurses understand their responsibilities and legal obligations in order to make safe, effective and ethical decisions in nursing practice. This practice guideline outlines the legislated scope of nursing practice as well as controlled acts authorized to nursing (general and extended classes).

    College of Nurses of Ontario. (2018). Authorizing Mechanisms. Toronto, ON, Canada: Author. Retrieved from https://www.cno.org/globalassets/docs/prac/41075_authorizingmech.pdf

    Copyright © College of Nurses of Ontario, 2019.

     

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    Bates-Jenson Wound Assessment Tool (BWAT) is a validated tool that measures the status of a wound. It is most appropriate for use by experienced wound-care clinicians as a discriminative tool to fully describe wounds during the initial wound assessment. 

    Copyright 2001 Barbara Bates-Jensen

    Reference: Bates-Jensen, Barbara (2001). Bates-Jenson Wound Assessment Tool (BWAT). Retrieved from: http://geronet.med.ucla.edu/centers/borun/modules/Pressure_ulcer_prevention/puBWAT.pdf

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    The Behaviour Monitoring Log from Penn Nursing Science helps determine the meaning of untoward events through examining patterns of behaviours/occurrences.

    Registered Nurses’ Association of Ontario. (2012). Appendix M of Promoting Safety: Alternative Approaches to the Use of Restraints. Toronto, Canada: Author.  (pp. 114-115). Retrieved from https://rnao.ca/sites/rnao-ca/files/Promoting_Safety_-_Alternative_Approaches_to_the_Use_of_Restraints_0.pdf

    Adapted from: Strumpf, N., Robinson, E.J.P., Wagner, J.S., & Evans L.K. (1998). Restraint-Free Care: Individual Approaches for Frail Elders. New York: Springer Publishing, pp. 44-46. Reprinted with permission from Penn Nursing Science.

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    The Website provides resources and presentations on Behaviour Supports Ontario. View the Behavioural Education and Training Supports Inventory (BETSI) and many other behavioural links and resources in Ontario.  Alzheimer Knowledge Exchange Resource Centre's Website: www.akeresourcecentre.org/BSO.

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    The BSO-DOS© is an observational tool that helps to identify patterns of behaviour for care planning purposes. It is based on the former DOS. Simple registration is required to access this free tool. A user guide and resource manual are available.

    Behavioural Supports Ontario. (2019). Behavioural Supports Ontario - Dementia Observation System. Retrieved from https://brainxchange.ca/BSODOS

     

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    This report provides rationale for using person-centred care language and helpful strategies for changing practice.

    Behavioural Supports Ontario. (October, 2018). Behavioural Supports Ontario person-centred language initiative report. Retrieved from http://www.behaviouralsupportsontario.ca/Content/Pledge/BSO_Person-Centred_Language_Initiative_Report%20_October_2018.pdf

     

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    This intervention toolkit provides links to universally recognized behavioural assessment tools for common responsive behaviours. The toolkit describes possible behavioural causes and a range of strategies to help with care planning.

    Reference:Central East Local Health Integration Network (LHIN) Behavioural Supports Ontario Education Committee (n.d.) Central East LHIN Behavioural Supports Ontario Intervention Tool Kit, retrieved from http://centraleast.behaviouralsupportsontario.ca/Uploads/ContentDocuments/Intervention%20Tool%20Kit_Version%201_May_2016.pdf  

    Acknowledgements: This tool was created by the Central East Local Health Integration Network (LHIN) Behavioural Supports Ontario Education Committee. Acknowledgment to the Psychogeriatric Resource Consults of the Central East Region for developing this tool. Thank you to the Central East Long-Term Care Homes for contributing to the development of the tool.

    Disclaimer: Permission to use, copy, modify, and distribute this material for educational, research, and not-for-profit purposes, without fee and without a signed licensing agreement, is hereby granted, provided that the above copyright notice, this paragraph and the following paragraphs appear in all copies, modifications, and distributions. Contact Terry Donaghue, Technology Transfer & Industrial Liaison, Mount Sinai Hospital, & The Samuel Lunenfeld Research Institute, 600 University Avenue, Toronto, ON Canada M5G 1X5, Tel. (416) 586-8225, Fax (416) 586-3110, E-mail: donaghue@mshri.on.ca for commercial licensing opportunities.

  • Show description [+]

    This HQO quality standard addresses care for people living with dementia and the specific behaviours of agitation and aggression. Accompanying resources include a Patient and Resident Reference Guide and Recommendations for adoption.

    Reference: Health Quality Ontario (2016). Behavioural Symptoms of Dementia. Care for Patients in Hospitals and Residents in Long-Term Care Homes. Retrieved from http://www.hqontario.ca/Evidence-to-Improve-Care/Quality-Standards/View-all-Quality-Standards/Behavioural-Symptoms-of-Dementia/ 

  • Show description [+]

    The Bereavement Risk Assessment Tool, or BRAT, is a psychosocial assessment tool used by care teams to communicate personal, interpersonal and situational factors that may place a caregiver or family member at greater risk for a significantly negative bereavement experience.

  • Show description [+]

    This guide provides an interview process from introduction to closing that supports accurate and comprehensive medication information is communicated consistently across transitions of care.

    Reference: Institute for Safe Medication Practices (ISMP) Canada, In collaboration with SaferHealthcareNow (2012). Best Possible Medication History Interview Guide. Retrieved August 8,2016 from https://www.ismp-canada.org/download/MedRec/SHN_medcard_09_EN.pdf

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    A game using the 'Jeopardy' format with the questions based on the RNAO Best Practices on Continence and Constipation.

    Reference: Registered Nurses Association of Ontario. 2014. Best Practice Jeopardy. Toronto, ON.

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    A sample Jeopardy game illustrates a fun way to evaluate learning.  

    Registered Nurses' Association of Ontario. (2014). Best practice Jeopardy: Alternative to restraints edition. Long-Term Care Best Practices Program, Toronto, ON.

     

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    This archived webinar and Power Point presentation provides an excellent overview of bladder and bowel continence issues. It has a strong assessment section and gives many helpful suggestions. While it is focused on multiple sclerosis, it is applicable to the broader population. 

    Reference: Multiple Sclerosis Society of Canada. 2017. Bladder and Bowel Continence: Meet Your Friend the Pelvic Floor Muscle! Retrieved from https://vimeo.com/202074102

    © 2016 brainXchange.

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    This leaflet on bladder and bowel incontinence is written is simple language.  It provides practical solutions to dealing with incontinence.  It is aimed at family’s supporting a relative with dementia, but is suitable for staff in long term care homes. 

    Reference:

    The Canadian Continence Foundation. No date. Bladder and Bowel Problems in People Living with Dementia. Accessed Mar. 18, 2018. http://www.canadiancontinence.ca/pdfs/Dementia-English.pdf

    Copyright © 2018 The Canadian Continence Foundation

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    This bladder and bowel care plan, developed by CorHealth is aimed at people with strokes, but is applicable to residents of long term care. It is one of a series of stroke care plans.

    Cor Health (2020) Bladder and Bowel Stroke Care Plans retrieved from Community Reengagement - CorHealth Ontario

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    An illustration showing the muscles that control bladder emptying. Two diagrams identifying one with weak control muscles and one with strong bladder control muscles

    Registered Nurses' Association of Ontario. (2006). Self-Learning Package Continence Care Education. Toronto, ON: Retrieved from: http://rnao.ca/bpg/guidelines/resources/continence-care-education-selflearning-package
     

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    A comprehensive assessment of bladder and bowel function for LTC residents developed by the LTC BPC Project with Toronto Best Practice Steering Committee and Northwest Continence Collaborative (2005). Includes list of medications that affect continence and treatment options.

    Reference: Toronto Best Practice Committee and Northwest Continence Collaborative (2006). Bladder & Bowel Continence Assessment.. Toronto.

    Sources: AHCPR. 2006. Urinary Incontinence. http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat6.section.10079. ; Brigham & Women’s Hospital. 2004, Urinary incontinence http://www.brighamandwomens.org/medical/HandbookArticles/Urinaryincontinence.pdf. ; The Hartford Institute for Geriatric Nursing. 2001. Urinary incontinence. http://www.hartfordign.org/publications/trythis/issue11.pdf. ; IC-5 Continence Project, 2005, http://www.hospitalreport.ca/projects/QI_projects/IC5.html.  Rehabilitation Nursing Foundation. 2002. Constipation. www.rehabnurse.org. ; RNAO. 2005, Preventing Constipation; Prompting Continence. http://www.rnao.org/bestpractices.  ; Royal Women’s Hospital. 2005. Urinary incontinence, http://www.rwh.org.au/rwhcpg/womenshealth.cfm?doc_id=3661.  ; Singapore Ministry of Health. 2003, http://www.moh.gov.sg/cmaweb/attachments/publication/Nursing_Management_of_Patients_with_Urinary_Incontinence_1-2003.pdf.  U.S. National Library of Medicine and U.S. National Institute of Health. 2006. Drugs, supplements. < http://www.nlm.nih.gov/medlineplus/druginformation.html 

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    A succinct, 2-page newsletter that covers myths and facts about pain. Developed by the BPG in LTC Initiative Central South and The Long Term Care Resource Centre, Hamilton, Ontario.  Source: http://www.rgpc.ca/
     

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    This BP Blogger presents credible bite-size pieces of information on dispellings myths related to stroke including prevention, transient ischemic attacks (TIAs), response to signs and symptoms of a stroke, and prevalence of stroke in long-term care.

    Regional Geriatric Program Central. (April-May 2010). BP Blogger - Stroke 1: Myth Busting Issue, 5(2). Retrieved from http://www.tostroke.com/wp-content/uploads/2012/12/BP-Blogger_Volume-5_Issue-2.pdf

    © Copyrighted. All Rights Reserved MLvanderHorst.

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    This BP Blogger presents credible bite-size pieces of information on dispellings myths related to stroke including managing a clenched fist, oral care, dysphagia and wheelchair seating.

    Regional Geriatric Program Central. (Fall 2010). BP Blogger - Stroke 2: Myth busting issue, 5(4). Retrieved from: https://admin.rgpc.ca/uploads/documents/BP%20Blogger%20-%20Stroke%202%20Issue.pdf

    © Copyrighted. All Rights Reserved MLvanderHorst.

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    This BP Blogger presents credible bite-size pieces of information that dispels stroke and exercise myths.

    Regional Geriatric Program Central and SHRTN Library Services. (Fall 2011). BP Blogger: Myth Busting: Stroke 3 Exercise Issue, 6(2). Retrieved from https://www.tostroke.com/wp-content/uploads/2012/12/BP-Blogger_Volume-6_Issue-2.pdf

    © Copyrighted. All Rights Reserved MLvanderHorst.

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    This BP Blogger presents credible bite-size pieces of information on dispellings myths related to depression after a stroke. The focus is on how to recognize and help residents with stroke who are suffering from depression.

    Regional Geriatric Program Central and SHRTN Library Services. (Spring 2012). BP Blogger - Stroke 4: Myth busting: Depression issue, 7(1). Retrieved from https://www.tostroke.com/wp-content/uploads/2012/12/BP-Blogger_Volume-7_Issue-1.pdf

    © Copyrighted. All Rights Reserved MLvanderHorst.

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    This BP Blogger presents credible bite-size pieces of information on dispellings myths related to perception problems after a stroke.

    Regional Geriatric Program Central. (Summer 2014). BP Blogger - Myth busting: Stroke 5: Perception issue, 9(1). Retrieved from http://cesnstroke.ca/professional/wp-content/uploads/sites/2/2015/07/BP-Blogger-Stroke-5-Summer-2014.pdf

    © Copyrighted. All Rights Reserved MLvanderHorst.

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    The Braden Scale can be used to assess a resident’s level of risk for developing pressure injuries by evaluating six areas of risk: sensory perception, moisture, activity, mobility, nutrition, and friction or shear.

    Reference: Braden Scale (1988). Retrieved from http://www.education.woundcarestrategies.com/coloplast/resources/BradenScale.pdf

    © Copyright Barbara Braden and Nancy Bergstrom, 1988

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    Canadian Dementia Resource and Knowledge Exchange (CDRAKE) and Alzheimer Knowledge Exchange (AKE) have amalgamated to create this new hub of dementia resources. Contained within are links to Behaviour Support Ontario (BSO), Psychogeriatric Resource Consultants (PRC) and many resources pertinent to dementia and responsive behaviours.

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    Purpose of the BPI tool is to assess the severity of pain and the impact of pain on daily functions. The tool can be used for patients with pain from chronic diseases or conditions such as cancer, osteoarthritis and low back pain, or with pain from acute conditions such as postoperative pain.

    Assessment areas included are severity of pain, impact of pain on daily function, location of pain, pain medications and amount of pain relief in the past 24 hours or the past week.

    The BPI copyright is held by Dr Charles S. Cleeland (1991). The copyright applies to the BPI and all it's derivatives in any language.

    Retrieved from http://www.npcrc.org/files/news/briefpain_short.pdf 

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    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).

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    This tool is used to assess the residents’ level of confusion, irritability, boisterousness, verbal threats, physical threats, and attacks on objects- as present or absent.

    Registered Nurses’ Association of Ontario. (2012). Appendix G of Promoting Safety: Alternative Approaches to the Use of Restraints. Toronto, Canada: Author.  (pp. 99-100). Retrieved from https://rnao.ca/sites/rnao-ca/files/Promoting_Safety_-_Alternative_Approaches_to_the_Use_of_Restraints_0.pdf

    Source: Almvik, R. & Woods, P. (April 2003). Short-Term Risk Prediction. The Broset Violence Checklist. Journal of Psychiatric and Mental Health. Nursing, 10(2), pp. 236-238

    Reprinted with permission from John Wiley and Sons

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    This website from Dalhousie University focuses on oral health care resources as a result of oral health activities in long term care homes. Resources include a manual, education videos, oral care tool kits, assessment and care planning tools and guidelines for organizationally mapping oral care.

    Dalhousie University. (n.d.). Population Health Institute: Brushing up on mouth care.  Retrieved from http://brushingup.ca/

     

     

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    My Personhood Summary© surfaces a person’s life experiences, important relationships, personal preferences, and other psychosocial and environmental factors that influence daily life. It is a foundational tool, intended for use with people living with dementia as well as older adults living with complex mental health, substance use, and/or other neurological conditions.

  • Show description [+]

    This site provides information on recognizing scams, frauds and identity theft and how to address and report them.

    Reference: Canadian Anti-Fraud Centre, Government of Canada, 2015. This site provides information on recognizing scams, frauds and identity theft and how to address and report them. http://www.antifraudcentre-centreantifraude.ca/index-eng.htm

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    Website that deals with suicide survivors, suicide grief, support for those living with suicide loss along with providing education materials and access to various support and crisis centers . it also addresses suicide risk in the aging population. Its main purpose is to reduce suicide rate in Canada and minimize the consequences of suicide behaviour.

    Reference: Canadian Association of Suicide prevention (CASP), https://suicideprevention.ca/ 

  • Show description [+]

    The CCSMH has developed guidelines including The Assessment and Treatment of Mental Health Issues in Long-Term Care Homes, as well as guidelines on a range of related topics such as Delirium, Depression and Suicide Prevention.  Website: http://www.ccsmh.ca/en/projects/ltc.cfm

  • Show description [+]

    The CANHELP caregiver questionnaire was designed to evaluate satisfaction with care for older patients with life threatening illnesses, and the family members. A straight forward satisfaction instrument that you can use t rate the quality of care at the programs or organization level.

    Reference: CARENET Canadian Researchers at the End of Life Network. (n.d.). CANHELP Tool.  Retrieved from www.thecarenet.ca/index.php?option=com_content&view=article&id=115&Itemid=57.

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    The CHPCA is the national voice for hospice palliative care in Canada. Advancing and advocating for quality end-of-life/hospice palliative care, its work includes public policy, public education and awareneness.  Website www.chpca.net.

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    A comprehensive, holistic assessment of individuals and their families at end-of-life.

    Reprinted with Permission from Canadian Hospice Palliative Care Association.  Registered Nurses' Association of Ontario.  (2011). Appendix K of End-of-Life Care During the Last Days and Hours. Toronto, ON: Author.  pp. 114-115. 

  • Show description [+]

    The Canadian Mental Health Association website offers free resources on mental health, including depression, bipolar disorder, grief and mental illness. Local chapters include important workshops, including Applied Suicide Intervention Skills Training (ASIST).

    Reference: Canadian Mental Health Association Website Retrieved from http://www.cmha.ca

  • Show description [+]

    This Canadian Stroke Best Practices site offers a variety of webinars about stroke, resumption of activities and strategies. Included are assessment videos for neurological scale and vascular cognitive assessment.

    Heart and Stroke Foundation of Canada Canadian Stroke Best Practices. (n.d.) Webinars. Retrieved from https://www.strokebestpractices.ca/resources/webinars 

     

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    This link provides information and support for professionals on palliative and end-of-life care, loss and grief.  There is a list of clinical tools and useful resources to enhance palliative and end life care. Website www.virtualhospice.ca.

  • Show description [+]

    This information fact sheet is developed as a supplement to the RNAO Nursing Best Practice Guideline document for nurses. The nursing best practice guideline End-of-life Care During the Last Days and Hours is available for public viewing and free to download at www.rnao.ca/bestpractices.

    Registered Nurses’ Association of Ontario. (2011).  Care In The Last Days And Hours Of Life.  Toronto, Canada: Author.  Retrieved from https://rnao.ca/sites/rnao-ca/files/Care_in_the_Last_Days_and_Hours_of_Life.pdf

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    Guide and Algorithm to guide assessment and management of cancer related anxiety.

    Cancer Care Ontario. (2013). Palliative Care Toolkit for Indigenous Communities. Retrieved from https://www.cancercareontario.ca/en/guidelines-advice/treatment-modality/palliative-care/toolkit-aboriginal-communities

     

  • Show description [+]

    The Health education fact sheet supports resident/family to understand that they are an important part of the health-care team. Speaking with members of the health-care team will help them get the information they need to understand any changes in their health and what it means for the situation.

    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 tool is used to determine reasons caregivers attribute using physical restraints with the elderly.

    Registered Nurses’ Association of Ontario. (2012). Appendix K of Promoting Safety: Alternative Approaches to the Use of Restraints. Toronto, Canada: Author.  (pp. 108-110). Retrieved from https://rnao.ca/sites/rnao-ca/files/Promoting_Safety_-_Alternative_Approaches_to_the_Use_of_Restraints_0.pdf

    Developed by Lois Evans and Neville Strumpf (1986). University of Pennsylvania School of Nursing: revised 1990 & 2010.

    Website: www.nursing.upenn.edu
     

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    This help sheet created by Alzheimer’s Australia provides a summary explaining incontinence and some of the reasons it may occur in people with dementia. It gives suggestions for managing incontinence.

    Reference: Alzheimer’s Austrailia (2012). Caring For Someone With Dementia- Continence Retrieved April 27,2017 from https://www.fightdementia.org.au/files/helpsheets/Helpsheet-CaringForSomeone18-Continence_english.pdf

    Copyright © Alzheimer’s Australia 2000-2017, all rights reserved.

    You may not link to or use our content except when granted explicit permission from Alzheimer's Australia (link sends e-mail) and subject to Alzheimer's Australia being credited and subject to the content not being changed in any way. Photos on this website may not be copied or reproduced without express permission.

    If permission is granted to link to an Alzheimer's Australia pdf or other format file, the link must be to the Alzheimer's Australia website address, you may not take a copy.

    Requests and enquiries can be addressed in writing to Alzheimer’s Australia, attn Copyright and Permissions Enquiries, PO Box 4194 Kingston ACT 2604 Canberra or by email to copyright@alzheimers.org.au (link sends e-mail). A number of photos on this website are copyright ©Lynton Crabb and cannot be reproduced. Apart from any use as permitted under the Copyright Act 1968, all other rights are reserved.

  • Show description [+]

    Having an ostomy procedure is a life changing experience for you and your family. Learning how to take care of your ostomy will help you to gain independence and live your life with comfort and confidence.

    Registered Nurses’ Association of Ontario. (2009). Caring for your Ostomy Health Education Fact Sheet. Toronto, ON: Author. Retrieved from: http://rnao.ca/bpg/fact-sheets/caring-your-ostomy 

  • Show description [+]

    A powerpoint presentation that succinctly describes ways to prevent Catheter-associated Urinary Tract Infections based on the CDC guideline.

    Reference: Centre for Disease Control and Prevention. (CDC). 2009. Catheter-associated Urinary Tract Infections Toolkit. http://www.cdc.gov/HAI/pdfs/toolkits/CAUTItoolkit_3_10.pdf.

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    This link takes you to the comprehensive resource aimed at nurse of theoretical knowledge, evidence based and practical guidelines on indwelling catheters. The recommendations state the level of evidence of each procedure. It has clear illustrations, extensive references and annotated procedures. The resource is created by the European Association of Urology Nurses.

    Reference: Vahr. S, Cobussen-Boekhorst, H, Eikenboom, J, Geng, V, Holroyd, S, Lester, M, Pearce, I. and Vandewinkel, C. 2012. Evidence-based Guidelines for Best Practices in Urological Health Care – Indwelling Catheters in Adults-Urethral and Suprapublic. European Association of Urology Nurses (EAUN). http://www.nursing.nl/PageFiles/11870/001_1391694991387.pdf

  • Show description [+]

    This guideline has illustrations and procedures on how to do intermittent catheterizations in adult.

    Reference: Vahr, S. Cobussen-Boekhorst, H, Eikenboom, J, Geng, V, Holroyd, S, Lester, M, Pearce, I and Vandewinke, C. 2013. Evidence-based Guidelines for Best Practice in Urological Health Care Catheterisation Dilatation, urethral intermittent in adults. European Association of Urology Nurses. http://nurses.uroweb.org/wp-content/uploads/2013_EAUN_Guideline_Milan_2013-Lr_DEF.pdf.
     

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    Visual illustration on placement of catheter within the female bladder.

    Registered Nurses' Association of Ontario. (2006). Self-Learning Package Continence Care Education. Toronto, ON: Retrieved from: http://rnao.ca/bpg/guidelines/resources/continence-care-education-selflearning-package
     

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    Numerous resources available with a simple search engine within this website

    Reference: Centre for Suicide Prevention [Online] Available: https://www.suicideinfo.ca/resources/ 

    Copyright: The Centre for Suicide Prevention Web Site is offered to you conditioned on your acceptance without modification of the terms, conditions, and notices contained herein. Your use of the Centre for Suicide Prevention Web Site constitutes your agreement to all such terms, conditions, and notices.

  • Show description [+]

    Centre for Suicide Prevention site contains a large collection of suicide prevention, intervention, and postvention resources, including Plus 65- a resource toolkit specific to seniors.

    Reference: Centre for Suicide Prevention Website: http://www.suicideinfo.ca/

  • Show description [+]

    A short, easy guide to help keep ageism out of your writing. These guidelines for age-inclusive communications address: what is ageism and why should we care; terminology to avoid and preferable terms; ageist imagery vs age-positive images; and avoiding ageist storylines

  • Show description [+]

    Checklist of Nonverbal Pain Indicators (CNPI). For adults who are nonverbal; designed to measure pain behaviors in cognitively impaired older adults.

  • Show description [+]

    The CNPI tool is designed to measure pain in cognitively impaired oler adults by observing their behaviours. The tool considers pain during movement and at rest.

    Reference: Feldt K.S. 2000. St Joseph Health System. Retrieved from: http://kentuckyonehealth.org/documents/Nursing/CNPI.pdf

  • Show description [+]

    Cinq mesures à adopter pour vous protéger Fiche de renseignements pour la sensibilisation en matière de santé. Association des infirmières et infirmiers autorisés de l’Ontario (2014, juillet).

    Cinq mesures à adopter pour vous protéger . Toronto, ON, Canada: Auteur. Récupérée de http://rnao.ca/bpg/guidelines/fact-sheets/cinq-mesures-%C3%A0-adopter-pour-vous-prot%C3%A9ger

  • Show description [+]

    A list of cleansing solutions and their actions for chronic wounds (including pressure injuries), identified by an expert panel and stakeholders providing feedback.

    Reference: Registered Nurses’ Association of Ontario. (2016). Appendix R of Assessment and Management of Pressure Injuries for Interprofessional Team, Third Edition. Toronto, Canada: R. G. Sibbald, H. Orsted, P. M. Coutts and D. H. Keast. Pp 147. http://rnao.ca/sites/rnao-ca/files/PI_BPG_FINAL_WEB_June_10_2016.pdf

  • Show description [+]

    Clinic Assessment tool is found as Appendix N of the RNAO BPG, Assessment and Management of Foot Ulcers for People with Diabetes. Pg 134-137.

    Reference: Registered Nurses’ Association of Ontario. (2013). Appendix N of Assessment and Management of Foot Ulcers for People with Diabetes. Toronto, Canada: Author. pp. 134-137.

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    Diseases such as chronic obstructive pulmonary disease or congestive heart failure run a more fluctuating course and result in death in a less predictable timeframe than diseases such as renal disease or dementia. Each exacerbation can lead to remission (and future exacerbation) or death; knowing which will occur on any given admission is extremely challenging. General indicators of poorer prognosis (life expectancy of only weeks to many weeks) include poor performance status, impaired nutritional status and a low albumin level.

    Registered Nurses’ Association of Ontario. (2011). Appendix E of End-of-Life Care During the Last Days and Hours. Toronto, Canada: Author. pp103-105 .

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    Numerous resources available with a simple search engine. Updates noted for 2017.

    Reference: Royal Australian and New Zealand College of Psychiatrists Clinical Practice Guidelines Team for Deliberate Self-harm. 2016, Australian and New Zealand Journal of Psychiatry 2016, Vol 50(10) 939-1000. https://www.ranzcp.org/Files/Resources/Publications/CPG/Deliberate-self-harm-CPG.aspx  

    The Centre for Suicide Prevention Web Site is offered to you conditioned on your acceptance without modification of the terms, conditions, and notices contained herein. Your use of the Centre for Suicide Prevention Web Site constitutes your agreement to all such terms, conditions, and notices.

  • Show description [+]

    This open textbook chapter discusses the types of ostomies and ostomy appliances, reviews physical and emotional assessments, provides checklists with steps for changing ostomy and urostomy appliances, with photographs, and discusses safety considerations. Included is a video on evidence-based research on ostomy care and a video on illiostomy and urostomy care.

    Web Address or Source: https://opentextbc.ca/clinicalskills/chapter/10-6-ostomies/  

    If you are an instructor who is using this book for a course, please let us know. For more information about this project, please contact opentext@bccampus.ca.

    Disclaimer The field of health care is constantly changing and evolving. Procedures and policies in schools and health care agencies will change in accordance with research and practice. This resource will require updates to remain in accordance with these changes, but the authors do not assume responsibility for these updates. Health care professionals must ensure that they have a strong foundation of knowledge in medical conditions and surgical procedures related to clinical skills and techniques before using this resource to guide their practice. Health care professionals should always put agency policy above the information in this resource and be mindful of their own safety and the safety of others. Any health care professional using this resource should do so in the appropriate environment and under the supervision of other relevant health care professionals, in accordance with their governing professional body and within their scope of practice. It is the responsibility of any health care professionals using this book to take all appropriate safety precautions and to determine best practice unique to the patient and the context of the situation. The authors do not assume responsibility for any injury or damage to persons or property pertaining to the use of the material and information in this resource.

  • Show description [+]

    This document was written by nurses for nurses to help them understand their own ethical beliefs and practice ethically when working with clients, families and within the confines of the public health system.

    All rights reserved, no part of this document may be reproduced, transcribed or stored in a retrieval system in any forms or by any means. Electronical, mechanical, photocopying, recording or otherwise without written permission of the publisher. ©Canadian Nurses Association

    Reference: Canadian Nurses Association (2008). Code of Ethics for Registered Nurses. Retrieved from https://www.cna-aiic.ca/~/media/cna/page-content/pdf-fr/code-of-ethics-for-registered-nurses.pdf?la=en

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    On Mar. 17, 2021, the federal government passed Bill C-7 to amend the Criminal Code to expand eligibility for Medical Assistance in Dying (MAID). 

    Retrieved from: https://www.cno.org/en/trending-topics/medical-assistance-in-dying/ 

    © 2022 College of Nurses of Ontario

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    Residents with severe dementia or other end stage diseases eat less as part of the natural progression of their disease. Research at end of life suggests that as residents eat and drink less they do not suffer from hunger or thirst. This session will focus on “Comfort Feeding Only” (CFO), when oral intake is not sufficient to sustain life, and if prolonging life with artificial hydration is not consistent with the residents' wishes (as expressed by the resident or their substitute decision maker (SDM)).

    This webinar is intended for long-term care leaders facilitating practice change and direct care staff that will benefit from understanding CFO process and the goal of the feedings to achieve comfort by employing the least invasive and potentially most satisfying way to provide nutrition. During this webinar, participants will:

    • Understand process followed to identify gap, develop policy and implementation of CFO
    • How to have a conversation with resident, family/SDM for comfort feeding only
    • Learn different implementation strategies to initiate CFO
    • Know strategies focusing on safe positioning and swallowing
    • Recognize symptoms such as dry mouth that can be alleviated with minimal oral intake and/or oral care

    Presented by Dr. Evelyn Williams and Jennifer Wong - Veteran's Centre Sunnybrook Health Sciences Centre in collaboration with Registered Nurses’ Association of Ontario (2017). Comfort Feeding Only(CFO): Managing Feeding at End-of-Life. RNAO You Tube. Retrieved from https://youtu.be/OB_HMSqKcao

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    This tool helps the resident and caregiver discuss individualized behavioural triggers and preferred measures of response.

    Registered Nurses’ Association of Ontario. (2012). Appendix T of Promoting Safety: Alternative Approaches to the Use of Restraints. Toronto, Canada: Author.  (p. 125). Retrieved from https://rnao.ca/sites/rnao-ca/files/Promoting_Safety_-_Alternative_Approaches_to_the_Use_of_Restraints_0.pdf

    Reprinted with permission from St. Joseph`s Health Care. Hamilton, Ontario

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    A quality improvement initiative looks at communication during shift report identifying 4 key themes as opportunities to improve upon. Improvement outcomes are shared in the article.

    Reference: Johnson C.,Carta, T., & Throndson, K. (2015) Canadian Nurse. Communicate with me: Information exchange between nurses. Retrieved from https://www.canadian-nurse.com/articles/issues/2015/march-2015/communicate-with-me-information-exchanges-between-nurses

  • Show description [+]

    This article looks at communication as being a key culprit in compromising patient safety in hand-over. Suggestions are given for strategies on how to approach hand-overs from shift to shift consistently, how to include patient and family along with potential barriers

    Reference: World Health Organization. (2007) Patient Safety Solutions. Communication during patient handovers. 1 (3). Retrieved from https://cdn.who.int/media/docs/default-source/integrated-health-services-(ihs)/psf/patient-safety-solutions/ps-solution3-communication-during-patient-handovers.pdf?sfvrsn=7a54c664_4&ua=1

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    This appendix outlines considerations, tips and resources to support effective communication when addressing issues of abuse and neglect of older adults.

    Registered Nurses’ Association of Ontario. (2014). Appendix F of Preventing and Addressing Abuse and Neglect of Older Adults: Person-Centred, Collaborative, System-Wide Approaches. Toronto, Canada: Registered Nurses’ Association of Ontario. pp 103-104. http://rnao.ca/sites/rnao-ca/files/Preventing_Abuse_and_Neglect_of_Older_Adults.pdf

  • Show description [+]

    This helpful table from Appendix D (page 127) of the BPG Delirium, Dementia and Depression in Older Adults: Assessment and Care (2016) helps to distinguish among delirium, dementia and depression where features are often similar or overlapping.

    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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    AThis table lists common components of universal falls precautions that health care organizations can determine which precautions are applicable to their setting.

    Registered Nurses’ Association of Ontario.  (2017).  Appendix K of RNAO Prevention of Falls and Reducing Injury from Falls Best Practice Guideline. (4th Ed.).  Toronto, ON: Author. (p.113)

     

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    The Comprehensive Geriatric Assessment (CGA) Toolkit is comprised of multiple resources for the personalized and person-centred care of the elderly. This link will take you to the page where you will find descriptions and possible signs and symptoms of the different types of abuse. A description and link for the Elder Assessment Instrument (EAI): Screening tool for elder mistreatment is provided as well as interventions that should be carried out based on the findings of the conducting clinician. Resources for the comprehensive geriatric assessment based on proactive and personalized primary care of the Elderly. Resources are provided on such geriatric syndromes such as falls, pressure injuries, incontinence, and sleep disorders. Hand-outs, videos and other tools are also available on this toolkit.

    Reference: http://www.cgakit.com/elder-abuse

  • Show description [+]

    Appendix O from the RNAO A Proactive Approach to Bladder and Bowel Management in Adults — Fourth Edition is a comprehensive list of physical, emotional and other factors that contribute to constipation.

     Registered Nurses’ Association of Ontario (RNAO). A proactive approach to bladder and bowel management in adults. 4th ed. Toronto (ON): RNAO; 2020. (p.144-145)

  • Show description [+]

    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.

  • Show description [+]

    Confusion Assessment Method (CAM) helps identify individuals who may be suffering from delirium or an acute confusional state and is useful for distinguishing between delirium and dementia. There are choices such as the long or short version CAM or the 3D CAM.

    Reference: Hospital Elder Life Program (2003). Confusion Assessment Method. Retrieved from http://www.hospitalelderlifeprogram.org/delirium-instruments/

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    Nurses have professional and legal obligations for obtaining consent. The College's Consent practice guideline provides an overview of the major features of the relevant legislation, pertinent definitions and the steps that nurses need to take to obtain consent.

    College of Nurses of Ontario. (2021). Consent. Retrieved from http://www.cno.org/en/learn-about-standards-guidelines/educational-tools/learning-modules/consent/  

     

     

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    Nurses have ethical and legal obligations for obtaining consent. The ethical obligations related to consent are discussed in the Ethics practice standard under the section Client Choice. This practice guideline replaces and updates the guide produced in June 1996 after the legislation, the Health Care Consent Act (HCCA) and the Substitute Decisions Act (SDA), was enacted. This practice guideline provides an overview of the major features of the legislation, pertinent definitions, the steps nurses need to take to obtain consent and the Guidelines for Nurses Advocating for Clients Found Incapable of Making Certain Decisions. It replaces an earlier Guide to the Health Care Consent and Substitute Decisions Legislation for RNs and RPNs. It does not address consent under the Mental Health Act.

    Reference: College of Nurses of Ontario Practice Guideline (2009) Consent Retrieved from http://www.cno.org/globalassets/docs/policy/41020_consent.pdf

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    A fact sheet on preventing constipation for patients and families with recommendations for action based on the RNAO Constipation BPG. Available in French.

  • Show description [+]

    This conversation sheet from Alzheimer Canada informs how dementia can affect intimacy and sexuality. Strategies are provided for caregivers. There is also a section to support LGBTQ persons with dementia.

    The Alzheimer Society is Canada’s leading health charity for people living with Alzheimer’s disease and other dementias. For more information visit the home page www.alzheimer.ca  

    Alzheimer Canada (2018). Conversations about dementia, intimacy and sexuality. Retrieved from https://alzheimer.ca/sites/default/files/files/national/brochures-conversations/conversations_intimacy-and-sexuality.pdf

     

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    The 5 questions in this tool are used to assess care preferences of patients if they become upset or have difficulty dealing with emotions.

    Registered Nurses’ Association of Ontario. (2012). Appendix I of Promoting Safety: Alternative Approaches to the Use of Restraints. Toronto, Canada: Author.  (pp. 102-103). Retrieved from https://rnao.ca/sites/rnao-ca/files/Promoting_Safety_-_Alternative_Approaches_to_the_Use_of_Restraints_0.pdf

    Copyright NY State Psychiatric Institute, Reprinted with permission from David J. Hellerstein, MD.

  • Show description [+]

    CorHealth Ontario’s Professional Stroke Education Inventory is an online repository of tools, resources and programs that support health care professionals working in stroke care.

    There are many sources of information related to stroke care. This Inventory organizes resources in alphabetical order and each resource is available by clicking on its link.

    CorHealth Ontario. (n.d.). Professional stroke education inventory. Retrieved from https://www.corhealthontario.ca/resources-for-healthcare-planners-&-providers/stroke-general/professional-education-inventory

     

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    These tips and interventions help caregivers to examine their own practices and best strategies to prevent escalation of behaviours.

    Registered Nurses’ Association of Ontario. (212). Appendix U of Promoting Safety: Alternative Approaches to the Use of Restraints. Toronto, Canada: Author.  (pp. 126-127). Retrieved from https://rnao.ca/sites/rnao-ca/files/Promoting_Safety_-_Alternative_Approaches_to_the_Use_of_Restraints_0.pdf

    Provided by the Milwaukee County Mental Health Division, Milwaukee, WI

    Adapted from Dr. Gudeman's Interaction with Patient on Interventions with De-Escalating Patient 10/99

  • Show description [+]

    Debridement Decision tool is found as Appendix P of the RNAO BPG, Assessment and Management of Foot Ulcers for People with Diabetes. Pg 143.

    Appendix P is based on the following resource : Rodd-Nielsen, E., Brown, J., Brooke, J., Fatum, H., Hill, M., Morin, J., St-Cyr, L., in Association with the Canadian Association for Enterostomal Therapy (CAET). Evidence-Based Recommendations for Conservative Sharp Debridement (2011).

    Reference: Registered Nurses’ Association of Ontario. (2013). Appendix P of Assessment and Management of Foot Ulcers for People with Diabetes. Toronto, Canada: Author. p. 143.

  • Show description [+]

    This debriefing tool provides examples of questions to ask the resident after they have been restrained or secluded.

    Registered Nurses’ Association of Ontario. (2012). Appendix X of Promoting Safety: Alternative Approaches to the Use of Restraints. Toronto, Canada: Author.  (p. 139). Retrieved from https://rnao.ca/sites/rnao-ca/files/Promoting_Safety_-_Alternative_Approaches_to_the_Use_of_Restraints_0.pdf

    Used with permission: Stone Institute of Psychiatry, Northwestern Memorial Hospital Chicago, IL

  • Show description [+]

    The Decision Making Framework provides an ethical approach for choosing care strategies following the observation of a deliberate act.

    Retrieved from http://ccethics.com/ethics-service/decision-making-framework/ 

  • Show description [+]

    Practice standards are documents that help nurses understand their responsibilities and legal obligations in order to make safe, effective and ethical decisions in nursing practice. This practice guideline outlines when nurses have the appropriate authority and competence to perform a particular procedure.

    College of Nurses of Ontario. (2018). Practice Standard: Decisions About Procedures and Authority. Toronto, ON, Canada: Author. Retrieved from https://www.cno.org/globalassets/docs/prac/41071_decisions.pdf

    Copyright © College of Nurses of Ontario, 2020

  • Show description [+]

    This resource describes the variety of abuse and neglect that can occur and will assist homes in planning a comprehensive education program.

    Registered Nurses’ Association of Ontario. (2014). Appendix D of Preventing and Addressing Abuse and Neglect of Older Adults: Person-Centred, Collaborative, System-Wide Approaches. Toronto, Canada: Registered Nurses’ Association of Ontario. Pp 97-99.rnao.ca/sites/rnao-ca/fi..._Adults_English_WEB.pdf

  • Show description [+]

    A one time, single resident risk assessment for dehydration based of the University of Iowa Dehydration BPG.

    References:

    Mentes, J. C. & The Iowa Veterans Affairs Nursing Research Consortium. (2004). Evidence-Based Practice Guideline: Hydration management. Iowa City, IA: The University of Iowa Gerontological Nursing Interventions Research Center Research Translation and Dissemination Core.

    Mentes, J. C. & Iowa-Veterans Affairs Research Consortium. (2000). Hydration management. Journal of Gerontological Nursing, 6-15.

  • Show description [+]

    This paper from the Institute for Safe Medication Practices in Canada (ISMP). A multi-incident analysis of delayed medication doses after transitions of care.

    Reference: Institute for Safe Medication Practices in Canada (2016) Delayed Treatment after Transitions of Care: A Multi-Incident Analysis Retrieved from https://www.ismp-canada.org/download/safetyBulletins/2016/ISMPCSB2016-07-DelayedTreatment.pdf?utm_source=safetybulletin&utm_medium=email&utm_campaign=sbv16i07#page=1

  • Show description [+]

    Appendix G from pages 133-134 of Delirium, Dementia and Depression in Older Adults: Assessment and Care (2016) identifies risk factors and related interventions for delirium.

    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

  • Show description [+]

    The delirium toolkit defines delirium and looks at prevention as well as management strategies in multiple settings, including within long-term care.

     Regional Geriatric Program of Toronto. (2019). Senior friendly care: Delirium toolkit. Retrieved from: https://www.rgptoronto.ca/wp-content/uploads/2018/11/SF7-Toolkit-Delirium.pdf

    © 2019 Regional Geriatric Program of Toronto. All Rights Reserved.

  • Show description [+]

    This comprehensive factsheet provides information to assist with the prevention and management of bladder and bowel problems in people with dementia.
    Reference: Australian Government (2016). Dementia and bladder and Bowel Control, retrieved Aug. 4, 2022 from https://www.health.gov.au/resources/publications/dementia-and-bladder-and-bowel-control. 

    © Commonwealth of Australia I Department of Health and Aged Care
  • Show description [+]

    The Alzheimer Society Canada website contains a number of resources on the unique needs of people with dementia at the end of their lives.

    Reference: Alzheimer Society Canada Dementia and End of Life Care. Retrieved from Website: http://www.alzheimer.ca/en/Living-with-dementia/Caring-for-someone/End-of-life-care

  • Show description [+]

    Indigenous Cognitive and Aging Awareness Research Exchange (I-CAARE) offers a number of factsheets, a health wheel and pathway for persons with dementia and their caregivers. The indigenous perspective may provide added support and comfort to families as they journey through dementia.

    Reference: Indigenous Cognitive and Aging Awareness Research Exchange (2018). Dementia Factsheets. Retieved from https://www.i-caare.ca/factsheets 

  • Show description [+]

    Learn more about living with dementia in these videos from Teepa Snow. She has used multi-modal therapies to support people living with dementia and their caregivers. You will find links to the following videos:

    • Dementia 101
    • Teepa's GEMS
    • Brain Changes
    • Challenging Behaviours
    • Meaingful Activities, and
    • Music

    You can also visit the website http://teepasnow.com/

    Refrence: Video Links for Tips from Teepa, 2016. Retrieved from http://teepasnow.com/resources/teepa-tips-videos/

  • Show description [+]

    This document from Mood Disorders Society of Canada considers a variety of strategies to manage depression in older persons.

    Reference: Mood Disorders Society of Canada (n.d.) Depression in Elderly, retrieved from http://mdsc.ca/documents/Consumer%20and%20Family%20Support/Depression%20in%20Elderly%20edited%20Dec16%202010.pdf 

  • Show description [+]

    Description of Foot Deformities is found as Appendix H of the RNAO BPG, Assessment and Management of Foot Ulcers for People with Diabetes. Pg. 117-122.

    Registered Nurses’ Association of Ontario. (2013). Appendix H of Assessment and Management of Foot Ulcers for People with Diabetes. Toronto, Canada: Author. pp. 117-122 Illustrations provided by Nancy A. Bauer, BA, Bus Admin, RN, ET.

    Reference: Diabetes Nursing Interest Group & RNAO, (2004). Diabetes foot: Risk assessment education program. Images of the diabetic foot. Toronto: Registered Nurses’ Association of Ontario. Retrieved from: http://rnao.ca/bpg/guidelines/resources/diabetes-foot-risk-assessment-education-program

  • Show description [+]

    This is a “Sentinel Event Action Alert” , a complimentary publication of The Joint Commission Issue 56, February 24, 2016 “Detecting and treating suicide ideation in all settings” Through this alert, The Joint Commission aims to assist all health care organizations providing both inpatient and outpatient care to better identify and treat individuals with suicide ideation

    Reference: Joint Commission on Accreditation of Healthcare Organizations (JCAHO). (2016). Detecting and treating suicide ideation in all settings. [Online]. Available: https://www.jointcommission.org/assets/1/18/SEA_56_Suicide.pdf  

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    This tips and tools guide is designed to assist you to better understand and learn how to plan, provide, develop and sustain interprofessional health care in your work environment.

    Registered Nurses of Ontario ( 2014) Developing and Sustaining Interprofessional Health Care: Tips and Tools for Health-care Teams, Toronto. ON retrieved fromhttps://rnao.ca/bpg/resources/developing-and-sustaining-interprofessional-health-care-tips-and-tools-health-care-tea

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    Les présentes lignes directrices sur les pratiques exemplaires, Développement et maintien des soins de santé interprofessionnels : optimisation des résultats pour le patient/client, l’organisme et le système sont conçues pour favoriser des milieux de travail sains. L’objectif de l’élaboration de ces lignes directrices était de déterminer les attributs des soins interprofessionnels qui permettront d’optimiser les résultats de qualité pour les patients/clients, les fournisseurs, les équipes, l’organisation et le système. Les présentes lignes directrices déterminent les pratiques exemplaires pour faciliter, améliorer et maintenir le travail d’équipe ainsi que la collaboration interprofessionnelle, et pour accroître les résultats positifs pour les patients/clients, les systèmes et les organisations. Elles sont fondées sur les meilleures données probantes existantes; lorsque ces données étaient limitées, les recommandations ont été fondées sur un consensus basé sur des opinions d’experts.

    Association des infirmières et infirmiers autorisés de l’Ontario. (2013). Développement et maintien des soins de santé interprofessionnels : optimisation des résultats pour le patient/client, l’organisme et le système. Toronto, Canada: Autheur. Récupéré: http://rnao.ca/bpg/language/d%C3%A9veloppement-et-maintien-des-soins-de-sant%C3%A9-interprofessionnels-optimisation-des-r%C3%A9sul

    Ce travail est financé par le Ministère de la Santé et des Soins de longue durée d'Ontario.

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    Diabetes Healthy Feet and You- Brochure is found as Appendix S of the RNAO BPG, Assessment and Management of Foot Ulcers for People with Diabetes. Pg 150-151. From “Diabetes, Healthy Feet and You,” by the Canadian Association of Wound Care, 2012, [Brochure].

    Copyright 2012 by Canadian Association of Wound Care. Reprinted with permission.

    Reference: Registered Nurses’ Association of Ontario. (2013). Appendix S of Assessment and Management of Foot Ulcers for People with Diabetes. Toronto, Canada: Author. pp. 150-151

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    Description of Foot Deformities is found as Appendix I of the RNAO BPG, Assessment and Management of Foot Ulcers for People with Diabetes. Pg. 123-126.

    Reference: Registered Nurses’ Association of Ontario. (2013). Appendix I of Assessment and Management of Foot Ulcers for People with Diabetes. Toronto, Canada: Author. pp. 123-126

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    An illustration of the structure of the lower male and female urinary tracts.

    Registered Nurses' Association of Ontario. (2006). Self-Learning Package Continence Care Education. Toronto, ON: Retrieved from: http://rnao.ca/bpg/guidelines/resources/continence-care-education-selflearning-package

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    An illustration of the urinary system from the front and side

    Registered Nurses' Association of Ontario. (2006). Self-Learning Package Continence Care Education. Toronto, ON: Retrieved from: http://rnao.ca/bpg/guidelines/resources/continence-care-education-selflearning-package

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    Practice standards are documents that help nurses understand their responsibilities and legal obligations to enable them to make safe, effective and ethical decisions when practising. This practice standard aims to help nurses understand the regulatory and legislative requirements for documentation.

    College of Nurses of Ontario. (2008). Documentation, Revised 2008. Toronto, ON: Author. Retrieved from http://www.cno.org/globalassets/docs/prac/41001_documentation.pdf


     

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    This learning module reviews documentation and how it is important component of nursing practice and interprofessional documentation that occurs

    Reference: College of Nurses of Ontario (2010) Documentation- Learning Module. Retrieved from http://www.cno.org/en/learn-about-standards-guidelines/educational-tools/learning-modules/documentation-2010/

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    The DOLOPLUS-2 Scale can be used for people having mild or moderate cognitive impairment and with proxy rating when a person is unable to self-report.

    Reference: Registered Nurses Association of Ontario (2013) Appendix M of Assessment and Management of Pain, Third Edition. Toronto, ON, Canada Author p. 95

    Used with permission from: Fuchs-Lacelle & Hadistavroplous, 2004; Hadistavropolous et al, 2006: Herr et al, 2011: Lefebvre-Chapiro & the DOLOPLUS Group, 2001: Schofield et al, 2008

    Website: http://www.assessmentscales.com/scales/doloplus

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    This resource uses a generic classification to describe wound dressings, local wound care outcomes and care considerations.

    Web Source: Appendix S of Assessment and Management of Pressure injuries for the Interprofessional Team, Third Edition http://rnao.ca/sites/rnao-ca/files/PI_BPG_FINAL_WEB_June_10_2016.pdf 

    Reference: Registered Nurses’ Association of Ontario. (2016). Appendix S of Assessment and Management of Pressure Injuries for Interprofessional Team, Third Edition. Toronto, Canada: R. G. Sibbald, J. A. Elliott, E. A. Ayello, and R. Somayaj Glasgow P.148

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    A list of medications associated with a moderate or high risk for falling

    Web Address: http://journals.lww.com/aswcjournal/Fulltext/2013/10000/International_Skin_Tear_Advisory_Panel__A_Tool_Kit.7.aspx Please refer to this link for further information how to apply for permission for re-use

    Reference: International Skin Tear Advisory Panel: A Tool kit to aid in the Prevention, Assessment and treatment of skin Tears using a Simplified Classification System. Advances in Skin and Wound Care. 26 (10): 459-476, October 2013

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    This fact sheet provides signs and symptoms of dry mouth and treatment options. Topics covered include: how saliva functions, causes, risk factors, prevention, treatment and maintenance interventions.

    Ontario Dental Hygienists’ Association. (n.d.). Dry Mouth. [Fact sheet]. Retrieved from https://odha.on.ca/wp-content/uploads/2016/08/Dry-Mouth-fact-sheet.v2.pdf
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    Early Identification & Prognostic Guide for Clinicians by Mississauga Halton PCN - This Early Identification and Prognostic Indicator Guide aims to help family physicians, specialist physicians and nurse practitioners in earlier identification of those patients nearing the end of life who could benefit from a palliative care approach to care.

    Reference: Mississauga Halton Palliative Care Network. (2019). Early Identification and Prognostic Indicator Guide. Retrieved from Ontario Palliative Care Network.

     

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    Developed by Registered Dietitians, this short, easy to read document provides definitions related to ostomies and provides a nutritional guide for the first 6 – 8 weeks after ostomy surgery as well as for after 6 – 8 weeks. It includes foods that may be problematic for people living with ostomies.

    Reference: Eating Well after Ostomy Surgery. Jan 2013. Alberta Health Services. Retrieved from: http://www.albertahealthservices.ca/assets/info/nutrition/if-nfs-eating-well-after-ostomy-surgery.pdf  

    Copyright: This handout may not be reproduced without permission for non-profit education purposes. This handout may not be changed without written permission from NutritionResources@albertahealthservices.ca 

    © Alberta Health Services (Jan 2013) D) Reference:

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    The revised Edmonton Symptom Assessment System (ESAS-r) is available in multiple languages and is designed to assist in the assessment of 10 common symptoms: pain, tiredness, drowsiness, nausea, lack of appetite, shortness of breath, depression, anxiety, well-being and constipation. It conveys the individual’s description of the severity of a symptom based on a scale ranging from 0 to 10. 

    Registered Nurses’ Association of Ontario. (2011). Appendix F of End-of-Life Care During the Last Days and Hours. Toronto, Canada: Author. pp. 106-107. 

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    A List of educational resources compiled by the development panel as a resource for nurses and their clients in learning more about suicidal ideation and behaviour. This is not intended to be an inclusive listing.

    Registered Nurses’ Association of Ontario. (2009). Assessment and Care of Adults at Risk for Suicidal Ideation and Behaviour. Toronto, ON, Canada: Author. Retrieved from http://rnao.ca/bpg/guidelines/assessment-and-care-adults-risk-suicidal-ideation-and-behaviour 

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    This resource has been designed to teach Registered Nurses (RNs), Registered Practical Nurses (RPNs) and Unregulated Care Providers how to implement the recommendations outlined in the RNAO Best Practice Guideline, Assessment and Management of Stage I to IV Pressure Ulcers.

    There are two parts to this program; Part A is directed towards RNs and RPNs while Part B is aimed towards Unregulated Care Providers (UCP). These materials are for use by the workshop facilitator, and include a list of components, questionnaires and case studies for participants, and answer keys.

    Retrieved from: http://rnao.ca/bpg/guidelines/resources/assessment-and-management-pressure-ulcers-education-program

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    Elder Abuse Ontario (EAO)) (formerly known as ONPEA, The Ontario Network for the Prevention of Elder Abuse) is a provincial, charitable, non-profit organization focused on supporting the implementation of The Ontario Strategy to Combat Elder Abuse and has been doing so since 2002. EAO has resources that are useful for LTC homes under the ‘Help for Seniors’ section of their website.

    Reference: Elder Abuse Ontario (EAO). 2017. Help for Seniors. Accessed Feb. 6, 2017 https://eapon.ca/

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    This is a series of animated learning resources that have been created to enhance the capacity of those working with seniors and to adopt a common approach to identify and respond to elder abuse. As you move through each training module, you will be prompted by a coach who will act as your guide to make sure you maximize your learning.

    Reference: Elder Abuse Ontario. (n.d.). Elder Abuse Training Tools: Interactive Animated Learning Resources_Recognizing Financial and Emotional Abuse. Retrieved from Training Tools - Elder Abuse Prevention Ontario (eapon.ca)

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    This reference guide is a tool considered to be a promising approach for professionals, family and friends to use when working with seniors who may be experiencing abuse.

    Reference: National Initiative for Care of the Elderly. (n.d.).Elder abuse: Assessment and intervention reference guide. Retrieved from http://www.nicenet.ca/tools-elder-abuse-assessment-and-intervention-reference-guide
     

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    The brainXchange End of Life Care section contains presentation slides and resources on end of life care, including care related to persons in the final stages of dementia.

    Website: http://brainxchange.ca/Public/Resource-Centre-Topics-A-to-Z/End-of-Life-Care.aspx

    © 2016 brainXchange

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    This brochure prepared by Alzheimer's Association provides support in preparing for the end of life, especially when families must make choices.

    Reference: Retrieved from Alzheimer's Association http://www.alz.org/national/documents/brochure_endoflifedecisions.pdf

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    Practice standard are documents that help nurses understand their responsibilities and legal obligations to enable them to make safe, effective and ethical decisions when practising. This practice standard aims to help nurses understand the ethical values and practice standards that the nursing profession in Ontario must uphold. It also provides scenarios of ethical situations in which there is a conflict of values.

    College of Nurses of Ontario. (2019). Ethics [PDF file]. Retrieved from https://www.cno.org/globalassets/docs/prac/41034_ethics.pdf

     

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    This resource from pages 94-98 of Delirium, Dementia and Depression in Older Adults: Assessment and Care (2016) includes structure, process and outcome indicators helpful in evaluating the changes made by an organization.

    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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    Cette ligne directrice a été élaborée afin d'aborder la question de l'évaluation et du traitement des personnes qui ont un diagnostic avéré de plaies du pied causées par le diabète. Elle fournit des recommandations fondés sur les données probantes à toutes les infirmières ainsiqu'aux membres de l'équipe pluridisciplinaire qui prodiguent des soins dans des établissements de santé à des personnes (âgées de plus de 15 ans) atteintes de type 1 ou de type 2, qui sont atteintes de plaies du pied causées par le diabète.

    Association des infirmières et infirmiers autorisés de l'Ontario (2013). Évaluation et traitement des plaies du pied chez les personnes atteintes de diabète (2e édition). Toronto, Ontario : Association des infirmières et infirmiers autorisés de l'Ontario. Récupérée de : http://rnao.ca/bpg/guidelines/assessment-and-management-foot-ulcers-people-diabetes-second-edition

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    This booklet can help understand your rights as a resident of a long-term care home. These rights are yours by law. Advocacy Centre for the Elderly & Community Legal Education Ontario. (2008).

    Every resident: Bill of rights for people who live in Ontario long term care homes. Retrieved from: http://www.advocacycentreelderly.org/appimages/file/everyresEN%20-%20Dec%202011.pdf

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    Table 18 summarizes different approaches to exercise and physical training interventions with varying degrees of effectiveness.

    Registered Nurses’ Association of Ontario.  (2017).  Appendix H of RNAO Prevention of Falls and Reducing Injury from Falls Best Practice Guideline. (4th Ed.).  Toronto, ON: Author. (p.104-107.)

     

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    This interview guide Subjective Experience of Being Restrained (SEBR) can be used with patients in hospital and then in nursing homes.

    Registered Nurses’ Association of Ontario. (2012). Appendix E of Promoting Safety: Alternative Approaches to the Use of Restraints. Toronto, Canada: Author.  (pp. 94-96). Retrieved from https://rnao.ca/sites/rnao-ca/files/Promoting_Safety_-_Alternative_Approaches_to_the_Use_of_Restraints_0.pdf

    Copyright 1986 University of Pennsylvania School of Nursing

    Website: www.nursing.upenn.edu/

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    Fallsloop is a free online communication platform for the virtual Falls community of practice (CoP). Practitioners, caregivers, researchers, older adult groups and policy planners working for the health and care of older adults come together to exchange information to problem solve and learn to implement evidence-informed and promising fall prevention practices. Register to join the Falls CoP and access free webinars and resources.

    The Ontario Neurotrauma Foundation (n.d.) Fall Prevention Community of Practice Loop. Retrieved from www.fallsloop.com
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    A fall prevention toolkit for planning events, information on evidence informed and evaluated fall prevention programs, resources and tools for practitioners and promotional materials for organizations.

    Fall Prevention Month. (n.d.). Fall prevention month toolkit. http://fallpreventionmonth.ca/ 

     

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    Example of a form for documentation from St Joseph’s Healthcare Hamilton on falls debriefing and action plan.

    Registered Nurses’ Association of Ontario.  (2017).  Appendix J: Example: Falls debriefing and action plan from St. Joseph's Healthcare Hamilton (Ontario, Canada) of RNAO Prevention of Falls and Reducing Injury from Falls Best Practice Guideline. (4th Ed.). Toronto, ON: Author. (p.111-112.)

     

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    The Centre for Effective Practice developed a discussion guide and caregiver supplement which includes topics of assessment of fall prevention and prevention in relation to associated co-morbidities. This guide includes references to available relevant tools and services.

    Centre For Effective Practice. (2016). Falls Prevention Discussion Guide. Retrieved from https://cep.health/clinical-products/falls-preventon/#pc_page_1032

     

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    Website containing resources and information for families of residents in Long term Care.

    Family Councils Ontario (2022) retrieved from Family Councils Ontario (fco.ngo)

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    A fact sheet with a concise overview of Urinary Tract Infections associated with catheter use. Available in poster/printable formats. Suitable for patients, families and health care providers.

    Reference: Centre for Disease Control and Prevention (CDC). 2015. FAQ’s about Catheter-associated Urinary Tract Infections. http://www.cdc.gov/hai/pdfs/uti/CA-UTI_tagged-BW.pdf.
     

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    This fact sheet from The Canadian Continence Foundation provides an overview of fecal incontinence, lifestyle changes and treatments.

    Reference:

    The Canadian Continence Foundation. 2010. Fecal Incontinence.  Accessed June 13, 2018.

    http://www.canadiancontinence.ca/pdfs/Faecal-Incontinence-2010-01-19.pdf

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    Alzheimer Society Ontario's Finding Your Way® helps people living with dementia, their families, caregivers and communities to recognize the risk of going missing, be prepared for incidents of going missing, and ensure that people with dementia can live safely in the community. At this link you will find free On-line Learning about keeping people with dementia safe. You will also find a Living Safely with Dementia Resource Guide and an interactive resource guide. http://findingyourwayontario.ca/ 

    Alzheimer Society of Canada (2018). Finding Your Way. http://findingyourwayontario.ca/ 

    2018 Alzheimer Society of Canada

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    Improving End-of-Life Care in First Nations, The Way Forward Integration Initiative, Quality End-of-Life Care Coalition of Canada and Canadian Hospice Palliative Care Association partnered to develop advance care planning educational resources for people living in First Nations Communities.

    Speak Up. (n.d.) Retrieved from http://www.advancecareplanning.ca/community-organizations/download-the-speak-up-campaign-kit/first-nations-acp-resources.aspx

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    This table is a theoretical framework to understand the psychological stages individuals may go through as they adapt to a transition

    Reference: Registered Nurses’ Association of Ontario (2014). Care Transitions. Toronto, ON, Canada: Author. http://rnao.ca/bpg/guidelines/care-transitions pp22

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    The Fixing Long-Term Care Act, 2021 (FLTCA) was proclaimed into force to regulate Ontario's long-term care home sector.
    The Long-Term Care Homes Act, 2007 (LTCHA) was revoked, which means it is no longer in force. The new Act also includes a new regulation.

    Government of Ontario (2021) Fixing Long-Term Care Act, 2021. Toronto ( ON) retrieved from Fixing Long-Term Care Act, 2021, S.O. 2021, c. 39, Sched. 1 (ontario.ca)

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    This flow chart from page 33 of the BPG Delirium, Dementia and Depression in Older Adults: Assessment and Care (2016) provides a concise and systematic overview of the best practice recommendations.

    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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    A flow chart that summarizes the steps, context, and considerations in falls prevention and injury reduction.

    Registered Nurses’ Association of Ontario.  (2017).  RNAO Prevention of Falls and Reducing Injury from Falls Best Practice Guideline. (4th Ed.).  Toronto, ON: Author. (p.24)
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    This fact sheet from the Ontario Dental Hygienists' Association provides signs of poor oral care and gives clear instructions for how a caregiver can give oral care to another person.

    Ontario Dental Hygienists' Association. (n.d.). For caregivers – A guide to providing oral care. Retrieved from https://odha.on.ca/wp-content/uploads/2016/08/CaregiversNewFactSheet.pdf

     

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    This scale's purpose is to determine how nurses feel about certain situations in which they are involved with patients. All statements concern nursing care given to the dying person and/or his/her family. Where there is a reference to a dying patient, assume it refers to a person who is considered to be terminally ill, with six months or fewer to live.

    Source: Folmelt, K. American Journal Hospice Palliative Care (Vol. 8, Issue 5) pp. 37-43 Copyright 1991 By Sage Publication

    Registered Nurses' Association of Ontario. (2011). Appendix G of End-of-Life Care During the last Days and Hours. Toronto, ON: Author pp. 108-109

    Retrieved from http://rnao.ca/sites/rnao-ca/files/End-of-Life_Care_During_the_Last_Days_and_Hours_0.pdf

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    nA tool to assist LTC homes in completing a gap analysis regarding how they are doing in their home with Person and Family Centred Care from a resident’s viewpoint. This tool was developed by staff at Woodingford Lodge as part of the LTC BPSO® pre-designation journey.

    Woodingford Lodge. (2016). Resident Report Card. Woodstock ON.

     

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    A tool to assist LTC homes in completing a gap analysis regarding how they are doing in their home with Person and Family Centred Care from a front-line viewpoint. This tool was developed by staff at Woodingford Lodge as part of the LTC BPSO® pre-designation journey.

    Woodingford Lodge. (2016). General Staff Report Card. Woodstock ON.
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    This web link provides GPA training information and educational resources. access to GPA newsletters. The Advanced Gerontological Education Website is www.ageinc.ca.

     

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    The GDS is a screening tool to facilitate the assessment of depression in older adults. It is available in both long form and short form versions and also in multiple languages.

    Reference: Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1983). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17(1), 37–49. Retrieved from https://web.stanford.edu/~yesavage/GDS.html

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    These open-access interactive geriatric learning modules are based on the Geriatrics interprofessional interorganizational Collaboration (GiiC) toolkit developed by the RGPs of Ontario. Users take on a senior character and follow their journey through the health system. Registration is required to access the eLearning Modules.

    Retrieved from: https://geriatricessentialselearning.ca/ 


     

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    This link takes you to the resources that include pain assessment terminology and Power Point presentations.

    Reference: Sigma Theta Tau International for the Center for Nursing Excellence in Long Term Care 2013. Pain assessment terminology and narrated power point presentations. Retrieved from http://www.geriatricpain.org

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    This link takes you to the Geriatric Pain website http://www.geriatricpain.org

    The website was created to provide nurses who work in LTC environments with access to free best practice pain assessment tools and resources to help manage pain in older adults, including quality improvement processes focused on pain management

     

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    This website has all the tools you need to initiate a Pain Quality Improvement program in your LTC Home. The document provides you with a overview of how t use the tools in this section. 

    Geriatric Pain, Website: http://www.geriatricpain.org

      

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    This free e-learn contains six modules which cover everything from the skin structure and blood composition right up to pressure ulcers and a guide to prevention. Each training module has interactive diagrams and has a certificate when the module is completed. To test comprehensive learning the user can read a case study and try and heal a wound.

    Website: http://www.globalwoundacademy.com/

    Permissible uses of EGWA materials EGWA is for your personal use. Unless you first obtain Smith & Nephew’s express written permission, you may not modify, copy, distribute, transmit, display, perform, reproduce, publish, license, create derivative works from, transfer, or sell any information, products or services obtained from EGWA. To do so will automatically terminate this Agreement and could result in civil and criminal penalties.

    Copyright notice Unless otherwise noted, all contents of EGWA, including but not limited to words, images and sounds, are: © 2001-present Smith & Nephew. All rights reserved. You may not reproduce, copy, download or distribute any content of this site without first obtaining express written permission from Smith & Nephew. Violations of Smith & Nephew’s copyrights may result in civil and criminal penalties.

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    This website offers a workbook with 10 accompanying videos to help long-term care home staff to learn techniques to provide better oral care to their residents. 

    Minnesota Dental Association. (n.d.). Growing old with a smile: Oral health for older adults in long-term care. Retrieved from https://www.mndental.org/public/oral-health/seniors-and-oral-health/

     

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    A best practice guideline on preventing Catheter-associated Urinary Tract Infections. For use by infection prevention staff, administrators, nurses, and other healthcare providers across the continuum of care. Developed by the Centre for Disease Control and Prevention.

    Reference: Healthcare Infection Control Practices Advisory Committee (HICPAC) and Centre for Disease Control and Prevention. (CDC). 2009. Guideline for Prevention of Catheter-associated Urinary Tract Infections. http://www.cdc.gov/hicpac/pdf/CAUTI/CAUTIguideline2009final.pdf.

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    This Canadian guideline was developed by the 'Toward Optimized Practices' (TOPS) Program. It was established by Alberta physicians to help implement clinical practice improvements using evidence-based best practices and quality initiatives to improve resident care and clinical management. This Urinary Tract Infection Clinical Practice Guideline is complemented with a UTI algorithm and simplified guideline.

    Reference: Toward Optimized Practice (TOP) Program. 2010. Guideline for the Diagnosis and Management of Urinary Tract Infections in Long Term Care. Edmonton, AB. Retrieved on Jan. 16, 2015 from: http://www.topalbertadoctors.org/cpgs/?sid=15&cpg_cats=66&cpg_info=41

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    The Cancer Care website links to the guidelines for palliative care. The target population is any individual requiring palliative care. All Clinicians and staff involved in the delivery of palliative care can use this guideline.

    Retrieved from: https://www.cancercareontario.ca/guidelines-advice/types-of-cancer/28286

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    This resource provides guidelines that support, give direction and improve services for adults with a developmental disability when applying to, moving into and residing In a Long-Term Care Home. It outlines the importance of planning, choice and consent and adults with developmental disabilities receiving appropriate developmental services and supports in a LTC home. Following these guidelines demonstrates the integrated and co-ordinated approach to care within and between the Developmental Services (DS) and LTC home sectors.

    Reference: QUEEN'S PRINTER FOR ONTARIO, 2012-14 - LAST MODIFIED: OCTOBER 18, 2017. RETRIEVED OCTOBER 31,2017 FROM https://www.health.gov.on.ca/en/public/programs/ltc/dsguidelines/ 

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    The revised ESAS-r is available in multiple languages. The link will take you to the guidelines for using the ESAS-r tool. The ESAS-r tool is freely available to use, with appropriate acknowledgement of its source.

    Website: http://www.palliative.org

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    The link will take you to the presentation by Judith Whal, hosted by Hospice Palliative Care Ontario https://hpco.adobeconnect.com/_a1122975890/p6js6fkeod3/?launcher=false&fcsContent=true&pbMode=normal

    The PDF version of the presentation is also attached. Retrieved from: http://www.hpco.ca/

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    This section of the brainXchange website focuses on health care consent and advance care planning, with many presentations and resources available to help when caring for persons at the end of life.

    Reference: Title: brainXchange, Health care consent and advance care planning (2016). This section of the brainXchange website focuses on health care consent and advance care planning, with many presentations and resources available to help when caring for persons at the end of life. Website: http://brainxchange.ca/capacity.aspx

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    You may need to seek assistance from a health-care professional when you have concerns about people you care for who are in pain. Uncontrolled pain is a common problem. Pain can affect anyone at any age and include people who are unable to communicate that they are experiencing some form of pain. If people have pain during their day-to-day activities or during any medical procedure, this can affect the way they behave and function. This behaviour may cause you to feel helpless and distressed, especially if you can not help them with their pain and they are not able to speak for themselves.

    Retrieved from: http://rnao.ca/bpg/guidelines/fact-sheets/helping-people-manage-their-pain

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    This assessment tool is used primarily by mental health professionals to “estimate” a persons’ probability of violence.

    Registered Nurses’ Association of Ontario. (2012). Appendix H of Promoting Safety: Alternative Approaches to the Use of Restraints. Toronto, Canada: Author.  (p. 101). Retrieved from https://rnao.ca/sites/rnao-ca/files/Promoting_Safety_-_Alternative_Approaches_to_the_Use_of_Restraints_0.pdf

    Reprinted with permission from Ronald Roesch, Professor, Director of Mental Health Law and Policy Institute, Simon Fraser University

    Website: http://kdouglas.wordpress.com/hcr-20/

  • Show description [+]

    Hollister Education has developed an online course in Ostomy Care that offers healthcare professionals the opportunity to learn more about this specialized area of care. There are a total of five lessons that may be viewed in any order, with an assessment at the conclusion of each lesson. Topics include:

    • Lesson 1: Ostomy overview
    • Lesson 2: Pouching systems
    • Lesson 3: Ostomy accessories
    • Lesson 4: Problem solving
    • Lesson 5: Education and resources

    Each lesson contains a glossary of terms and reference resources.

    Web Address or Source: http://www.hollister.ca/en-ca/ostomycare/ostomycareprofessionalresources/hollisterostomycareelearning  

    Intellectual Property:

    Unless otherwise specified, all content and the intellectual property rights in such content included on this Web site, such as works, images, pictures, dialogues, music, sounds, videos, documents, drawings, figures, logos, menus, Web pages, graphics, colors, schemes, tools, fonts, designs, diagrams, layouts, methods, processes, functions and software (collectively, “Content”), are the property of Hollister. You may not reproduce, publish, distribute, display, modify, create derivative work from, or exploit in any way, in whole or in part, the Content without getting prior express written consent from us.

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    This guide is intended to help health care/hospice palliative care professionals and volunteers to have a conversation with and/or respond to patients or their families around Medical Assistance in Dying (MAiD).

    Reference: Palliative Care and Medical Assistance in Dying (MAiD) in Canada (2017, June). Retrieved from https://www.chpca.ca/wp-content/uploads/2019/12/chpca-maid-booklet-eng-12page-final-web.pdf

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    The Hospice Palliative Care Ontario offers many educational resources for caregivers including Advance Care Planning and Health Care Consent for Health Service Providers. There is also a Palliative Care Core Course for Interdisciplinary staff which covers pain and symptom management, ethical decisions, communication and end of life in dementia. Materials are freely accessible.

    Reference: Title: Hospice Palliative Care Ontario (2015) Description: The Hospice Palliative Care Ontario offers many educational resources for caregivers including Advance Care Planning and Health Care Consent for Health Service Providers. There is also a Palliative Care Core Course for Interdisciplinary staff which covers pain and symptom management, ethical decisions, communication and end of life in dementia. Materials are freely accessible. Website: http://www.hpco.ca/

  • Show description [+]

    Downloadable practical implementation resources on implementing Person-Centred Language in Patient Documentation

    Regional Geriatric Program of Toronto ( 2022) Implement Person-Centred Language in Patient Documentation retrieved from Implement Person-Centred Language in Patient Documentation | Regional Geriatric Program of Toronto (rgptoronto.ca)

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    Watch a video of nurses implementing the Assessment and Management of Pain Guideline into their practice. 

    RNAO (2009) Implementation of Pain Assessment and management Guideline

    Source: http://www.youtube.com/watch?v=Ssymdf8CFQ4&feature=channel_page.

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    Implementing a Palliative Approach to Care in Long Term Care: An Implementation Guide and Resource Toolkit that aligns with the expanded Palliative Approach to Care requirements within the Fixing Long-Term Care Act, 2021 (FLTCA). The document is divided into 3 sections, each section starts with content related to the section’s theme, followed by a comprehensive list of resources, including hyperlinks. 
    1. Key concepts in a palliative approach to care
    2. Mentorship, education and support to build competency and capacity
    3. Implementing a palliative approach to care

    Retrieved from: https://www.palliativecareswo.ca/docs/LTCH_Resource_%20Guide.pdf  

  • Show description [+]

    At the 2017 Ontario Long Term Care Association Together We Care Convention and Trade Show, Primacare Living Solutions shared their experience with the first MAID case in long-term care. This resource highlights a listing of key learnings and implementation strategies that homes can consider to support them to implement MAID. Please note that this is evolving issue, and some resources and strategies may become outdated with time, and as new legislation and clinical direction emerge from government and other regulatory bodies.

    This toolkit, including all associated resources, may be utilized and adapted by long-term care homes free of charge. We ask that Primacare Living Solutions be referenced and acknowledged where appropriate. D) Reference: Implementing the First MAID case in Ontario Long-Term Care: Primacare Living Solutions (2017) Retrieved from http://www.oltca.com/OLTCA/Documents/InnovationExchange/MAID/PrimacareSolutions_MAIDToolkit.pdf 

  • Show description [+]

    This website provides all Ontario health care practitioners the information and resources they need to:

    • Prepare people and their Substitute Decision-Makers (SDMs) for future decision-making (Advance Care Planning).
    • Support decision-making by engaging people and caregivers in decision-making conversations when needed (Goals of Care Discussions

    Hospice Palliative Care Ontario (2022) Improving Person-Centred Conversations retrieved from Welcome to HPCO's Online Learning Portal (pcdm.ca)

  • Show description [+]

    This collaboration between LGBT and mainstream organizations examines why the LGBT population face additional obstacles to successful aging. It also looks at what groundwork needs to be in place for these obstacles to be overcome . Copyright © 2015 Movement Advancement Project ©

    Reference: LGBT Movement Advancement Project (MAP), & Services and Advocacy for Gay, Lesbian, Bisexual, and Transgender Elders (SAGE). (2010). Improving Lives of the LGBT older adults. Retrieved from https://lgbtmap.org/improving-the-lives-of-lgbt-older-adults

  • Show description [+]

    This IADIT tool is an excellent resource on skin care for incontinent people. It has clear pictures, definitions and short descriptions of skin changes and rashes.

    Copyright © 2008 Joan Junkin. All rights reserved. Please send request for permissions to IADIT@medbiopub.com.  

    1. Bliss DZ, Zehrer C, Savik K, et al. Incontinence-associated skin damage in nursing home residents: a secondary analysis of a prospective, multicenter study. Ostomy Wound Manage. 2006;52:46–55.

    2. Institute for Healthcare Improvement. Prevent Pressure Ulcers: How-To Guide. May 2007. Available at: http://www.ihi.org/nr/rdonlyres/5ababb51-93b3-4d88-ae19- be88b7d96858/0/pressureulcerhowtoguide.doc  

    3. Gray M, Bliss DB, Ermer-Seltun J, et al. Incontinence-associated dermatitis: a consensus. J Wound Ostomy Continence Nurs. 2007;34:45-54.

    4. Junkin J, Selekof JL. Prevalence of incontinence and associated skin injury in the acute care inpatient. J Wound Ostomy Continence Nurs. 2007;34:260-269.

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    A fact sheet on urinary continence for patients and families with recommendations for action based on the RNAO Continence BPG. Available in French.

  • Show description [+]

    This definitive report on incontinence was commissioned by the Canadian Continence Foundation. It provides an overview of both urinary and fecal incontinence in Canada. There are statistics and cost estimates on the burden of incontinence, as well as advocacy recommendations. A discussion on treatments for urinary incontinence is included.

    Reference: The Canadian Continence Foundation. 2014. Incontinence: The Canadian Perspective. Accessed Mar. 18, 2018. http://www.canadiancontinence.ca/pdfs/en-incontinence-a-canadian-perspective-2014.pdf 

    Copyright © 2018 The Canadian Continence Foundation.  
  • Show description [+]

    This algorithm looks at a multidisciplinary approach to management of Urinary incontinence in community or long term care. It addresses presenting symptoms, clinical assessments, Presumed Etiology, Treatment/ Management and evaluation. This one page tool an be used for lamination and posted.

    Reference:

    The Canadian Continence Foundation.2001 Initial UI Management algorithm women, men and frail elderly. Incontinence Toolkit, Date Retrieved:Sept. 5, 2018 http://www.canadiancontinence.ca/images/chart-initial-management-of-ui.gif

  • Show description [+]

    An illustration showing how the urinary tract nerves come from the brain and spinal cord.

    Registered Nurses' Association of Ontario. (2006). Self-Learning Package Continence Care Education. Toronto, ON: Retrieved from: http://rnao.ca/bpg/guidelines/resources/continence-care-education-selflearning-package

  • Show description [+]

    Example signage of Intentional Hourly Rounding Poster from Fraser Health, British Columbia, Canada.

    Registered Nurses’ Association of Ontario.  (2017).  Appendix K of RNAO Prevention of Falls and Reducing Injury from Falls Best Practice Guideline. (4th Ed.). Toronto, ON: Author. (p.115)

     

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    This tool was developed and validated by the ISTAP groups to allow for a universal language for identifying and documenting skin tears.

    Web Address: http://journals.lww.com/aswcjournal/Fulltext/2013/10000/International_Skin_Tear_Advisory_Panel__A_Tool_Kit.7.aspx Please refer to this link for further information how to apply for permission for re-use

    Reference: International Skin Tear Advisory Panel: A Tool kit to aid in the Prevention, Assessment and treatment of skin Tears using a Simplified Classification System. Advances in Skin and Wound Care. 26 (10): 459-476, October 2013

  • Show description [+]

    Pallium Canada provides palliative care education to all health providers through workshops, e-learning and more.

    Website: http://pallium.ca/

  • Show description [+]

    This article describes the challenges involved and potential solutions for improving the quality of transitional care.

    Reference: Fancott, C. (2011). The Change Foundation. Interventions and measurement tools related to improving the patient experience through transitions in care: A summary of key literature. Retrieved from http://www.hqontario.ca/Portals/0/modals/qi/en/processmap_pdfs/resources_links/care%20transitions%20literature%20review.pdf

  • Show description [+]

    This table from page 76-77 of the Delirium, Dementia, Depression in Older Adults: Assessment and Care BPG (2016) reviews interventions for depression, including psychotherapy, psychological/social and antidepressants.

    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

  • Show description [+]

    Table-14, 15, 16 and 17 summarize evidence from the reviewed literature on specific fall prevention and injury reduction interventions. They are organized according to the benefit of the interventions. Health-care providers use clinical judgment to determine if interventions apply to their settings.

    • Table 14: interventions with strong evidence of benefit.
    • Table 15: interventions that have potential benefit.
    • Table 16: interventions with mixed findings.
    • Table 17: interventions with insufficient evidence of benefit.
    Registered Nurses’ Association of Ontario.  (2017).  Appendix G of RNAO Prevention of Falls and Reducing Injury from Falls Best Practice Guideline. (4th Ed.).  Toronto, ON: Author. (p.98-103)

     

  • Show description [+]

    This powerpoint presentation for health care providers, shows how to distinguish between the types of urinary incontinence and interventions to treat urinary incontinence.  A poster and patient handout are also part of this module which is also available in french.
     

    Spencer, Martha ( 2019) Introduction to Urinary Incontinence- Clinician Learning Series.Ontario. Retrieved from https://www.rgptoronto.ca/resource/introduction-to-urinary-incontinence-clinician-learning-series/ 

  • Show description [+]

    Video of recognizing the warning signs/attitudes present in elder abuse situations.

    ©2015 Centre For Research & Education On Violence Against Women & Children

    Reference: Centre for research & education on violence against women & children. (n.d.). It's not right: Neighbours, friends & family for older adults. Retrieved from http://itsnotright.ca.

  • Show description [+]

    This resource outlines the key factors in deciding the method of debridement. Includes definition and examples of debridement. Taken from RNAO's Assessment and Management of Pressure Injuries for the Interprofessional Team, Third Edition Best Practice Guideline, (Appendix U, pp 151

    Reference: Registered Nurses’ Association of Ontario (2007). Appendix U - Key Factors in Deciding Method of Debridement. RNAO Assessment & Management of Pressure Injuries for the Interprofessional Team, Third Edition Best Practice Guideline. Toronto, Canada. Sibbald, Orsted et al. Page 151 http://rnao.ca/sites/rnao-ca/files/PI_BPG_FINAL_WEB_June_10_2016.pdf

  • Show description [+]

    The expert panel for the BPG Facilitating Client Centred Learning (2012) developed the L.E.A.R.N.S. Model, which describes how to support effective learning. LEARNS stands for Listen, Establish, Adopt, Reinforce, Name, Strengthen and refers to the nurse/client interaction.

    Reference: Registered Nurses’ Association of Ontario (2012). Facilitating Client Centred Learning. Toronto, Canada: Registered Nurses’ Association of Ontario. pp. 19-20. http://rnao.ca/bpg/guidelines/facilitating-client-centred-learning

  • Show description [+]

    Fiche de renseignements pour la sensibilisation en matière de santé.

    Association des infirmières et infirmiers autorisés de l’Ontario. (2003, Juilet). La constipation: La prévention est maître. Toronto, Canada: Auteur.

  • Show description [+]

    Les lignes directrices sur les pratiques exemplaires portent principalement sur le personnel infirmier, les équipes soignantes et les processus qui favorisent la mise en place de milieux de travail sains. Ces lignes directrices traitent de la gestion et de l’atténuation des conflits interpersonnels au sein des équipes de soins de santé. Elles partent du principe que même s’il est possible d’éviter certains conflits, des conflits sains peuvent également être bénéfiques.

    Association des infirmières et infirmiers autorisés de l’Ontario (2012). La gestion et l’atténuation des conflits dans les équipes de soins de santé. Toronto, Canada : Autheur. Récupéré http://rnao.ca/bpg/language/la-gestion-et-l%E2%80%99att%C3%A9nuation-des-conflits-dans-les-%C3%A9quipes-de-soins-de-sant%C3%A9

     Ce travail est financé par le Ministère de la Santé et des Soins de longue durée d'Ontario.

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    L'objectif de cette prochaine édition de la ligne directrice sur les pratiques exemplaires (LDPE) est de fournir aux infirmières, à l'équipe interprofessionnelle et aux soignants des recommandations fondées sur des données probantes pour la prestation de soins bucco-dentaires aux adultes (18 ans et plus) qui : (a) favoriseront une approche interprofessionnelle de la prestation soins bucco-dentaires, (b) améliorer la prestation des interventions de soins bucco-dentaires, et (c) conduire finalement à des résultats positifs en matière de santé bucco-dentaire pour les personnes.

    Le BPG se concentre sur la prestation de soins bucco-dentaires dans tous les établissements de santé aux adultes qui ont besoin d'aide pour les soins bucco-dentaires dans un continuum qui va de la mise en place de fournitures de soins bucco-dentaires à une assistance physique complète pour les soins bucco-dentaires. Cette LDPE fournit des recommandations pour soutenir la prestation de soins bucco-dentaires, y compris une supervision, une incitation et une assistance appropriées, tout en préconisant l'indépendance et l'autonomie de la personne.

    Association des infirmières et infirmiers autorisés de l’Ontario (AIIAO). Santé buccodentaire : Soutenir les adultes qui ont besoin d’aide. 2e  édition. Toronto (Ont.) : RNAO 2020
    https://rnao.ca/sites/rnao-ca/files/bpg/translations/Oral_Health_FR.pdf 

    Ce travail est financé par le Ministère de la Santé et des Soins de longue durée.

  • Show description [+]

    This e-resource offered by Baycrest provides six sections of learning including understanding depression, signs and symptoms, self-check, causes, types and treatments for late-life depression.

    Reference: Baycrest Health Sciences (2016) Late-Life Depression. Retrieved from http://www.baycrest.org/educate/mental-health/depression/

     

    © 2016 BAYCREST HEALTH SCIENCES - ALL RIGHTS RESERVED. UNAUTHORIZED COPYING, REPRODUCTION, REPUBLISHING, UPLOADING, DOWNLOADING, POSTING, TRANSMITTING OR DUPLICATING ANY OF THE MATERIAL FOUND ON THIS WEBSITE IS PROHIBITED. Your use of this site constitutes your agreement to abide by these Terms of Use. Baycrest reserves the right, in their sole discretion, to modify, alter or otherwise update these Terms of Use at any time and you agree to be bound by such modifications, alterations or updates. You agree to review these Terms of Use on an ongoing basis. Baycrest hereby grants you a personal, non-exclusive, non-assignable and non-transferable license to use and display, one copy of any Material and/or software that you may download from this site, including, but not limited to, any files, codes, audio or images incorporated in or generated by the software (collectively called the “Downloaded Material”) provided, however, that you must maintain all copyright and other notices contained in such Downloaded Material. You acknowledge and agree that you may not sublicense, assign or otherwise transfer this license or the Downloaded Material and that no title to the Downloaded Material has been or will be transferred to you from Baycrest or anyone else. You also agree that you will not alter, disassemble, decompile, reverse engineer or otherwise modify the Downloaded Material.

  • Show description [+]

    A complete toolkit for educational purposes. Composed in 2008 and content uploaded in 2016. Key elements of the CCSMH Late Life Suicide Prevention Toolkit include: • DVD - Suicide Assessment & Prevention for Older Adults: Life Saving Tools for Health Care Providers • CCSMH National Guidelines for Seniors’ Mental Health: The Assessment of Suicide Risk and Prevention of Suicide • Clinician pocket-card • PowerPoint presentation • Facilitator’s Guide with tips for using the Toolkit in a variety of ways

    Reference: Canadian Coalition for Seniors’ Mental Health (2008) Late Life Suicide Prevention Toolkit, Facilitators Guide. Available at http://ccsmh.ca/wp-content/uploads/2016/03/FacilitatorsGuide.pdf 

    © Canadian Coalition for Seniors’ Mental Health, 2008 In order to meet the educational needs of your learners, some materials in the toolkit may be modified. Please acknowledge that the information was provided by the Canadian Coalition for Seniors’ Mental Health Late Life Suicide Prevention Toolkit.

  • Show description [+]

    The link will take you to the document that the Law Commission of Ontario released October 2015 it is entitled Legal Capacity, Decision-Making and Guardianship, this  report provides a number of recommendations designed to reduce opportunities for elder abuse.

    Law Commission of Ontario (2017) Legal Capacity, Decision-making and Guardianship. Toronto, On. Retrieved from:  http://www.lco-cdo.org/wp-content/uploads/2017/03/CG-Final-Report-EN-online.pdf

  • Show description [+]

    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 http://rnao.ca/bpg/language/lignes-directrices-sur-le-d%C3%A9veloppement-et-le-maintien-du-leadership-infirmier

     Ce travail est financé par le Ministère de la Santé et Ministère des Soins de longue durée d'Ontario

     

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    Tables 10, 11 and 12 list of risk factors that include fall risk factors, health conditions associated with increased risk of falls, and factors associated with increased risk of falls injury.

    Registered Nurses’ Association of Ontario.  (2017).  Appendix E of RNAO Prevention of Falls and Reducing Injury from Falls Best Practice Guideline. (4th Ed.).  Toronto, ON: Author. (p.88-91.)

     

  • Show description [+]

    This resource provides a non-exhaustive list of topical antiseptic agents and their effects on wounds. This list was identified by experts and stakeholder feedback

    Reference: Registered Nurses’ Association of Ontario. (2016). Appendix T of Assessment and Management of Pressure Injuries for Interprofessional Team, Third Edition. Toronto, Canada: R. Sibbald, J. A. Elliott, E. A. Ayello, and R. Somayaji, P.150 http://rnao.ca/sites/rnao-ca/files/PI_BPG_FINAL_WEB_June_10_2016.pdf

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    LTC Series - Personal Support Worker: How to Safely Transfer In and Out of Bed is a two minute Osteoporosis Canada video discusses and demonstrates how to safely transfer residents in and out of bed.

    Osteoporosis Canada. [GERAS Centre]. (2018, Feb 8). LTC Series - Personal Support Worker: How to Safely Transfer Out/In Bed [Video]. YouTube. https://www.youtube.com/watch?v=3l93LkyHyLY&t=5s

     

  • Show description [+]

    LTC Series - Personal Support Worker: Practicing Sit to Stands Daily is a two and a half minute Osteoporosis Canada video discusses and demonstrates how to do daily sit to stand exercises for long term care residents.

    Osteoporosis Canada. [GERAS Centre]. (2018, Feb 8). LTC Series - Personal Support Worker: Practicing Sit to Stands Daily [Video]. YouTube. https://www.youtube.com/watch?v=yUWg3x6LUgU

     

  • Show description [+]

    LTC Series - Personal Support Worker: Proper Positioning for Sitting is a one and a half minute Osteoporosis Canada video discusses and demonstrates how to properly position residents for sitting.

    Osteoporosis Canada. [GERAS Centre]. (2018, Feb 8). LTC Series - Personal Support Worker: Proper positioning for sitting. [Video]. YouTube. https://www.youtube.com/watch?v=ssxzMpcCRDM

     

  • Show description [+]

    Fiche de renseignements pour la sensibilisation en matière de santé.

    Association des infirmières et infirmiers autorisés de l’Ontario (2002, Novembre). Maîtriser sa douleur. Toronto, ON, Canada: Auteur. Récupérée de http://rnao.ca/sites/rnao-ca/files/Maitriser_sa_douleur_0.pdf.

  • Show description [+]

    This tool is designed to help family physicians and nurse practitioners (primary care providers) develop and implement a management plan for adult patients with Chronic Non Cancer Pain (CNCP) in the primary care setting. CNCP is defined as pain that typically persists or recurs for more than 3 months or past the time of normal tissue healing.1,2,3,4 This tool applies to, but is not limited to pain conditions such as osteoarthritis (OA), low back pain (LBP), musculoskeletal (MSK) pain, fibromyalgia (FM) and neuropathic pain (NP). This tool focuses on a multi-modal approach to manage CNCP.

    Web Address or Source: https://thewellhealth.ca/wp-content/uploads/2017/03/CEP_CNCP_Main_V1.pdf

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    Why should I be concerned about foot ulcers?

    Foot ulcers increase the risk of infection (a germ or bacteria that invades and damages the tissues) and may reduce your quality of life. While most foot ulcers heal, when they are left untreated, they could lead to foot amputations. This could lead to lost income, longer hospital stays and a need for special therapy.

    Retrieved from: http://rnao.ca/bpg/guidelines/fact-sheets/managing-foot-ulcers-people-diabetes

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    The McCaffrey Initial Pain Assessment tool can be used to guide health care professionals through an initial assessment of pain. This tool includes diagrams of the human body to help patients locate the pain they experience as well as questions to prompt the patient to describe the intensity, quality, causes, effects, and contributing factors of the pain.

    Reference: McCaffrey M, Pasero C. (1999). McCaffrey Initial Pain Assessment Tool

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    Medical assistance in dying (MAID) has been legal in Canada since 2016. Nurse practitioners, physicians, pharmacists, and “persons aiding practitioners” (including nurses) are permitted to help those who have explicitly requested MAID.
    Resources:

    • CNA Statement on the Passage of Bill C-14 (media release)
    • Code of Ethics for Registered Nurses
    • Palliative care and end-of-life resources

    © Copyright 2022 Canadian Nurses Association

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    On June 16, 2016, the federal government passed legislation to amend Canada’s Criminal Code and established a federal framework for Medical Assistance in Dying (MAID) for individuals who meet pre-defined eligibility criteria.

    MAID, as defined by the Government of Canada, refers to: The administering by a medical practitioner or nurse practitioner of a substance to a person, at their request, that causes their death. The prescribing or providing by a medical practitioner or nurse practitioner of a substance to a person, at their request so that they may self-administer the substance, and in doing so, cause their own death. As part of its efforts to implement a consistent approach to the MAID process in Ontario, the Ministry of Health and Long-Term Care (MOHLTC) has engaged the Centre for Effective Practice (CEP) to develop a resource to support clinicians (physicians and nurse practitioners) with the provision of MAID. Retrieved from: https://thewellhealth.ca/maid/

    Centre for Effective Practice. (2019). Medical Assistance in Dying (MAID): Ontario (rev). Retrieved from: https://thewellhealth.ca/maid/

     

  • Show description [+]
    This guide developed by the Ontario government is intended to provide information for those individuals who are considering Medical Assistance in Dying (MAiD). Web Address or Source: http://health.gov.on.ca/en/pro/programs/maid/docs/maid.pdf Reference: Medical Assistance in Dying – Information for Patients. (2017, May). Retrieved from http://health.gov.on.ca/en/pro/programs/maid/docs/maid.pdf
  • Show description [+]

    The Ministry of Health and Long-term Care (MOHLTC) has provided an update on medical assistance in dying (MAID) implementation pieces. This webpage is to provide the general public, patients and providers with MAID-specific information, guidance and resources.

    Retrieved from http://www.health.gov.on.ca/en/pro/programs/maid/default.aspx

  • Show description [+]

    Med Rec is a formal process to ensure accurate and comprehensive medication information is communicated consistently across transitions of care. This site provides information that can support medication reconciliation policies and procedures within organizations.

    Reference: Institute for Safe Medication Practices (ISMP). (2012). Medication Reconciliation. Retrieved from http://www.ismpcanada.org/medrec/

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    Table 19 provides a list of medication resources for use in fall prevention and reduction of injury from falls.

    Registered Nurses’ Association of Ontario.  (2017).  Appendix I of RNAO Prevention of Falls and Reducing Injury from Falls Best Practice Guideline. (4th Ed.).  Toronto, ON: Author. (p.108.)

     

  • Show description [+]

    The Medication practice standard describes nurses’ accountabilities when engaging in medication practices, such as administration, dispensing, medication storage, inventory management and disposal.

    Reference: College of Nurses of Ontario (2015) CNO Practice Standard-Medication Retrieved from http://www.cno.org/globalassets/docs/prac/41007_medication.pdf

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    A list of medications that can impact on skin integrity

    Web Address: http://journals.lww.com/aswcjournal/Fulltext/2013/10000/International_Skin_Tear_Advisory_Panel__A_Tool_Kit.7.aspx Please refer to this link for further information how to apply for permission for re-use

    Reference: International Skin Tear Advisory Panel: A Tool kit to aid in the Prevention, Assessment and treatment of skin Tears using a Simplified Classification System. Advances in Skin and Wound Care. 26 (10): 459-476, October 2013

  • Show description [+]

    Appendix P from the RNAO A Proactive Approach to Bladder and Bowel Management in Adults — Fourth Edition is a list of the major drug groups that can contribute to constipation. 

    Registered Nurses’ Association of Ontario (RNAO). A proactive approach to bladder and bowel management in adults. 4th ed. Toronto (ON): RNAO; 2020 (p. 146).

  • Show description [+]

    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.

  • Show description [+]

    This resource lists medications that can have an impact on oral health.

    South West: Best Practice Coordinators in Long-Term Care Initiative. (n.d.). Medications that impact oral health. Retrieved from https://admin.rgpc.ca/uploads/documents/8%20medications%20that%20impact%20oral%20health%20primary%20care.pdf

      

  • Show description [+]

    This Government of Ontario website contains the Mental Health Act 1990 and Regulation that falls under it.

    Reference: Mental Health Act 1990 Website: https://www.ontario.ca/laws/statute/90m07

  • Show description [+]

    This WHO webpage, Mental Health of Older Adults, recognizes dementia and depression in older adults as a global public health issue and identifies interventions.

    World Health Organization. (12 December, 2017). Mental Health of Older Adults. Retrieved from www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults

    Licence: CC BY-NC-SA 3.0 IGO.

     

  • Show description [+]

    The Mental Health First Aid courses focus on the most common mental health disorders related to substances, mood, anxiety, trauma and psychosis.

    Reference: Mental Health Commission of Canada (2017). Mental Health First Aid Canada. Retrieved from http://www.mentalhealthfirstaid.ca/en/course-info/courses  

    © 2017 Mental Health Commission of Canada

  • Show description [+]

    Website full of educational resources with a great search engine pertaining to suicide and the elderly.

    Reference: Baycrest [Online] Available: http://www.baycrest.org

    Your use of this site constitutes your agreement to abide by these Terms of Use. Baycrest reserves the right, in their sole discretion, to modify, alter or otherwise update these Terms of Use at any time and you agree to be bound by such modifications, alterations or updates. You agree to review these Terms of Use on an ongoing basis. Baycrest hereby grants you a personal, non-exclusive, non-assignable and non-transferable license to use and display, one copy of any Material and/or software that you may download from this site, including, but not limited to, any files, codes, audio or images incorporated in or generated by the software (collectively called the “Downloaded Material”) provided, however, that you must maintain all copyright and other notices contained in such Downloaded Material. You acknowledge and agree that you may not sublicense, assign or otherwise transfer this license or the Downloaded Material and that no title to the Downloaded Material has been or will be transferred to you from Baycrest or anyone else. You also agree that you will not alter, disassemble, decompile, reverse engineer or otherwise modify the Downloaded Material.

  • Show description [+]

    The Mini-Cog is a brief screening instrument to determine memory recall and clock drawing ability. A positive screen would suggest more in-depth assessment for cognitive impairment. Mini-Cog instrument, instructions and scoring are provided.

    Reference: Borson, S. (n.d.). Mini-Co. Retrieved from https://mini-cog.com/

    Mini-Cog™ © S. Borson. All rights reserved. Reprinted with permission of the author solely for clinical and educational purposes. May not be modified or used for commercial, marketing, or research purposes without permission of the author (soob@uw.edu). v. 01.19.16

  • Show description [+]

    A useful tool for assessing early stage dementia.  For more information or feedback on MoCA© contact Dr Z. Nasreddine at info@mocatest.org.

    Nasreddine, Z.  (2003). Welcome to the Montreal Cognitive Assessment.   Quebec, QC, Canada: Center for Diagnosis & Research on Alzheimer’s disease.  Retrieved from www.mocatest.org.  Copyright Dr Z. Nasreddine 2003 to 2013 - The Montreal Cognitive Assessment - MoCA© - All rights reserved.

  • Show description [+]

    This website contains many useful resources for understanding depression, bipolar disorder, suicidality. There is an education tab with links to training modules. Useful supportive strategies can be found under the support tab.

    Reference: Website: http://mooddisorderscanada.com/ 

  • Show description [+]

    This website will assist families when an individual with dementia is looking at transitioning to long-term care. The Alzheimer Society of Canada webpage has resources for the following areas to support decision-making:

    • Considering the move to LTC Home
    • Preparing for a move
    • Handling moving day
    • Adjusting after a move
    • Caregiver stress assessment checklist
    • LTC Home evaluation checklist
    • What to bring on moving day checklist
    • Transition to LTC e-learning module
    • All about me

    Web Address: http://www.alzheimer.ca/en/Living-with-dementia/Caring-for-someone/Long-term-care

    Reference: Alzheimer Society of Canada (2016)“ Alzheimer Society of Canada, Long Term Care” retrieved from https://alzheimer.ca/en/help-support/im-caring-person-living-dementia/long-term-care/moving-long-term-care

  • Show description [+]

    Music and Memory looks at how music can enrich the lives of long-term care residents with cognitive impairment.

    Reference: Blanchard, Laurie (2016). Music and Memory. Retrieved from http://libguides.lib.umanitoba.ca/ld.php?content_id=25047510

  • Show description [+]

    The Mutual Action Plan (MAP) takes into account the resident's individual style of learning and communicating.

    Registered Nurses’ Association of Ontario. (2012). Appendix O of Promoting Safety: Alternative Approaches to the Use of Restraints. Toronto, Canada: Author.  (pp. 117-118). Retrieved from https://rnao.ca/sites/rnao-ca/files/Promoting_Safety_-_Alternative_Approaches_to_the_Use_of_Restraints_0.pdf

    MAP Behavioural Profile - Draft 2009/11/18 adapted from: Safe Management Group Inc. 2008. Copyright 2009, Ontario Shores Centre for Mental Health Sciences. All rights reserved.

    Reproduction in whole or in part by any means without written consent of Ontario Shores is prohibited by law.

  • Show description [+]

    National Initiative for the Care of the Elderly (NICE) is an international network of researchers, practitioners, and students dedicated to improving the care of older adults in Canada and abroad. The website includes various resources, some specific to dementia care and caregiving.

    Reference:National Initiative for the Care of the Elderly (NICE) Website: http://www.nicenet.ca/

  • Show description [+]

    The National Pressure Ulcer Advisory Panel (NPUAP) serves as the authoritative voice for improved patient outcomes in pressure ulcer prevention and treatment through public policy, education and research.

    Website: http://www.npuap.org
     

  • Show description [+]

    Pauktuutit Inuit Women of Canada is the national organization that represents all Inuit women in Canada. Pauktuutit has been active in abuse prevention and building capacity to address abuse issues since its inception in 1984. Pauktuutit brought together individuals, agencies and groups who share a common interest in preventing abuse in Inuit communities, to collaborate on the development and implementation of this unique national,community-based strategy.

    Reference: Pauktuutit Inuit Women of Canada. (2006). National Strategy to Prevent Abuse in Inuit Communities and Sharing Knowledge, Sharing Wisdom: A Guide to the National Strategy. Ottawa, ON: Author. Retrieved from http://pauktuutit.ca/wp-content/blogs.dir/1/assets/InuitStrategy_e.pdf

  • Show description [+]

    Neuropsychiatric Inventory (NPI) is used to assess behavioural and psychological symptoms in clients with dementia. It evaluates the frequency and severity of the following symptoms: delusion, hallucinations, agitation, depression/dysphoria, anxiety, euphoria/jubilation, and apathy/indifference, disinhibition, irritability/lability, motor behaviour without a purpose, sleep alteration, and eating disorder. It is used to assess behavioural and psychological symptoms in patients

    Reference: Wood S, Cummings JL, Hsu M-A, Barclay T, Wheatley MV, Yarema KT, Schnelle JF. The use of the Neuropsychiatric Inventory in nursing home residents, characterization and measurement. Am J Geriatr Psychiatry 2000; 8: 75-83. http://www.dementia-assessment.com.au/behavioural/NPI.pdf

  • Show description [+]

    This Table from page 61 of Delirium, Dementia and Depression in Older Adults: Assessment and Care (2016) describes non- pharmacological approaches to use to minimize behavioural and psychological symptoms of dementia.

    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

  • Show description [+]

    A diagram showing the bladder filling and emptying cycles and the muscles involved in this process.

    Registered Nurses' Association of Ontario. (2006). Self-Learning Package Continence Care Education. Toronto, ON: Retrieved from: http://rnao.ca/bpg/guidelines/resources/continence-care-education-selflearning-package

  • Show description [+]

    NPUAP Pressure Injury Stages webpage provides definitions for the new pressure injury stages.

    Reference: National pressure ulcer advisory panel (n.d.). NPUAP Pressure Injury Stages. Copyright 2013. Retrieved from http://www.npuap.org/resources/educational-and-clinical-resources/npuap-pressure-injury-stages/

  • Show description [+]

    Asks persons to rate their pain from 0 to 10

    • Scored 0-10 with the anchors of 0 being ‘no pain’ and 10 being ‘pain as bad as it can be’ Used in adults, older adults, and adolescents and children over age 8.
    • Well established evidence of reliability, validity, and ability to detect change
    • No equipment is needed to administer this measure
    • High feasibility (quick and easy to use)

     

    Reference:

    Registered Nurses’ Association of Ontario. (2013). Appendix E of Assessment and Management of Pain, Third Edition.Toronto, Canada: Author. 81-82.

    McCaffery, M., Beebe, A., et al. (1989). Pain: Clinical manual for nursing practice, Mosby St. Louis, MO

  • Show description [+]

    This table discusses two tools which can provide a quick assessment of nutrition status: Canadian Nutrition Screening Tool and the Subjective Global Assessment

    Reference: Registered Nurses Association of Ontario (RNAO). 2016. Appendix M: Nutrition Screening and Assessment Tools. Assessment and Management of Pressure Injuries for the Interprofessional Team, Third Edition. Accessed July 28, 2016 http://rnao.ca/sites/rnao-ca/files/PI_BPG_FINAL_WEB_June_10_2016.pdf  pp. 138.

  • Show description [+]

    This observation and documentation record is when chemical restraints, seclusion and/or mechanical restraint are used.

    Registered Nurses’ Association of Ontario. (2012). Appendix W of Promoting Safety: Alternative Approaches to the Use of Restraints. Toronto, Canada: Author.  (pp. 131-138). Retrieved from https://rnao.ca/sites/rnao-ca/files/Promoting_Safety_-_Alternative_Approaches_to_the_Use_of_Restraints_0.pdf

    Copyright Centre for Addiction and Mental Health (2009). This material is prepared solely for internal use at CAMH. No part of this document may be reproduced in any form for publication without the permission of CAMH

  • Show description [+]

    The Privacy Commissioner of Canada is an Agent of Parliament whose mission is to protect and promote privacy rights. The Office of the Privacy Commissioner of Canada (OPC) oversees compliance with the Privacy Act. The OPC carries out its mission by: promoting public awareness; investigating complaints, conducting audits, pursuing court action; publicly reporting; and supporting, undertaking and publishing research

    Reference: Office of the Privacy Commissioner of Canada Retrieved from: http://www.priv.gc.ca/resource/prov/index_e.asp

  • Show description [+]

    The Office of the Public Guardian and Trustee (“OPGT”) delivers a unique and diverse range of services that safeguard the legal, personal and financial interests of certain private individuals and estates. Services are provided by multi-disciplinary teams of dedicated staff with experience in the health care, social work and financial planning fields. They receive professional support from lawyers, accountants and investigators. A brief description of many of the services offered by the OPGT is set out in the website.

    Reference: Office of the Public Guardian and Trustee (OPGT)

    Website: https://www.attorneygeneral.jus.gov.on.ca/english/family/pgt/overview.php

  • Show description [+]

    Offloading Devices is found as Appendix M of the RNAO BPG, Assessment and Management of Foot Ulcers for People with Diabetes. Pgs. 130-133.

    Reference: Registered Nurses’ Association of Ontario. (2013). Appendix M of Assessment and Management of Foot Ulcers for People with Diabetes. Toronto, Canada: Author. pp.130-133.

  • Show description [+]

    Bullying (also known as harassment) happens when a person or a group of people repeatedly hurts, threatens, or scares a peer. Bullying awareness and prevention activities have been traditionally aimed at younger generations, even though the behaviours occur across the life course and can affect older adults where they live and socialize. This factsheet summarizes the definition of bullying, causes, impacts on older adults, strategies for prevention, and available services in Ontario. 

    Adapted from: A&O and CNPEA Info-graph on Older Adults and Bullying 2020

  • Show description [+]

    Website of Ontario Association of Resident Councils with resources, advocacy  and information for residents in LTC in Ontario

     

    Ontario Association of Resident Councils (2022) retrieved from Ontario Association of Residents' Councils - OARC (ontarc.com)

  • Show description [+]

    The Ontario Palliative Care Network is a partnership of community stakeholders, health service providers and health systems planners who are developing a coordinated and standardized approach for delivering palliative care services in Ontario. In the website Resources section can be found many useful palliative care tools, guidance and evidence, reports and legislative updates.

    Web Address or Source:www.ontariopalliativecarenetwork.ca/

  • Show description [+]

    Ontario Regulation 246/22 was made under The Fixing Long-Term Care Act, 2021 (FLTCA) was proclaimed into force to regulate Ontario's long-term care home sector April 11, 2022.

    Government of Ontario (2022) Ontario Regulation 246/22. Toronto ( ON) retrieved from O. Reg. 246/22: GENERAL (ontario.ca)

  • Show description [+]

     Ontario Regulation 246/22 was made under The Fixing Long-Term Care Act, 2021 (FLTCA) was proclaimed into force to regulate Ontario's long-term care home sector April 11, 2022.
     

    Government of Ontario (2022) Ontario Regulation 246/22. Toronto ( ON) retrieved from O. Reg. 246/22: GENERAL (ontario.ca)

  • Show description [+]

    Ontario Regulation 246/22 was made under The Fixing Long-Term Care Act, 2021 (FLTCA) was proclaimed into force to regulate Ontario's long-term care home sector April 11, 2022.

    Government of Ontario (2022) Ontario Regulation 246/22. Toronto ( ON) retrieved from O. Reg. 246/22: GENERAL (ontario.ca)

  • Show description [+]

    Ontario Regulation 246/22 was made under The Fixing Long-Term Care Act, 2021 (FLTCA) was proclaimed into force to regulate Ontario's long-term care home sector April 11, 2022.

    Government of Ontario (2022) Ontario Regulation 246/22. Toronto ( ON) retrieved from O. Reg. 246/22: GENERAL (ontario.ca)

  • Show description [+]

    Ontario Regulation 246/22 was made under The Fixing Long-Term Care Act, 2021 (FLTCA) was proclaimed into force to regulate Ontario's long-term care home sector April 11, 2022.

    Government of Ontario (2022) Ontario Regulation 246/22. Toronto ( ON) retrieved from O. Reg. 246/22: GENERAL (ontario.ca)

  • Show description [+]

    This link to the RNAO Interest Group website leads to resources and information regarding the benefits of membership and the role of interest group members in leading, promoting and influencing wound related public policy in Ontario.

    Reference: Ontario Wound Interest Group. Website http://ontwig.rnao.ca

  • Show description [+]

    This brochure helps identify several key issues regarding managing the stigma and discrimination in housing, family and social support found in LGBTT population. The resource is available for free download.

    Senior Pride Network. (2014). Opening the Closet on Aging: Working with older lesbian, gay, bisexual, transsexual, and transgender people. Retrieved from http://www.rainbowhealthontario.ca/resources/opening-the-closet-on-aging-working-with-older-lesbian-gay-bisexual-transsexual-and-transgender-people/ 

     

  • Show description [+]

    The Opiod Manager condenses key elements from the Canadian Opiate Guideline into a workable format for prescribing opiates for persons with chronic, non-cancer pain.

    Reference: National Opiod Use Guidelines Group (2010), Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain Practice Toolkit, Opioid Manager. Retrieved from http://nationalpaincentre.mcmaster.ca/opioidmanager/

    © 2016 McMaster University

  • Show description [+]

    Optional Treatment Modalities is found as Appendix O of the RNAO BPG, Assessment and Management of Foot Ulcers for People with Diabetes. Pg 138-142.

    Reference: Registered Nurses’ Association of Ontario. (2013). Appendix O of Assessment and Management of Foot Ulcers for People with Diabetes. Toronto, Canada: Author. pp. 138-142.

  • Show description [+]

    This YouTube webinar from the Registered Nurses Association of Ontario Oral Care Community of Practice describes options for giving oral care to residents who have expressive behaviours.  It provides a background on the meaning of behaviours and practical ways to approach oral care.

    Thoma, J., & Kurchinski, K. (2016). Oral Care Approaches when Residents have Expressive Behaviours [Video file]. Retrieved from https://youtu.be/ntcCpfOZBPE
  • Show description [+]

    This is a comprehensive collection of audits to review oral care in long term care. It contains instructions and audits on: dental equipment; Denture and denture supplies; Oral care supplies in residents’ care caddie; Oral care practices; POC/Flowsheet; Actual Resident Assessment of oral care; Admission Process; Levels of assistance and behaviours; Annual Assessment; Quarterly Assessment; Annual evaluation of oral care education; and Resident and Family Information.

    MacDonald, I. (2016). Oral Care Auditing Tool. Toronto, ON: Registered Nurses Association of Ontario - Oral Care Community of Practice 2015-16.

     

  • Show description [+]

    This RNAO-sponsored webinar is 34 minutes long, with a focus on dementia oral care.

    Kurchinski, K., & Woodbeck, H. (2016). Oral care best practices for residents with responsive behaviour: Approaches and strategies [Video file]. Retrieved from https://youtu.be/oFS1c-qpCeE

     

  • Show description [+]

    This booklet is a group of tools that long term care or other health care organizations can use to collect baseline data on the status of oral care. Tools included are: RAI-MDS indicators; audits for oral supplies and care on charts; and an oral health knowledge survey.

    MacDonald, I. (2015). Oral care community of practice data collection tools. Toronto, ON: Registered Nurses Association of Ontario.

     

  • Show description [+]

    This is a link to a series of six videos that discusses why oral care is important and demonstrates appropriate oral care techniques for the various stages of dementia.  A DVD of these videos, Oral Hygiene for Residents with Dementia is available for purchase at the RNAO Online Store: https://shop.rnao.ca/node/113.

    Registered Nurses’ Association of Ontario (December 2009). Oral care for residents with dementia. [Video series]. Retrieved from https://youtu.be/MP576ht84Fg

     

  • Show description [+]

    This is a link to a series of six videos that describes the specialized oral care required for patients with the challenges of xerostoma (dry mouth), dysphasia (difficulty swallowing) and mucositis (inflamed oral tissues). A DVD of these videos, Oral Care for Xerostomia, Dysphagia and Mucositis is available for purchase at the RNAO Online Store: https://shop.rnao.ca/node/115.

    Registered Nurses’ Association of Ontario (December 2009). Oral care for xerostomia, dysphagia, and mucositis. [Video series]. Retrieved from https://youtu.be/D5_m5PYRd_g

     

  • Show description [+]

    This document is a sample policy and procedure on oral care. The policy was created by the RNAO Long-Term Care Best Practices Program Oral Care Toolkit Team to support LTC Homes.

     Registered Nurses' Association of Ontario. (2016). Oral care sample policy and procedure. Toronto, ON: Author 

     

  • Show description [+]

    This is a link to webinar series on thirteen different oral health topics that can be used for staff education. These include topics on oral health such as: diabetes, dementia, dry mouth, stroke, palliative care, bad breath, care planning, infection control, dentures, 2-toothbrush technique, tools, and oral assessment (OHAT).

    Terry Kirkpatrick. (2013).  Oral health care. [Video series].  Retrieved on October 8, 2013 from http://www.youtube.com/user/TerryKirkpatrick1/videos?sort=dd&live_view=500&flow=list&view=0.

     Sponsored by the Seniors Health Knowledge Network's Oral Health Community of Practice.  

    Website http://seniorshealthknowledgenetwork.com/community/oral-health-community-practice.

  • Show description [+]

    This oral health care planning guideline provides information on a standard protective care regimen, additional oral care treatment, oral care and changed behaviour and palliative care considerations. An Oral Health Care Plan guide is included.

    Government of South Australia. (2008). Better oral health care in residential: Oral health care planning guidelines. Retrieved from https://www.sahealth.sa.gov.au/wps/wcm/connect/77fd7a004b3323958834ade79043faf0/BOHRC_Professional_Portfolio_Full_Version%5B1%5D.pdf?MOD=AJPERES&amp;CACHEID=ROOTWORKSPACE-77fd7a004b3323958834ade79043faf0-nwm-H7C

    Source: Government of South Australia © 2012 SA Health

  • Show description [+]

    This tool was developed for use during resident admissions. Its aims is to have conversations with residents and/or family about oral/dental history along with preferences for oral care.

    MacDonald, I. (2016). Admission oral health history and preferences tool. Toronto, ON: Registered Nurses Association of Ontario.

     

  • Show description [+]

    This is a link to videos on thirteen oral health topics that can be used for staff education. Series 10 on Oral Health and Stroke July 2012 is specific for care of stroke survivors. It provides information on how oral health issues can cause a stroke, oral health care of stroke survivors and preventing oral disease. The other videos in the series also support education on oral health assessment tool (OHAT), infection control, oral care, halitosis, tooth brushing, denture care, oral care planning.

    Reference: Terry Kirkpatrick. (2013).  Oral health. [Video series].  Retrieved from: https://www.youtube.com/results?search_query=terry+kirkpatrick+oral+health+

     

  • Show description [+]

    This fact sheet from the British Columbia Dental Association provides a succinct description on how to do an oral exam, along with clear pictures of common oral problems.  It is available in Farsi, Chinese, Tagalog, and Punjabi. There are also video resources connected to this fact sheet.

    British Columbia Dental Association. (n.d.).  Oral Inspection Tips for Caregivers.  Retrieved from https://www.oda.ca/wp-content/uploads/2021/03/2019June_Oral-Inspection-Tips-for-Caregivers_FINAL.pdf

     

  • Show description [+]

    Les normes d’exercice informent les infirmières de leurs responsabilités et expliquent leur rôle au public. Le présent document a pour objectif d’aider les infirmières à comprendre leurs responsabilités et à prendre des décisions en matière de contention. La contention, qu’elle soit physique, environnementale ou chimique, est un moyen controversé visant à restreindre les mouvements d’un client ou à maîtriser son comportement.

    Copyright © Ordre des infirmières et infirmiers de l’Ontario, 2009.

    Ordre des infirmières et infirmiers de l’Ontario. (2006).  La contention. Toronto, ON, Canada: Auteur. Récupérée de http://www.cno.org/fr/exercice-de-la-profession/normes-et-directives-professionnelles/.

  • Show description [+]

    Les normes d’exercice informent les infirmières de leurs responsabilités et expliquent leur rôle au public. La relation thérapeutique est la pierre angulaire de la profession infirmière. Et son objectif premier est de favoriser la santé et le bien-être des clients. Pour établir et cultiver cette importante relation, l’infirmière fait appel à ses connaissances et compétences professionnelles ainsi qu’à sa compassion.

    Ordre des infirmières et infirmiers de l’Ontario. (2006).  La relation therapeutique. Toronto, ON, Canada: Auteur. Récupérée de http://www.cno.org/fr/exercice-de-la-profession/normes-et-directives-professionnelles/.

    Copyright © Ordre des infirmières et infirmiers de l’Ontario, 2009.

     

  • Show description [+]

    Organizational data collection tool that can be used when restraints are used as a “last resort”.

    Registered Nurses’ Association of Ontario. (212). Appendix Y of Promoting Safety: Alternative Approaches to the Use of Restraints. Toronto, Canada: Author.  (pp. 140-142). Retrieved from https://rnao.ca/sites/rnao-ca/files/Promoting_Safety_-_Alternative_Approaches_to_the_Use_of_Restraints_0.pdf

    All requests to use or adapt the Appendix: The Ottawa Hospital Organizational Audit Form must be directed to the Ottawa Hospital, Department of Nursing Professional Practice for permission.

  • Show description [+]

    This website is a source of information created for Ontario Long-term care homes regarding osteoporosis and fracture prevention. It includes resources, tools and the recommendations for preventing fractures in long-term care.

    Geriatric Education and Research in Aging Sciences (GERAS). (n.d.). Osteoporosis Long-Term Care. Retrieved from https://www.gerascentre.ca/osteoporosis-strategy-for-long-term-care/ 

     

  • Show description [+]

    Ostomy Canada Society (OCS) is a non-profit volunteer organization for people with ostomies and their families. The OCS website has practical ostomy care information on a variety of topic with good visuals. Resources are aimed at patients and families, but are applicable to health care professionals.

    Reference: Ostomy Canada Society. 2017. Accessed Aug. 22, 2017 https://www.ostomycanada.ca/

    Copyright © Ostomy Canada Society. All Rights Reserved.

  • Show description [+]

    This article on the Wound Care Advisor website provides clear and concise instructions for documenting the condition of ostomies. It reviews what to assess in an ostomy: general characteristics; stoma; effluent; peristomal skin; appliance and accessories; etc.

    Reference: Wound Care Advisor. 2016. Ostomy-Documentation-Tips. Accessed Aug. 22, 2017 at https://woundcareadvisor.com/ostomy-documentation-tips/

    Copyright: Information in Apple Bites is courtesy of the Wound Care Education Institute (WCEI), © 2016. Apple Bites, Ostomy2016 Journal Vol5 No6, clinical journal, ostomy, tips, wound infections

  • Show description [+]

    This website provides information and resources about the P.I.E.C.E.S.™ program. "Putting the P.I.E.C.E.S.™ Together" represents Physical, Intellectual, Emotional, Capabilities, Environment, Social, and are the cornerstones of the philosophy and care of the P.I.E.C.E.S.™ approach.

    P.I.E.C.E.S.™ (n.d.). P.I.E.C.E.S. website. Retrieved from http://pieceslearning.com/

     

  • Show description [+]

    PACSLAC is a tool to observe and assess both common and subtle pain behaviours. Copyright © Shannon Fuchs-Lacelle and Thomas Hadjistavropoulos. The PACSLAC may not be reproduced without permission. For permission to reproduce the PACSLAC, please contact the copyright holders (Thomas.Hadjistavropoulos@uregina.ca).

    Retrieved from http://www.geriatricpain.org/content/Assessment/Impaired/Pages/default.aspx

  • Show description [+]

    Comprehensive pain assessment tool for use in cognitively intact adults with pressure injuries. This pain assessment tool is useful for people with dementia who are unable to verbally express their pain. It focuses on behaviours and provides the ability to score pain levels.

    Reference: Interior Health. Retrieved from http://bcbpsd.ca/docs/part-1/Final%20Provincial%20PAINAD%20Scale.pdf

     

  • Show description [+]

    The following is not an exhaustive list of pain assessment tools but rather suggestions of tools identified within the systematic review; AGREE II appraised guidelines, by the expert panel or external stakeholder feedback.

    Reference: Registered Nurses 'Association of Ontario. (2016). Appendix N of Assessment and Management of Pressure Injuries for the Interprofessional Team. Toronto, Canada: Author. pp 139. http://rnao.ca/bpg/guidelines/pressure-injuries

  • Show description [+]

    This quality standard addresses palliative care for people who are living with a serious, life-limiting illness, and for their family and caregivers. The goal of palliative care is to relieve pain and suffering, and to improve a person’s quality of life. This quality standard focuses on care for people in all settings, including home and community, hospice, hospital, and long-term care.

    Health Quality Ontario (2018). Palliative Care Guide. Retrieved from: https://www.hqontario.ca/portals/0/documents/evidence/quality-standards/qs-palliative-care-clinical-guide-en.pdf

     

  • Show description [+]

    Cancer Care Ontario website links to best-practice tools from around the world to support primary care providers in the delivery of palliative care.  Tools are organized according to the 3-step model of best practice: Identify, Assess, and Plan.

    For resources tailored to support First Nations, Métis and Inuit families and communities, please see Tools for the Journey: Palliative Care in First Nations, Inuit and Métis Communities , a Resource Toolkit, developed by the Aboriginal Cancer Control Unit at Cancer Care Ontario.

    Retrieved from: https://www.cancercare.on.ca/toolbox/pallcaretools/

  • Show description [+]

    The Website contains numerous end-of-life resources for health care professionals.

    Copyright: End of Life Curriculum Project, a joint venture of the US Veterans Administration and SUMMIT, Stanford University Medical School

    Retrieved from http://palliative.stanford.edu/

  • Show description [+]

    Resource for palliative, pain and symptom management.

    Palliative Pain and Symptom Management Consultation Program: South Western Ontario.  (n.d.). Resources.  Retrieved on September 29, 2013.  Website www.palliativecareswo.ca.  © Copyright 2002-2008.

  • Show description [+]

    PPS may be used for several purposes. It is an excellent communicatiuon tool for quickly describing a patients current functional level.

    The Victoria Hospice Palliative Performance Scale (PPS, version 2) is an 11-point scale  communication tool for describing the current functional level and appears to have prognostic value.  The PPS provides a framework for measuring progressive decline over the course of illness.  If you wish to print any of these tools for your use, please go to https://victoriahospice.org/wp-content/uploads/2019/12/PPSv2-English-Sample.pdf to download a copy of Victoria Hospice's reprint and use permission request form.

    Victoria Hospice Society. (2001) Clinical Tools. Retrieved from hhttps://victoriahospice.org/wp-content/uploads/2019/12/PPSv2-English-Sample.pdf.

     © Victoria Hospice Society, 2006.

  • Show description [+]

    PPI relies on the assessment of performance status using PPS, oral intake, and the presence or absence of dyspnea, edema or delirium.

    Registered Nurses’ Association of Ontario. (2011). Appendix D of End-of-Life Care During the Last Days and Hours.  Toronto, Canada: Author. p 101.  Copyright (2008), with permission from Elsevier.

  • Show description [+]

    PaP uses the Karnofsky Performance Scale (KPS) and 5 other criteria to generate a numerical score from 0 to 17.5 to predict 30 day survival (higher scores predict shorter survival).

    Registered Nurses’ Association of Ontario. (2011).  Appendix D of End-of-Life Care During the Last Days and Hours. Toronto, Canada: Author. pp. 102-103.  Copyright (1999), with permission from Elsevier.

    Reprinted from Journal of Pain and Symptom Management, Vol. 17, No. 4, Maltoni, M, Nanni, O, Pirovano, M., Scarpi, E., Indelli, M, Martini, C, et al., Successful Validation of he Palliative Prognostic Score in Terminally ill Cancer Patient, 240-247

     

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    This link takes you to PARC which supports, educates and informs persons with Reflex Sympathetic Dystrophy (RSD), otherwise known as Complex Regional Pain Syndrome (CRPS) the community and the medical professionals treating RSD, about the importance of early diagnosis and treatment.

    Website: http://www.rsdcanada.org/parc/english/index.html

  • Show description [+]

    The Parkinson Canada website contains several useful resources for LTC including a Guide to the Non-Motor Symptoms of Parkinson's Disease (client and physician versions). These guides cover cognitive dysfunction, dementia, anxiety, depression, delusions and impulse control in Parkinson's disease. Also available is a booklet specific to the LTC sector as well as a medication booklet.

    Reference: Parkinson Canada website, retrieved from http://www.parkinson.ca/

  • Show description [+]

    This factsheet on describes why freezing occurs in Parkinson disease and how it increases a resident’s chances of falling. It provides  tips to help prevent freezing and related falls. It is useful for family or resident education.

    Source: Pacific Parkinson’s Research Centre, University of British Columbia, Vancouver, BC. Freezing. Retrieved from https://www.parkinson.ca/wp-content/uploads/Freezing.pdf

     

     

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    A 30 minute presentation for LTC is a collaboration between the RNAO LTC Best Practice Co-ordinators Deirdre Boyle and Shaila Aranha; and the Regional Stroke Rehabilitation and Community Coordinator, Eileen Britt, from the Central South Regional Stroke Network.

    This is part one of a four part Stroke Education series to support LTC staff in their fall prevention and management program. The objectives are to:

    • Identify risk factors for falls for residents with Stroke.
    • Understand the relationship between fall prevention and management, pain management, reducing and supporting behaviors, and preventing pressure injuries in residents with Stroke.
    • Discuss the importance of an inter-professional team approach in Stroke Care.
    • Understand how to Integrate evidence-based resources in planning and improving care for residents with Stroke.
    Aranha,S., Boyle, D., & Britt, E. (2019). Reducing the risk for falls in residents with stroke: Putting best practices into practise in the care of residents with stroke [PowerPoint presentation]. 

     

  • Show description [+]

    A 30 minute presentation for LTC is a collaboration between the RNAO LTC Best Practice Co-ordinators Deirdre Boyle and Shaila Aranha; and the Regional Stroke Rehabilitation and Community Coordinator, Eileen Britt, from the Central South Regional Stroke Network.

    This is part two of the four part Stroke Education series to support LTC staff to:

    • Assess pain,  for residents with Stroke.
    • Understand the relationship between pain assessment and management, fall prevention and management,  reducing and supporting behaviors, and  preventing pressure injuries in residents with Stroke.
    •  Discuss the importance of an inter-professional team approach in Stroke Care.
    • Understand how to Integrate evidence-based resources in planning and improving care for residents with Stroke.

    Aranha, S., Boyle, D., & Britt, E. (2019). Minimizing and managing pain for residents with stroke: Putting best practices into practise in the care of residents with stroke. [PowerPoint Presentation]. 

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    This 25-minute video shows a range of unhealthy changes and common abnormalities that can be found during oral assessments of residents living in long term care homes. How to do an oral assessment is reviewed. It is Part 2 of the RNAO Long-Term Care Best Practices Program - Oral Health Assessment Series (3 parts).

    MacDonald, I. & Peachman-Faust, T. (2015). Part 2 - Oral assessment in LTC: Unhealthy changes and common abnormalities. [Video file]. Retrieved from  https://www.youtube.com/watch?v=fsQF-ElrwZk

     

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    This 30-minute video demonstrates how to brush another persons teeth and describes interventions for various oral care problems found in residents in long term care. It is Part 3 of the RNAO Long-Term Care Best Practices Program - Oral Assessment Series (3 parts).

    MacDonald, I. & Peachman-Faust, T. (2016). Part 3 - Best practices for oral care interventions in long term care. [Video file]. Retrieved from https://www.youtube.com/watch?v=fp5oXYNHQp4

     

  • Show description [+]

    A 30 minute presentation for LTC is a collaboration between the RNAO LTC Best Practice Co-ordinators Deirdre Boyle and Shaila Aranha; and the Regional Stroke Rehabilitation and Community Coordinator, Eileen Britt, from the Central South Regional Stroke Network.

    This is part three of the four part Stroke Education series to support LTC staff to:

    • Identify risk factors to prevent responsive behaviours for residents with Stroke.
    • Understand the relationship between reducing and supporting behaviors, pain assessment and management, falls prevention and management and preventing pressure injuries in residents with Stroke.  
    • Discuss the importance of an inter-professional team approach in Stroke Care.
    • Understand how to Integrate evidence-based resources in planning and improving care for residents with Stroke.

    Aranha, S., Boyle, D., & Britt, E. (2019). Reducing and supporting behaviours in residents with stroke: Putting best practices into practise in the care of residents with stroke. [PowerPoint Presentation]. 

  • Show description [+]

    A 30 minute presentation for LTC is a collaboration between the RNAO LTC Best Practice Co-ordinators Deirdre Boyle and Shaila Aranha; and the Regional Stroke Rehabilitation and Community Coordinator, Eileen Britt, from the Central South Regional Stroke Network.

    This is part four of the four part Stroke Education series to support LTC staff to:

    • Identify risk factors to prevent responsive behaviours for residents with Stroke.
    • Understand the relationship between reducing and supporting behaviors, pain assessment and management, falls prevention and management and preventing pressure injuries in residents with Stroke.  
    • Discuss the importance of an inter-professional team approach in Stroke Care.
    • Understand how to Integrate evidence-based resources in planning and improving care for residents with Stroke.

    Aranha, S., Boyle, D., & Britt, E. (2019). Preventing pressure injuries for residents with stroke: Putting best practices into practise in the care of residents with stroke. [PowerPoint Presentation]. 

  • Show description [+]

    Partnerships in Dementia Care Alliance (PiDC) helps to change culture in long-term care and community settings to enhance dementia care. Examples of culture change in LTC homes is included.

    Reference: Partnerships in Dementia Care Alliance Website: https://uwaterloo.ca/partnerships-in-dementia-care/

  • Show description [+]

    A validated and reliable sedation scale for assessing and reporting opioid induced sedation.

    Registered Nurses' Association of Ontario. (2013). Appendix O of Assessment and Management of Pain Third Edition. Toronto, ON, Canada p.99

    Used with permission from: Pain Assessment and Pharmacologic Management, by C. Pasero and M. McCaffery, 2011, St. Louis, MO: Mosby/Elsevier. Copyright (1994) by Chris Pasero

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    Judith Wahl outlines that the communication of the Health Care Consent Act to the resident by the health provider is required and is part of the responsibility to obtain an informed consent from the resident before treatment is delivered. Health Care Providers need to understand the basic requirements of the Health Care Consent Act.

    Advocacy Centre for the Elderly. (2016). Patient Centred Care: “Wishes” are not Consent. Retrieved from: http://www.advocacycentreelderly.org/appimages/file/Wishes-not-consent.pdf

     

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    PEDIS: Diabetic Foot Ulcer Classification System is found as Appendix G of the RNAO BPG, Assessment and Management of Foot Ulcers for People with Diabetes. Pg. 113-116. Reference: Registered Nurses’ Association of Ontario. (2013). Appendix G of Assessment and Management of Foot Ulcers for People with Diabetes. Toronto, Canada: Author. pp. 113-116

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    A diagram illustrating the pelvic floor and a descended pelvic floor.

    Registered Nurses' Association of Ontario. (2006). Self-Learning Package Continence Care Education. Toronto, ON: Retrieved from: http://rnao.ca/bpg/guidelines/resources/continence-care-education-selflearning-package

  • Show description [+]

    This resource explains pelvic muscle exercises, how they may help incontinence, and how to properly perform them.

    Reference:

    Retrieved June 22, 2018 from http://www.canadiancontinence.ca/pdfs/pelvicmuscleexercises.pdf

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    The health care you receive should be tailored to your unique needs and goals. Person- and family-centred care invites you and your family to partner with your health-care team, helping you make decisions best suited to you.

    Registered Nurses’ Association of Ontario.  (2017).  RNAO Person-and Family-Centred Care - fact sheet. Toronto, ON: Author.

     

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    Learn more about the benefits of Person-Centred Care (PCC) with this educational video that defines the fundamental concepts of PCC.

    Cancer Care Ontario. (2015, May 26). Person-Centred Care [Video file]. YouTube. Retrieved Sept 14,2015 from https://www.youtube.com/watch?v=NTYRtRNsAko.

     

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    These guidelines have been developed to promote person-centred language.

    Alzheimer Society. (n.d.). Using person-centred language. Retrieved from https://alzheimer.ca/en/take-action/become-dementia-friendly/using-person-centred-language

     

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    This individualized de-escalation plan considers cause and effect and solutions focused on the resident’s strengths.

    Registered Nurses’ Association of Ontario. (2012). Appendix R of Promoting Safety: Alternative Approaches to the Use of Restraints. Toronto, Canada: Author.  (pp. 122-123). Retrieved from https://rnao.ca/sites/rnao-ca/files/Promoting_Safety_-_Alternative_Approaches_to_the_Use_of_Restraints_0.pdf

    Reprinted with permission from The Massachusetts Department of Mental Health

     

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    This article published for US library of Medicine article compares depressed in patients with and without CCPD in terms of suicidal behaviour and associated psychopathology.

    Reference: Dervic, Kanita et al. “Cluster C Personality Disorders in Major Depressive Episodes: The Relationship Between Hostility and Suicidal Behavior.” Archives of suicide research : official journal of the International Academy for Suicide Research 11.1 (2007): 83–90. PMC. Web. 22 Dec. 2017. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3779124/ 

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    The Photographic Wound Assessment Tool© (PWAT) Revised is a valid and reliable tool for assessing wound status over time, recognizing that standardized equipment and a consistent technique should be used with serial wound photography.

    Reference: Hodgkinson, Bowles H, Gordey L, Parslow N, and Houghton P. 2010. Photographic Wound Assessment Tool (PWAT) Revised. http://www.southwesthealthline.ca/healthlibrary_docs/B.9.3b.PWATInstruc.pdf

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    This is the Behavioural Supports Ontario (BSO) website that supports staff with pledging their commitment to Person and Family Centered. Posters and a report are also available to support adaption of Person and Family Centred Approach.

    Behavioural Supports Ontario. (n.d.). Pledge: Person-centred language committment statements. retrieved from http://www.behaviouralsupportsontario.ca/Pledge

     

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    Tips to assist front line staff on practical ways to be more person centred.  A pocket card adopted from a sample developed by Braemar Retirement Centre as part of their BPSO work.

    Braemar Retirement Centre ( 2019) Pocket Card- How to be Person Centred: Tips for Health-care Providers. Wingham. On

     

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    This list of suggestions helps staff provide an approach to minimize responsive behaviours.

    Registered Nurses’ Association of Ontario. (2009). Appendix D-9 of Preventing and Managing Violence in the Workplace. Toronto, ON, Canada: Author. pp.  118. Retrieved from http://rnao.ca/bpg/guidelines/preventing-and-managing-violence-workplace.  This work is funded by the Ontario Ministry of Health and Long-Term Care.

    OSACH Website: www.osach.ca/

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    A detailed policy and procedure for improving both bladder and bowel continence in LTC residents with sample policies and nursing care plans. It can also be used as a reference guide

    Reference: Toronto Best Practice in LTC initiative working group , (December 2006), Policy and Procedure for Bladder and Bowel Management, date retrieved, June 8 2015,

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    A detailed policy and procedure for preventing dehydration in LTC residents. It was developed by the Toronto Best Practice Implementation Steering Committee.

    Reference: Toronto Best Practice in LTC initiative working group , (December 2006), Policy and Procedure: Hydration Management Toronto Best Practice in LTC Initiative, date retrieved, June 8 2015,

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    This policy and procedure for pain assessment and management provides examples for inclusion of evidence –based recommendations in an organization’s policy to address acute and chronic pain. This document was created prior to the LTCHA (2007).
    Toronto Best Practice in LTC Initiative. (2006). Policy and Procedure: Pain Assessment and Management. Retrieved 2013, from http://rgp.toronto.on.ca/torontobestpractice/Policyprocedurepainassessmentmanagement.pdf

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    Gain the knowledge and skill required to manage the unique challenges inherent in the positioning of residents with varying degrees of dependency.

    Learn how to position a resident in good body alignment, taking into consideration typical scenarios that may occur in a long-term care setting and contribute to the resident’s comfort while reducing the instance of pressure ulcers and contractures.

    Retrieved from: http://rnao.ca/bpg/guidelines/resources/positioning-techniques-longterm-careselfdirected-learning-package-health-ca
     

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    Table 20 is a description of resources available to support post fall assessments.

    Registered Nurses’ Association of Ontario.  (2017).  Appendix J of RNAO Prevention of Falls and Reducing Injury from Falls Best Practice Guideline. (4th Ed.).  Toronto, ON: Author. (p.109-110)

     

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    This Canadian Stroke Best Practices Post-stroke checklist considers common impairments after a stroke and suggests possible referrals.

    Heart and Stroke Foundation of Canada Canadian Stroke Best Practices. (n.d.) Post-stroke checklist. Retrieved from https://www.strokebestpractices.ca/-/media/1-stroke-best-practices/resources/professional-resouces/csbp_post_stroke_checklist_en.ashx

     

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    RNAO resource page 105, Appendix M. Listed interventions as potentially beneficial to providing supportive care in postvention. Registered Nurses’ Association of Ontario. (2009). Assessment and Care of Adults at Risk for Suicidal Ideation and Behaviour. Toronto, ON, Canada: Author. Retrieved from http://rnao.ca/bpg/guidelines/assessment-and-care-adults-risk-suicidal-ideation-and-behaviour 

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    This table is an overview and comparison of the strengths and weakness of wound assessment tools including the: Pressure Ulcer Scale for Healing (PUSH); Photographic Wound Assessment Tool (PWAT); and the Bates-Jensen Wound Assessment Tools.

    Reference: Registered Nurses Association of Ontario (RNAO). 2016. Appendix I: Pressure Injury Assessment Tools. In Assessment and Management of Pressure Injuries for the Interprofessional Team, Third Edition http://rnao.ca/sites/rnao-ca/files/PI_BPG_FINAL_WEB_June_10_2016.pdf

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    This webpage provides links to illustrations for each of the new pressure injury stages.

    Copyright: These illustrations can be downloaded by clicking on the links below directly to your computer at no cost, if for educational purposes. There is no cost to use these illustrations; however donations to support the work of NPUAP are graciously accepted. For profit uses of the drawings are subject to a charge, please contact Jen Bank for more information. **Use of drawings is permitted for educational purposes only.

    Reference: National pressure ulcer advisory panel (n.d.). Pressure Injury Staging Illustrations. Retrieved from http://www.npuap.org/resources/educational-and-clinical-resources/pressure-injury-staging-illustrations/

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    This document released by the Medical Advisory Secretariat contains a systematic review of pressure ulcer prevention interventions.

    Medical Advisory Secretariat. Pressure Ulcer prevention: an evidence-based analysis. Ontario Technology health Assessment Series 2009; 9(2).

    Weblink: http://www.hqontario.ca/english/providers/program/mas/tech/reviews/pdf/rev_pup_20090401.pdf

     

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    This tool identifies seven areas related to PURS assessment. A high score indicates high risk for pressure ulcer.

    Registered Nurses’ Association of Ontario. (2011) Appendix K of Risk assessment and prevention of pressure ulcers: Guideline Supplement. Toronto, Canada. P.40. Retrieved from:

    http://rnao.ca/bpg/guidelines/risk-assessment-and-prevention-pressure-ulcers
     

     

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    Pressure Ulcer Scale for Healing (PUSH) Tool 3.0 was developed by the National Pressure Ulcer Advisory Panel (NPUAP) as a valid and reliable tool to assess the change in status of pressure ulcers over time.

    The link takes you to the NPUAP website where you will find the tools and information on use and copyright.

    • PUSH Tool (web version)
    • PUSH Tool (PDF version)
    • Reprint Agreement (PDF)
    • Information and Resgistration Form
    • Instructions for Using PUSH
    • Copyright Policy and Contract

    Reference: National Pressure Ulcer Advisory Committee (1998). Accessed Sept. 14, 2016. Retrieved from: http://www.npuap.org/resources/educational-and-clinical-resources/push-tool/

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    The Pressure Ulcer Scale for Healing is found as Appendix T of the RNAO BPG, Assessment and Management of Foot Ulcers for People with Diabetes. Pg 152-153. From “Pressure Ulcer Scale for Healing tool (PUSH tool) 3.0,” by National Pressure Ulcer Advisory Panel, 2012. Retrieved from http://www.npuap.org/ wp-content/uploads/2012/02/push3.pdf Reprinted with permission

    Reference: Registered Nurses’ Association of Ontario. (2013). Appendix T of Assessment and Management of Foot Ulcers for People with Diabetes. Toronto, Canada: Author. pp. 152-153

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    This table developed through the Residents First Initiative provides examples of clinical and organizational change strategy options in the area of pressure ulcers.
    Health Quality Ontario. (2011, February). Pressure Ulcers – Clinical and Organizational Change Concepts and Ideas.
    Retrieved from: http://www.hqontario.ca/quality-improvement/long-term-care/tools-and-resources

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    This poster outlines key steps in the development of a pressure ulcer Quality Improvement plan. The poster is intended for use as a worksheet that can support the needs of individual organizations.

    Reference: Health Quality Ontario, (2011), Pressure Ulcer Change Poster, http://www.hqontario.ca/portals/0/Documents/qi/rf-poster-pressure-ulcers-en.pdf

     

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    This tool provides a consistent method of collecting skin tear prevalence data.

    Web Address: http://journals.lww.com/aswcjournal/Fulltext/2013/10000/International_Skin_Tear_Advisory_Panel__A_Tool_Kit.7.aspx Please refer to this link for further information how to apply for permission for re-use

    Reference: International Skin Tear Advisory Panel: A Tool kit to aid in the Prevention, Assessment and treatment of skin Tears using a Simplified Classification System. Advances in Skin and Wound Care. 26 (10): 459-476, October 2013

  • Show description [+]

    The fact sheet is a tool to increase awareness of the regulatory mandate on educating and preventing client abuse and provide further resources to support nurses in the prevention of abuse in practice.

    College of Nurses of Ontario. (2011). Preventing client abuse fact sheet. [PDF file]. Retrieved from https://www.cno.org/globalassets/docs/ih/47008_fspreventabuse.pdf

     

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    Patient education pamphlet explaining how older adults can prevent dehydration in themselves

    Reference: Preventing dehydration in older adults. Patient education pamphlet explaining how older adults can prevent dehydration in themselves. Source: Hamilton Health Sciences, Hamilton, Ontario

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    This internationally developed quick reference guide summarizes evidence based guidelines on pressure ulcer prevention and treatment.

    Copyright © National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance. All rights reserved. Apart from any fair dealing for the purposes of private study, research or review, as permitted under the Copyright Act, no part may be reproduced or copied in any form or by any means without written permission. Requests to reproduce information can be emailed to admin@internationalguideline.com  

    Reference: National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance. Emily Haesler (Ed.) (2014). Prevention and Treatment of Pressure Ulcers: Quick Reference Guide. Cambridge Media: Osborne Park, Western Australia. Retrieved from: http://www.npuap.org/wp-content/uploads/2014/08/Updated-10-16-14-Quick-Reference-Guide-DIGITAL-NPUAP-EPUAP-PPPIA-16Oct2014.pdf

  • Show description [+]

    Cette ligne directrice sur les pratiques exemplaires en soins infirmiers est axée sur la prévention et résolution des mauvais traitements et de la négligence envers les aînés dans divers établissements de santé et services communautaires à travers le Canada. Ces auditoires comprennent les infirmières, les gestionnaires, les éducateurs, les équipes d'amélioration de la qualité, les administrateurs, les décideurs, les organismes de réglementation des soins infirmiers et les organismes gouvernementaux. Financé par le programme Nouveaux Horizons pour les aînés du gouvernement du Canada.

    Association des infirmières et infirmiers autorisés de l’Ontario. (2014). Prévention et résolution des mauvais traitements et de la négligence envers les aînés: approches axées sur la personne, coopératives et à l'échelle du système Toronto, ON, Canada: Auteur. Récupérée de http://rnao.ca/sites/rnao-ca/files/Preventing_Abuse_and_Neglect_of_Older_Adults_Final_French_0.pdf

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    This Website provides local, provincial, federal and multicultural links to elder abuse resources. It also provides strategies to minimize the risk of elder abuse.
    Reference: http://elderabuse-yorkregion.ca/prevention/

    Disclaimer: The Prevention of Elder Abuse Committee of York Region has a mission to reduce elder abuse by increasing awareness. The committee does not provide services or assistance.

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    This table uses graphs, pictures and words to illustrate the impact of high, medium and low bacterial contamination/colonization on wound healing.

    Reference: Registered Nurses Association of Ontario (RNAO). 2016. Appendix J: Progression from Bacterial Balance to Bacterial Damage. Assessment and Management of Pressure Injuries for the Interprofessional Team, Third Edition. Accessed July 28, 2016 http://rnao.ca/sites/rnao-ca/files/PI_BPG_FINAL_WEB_June_10_2016.pdf  pp.130-133.

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    This presentation shares strategies for managing bladder and bowel problems in stroke survivors. It describes normal bladder and bowel function, urinary incontinence and the effects of stroke on assessment and management of bladder and bowel incontinence. It connects nursing restorative services and incontinence.

    Woodbeck, H., & Edwards, E.  (2011). Promoting bladder and bowel continence with nursing restorative care. [PowerPoint slides]. Retrieved from http://ltctoolkit.rnao.ca/resources/self-learning-and-powerpoint-presentations/promoting-bladder-and-bowel-continence-nursing-
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    Algorithm for supporting the process including evaluation of promoting continence using prompted voiding

    Reference: Registered Nurses' Association of Ontario (2005) Promoting Continence Using Prompted Voiding Appendix B:Promoting Continence Using Prompted Voiding Algorithm p.40 Toronto, Ontario

    Retrieved from: http://rnao.ca/bpg/guidelines/promoting-continence-using-prompted-voiding

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    A presentation on causes, risk factors and interventions for dehydration developed by the Committee for the Enhancement of Elder Friendly Environments (CEEFE) Central South Geriatric Program (Ontario).

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    Coloured poster that defines dehydration, shows the risk factors related to dehydration and strategies(mnemonic H2O) to prevent dehydration.

    Reference: Developed by the Elder friendly environments Coalition http://www.rgpc.ca

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    In Ontario, Canada the Patient Restraints Minimization Act asks healthcare settings to consider alternative approaches and only use restraints as a last resort when a person is at risk of harm to themselves and/or others.

    Registered Nurses’ Association of Ontario. (2012). RNAO Promoting Safety: Alternative Approaches to the Use of Restraints. [Fact sheet]. Toronto, ON: Author. Retrieved from https://rnao.ca/sites/rnao-ca/files/Promoting_Safety_-_Alternative_Approaches_to_the_Use_of_Restraints.pdf


     

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    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. 

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    This article highlights the impact of implementing the RNAO Falls Best practice guideline.

    Laviolette, K. (2020). Purposeful hourly rounding in long-term-care. Canadian Nurses Association. https://www.canadian-nurse.com/en/articles/issues/2020/april-2020/purposeful-hourly-rounding-in-long-term-care

    Copyright ©, Canadian Nurses Association, 50 Driveway, Ottawa, Ontario, K2P 1E2 CANADA, 2018 all rights reserved

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    This tool is designed to be used with tools included in the ISTAP Risk Reduction Program.

    Web Address: http://journals.lww.com/aswcjournal/Fulltext/2013/10000/International_Skin_Tear_Advisory_Panel__A_Tool_Kit.7.aspx Please refer to this link for further information how to apply for permission for re-use

    Reference: International Skin Tear Advisory Panel: A Tool kit to aid in the Prevention, Assessment and treatment of skin Tears using a Simplified Classification System. Advances in Skin and Wound Care. 26 (10): 459-476, October 2013

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    The provincial RAI-MDS© and P.I.E.C.E.S.™ Integration Working Group have developed a Job Aid that allows for the streamlining of the RAI assessment and the P.I.E.C.E.S. 3-Question Assessment and Care Planning Framework.

    Retrieved from: http://piecescanada.com/index.php?option=com_content&view=article&id=27&Itemid=30

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    The Website provides excellent resources focussed on the intersection of the LGBTQ community and aging. Some resources are available for download and some resources can be purchased.

    Copyright with Rainbow Health Ontario

    Reference: Rainbow Health Ontario Website (n.d.). Retrieved from http://www.rainbowhealthontario.ca/resource-search/

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    Canadian Patient Safety Institute website contains tools and resources on Reducing Falls and Injury from Falls: Getting Started Kit. It contains clinical information on reducing falls and injuries from falls; and information on making improvements. Icons and resources to successfully implement interventions in an organization on best practices related to falls

    Canadian Patient Safety Institute. (n.d.). Reducing falls and injury from falls (falls): Getting started kit. http://www.patientsafetyinstitute.ca/en/toolsResources/Pages/Falls-resources-Getting-Started-Kit.aspx 

     

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    This guideline focuses its recommendations on three areas: 1.Practice recommendations directed at the nurse 2.Education recommendations directed at the competencies required for practice 3.Organization and Policy recommendations addressing the importance of a supportive practice environment as an enabling factor for providing high quality nursing care, which includes ongoing evaluation of guideline implementation. Supplement: 2007

    This best practice guideline provides evidence-based recommendations for nurses who are not specialists in the area of Diabetes. These recommendations assist nurses to conduct risk assessments for foot ulcers, provide basic education for the prevention of foot ulcers and implement the appropriate interventions when there is a high risk for ulcer or amputation present.

    Registered Nurses’ Association of Ontario (2007). RNAO Reducing foot Complications for People with Diabetes. Toronto, ON: Author. Retrieved from: http://rnao.ca/bpg/guidelines/reducing-foot-complications-people-diabetes

  • Show description [+]

    This guideline focuses its recommendations on three areas: 1.Practice recommendations directed at the nurse 2.Education recommendations directed at the competencies required for practice 3.Organization and Policy recommendations addressing the importance of a supportive practice environment as an enabling factor for providing high quality nursing care, which includes ongoing evaluation of guideline implementation. Supplement: 2007

    This best practice guideline provides evidence-based recommendations for nurses who are not specialists in the area of Diabetes. These recommendations assist nurses to conduct risk assessments for foot ulcers, provide basic education for the prevention of foot ulcers and implement the appropriate interventions when there is a high risk for ulcer or amputation present.

    Registered Nurses’ Association of Ontario (2007). RNAO Reducing foot Complications for People with Diabetes. Toronto, ON: Author. Retrieved from: http://rnao.ca/bpg/guidelines/reducing-foot-complications-people-diabetes

  • Show description [+]

    Les recommandations contenues dans cette Ligne directrice sont axées sur trois volets : (1) les recommandations relatives à la pratique professionnelle, axées sur les infirmières, (2) les recommandations relatives à la formation, axées sur les compétences requises pour la pratique, et (3) les recommandations relatives à l’établissement et aux politiques, qui traitent de l’importance d’un milieu favorable en tant que facteur nécessaire à la prestation de soins infirmiers de haute qualité, notamment une évaluation continue de la mise en place de la Ligne directrice. Supplément : 2007 Cette ligne directrice sur les pratiques exemplaires fournit des recommandations pour les infirmières qui ne sont pas des spécialistes dans le secteur du diabète. Ces recommandations aident des infirmières pour conduire des évaluations des risques pour des ulcères de pied, fournissent l'éducation de base pour la prévention des ulcères de pied et mettez en application les interventions appropriées quand il y a un à haut risque pour le présent d'ulcère ou d'amputation.

    Association des infirmières et infirmiers autorisés de l’Ontario. Réduction des complications des plaies du pied chez les diabétiques. Association des infirmières et infirmiers autorisés de l’Ontario, Toronto, Canada, 2007. Recuperé de : http://rnao.ca/bpg/guidelines/reducing-foot-complications-people-diabetes

  • Show description [+]

    Within Ontario, there are eleven regional stroke networks, which support stroke system integration and best practice implementation at a regional level. For each network, there is a Community and Long-Term Care Coordinator who is involved in supporting hospital and community partners in implementation of stroke best practices.

    Regional Stroke Networks (n.d.). Regional stroke networks [word document]. 
  • Show description [+]

    This resource list helps you identify key contacts in addressing elder abuse. Complete the contact details for your local resources.

    Reference:Registered Nurses’ Association of Ontario. (2014). Appendix H of Addressing and Preventing Abuse and Neglect of Older Adults: Person-Centred, Collaborative, System-Wide Approaches. Toronto, ON: Registered Nurses’ Association of Ontario. , pp.112-114. http://rnao.ca/bpg/guidelines/abuse-and-neglect-older-adults
     

  • Show description [+]

    Delirium resources for healthcare providers. Includes posters, communication tips, clinician learning series slide deck, delirium prevention toolkit, how to prevent and support delirium in older adults, Ontario's delirium quality standard, pocket guide for PSWs, and various handouts. 

    © 2022 Regional Geriatric Program of Toronto. 

  • Show description [+]

    The manual contains a series of clearly written, interactive modules on violence against older persons. Module 3 (page 42) focuses on violence against older persons in residential care facilities. The manual is intended for use in a training program on preventing violence, but could be used for self-learning. References and resources are Newfoundland and Labrador based.

    Violence Prevention Initiative - Women’s Policy Office, Government of Newfoundland and Labrador. (2013). Respect Aging: An Education and Training Program for Recognizing, Preventing and Intervening in Violence Against Older Persons Participant Manual [PDF document]. Retrieved from https://www.respectaging.ca/training/Participant_Manual.pdf

    Copyright, Government of Newfoundland and Labrador

  • Show description [+]

    This link takes you to the University of Iowa Geriatric Education Center website that provides you access to multiple resources. Follow the link to publications in infoconnect for restraint-free resident care.

    McKay, S. (n.d.). Info-connect: Restraint-free resident care. University of Iowa Geriatric Education Center. 

     

  • Show description [+]

    This link takes you to the website of Executive office of Health and Human Services (EOHHS) with resources on Restraint/Seclusion Reduction Initiative and Boston Medical Centre Person De-escalation Plan and Intensive Residential Program.

    Commonwealth of Massachusetts. (n.d.). Restraint/Seclusion Reduction Initiative. Mass.gov. retrieved from https://www.mass.gov/service-details/restraintseclusion-reduction-initiative-rsri

    Website: http://www.mass.gov/eohhs/gov/departments/dmh/

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    Alberta Health Services presentation describing different types of restraints. Why restraints are used and possible side effects of restraint use.

    Alberta Health Services. (n.d.). Restraints as a last resort. [Presentation]. Retrieved from https://www.albertahealthservices.ca/assets/about/scn/ahs-scn-srs-efc-restraints-notes.pdf

     

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    This table from page 71 of the Delirium, Dementia, and Depression in Older Adults: Assessment and Care BPG (2016) looks at predisposing and precipitating risk factors as well as signs of depression.

    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

  • Show description [+]

    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.

  • Show description [+]

    This document from Mood Disorders Society of Canada provides helpful information on suicide risk and support strategies.

    Reference: Mood Disorders Society of Canada (n.d.) Risk of Suicide. Retrieved from http://mdsc.ca/documents/Consumer%20and%20Family%20Support/Risk%20of%20suicide.pdf

    © Copyright 2016 Mood Disorders Society of Canada | All Rights Reserved | Powered by Dreamconcepts 

  • Show description [+]

    Nursing is a profession that is focused on collaborative relationships that promote the best possible outcomes for clients. These relationships may be intraprofessional, with multiple members of the same profession working collaboratively to deliver quality care within and across settings. This practice guideline focuses on three factors—the client, the nurse and the environment—to support nurses in making decisions that are specific to their intraprofessional responsibilities when providing client care.

    Reference: College of Nurses of Ontario Practice Guideline (2014) RN and RPN practice: The Client, the Nurse and the Environment. Retrieved from http://www.cno.org/globalassets/docs/prac/41062.pdf

  • Show description [+]

    This webcast is based on the RN and RPN Practice: The Nurse, the Client and the Environment practice document which discusses concepts that apply to RNs and RPNs in all roles in all practice settings.

    Reference: College of Nurses of Ontario (2013) RN and RPN practice: The Client, the Nurse and the Environment. Retrieved from http://www.cno.org/en/learn-about-standards-guidelines/educational-tools/webcasts/rn-and-rpn-practice-the-nurse-the-client-and-the-environment-webcast/

  • Show description [+]

    The aim of this guideline is to provide evidence-based recommendations  to facilitate client centred learning that promotes and enables clients to take action for their health.

    Registered Nurses Association of Ontario (2012) Facilitating Client Centred Learning. Toronto. ON Retrieved from Facilitating Client Centred Learning | Registered Nurses' Association of Ontario (rnao.ca)

  • Show description [+]

    This best practice guideline focuses on collaborative practice between RNs, RPNs and NPs and fostering healthy work environments for these 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

  • Show description [+]

    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
  • Show description [+]

    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

  • Show description [+]

    While the primary focus of this guideline is on mental health crises, its application has relevance to all settings and populations who experience developmental, situational, community or environmental crises. It is intended that this guideline will enhance the understanding of crisis intervention and standardize its practice, as well as enhance professional nursing practice. Supplement: 2006

    .

    Registered Nurses’ Association of Ontario. (2013). RNAO Crisis Intervention. Toronto, ON: Author. Retrieved from https://rnao.ca/sites/rnao-ca/files/bpg/Crisis_Intervention_FINAL_WEB_0.pdf

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

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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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    The BPG assists nurses in exploring how the decision making process can ensure that appropriate structures and supports are in place to maximize the nursing care and outcomes and minimize the potential for abuse of residents/patients/clients.

    Registered Nurses’ Association of Ontario. (2017). RNAO Developing and sustaining safe, effective staffing and workload practices. Toronto, ON: Author. Retrieved from https://rnao.ca/sites/rnao-ca/files/Establishing_Therapeutic_Relationships.pdf?_ga=2.88936027.1702348378.1602485970-1685849072.1567072300

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

     

  • Show description [+]

    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
  • Show description [+]

    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
  • Show description [+]

    This nursing best practice guideline will address the therapeutic relationship and its central importance to  practice.

    Registered Nurses Association of Ontario (2002)  Establishing therapeutic Relationships. Toronto, ON retrieved from Establishing Therapeutic Relationships | Registered Nurses' Association of Ontario (rnao.ca)

     

  • Show description [+]

    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
  • Show description [+]

    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.

    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: http://rnao.ca/bpg/guidelines/managing-conflict-healthcare-teams

  • Show description [+]

    This guideline is to be used to enhance the safety of health service organizations and academic institutions through the adoption of evidence based practices. Safe and healthy work environments are an enabler for nurses and other health workers to optimize clinical outcomes for those receiving care. 

    Registered Nurses Association of Ontario (2019) Preventing Violence, Harassment and Bullying Against Health Workers. Toronto, ON. retrieved from Preventing Violence, Harassment and Bullying Against Health Workers | Registered Nurses' Association of Ontario (rnao.ca)

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    Cette ligne directrice fournit des recommandations fondées sur les données probantes à l'intention des infirmières autorisées et des infirmières auxiliaires autorisées, relatives à l'évaluation et à la prise en charge de personnes ayant une colostomie, une iléostomie ou une urostomie, y compris l'évaluation et la prise en charge de la peau péristomiale. Cette ligne directrice met l'accent sur trois domaines des soins : préopératoire, postopératoire et suivi. Tous les individus stomisés, d'un bout à l'autre du continuum des soins, y compris les besoins de la famille et des fournisseurs de soins, sont pris en considération. Cette ligne directrice devrait s'appliquer à tous les domaines des soins infirmiers, y compris la pratique clinique, l'administration et l'éducation.

    Référence : Registered Nurses' Association of Ontario. (2009). les soins de stomie et de la gestion. Toronto, Ontario : auteur. Récupérée de :http://rnao.ca/bpg/translations/soins-et-prise-en-charge-des-stomies

  • Show description [+]

    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
  • Show description [+]

    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-Establishing Therapeutic Relationships. Toronto. ON

  • Show description [+]

    A tool to assist with comparing your organization’s current practice with evidence-based RNAO best practice recommendations.

    Registered Nurses Association of Ontario (2022)  Facilitating Client Centred Learning. Toronto. ON retrieved from Facilitating Client Centred Learning | Registered Nurses' Association of Ontario (rnao.ca)

  • Show description [+]

    This nursing best practice guideline will address the therapeutic relationship and its central importance to nursing practice

    Registered Nursing Association of Ontario (2002) Establishing Therapeutic Relationships. Toronto, ON Retrieved from Establishing Therapeutic Relationships | Registered Nurses' Association of Ontario (rnao.ca)

  • Show description [+]

    The aim of this guideline is to provide evidence-based recommendations for registered nurses, registered practical nurses and other health-care providers to facilitate client centred learning that promotes and enables clients to take action for their health.

    Registered Nurses Association of Ontario ( 2012) Facilitating Client Centred Learning . Toronto. ON Retrieved from Facilitating Client Centred Learning | Registered Nurses' Association of Ontario (rnao.ca)

  • Show description [+]

    La ligne directrice sur les pratiques exemplaires (LDPE) Une approche proactive de la gestion de la vessie et des intestins chez les adultes Quatrième édition, remplace les LDPE de la RNAO Favoriser la continence par le déclenchement de la miction et Prévention de la constipation chez les personnes âgées - Lignes directrices sur les pratiques, toutes deux mises à jour pour la dernière fois en 2011. Cette LDPE fournit des recommandations fondées sur des preuves pour des stratégies efficaces pour soutenir les adultes (âgés de 18 ans et plus) qui vivent avec l'incontinence urinaire, l'incontinence fécale et/ou la constipation qui amélioreront la qualité des soins et mèneront à des résultats de santé positifs.

    Le LDPE comprend des énoncés de bonnes pratiques sur la réalisation d'une évaluation initiale ciblée et des domaines de recommandation qui traitent des éléments suivants : stratégies d'élimination des toilettes, activité physique, apport adéquat de fibres et/ou de liquides, approche interprofessionnelle et protocole intestinal.

    Ces LDPE peuvent être utilisées par les infirmières, les membres de l'équipe interprofessionnelle et les soignants dans tout le continuum de soins et dans tous les domaines de pratique tels que l'administration, la clinique, l'éducation, les politiques et la recherche. Les recommandations fondées sur des données probantes de ce LDPE s'appliquent à tous les milieux de pratique où les personnes qui vivent avec une incontinence urinaire, une incontinence fécale et/ou une constipation accèdent à des services.

     

    Registered Nurses' Association of Ontario (2020)  Une approche proactive de la gestion de la vessie et des intestins chez les adultes retrieved from Bladder_and_Bowel_Management_FINAL_WEB_FR_LR_0.pdf (rnao.ca)

  • Show description [+]

    Cette trousse d'outils a été conçu pour aider les établissements de santé à maximiser le potentiel de LDPE, par le biais de mise en œuvre systématique et bien planifiée. Il a été également conçu pour accompagner les soins infirmiers pratiques recommandées (NBPGs) mis au point par la Registered Nurses' Association de l'Ontario (RNAO) afin de faciliter leur mise en œuvre.

  • Show description [+]

    The Relating to Older People Evaluation (ROPE) is a self-report measure of the frequency and type of ageist behaviours. ROPE is a 20-item questionnaire that measures personal discrimination through 14 statements that reflect negative types of ageism, and 6 statements that reflect positive types of ageism.

    Reference: Cherry, K., & Palmore, E. (2008)). Relating to Old People Evaluation (ROPE). Retrieved from rope_tool_web_relating_to_old_people_evaluation.pdf (cnpea.ca)

  • Show description [+]

    This document outlines interventions that can be used with residents exhibiting signs of aggression, disorientation, frequent falls and or inappropriate behaviours.

    Registered Nurses’ Association of Ontario. (2012). Appendix P of Promoting Safety: Alternative Approaches to the Use of Restraints. Toronto, Canada: Author.  (pp. 119-120). Retrieved from https://rnao.ca/sites/rnao-ca/files/Promoting_Safety_-_Alternative_Approaches_to_the_Use_of_Restraints_0.pdf

    Used with permission from Caressant Care

  • Show description [+]

    This tool helps the resident identify their responses to stress and their individualized coping strategies.

    Registered Nurses’ Association of Ontario. (2012). Appendix S of Promoting Safety: Alternative Approaches to the Use of Restraints. Toronto, Canada: Author.  (p124). Retrieved from https://rnao.ca/sites/rnao-ca/files/Promoting_Safety_-_Alternative_Approaches_to_the_Use_of_Restraints_0.pdf

    Copyright Centre for Addiction and Mental Health (2008). Reprinted with permission from CAMH

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    Information on the importance of person and family centred care and how it can improve the health care experience of clients, families and health providers. There are also resources such as: inventory of person and family centred care; fact sheets that summarize the concept of person and family centred care and a short video demonstrating the difference between “usual care and person centred care”.

    Saint Elizabeth Heath Care. (n.d.). Person and family centered care. [website]. https://pfcc.sehc.com/resources

    © 2015 Saint Elizabeth Health Care Retrieved from https://www.saintelizabeth.com/Home.aspx
     

  • Show description [+]

    This document is a sample of the holistic and reliable Oral assessment tool (THROAT) oral health assessment tool.

    Registered Nurses’ Association of Ontario (2008). Appendix E – Sample 2 of Oral Health: Nursing Assessment and Intervention. Toronto, Canada: Author. p. 70.

    Reference: Dickinson, H., Watkins, C. & Leathley, M. (2001). The Development of the THROAT: The Holistic and Reliable Oral Assessment Tool. Clinical Effectiveness in Nursing. 5, 106-110.

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

  • Show description [+]

    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).

  • Show description [+]

    This document provides two examples of oral care plans for long-term care. 

    Registered Nurses’ Association of Ontario. (2020). Appendix K of Oral Health: Supporting Adults Who Require Assistance (2nd ed.). Toronto, Canada: Author.  (pages 120-121). Retrieved from https://rnao.ca/sites/rnao-ca/files/bpg/RNAO_Oral_Health_Supporting_Adults_Who_Require_Assistance_Second_Edition_final.pdf

     

  • Show description [+]

    This toolkit offers resources to support the use of SBAR. SBAR offers a simple way to help standardize communication and allows parties to have common expectations related to what is to be communicated and how the communication is structured.

    Reference: Institute for Healthcare Improvement (IHI) : SBAR Toolkit (2016) Retrieved September 29,2016 from http://www.ihi.org/resources/pages/tools/sbartoolkit.aspx

  • Show description [+]

    The following is one method of how to perform a seating assessment for people with pressure injuries. This is not an exhaustive list but rather an example of a seating assessment identified within the systematic review, AGREE II appraised guidelines, by the expert panel or external stakeholder feedback. The term “pressure ulcer” used in this appendix, refers to “pressure injury.”

    Reference: Registered Nurses 'Association of Ontario. (2016). Appendix O of Assessment and Management of Pressure Injuries for the Interprofessional Team. Toronto, Canada: Author. pp 140-141.

  • Show description [+]

    The article highlights the basics of shared governance and how to establish committees and outlines the role of a quality committee.

    Reference: Ward. J. (nd) Retrieved from http://www.nursetogether.com/shared-governance-what-exactly-it

  • Show description [+]

    This tool evaluates the client risk and treatability related (i.e. violence, self-harm, suicide, absconding, substance use, self-neglect, and victimization).

    Registered Nurses’ Association of Ontario. (2012). Appendix F of Promoting Safety: Alternative Approaches to the Use of Restraints. Toronto, Canada: Author.  (pp. 97-98). Retrieved from https://rnao.ca/sites/rnao-ca/files/Promoting_Safety_-_Alternative_Approaches_to_the_Use_of_Restraints_0.pdf

    Reprinted with permission from British Columbia Mental Health & Addiction Services

  • Show description [+]

    This decision tree can be used to this determine if a siderail is a restraint or if alternatives are available.

    Registered Nurses’ Association of Ontario. (2012). Appendix Q of Promoting Safety: Alternative Approaches to the Use of Restraints. Toronto, Canada: Author.  (p. 121). Retrieved from https://rnao.ca/sites/rnao-ca/files/Promoting_Safety_-_Alternative_Approaches_to_the_Use_of_Restraints_0.pdf

    Source: Talerico, K. & Capezuti, E. Myths and Facts About Side Rails: Despite Ongoing Debates About Safety and Efficacy, Side Rails Are Still a Standards Component of Care in Many Hospitals. So How Do You Determine Their Safe Use? AJN: American Journal of Nursing, Volume 101, Issue 7, pp. 43-48. Reprinted with permission from Wolters Kluwer Health

  • Show description [+]

    SIGECAPS is a mnemonic used to recall the most frequent symptoms of depression (prescription for energy capsules).

    Reference: adapted from "The patient who is depressed" in Psychiatry in Primary Care by Raymond W. Lam, (CAMH, 2019).

     

     

     

  • Show description [+]

    A one-time, single resident assessment for 30 signs and symptoms of dehydration.

    Author and Date unknown

  • Show description [+]

    This poster from the Regional Geriatric Program of Toronto reveals 6 strategies to prevent and manage delirium.

    Regional Geriatric Program of Toronto. (n.d.). Six proven strategies to prevent delirium in older adults. Retrieved from https://www.rgptoronto.ca/wp-content/uploads/2019/01/Delirium-prevention-PRINT.pdf

    © 2019 Regional Geriatric Program of Toronto. All Rights Reserved.

  • Show description [+]

    Cette affiche du Regional Geriatric Program de Toronto nous donne 6 stratégies pour prévenir et soutener le délire.

    Regional Geriatric Program of Toronto. (n.d.). Six stratégies éprouvées pour prévenir le délire chez la personne âgée. Récupéré de https://www.rgptoronto.ca/wp-content/uploads/2019/01/Delirium-prevention-PRINT-French.pdf

    © 2019 Regional Geriatric Program of Toronto. All Rights Reserved.

  • Show description [+]

    Skin and Wound Refresher for LTC with associated powerpoint slide hand-out. This three part YouTube webinar series is a refresher course for registered staff and DOC in LTC. The three part series can be viewed all together, or broken up into three parts. It also includes one additional video of the Q&A that were asked of the presenters following the presentations. Topics covered in the webinars include

    • Assessment of Skin
    • Pressure Management and
    • Pressure Ulcers

    Web Address or Source: https://www.youtube.com/playlist?list=PL2DgRL1VXwQJ44YGeF0HX0_enTKagMU3w  and the presentation that goes with http://www.usask.ca/nursing/cedn/docs/SkinCareSkinTearsandPressureUlcers.pdf Fentiman, P. (Continuing education and development for nurses). (2015, November 19). Skin and Wound Care Refresher for LTC. Retrieved from https://www.youtube.com/playlist?list=PL2DgRL1VXwQJ44YGeF0HX0_enTKagMU3w

  • Show description [+]

    This tool is designed to help clinicians assess and treat skin tears, complement the pathway to the assessment/treatment of skin tears, and assist in skin tear classification and wound assessment.

    Web Address: http://journals.lww.com/aswcjournal/Fulltext/2013/10000/International_Skin_Tear_Advisory_Panel__A_Tool_Kit.7.aspx Please refer to this link for further information on how to apply for permission for re-use

    Reference: International Skin Tear Advisory Panel: A Tool kit to aid in the Prevention, Assessment and treatment of skin Tears using a Simplified Classification System. Advances in Skin and Wound Care. 26 (10): 459-476, October 2013

  • Show description [+]

    These presentation slides contain information related to the risks, assessment , prevention and treatment of skin tears in long term care.

    Reference: Mings, D., (2013) Skin Tear Management. RNAO Skin and Wound webcast series.

  • Show description [+]

    A guide to support selection of products that support healing of skin tears

    Web Address: http://journals.lww.com/aswcjournal/Fulltext/2013/10000/International_Skin_Tear_Advisory_Panel__A_Tool_Kit.7.aspx

    Please refer to this link for further information on how to apply for permission for re-use

    Reference: International Skin Tear Advisory Panel: A Tool kit to aid in the Prevention, Assessment and treatment of skin Tears using a Simplified Classification System. Advances in Skin and Wound Care. 26 (10): 459-476, October 2013

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    This pathway is recommended to determine those at risk and in need of a skin tear risk reduction program.

    Web Address: http://journals.lww.com/aswcjournal/Fulltext/2013/10000/International_Skin_Tear_Advisory_Panel__A_Tool_Kit.7.aspx

    Please refer to this link for further information on how to apply for permission for re-use

    Reference: International Skin Tear Advisory Panel: A Tool kit to aid in the Prevention, Assessment and treatment of skin Tears using a Simplified Classification System. Advances in Skin and Wound Care. 26 (10): 459-476, October 2013.

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    This article discusses standards and recommendations for the assessment, treatment, and prevention of skin tears developed by the International Skin Tear Advisory Panel (ISTAP)

    Reference: Leblanc, K., Baranoski,S., (May 2014). Skin Tears: Best Practices for Care and Prevention. Nursing, (44) 5, pp.36-46. Retrieved from www.Nursing2014.com

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    Le but de la présente ligne directrice est de promouvoir les pratiques fondées sur des données probantes, qui sont associées aux soins axés sur les besoins de la personne et de la famille, et d'aider les infirmières et d'autres fournisseurs de soins de santé à acquérir les connaissances et les compétences nécessaires pour améliorer leur pratique de ces soins. Les recommandations aideront les infirmières et d'autres fournisseurs de soins de santé à obtenir le savoir requis pour collaborer et établir des relations habilitantes avec des personnes et leur famille qui font appel aux services de santé, afin d'optimiser la santé et le bien-être au cours de leur vie. Cette approche fondée sur des données probantes, et combinée à une perspective qui reconnaît la place de la personne au centre des soins de santé, permettra d'améliorer l'expérience de cette personne et sa satisfaction à l'égard des soins et des services offerts par le système de santé. Elle s'applique à tous les domaines de la pratique des soins infirmiers, y compris les secteurs clinique, administratif et éducatif.

    Cette ligne directrice recommande des pratiques exemplaires dans trois domaines principaux : ■ Les recommandations au sujet des pratiques exemplaires ont été rédigées principalement à l'intention des infirmières et d'autres fournisseurs de soins de santé dans l'équipe interprofessionnelle qui offre des soins directs à des personnes dans les milieux de soins du système de santé (p. ex., soins actifs, soins de longue durée et soins à domicile) et dans la collectivité (p. ex., soins primaires, équipes de santé familiale et santé publique). ■ Les recommandations en matière d'éducation s'adressent à ceux qui sont responsables de la formation du personnel et des étudiants, tels que les éducateurs, les équipes d'amélioration de la qualité, les gestionnaires, les administrateurs ainsi que les établissements d'enseignement universitaire et professionnel. ■ Les recommandations sur le système, l'organisation et la politique s'appliquent à divers publics selon le type de recommandation. Les publics comprennent les gestionnaires, les administrateurs, les décideurs, les organismes de réglementation en soins infirmiers, les établissements d'enseignement et les organismes gouvernementaux. Pour obtenir une efficacité optimale, les recommandations dans ces trois secteurs doivent être mises en œuvre simultanément. Cette ligne directrice remplace le soin centré au client précédent .

    Association des infirmières et infirmiers autorisés de l’Ontario.  (2015).  RNAO Soins axés sur les besoins de la personne et de la famille. Toronto, ON: Autheur. https://rnao.ca/sites/rnao-ca/files/Final_13.pdf

    Ce travail est financé par le Ministère de la Santé et Ministère des Soins de longue durée de l'Ontario

     

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    To facilitate sharing information about prognosis with the patient during end-of-life care discussions, clinicians can use the "SPIKES" process (Setting up, Perception, Invitation, Knowledge, Emotions, and Strategy and Summary).

    Registered Nurses’ Association of Ontario. (2011). SPIKES: A Six Step Strategy for Delivering Bad News (Baile et al., 2000, p. 305-307) of End-of-Life Care During the Last Days and Hours.Toronto, Canada: Author. p 30.

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    This tool is utilized when exploring the spiritual aspects of end-of-life.  ©1999 Christina Puchalski, M.D.

    Retrieved from  The George Washington Institute for Spirituality & Health https://smhs.gwu.edu/gwish/clinical/fica/spiritual-history-tool 

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    RNAO resource page 106, Appendix N. Listed potential strategies that offers debriefing for staff involved in the care of a client who has completed suicide.

    Registered Nurses’ Association of Ontario. (2009). Assessment and Care of Adults at Risk for Suicidal Ideation and Behaviour. Toronto, ON, Canada: Author. Retrieved from http://rnao.ca/bpg/guidelines/assessment-and-care-adults-risk-suicidal-ideation-and-behaviour 

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    The Staff Mix Decision-making framework for quality Nursing Care is a comprehensive and evidence informed resource that presents a systematic approach to staff mix decision making. It can be used in all clinical practice settings. It is a Joint Position statement between the CNA, Canadian Council for Practical Nurse Regulators, and the Registered Psychiatric Nurses of Canada.

    Reference: Canadian Nurses Association. (2012). Staff Mix Decision Making Framework for Quality Nursing Care. Retrieved from: http://cna-aiic.ca/~/media/cna/files/en/jointps_staff_mix_partnership_e.pdf

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    This information from the Colostomy Association in Britain provides practical suggestions for the most common stoma problems such as Ballooning; Constipation/Diarrhoea; Odour; Pancaking; etc.

    Web Address: Colostomy Association. 2017. Stoma Problems. Accessed Aug. 22, 2017 at: http://www.colostomyassociation.org.uk/index.php?p=201&pp=3&page=Problematic%20Stomas

    Reference: Colostomy Association. 2017. Stoma Problems. Accessed Aug. 22, 2017 at:  http://www.colostomyuk.org/information/stoma-problems/ 

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    Individuals have a right t know their options and to have their preferences considered. Supporting individuals who are nearing the end of life requires interprofessional collaboration and problem-solving. Shared decision-maing can help individuals participate in the decision-making process in the ways the prefer and can help to meet their needs.

    Strategies for health-care providers to help families and individuals with decision making on end-of-care.

    Registered Nurses’ Association of Ontario (2011). Appendix J of End-of-Life Care During the Last Days and Hours. Toronto, ON: Author. pp. 112-113.

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    This presentation outlines the assessment and management of the types of pain experienced following a stroke.

    Central South Regional Stroke Network. (n.d.). Stroke and RNAO best practices: Pain [PowerPoint slides]. Hamilton, ON: Author.

     

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    The Canadian Stroke Best Practices stroke assessment and prevention pocket cards provide a handy reference on: types of strokes, signs, symptoms and associated brain function. 

    Heart and Stroke Foundation of Canada Canadian Stroke Best Practices. (2018) Stroke assessment and prevention pocket cards. Retrieved from https://www.strokebestpractices.ca/-/media/1-stroke-best-practices/resources/professional-resouces/00217csbpstrokeassesspocketguide75x425env6lr.ashx

     

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    This link takes you to resources with tips and information to assist long-term care homes in integrating the stroke care plans into their existing care plan libraries. There are twelve care plans:

    • Activities of Daily Living
    • Behaviour Change
    • Bladder and Bowel Continence
    • Cognition
    • Communication
    • Depression
    • Leisure
    • Mobility, Positioning & Transfers
    • Nutrition, Hydration & Swallowing
    • Pain
    • Perception
    • Skin Care & Hygiene
    CoHealth Ontario. (n.d.). Stroke care plans for long-term care. Retrieved from https://www.corhealthontario.ca/resources-for-healthcare-planners-&-providers/stroke-general/qbp/clinical-tools-&-resources/community-reengagement
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    This Government of Ontario website contains the Substitute Decisions Act and Regulations that fall under it.

    Reference: Substitute Decisions Act 1992 Website: https://www.ontario.ca/laws/statute/92s30

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    This table from pages 83-84 of the Delirium, Dementia, and Depression in Older Adults: Assessment and Care BPG (2016) informs nurse educators of relevant content for designing education sessions for those caring for clients with delirium, dementia and depression.

    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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    Suggestions for Assessing and Selecting Shoes and Socks is found as Appendix L of the RNAO BPG, Assessment and Management of Foot Ulcers for People with Diabetes. Pg 129.

    Adapted from: International Diabetes Federation (2005). Diabetes and Foot Care – A Time to Act. Retrieved from http://www.idf.org/webdata/docs/T2A_Introduction.pdf International Diabetes Group & International Working Group on the Diabetic Foot. In Lorimer, D. L., French, G. J., O’Donnell, M., Burrow, J. G., & Wall, B. (2006). Neale’s Disorder of the Foot. Edinburgh: Churchill Livingstone Elsevier. Zangaro, G. A. & Hull, M. M. (1999). Diabetic neuropathy: Pathophysiology and prevention of foot ulcers. Clinical Nurse Specialist, 13(2), 57-65. C)

    Reference: Registered Nurses’ Association of Ontario. (2013). Appendix L of Assessment and Management of Foot Ulcers for People with Diabetes. Toronto, Canada: Author. p. 129.

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    This clinician pocket-card provides suicide information and is based on the Canadian Coalition for Seniors Mental Health national guideline: The Assessment of Suicide Risk and Prevention of Suicide

    Reference: Canadian Coalition for Seniors Mental Health (2000). National Guidelines for Seniors Mental Health- The Assessment of Suicide Risk and Prevention of Suicide Brochure. Retrieved from http://ccsmh.ca/wp-content/uploads/2016/03/CCSMH_suicideBrochure.pdf  

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    This clinician pocket card supports assessment resources for the assessment and prevention of suicide in older adults. The Geriatric Suicide Ideation Scale and the Harmful Behaviours Scale mentioned on the clinician pocket-card can be used by health care providers with appropriate training.

    Reference: Canadian Association of Mental Health (CAMH) Clinician Pocket Care Suicide Assessment and Prevention for Older Adults (2015). Retrieved from http://ccsmh.ca/wp-content/uploads/2016/03/CCSMH_suicideBrochure.pdf 

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    The CAMH Suicide Prevention and Assessment Handbook is a quick, comprehensive and interactive starting point for staff across all clinical programs on the subject of suicide assessment and management. It provides key clinical information, current CAMH tools and resources, and further population-specific resources.

    Reference: Canadian Association of Mental Health (CAMH). (2015). Retrieved from https://www.camh.ca/en/hospital/health_information/a_z_mental_health_and_addiction_information/suicide/Documents/sp_handbook_final_feb_2011.pdf 

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    Website full of resources with a great search engine pertaining to suicide and the elderly.

    Reference: Centers for Disease Control and Prevention (CDC) [Online] Available: https://www.cdc.gov/ViolencePrevention/suicide/ 

    Copyright: Information that is created by or for the US government on this site is within the public domain. Public domain information on CDC Stacks may be freely distributed and copied. However, it is requested that in any subsequent use of this work, CDC be given appropriate acknowledgment.

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    A website from Government of Canada about suicide, prevention, risk factors, how to get help. It reviews potential risks, prevention, factors that may increase risk and resources along with overview of federal initiative in suicide prevention.

    Reference: https://www.canada.ca/en/public-health/services/suicide-prevention.html 

    https://www.canada.ca/en/public-health/services/publications/healthy-living/overview-federal-initiatives-suicide-prevention.html 

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    Canadian Coalition for Seniors’ Mental Health, Suicide Assessment & Prevention for Older Adults, Life Saving Tools for Health Care Providers.

    Web Address or Source: http://ccsmh.ca/projects/suicide/  

    © Canadian Coalition for Seniors’ Mental Health, 2008 In order to meet the educational needs of your learners, some materials in the toolkit may be modified. Please acknowledge that the information was provided by the Canadian Coalition for Seniors’ Mental Health Late Life Suicide Prevention Toolkit.

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    The following is one method of how to select the appropriate support surface for people with pressure injuries. This is not an exhaustive list but rather an example of a tool for support surface selection identified within the systematic review, AGREE II appraised guidelines, by the expert panel or external stakeholder feedback. The term “pressure ulcer” used in this appendix, refers to “pressure injury.”

    Reference: Registered Nurses 'Association of Ontario. (2016). Appendix Q of Assessment and Management of Pressure Injuries for the Interprofessional Team. Toronto, Canada: Author. pp 143-146.

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    Supportive and Palliative Care Indicator Tool SPICT™ helps clinicians identify people with one or more general indicators of poor or deteriorating health and clinical signs of life-limiting conditions for assessment and care planning.
    A single page tool that includes general (i.e. weight loss, hospital admissions, etc.) and broad specific disease indicators (i.e. breathlessness at rest for heart and respiratory disease). Also includes an assessment paradigm.

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    This appendix describes the Levine technique, a method of obtaining a semi-quantitative wound culture swab in order to guide the use of appropriate anti-infective agents

    Reference: Registered Nurses Association of Ontario (RNAO). 2016. Appendix L: Swabbing Technique. Assessment and Management of Pressure Injuries for the Interprofessional Team, Third Edition. Accessed July 28, 2016 http://rnao.ca/sites/rnao-ca/files/PI_BPG_FINAL_WEB_June_10_2016.pdf  pp. 137.

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    Symptom Management Algorithm for pain in adults with cancer developed by Cancer Care Ontario.

    Cancer Care Ontario (2018) Symptom Management Algorithm- Pain in Adults with Cancer retrieved from https://www.cancercareontario.ca/en/symptom-management

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    Venous leg ulcers can occur in both men and women; and may develop as a result of any injury to the leg or conditions such as varicose vein, blood clot in the leg, multiple pregnancies, overweight and standing for long periods of time (e.g., job related situations). They can take long time to heal and are costly to treat. Venous leg ulcers can also cause you to not be able to move and get around.

    Retrieved from: http://rnao.ca/bpg/fact-sheets/taking-care-your-legs

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    Pressure ulcers or bedsores are caused by constant pressure that damages the skin and underlying tissue. They can develop in a very short time period and take longer to heal. They may have a huge impact on your every day life, as normal activities can be restricted while the ulcer heals.

    If you spend long periods of time in a bed, chair or wheelchair and have lost your feeling in your lower body, you maybe at increased risk of getting pressure ulcers. In most cases, pressure ulcers can be prevented.

    Retrieved from: http://rnao.ca/bpg/fact-sheets/taking-pressure-preventing-pressure-ulcers
     

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    This comprehensive website from the Canadian Continence Foundation is an excellent source of resources on both urinary and fecal incontinence.  They have general information, pamphlets and videos. Sections of the website include: Bladder Health; Diagnosis and Treatment; The Men’s Room; Fecal Incontinence, Pelvic Pain, Health Care Professional resources, etc.

    Reference:

    The Canadian Continence Foundation. 2018.  The Canadian Continence Foundation Website. Accessed Mar. 18, 2018. http://www.canadiancontinence.ca

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    The Fixing Long-Term Care Act, 2021 (FLTCA) was proclaimed into force to regulate Ontario's long-term care home sector.
    The Long-Term Care Homes Act, 2007 (LTCHA) was revoked, which means it is no longer in force. The new Act also includes a new regulation.

    Government of Ontario (2021) Fixing Long-Term Care Act, 2021. Toronto ( ON) retrieved from Fixing Long-Term Care Act, 2021, S.O. 2021, c. 39, Sched. 1 (ontario.ca)

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    The Fixing Long-Term Care Act, 2021 (FLTCA) was proclaimed into force to regulate Ontario's long-term care home sector.
    The Long-Term Care Homes Act, 2007 (LTCHA) was revoked, which means it is no longer in force. The new Act also includes a new regulation.

    Government of Ontario (2021) Fixing Long-Term Care Act, 2021. Toronto ( ON) retrieved from Fixing Long-Term Care Act, 2021, S.O. 2021, c. 39, Sched. 1 (ontario.ca)

  • Show description [+]

    The Fixing Long-Term Care Act, 2021 (FLTCA) was proclaimed into force to regulate Ontario's long-term care home sector.
    The Long-Term Care Homes Act, 2007 (LTCHA) was revoked, which means it is no longer in force. The new Act also includes a new regulation.

    Government of Ontario (2021) Fixing Long-Term Care Act, 2021. Toronto ( ON) retrieved from Fixing Long-Term Care Act, 2021, S.O. 2021, c. 39, Sched. 1 (ontario.ca)

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    The National GSF Centre’s guidance for clinicians to support earlier identification of patients nearing the end of life leading to improved proactive person-centred care.  This updated 6th edition of the GSF PIG, renamed as Proactive Identification Guidance and formally known as Prognostic Indicator Guidance, aims to enable the earlier identification of people nearing the end of their life who may need additional supportive care. This includes people who are nearing the end of their life following the three main trajectories of illness for expected deaths – rapid predictable decline e.g. cancer, erratic decline e.g. organ failure and gradual decline e.g. frailty and dementia

    The Gold Star Framework. (2018). The Gold Standards Framework Proactive Identification Guidance (PIG). Retrieved from: https://www.goldstandardsframework.org.uk/cd-content/uploads/files/PIG/NEW%20PIG%20-%20%20%2020.1.17%20KT%20vs17.pdf

     

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    Brief, easy to use, and have established reliability and validity. The link takes you to screening questionnaires for neuropathic pain that incorporates the persons signs and symptoms.

    Reference: Try This: Best Practices in Nursing Care to Older Adults. Issue Number SP1, 2010 DN-4 Questionnaire

    Adapted from - Bouhassira, D., Attal, N., Alchaar, H, et al. (2005). Comparison of Pain Syndromes Associated with Nervous or Somatic Lesions and Development of a New Neuropathic Pain Diagnostic Questionnaire (DN4). Pain, 114 (1-2), 29-36

    Retrieved from http://consultgerirn.org/

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    The Ontario Palliative Care Competency Framework A Reference Guide for Health Professionals and Volunteers - The Health Services Delivery Framework aims to provide guidance on how to optimize the current palliative care delivery model to ensure that the right care is provided by the right provider at the right time. This document focuses on adults with a progressive, life-limiting illness, who would benefit from palliative care along with the supports required for their families and caregivers. The document emphasizes the important role of education in building capacity for palliative care, as well as the need for providers to have the necessary competencies.

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    The RGP of Eastern Ontario is a coordinated network of specialized geriatric services, from hospital to home. Their clinical services, teaching and research are committed to optimizing the health and independence of seniors in the Champlain region. Website: http://www.rgpeo.com/en.aspx

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    Reviews how to support workplace and colleagues as a result of suicide, along with workplace bullying and strategies to minimize suicide rates.

    Reference: The workplace suicide prevention toolkit: Center for Suicide Prevention, Canadian Mental Health Association; https://www.suicideinfo.ca/wp-content/uploads/2017/05/Workplace-Toolkit.pdf 

    © Center for suicide prevention, All contents of the Centre for Suicide Prevention Web Site are: © Centre for Suicide Prevention and/or its suppliers. All rights reserved.

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    This resource describes the variety of theories as to why elder abuse and neglect can occur and will assist homes in planning a comprehensive education program.

    Registered Nurses’ Association of Ontario. (2014). Appendix E of Preventing and Addressing Abuse and Neglect of Older Adults: Person-Centred, Collaborative, System-Wide Approaches. Toronto, Canada: Registered Nurses’ Association of Ontario. Pp 100-102. http://rnao.ca/sites/rnao-ca/files/Preventing_Abuse_and_Neglect_of_Older_Adults.pdf

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    At the core of nursing is the therapeutic nurse-client relationship. The College's Therapeutic Nurse-Client Relationship, Revised 2006, practice standard describes the expectations for all nurses in establishing, maintaining and terminating a therapeutic relationship.

    College of Nurses of Ontario. (2006).  Therapeutic nurse-client relationship. [PDF document]. Retrieved from https://www.cno.org/globalassets/4-learnaboutstandardsandguidelines/prac/learn/modules/tncr/pdf/tncr-chapter3.pdf

     

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    The link takes you to the COllege of Nurses of Ontario webcast on Therapeutic Nurse-Client Relationship – Maintaining Boundaries

    College of Nurses of Ontario. (2011). Therapeutic Nurse-Client Relationship – Maintaining Boundaries. [Webcase]. Retrieved from https://www.cno.org/en/learn-about-standards-guidelines/educational-tools/webcasts/therapeutic-nurse-client-relationship/ 

     

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    This site from Capital District health Authority, Halifax, Nova Scotia includes a vignette showing a daughter recognizing that her mother's behaviour has changed suddenly and therefore is not just related to her dementia. Delirium is described in the video and the site includes other information and resources for delirium.

    Reference: This is not My Mom Website: http://thisisnotmymom.ca/

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    Amy Edmondson, Novartis Professor of Leadership and Management at Harvard Business School, describes three key actions to foster a psychologically safe work environment. In a 4 minute video she highlights;

    1. Frame the work – leaders need to let workers know why the work is so important and remind people the work done in health care is uncertain and there is a potential for error. It is suggested in the video the need to be open and bring full self to work

    2. Model fallibility –Leaders need to be inclusive “hey I may miss something, I need your help” she suggest leaders actively get input from others.

    3. Embrace, thank people and close the loop.

    IHI: Institute of Healthcare Information. (2017, August). Three ways to create psychological safety in health care. [Video file]. Retrieved from https://www.youtube.com/watch?v=jbLjdFqrUNs&t=40s
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    Ideas to conduct a conference with individuals and families to assist with decision making at end-of-life.

    Registered Nurses’ Association of Ontario (2011). Appendix H of End-of-Life Care During the Last Days and Hours. Toronto, ON: Author. pp. 109-110.

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    A toolkit from Mental Health Commission of Canada information and access to resources on suicide grief, immediate aftermath, advocacy, information for first nations and capacity building tools.

    Reference: Available online: Toolkit for survivors of suicide loss and Postvention professionals; https://www.mentalhealthcommission.ca/English/initiatives/11889/tool-kit-survivors-suicide-loss-and-postvention-professionals 

    © (2013) Mental Health Commission of Canada. All rights reserved. All materials (including the organization and presentation of such material) on this Web site (the "Materials") are the property of MHCC and its licensors and may be protected by intellectual property laws including laws relating to copyrights, trade-marks, trade-names, internet domain names and other similar rights. Access and use of this Web site is provided by MHCC to accept identified and agree to the listed Terms of Use; such as the information must only be used for lawful purposes, no interference to the website, visit the terms of use periodically as it is updated regularly.

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    Tools to Support Early Identification for Palliative Care. The aim of this document is to support providers and system level leadership in earlier identification of patients who would benefit from palliative care.

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    Topical Antimicrobial Agents is found as Appendix Q of the RNAO BPG, Assessment and Management of Foot Ulcers for People with Diabetes. Pg 144-146.

    Reprinted in the BPG with permission from Dr. R. G. Sibbald©2013

    Reference: Registered Nurses’ Association of Ontario. (2013). Appendix Q of Assessment and Management of Foot Ulcers for People with Diabetes. Toronto, Canada: Author. pp. 144-146.

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    This information sheet is intended to provide tips that can help to decide if bladder training is feasible and how to get started.

    Reference: Retrieved June 22, 2018 from http://www.canadiancontinence.ca/pdfs/TrainingYourBladder.pdf

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    A detailed, 5 page assessment of bowel continence issues that can be completed by a patient. Treatment options are suggested and a client record sheet is included.

    Reference: Registered Nurses’ Association of Ontario (2006). Transdisciplinary Patient/Client Continence Assessment Tool. Toronto, Canada: Registered Nurses’ Association of Ontario.

    Retrieved from: http://ltctoolkit.rnao.ca/sites/default/files/resources/continence/Continence_AssessmentTools/RNAO_TransdisciplinaryPatientClient_Continence.pdf

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    A detailed, 8 page assessment of urinary and bowel continence issues that can be completed by a staff. Treatment options are suggested and a client record sheet is included.

    Reference: Registered Nurses’ Association of Ontario (2006). Transdisciplinary Patient/Client Continence Assessment Tool. Toronto, Canada: Registered Nurses’ Association of Ontario. Retrieved from: http://ltctoolkit.rnao.ca/sites/default/files/resources/continence/Continence_AssessmentTools/RNAO_TransdisciplinaryPatientClient_Continence.pdf

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    Cette feuille d’information de l’ASSSP vise à offrir aux parties du lieu de travail de l’information qui peut contribuer à améliorer la transition des pratiques thérapeutiques. L’amélioration de la transition des soins peut améliorer la sécurité des employés et des clients.

    Reference: http: Public Services Health & Safety association (2017). Retrieved October 31, 2017 from http://www.pshsa.ca/products/transition-des-soins-batir-un-systeme-plus-sur/ 

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    This Public Services Health & Safety Association (PSHSA) Fast Facts is intended to provide workplace parties with information that can help improve transition of care practices. Improving transitions in care results in improved employee and client safety.

    Reference: Public Services Health & Safety association (2017). Retrieved October 31,2017 from http://www.pshsa.ca/products/transition-of-care-fast-fact/ 

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    This 15 minute Public Services Health & Safety Association (PSHSA) web tutorial describes the transition of care process, challenges and opportunities to improve practice when supporting those going through a healthcare transition of care.

    Reference: http: Public Services Health & Safety association (2017). Retrieved October 31,2017 from http://www.pshsa.ca/product/transition-of-care/ 

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    Stroke patients are among the largest patient population receiving long-term care. The transition by stroke survivors and their families is known to be a stressful and challenging time as they adjust to new roles, altered functional and cognitive abilities, and changes in living setting for patients admitted to long-term care following an acute stroke. This Transition of Patients to Long-Term Care Following a Stroke Canadian Stroke Best Practice Recommendations identify what is required to have a successful transition.

    Reference: Canadian Stroke Best Practice Recommendations. Managing Stroke Transitions of Care (July 2016). Retrieved from: http://www.strokebestpractices.ca/index.php/transitions/transition-of-patients-to-long-term-care-following-a-stroke/

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    This resource includes the key components of successful transitions to long-term care after a stroke: 1. Assessment and Care Planning. 2. Rehabilitation and Restorative Care; and 3. Support and Education for the Person with Stroke and Their Family. These include recommendations  specifically to persons with stroke who are new or living in long-term care at the time of their stroke. This resource is also useful for chronic or continuing care settings.

    Reference - Heart and Stroke Foundation (2019). 6th edition. Section 5. Transition to Long-Term Care Following a Stroke. Retrieved from https://www.strokebestpractices.ca/recommendations/managing-stroke-transitions-of-care/transition-of-patients-to-long-term-care-following-a-stroke

     

  • Show description [+]

    This Care Transitions change package provides information that can be used sequentially to complete a specific task (or series of tasks), or can be used selectively and independently, depending on the user’s needs. This package includes an overview of transitions of care, four (4) key evidence-informed change concepts, and a deeper dive into the change concepts.

    Reference: Health Quality Ontario (2013)Transitions of Care: Evidence Informed Improvement Package Retrieved September 1,2016 from http://www.hqontario.ca/Portals/0/documents/qi/health-links/bp-improve-package-transitions-en.pdf

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    Management of Chronic Non-Cancer Pain – Center for Effective Practice
    “This tool is designed to help family physicians and nurse practitioners (primary care providers) develop and implement a management plan for adult patients with chronic non-cancer pain (CNCP). This tool applies to, but is not limited to pain conditions such as osteoarthritis, low back pain, musculoskeletal pain, fibromyalgia and neuropathic pain.”

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    Appendix E pages 128-130 of the BPG Delirium, Dementia and Depression in Older Adults: Assessment and Care (2016) identifies the major types of dementia and a description of each.

    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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    U-FIRST! Is a proven and effective approach to working with people with dementia. Through dialogue and a case-based approach, learners will have more confidence in working with people with responsive behaviours. Training is especially designed for people working in community care, acute care and long-term care. For more information visit www.u-first.ca.  Permission to post obtained from Cathy Conway.

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    The University of Tasmania, Australia, offers a free online course on Understanding Dementia. The course is delivered over 7 week, in order to obtain the most from this course, participants should expect to spend approximately 3 hours per week engaging with the course content and activities. 

    University of Tasmania. (n.d.). Understanding dementia. Retrieved from http://www.utas.edu.au/wicking/understanding-dementia

     

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    The educational website contains:

    • A narrated presentation about pain and dementia
    • A downloadable resource pack for family members, and
    • A downloadable pain-log and the PAINAD assessment tool (Warden, Hurley, Volicer, 2003)

    A facilitator's toolkit of background material, a planning guide, promotional material, and supplemental information for organizations who wish to conduct a workshop using he materials.

    Retrieved from: http://brainxchange.ca/Public/Resource-Centre-Topics-A-to-Z/Pain.aspx

    This link takes you to the CDRAKE and AKE combined activities to form an exciting new network.

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    This link takes you to the College of Nurses of Ontario website and includes information on understanding restraints and the key accountabilities nurses have related to restraint use.

    College of Nurses of Ontario (2018). Understanding Restraints. Toronto, ON: Author. Retrieved from https://www.cno.org/en/learn-about-standards-guidelines/educational-tools/restraints/

     

     

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    University Foot Classification system-Categories 0-3 risk Factors for Amputation is found as Appendix E of the RNAO BPG, Assessment and Management of Foot Ulcers for People with Diabetes. Pgs. 110-111.

    Note. From “Practical criteria for screening patients at high risk for diabetic foot ulceration,” by L.A. Lavery, D.G. Armstrong, S.A. Vela, T.L. Quebedeau and J.G. Fleishchli, 1998, Archives of Internal Medicine,158(2), p. 157-162. Reprinted with permission of Dr. D.G. Armstrong.

    Reference: Registered Nurses’ Association of Ontario. (2013). Appendix E of Assessment and Management of Foot Ulcers for People with Diabetes. Toronto, Canada: Author. pp. 110-111

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    University Foot Classification system-Categories 4-6 risk Factors for Amputation is found as Appendix D of the RNAO BPG, Assessment and Management of Foot Ulcers for People with Diabetes. Pg 109.

    Note. From “Practical criteria for screening patients at high risk for diabetic foot ulceration,” by L.A. Lavery, D.G. Armstrong, S.A. Vela, T.L. Quebedeau and J.G. Fleishchli, 1998, Archives of Internal Medicine,158(2), p. 157-162. Reprinted with permission of Dr. D.G. Armstrong

    Reference: Registered Nurses’ Association of Ontario. (2013). Appendix D of Assessment and Management of Foot Ulcers for People with Diabetes. Toronto, Canada: Author. pg. 109.

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    University of Texas Health Science Center Classification System is found as Appendix F of the RNAO BPG, Assessment and Management of Foot Ulcers for People with Diabetes. Pg 112.

    Note. From “Validation of a diabetic wound classification system: The contribution of depth, infection and ischemia to risk of amputation,” by D.G. Armstrong, L.A. Lavery and L.B. Harkless, 1998, Diabetes Care, 21(5), p. 855-859. Reprinted with permission

    Reference: Registered Nurses’ Association of Ontario. (2013). Appendix F of Assessment and Management of Foot Ulcers for People with Diabetes. Toronto, Canada: Author. p 112.

  • Show description [+]

    Urinary Continence Toolkit was produced by the Regional Geriatric Program of Toronto.  It is aimed at older adults and caregivers. It has simple fact sheets and explanations. There is a decision aid for managing urinary incontinence aimed at health care providers.   

    Regional Geriatric Program of Toronto, (2018). SF7 Toolkit. Retrieved from https://www.rgptoronto.ca/resources/”

    Reproduction of these materials is permitted in whole without restriction. If adapting this content, or using in part, RGP must be contacted.

  • Show description [+]

    This powerpoint presentation aimed at health care providers, describes bladder physiology, classifies and identifies medications that contribute to incontinence and pharmacological treatments used for urinary incontinence. It is also available in french

    Alston, Jillian ( 2020) Urinary Incontinence & Medications- Clinician Learning Series. Ontario. Retrieved from https://www.rgptoronto.ca/resource/urinary-incontinence-medications-clinician-learning-series/

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    A succinct algorithm for UTI’s both catheter and non-catheter related with a built-in checklist that can be used to monitor interventions.

    Reference: Alberta Health Services. 2014. Urinary Tract Infections in LTCF Checklist. http://www.dobugsneeddrugs.org/wp-content/uploads/uti-checklist.pdf

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    This resource highlights a treatment plan for an elderly person with a diagnosis of memory impairment who develops a urinary tract infection that results in delirium. 

    © 2022 Alzheimer's Society.

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    This presentation gives a summary of the research evidence on UTI’s in Long Term Care. It discusses challenges in diagnosis, treatment and prevention of UTI’s. Developed by Barbara Grace Cowie, RN MN, Nurse Continence Advisor, Advanced Practice Nurse, West Park Healthcare Centre.

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    The Centre for Effective Practice provides the BPSD Discussion Guide designed to help providers understand, assess, and manage residents in long-term-care homes with behavioural and psychological symptoms of dementia, with a focus on antipsychotic medications.

    Reference: Centre for Effective Practice (2016). Use of Antipsychotics in Behavioural and Psychological Symptoms of Dementia (BPSD) Discussion Guide. Retrieved from https://cep.health/media/uploaded/UseofAntipsychotics_LTC2016-2.pdf

    © April 2016. Version 2. Centre for Effective Practice Inc. All Rights Reserved.

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    Use of the Semmes-Weinstein monofilament is found as Appendix K of the RNAO BPG, Assessment and Management of Foot Ulcers for People with Diabetes. Pg 128.

    Reference: Registered Nurses’ Association of Ontario. (2013). Appendix K of Assessment and Management of Foot Ulcers for People with Diabetes. Toronto, Canada: Author. p. 128.

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    This is a one-page algorithm that is part of Public Health Ontario’s Urinary Tract Infection (UTI) Program. It clearly describes signs and symptoms of UTI’s and promotes ‘watchful waiting’ as an acceptable alternative before treating probable UTI’s. Is suitable for posting on a bulletin board.

    Reference: Public Health Ontario (PHO). 2017. Assessment algorithm for urinary tract infections (UTIs) in medically stable non-catheterized residents. Accessed Mar. 13, 2017. http://www.publichealthontario.ca/en/BrowseByTopic/IPAC/Documents/UTI_Assessment_Algorithm.pdf

    © 2017 Ontario Agency for Health Protection and Promotion

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    This PHO resource provides basic facts about asymptomatic bacteriuria

    Reference: Public Health Ontario, 2014, Asymptomatic Bacteriuria Fact Sheet. Retrieved from http://www.publichealthontario.ca/en/Pages/default.aspx

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    This PHO resource provides step-by-step instructions and detailed process information for specimen collection.

    Reference: Public Health Ontario, 2014, Collecting Mid-Stream Urine Specimen Fact Sheet. Retrieved from http://www.publichealthontario.ca/en/Pages/default.aspx

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    This fact sheet is part of Public Health Ontario’s Urinary Tract Infection (UTI) Program. It succinctly describes the evidence for not using dipsticks to diagnose UTI’s. Is suitable for sharing with staff, residents and families.

    Reference: Public Health Ontario (PHO). Revised 2019.Urinary Tract Infection (UTI) Program Evidence to Support Discontinuing the Use of Dipsticks to Diagnose a UTI in Residents of Long-Term Care Homes (LTCHs) https://www.publichealthontario.ca/-/media/Documents/U/2016/uti-dipsticks.pdf?sc_lang=en

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    This resource can be used by health care providers at the long-term care homes (LTCHs) when consulting or meeting with friends and families of residents who have questions about a LTCH’s approach to managing suspected UTIs.

    Reference: Public Health Ontario (PHO). Revised 2016. Retrieved from https://www.publichealthontario.ca/-/media/Documents/U/2016/uti-faq-residents-families.pdf?sc_lang=en

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    This PowerPoint presentation is part of Public Health Ontario’s Urinary Tract Infection (UTI) Program. It provides an overview of how to implement a UTI program.

    Reference: Public Health Ontario (PHO). 2017.  UTI Program (PHO) Management of UTIs in Non-catheterized Long-Term Care Home Residents. http://www.publichealthontario.ca/en/BrowseByTopic/IPAC/Documents/UTI_Presentation_Orientation_Education_Program.pdf

    © 2017 Ontario Agency for Health Protection and Promotion

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    This policy and procedure is part of Public Health Ontario’s Urinary Tract Infection (UTI) Program. It is a comprehensive policy that could be adapted by long term care homes and other health care organizations. It is complimented by a guidance document available on the PHO website.

    Reference: Public Health Ontario (PHO). Revised 2019. UTI Program: Sample policy and procedure for assessment and management of urinary tract infections (UTIs) in non-catheterized residents. Retrieved from https://www.publichealthontario.ca/-/media/Documents/U/2018/uti-sample-policy-procedure.pdf?sc_lang=en

     

     

     

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    This Public Health Ontario resource provides a list of UTI symptoms, contrasts between non-catheterized and catheterized residents and when not to send a specimen.

    Reference: Public Health Ontario, 2014, When To Collect A Urine Specimen For Culture And Sensitivity Fact Sheet. Retrieved from https://www.publichealthontario.ca/-/media/Documents/U/2016/uti-urine-collection.pdf?sc_lang=en

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    Public Health Ontario (PHO) has developed the Urinary Tract Infection (UTI) Program in response to concerns about the overuse of antibiotics for presumed UTI's in residents in long-term care homes (LTCHs) and the associated antibiotic-related harms. The Program contains a number of tools for assessment, planning, implementation and evaluation of a program to reduce UTI’s in LTC homes.

    Reference: Public Health Ontario (PHO), 2018. Urinary Tract Infection (UTI) Program.

    Retrieved Aug. 4, 2022 from https://www.publichealthontario.ca/en/Health-Topics/Antimicrobial-Stewardship/UTI-Program

    © 2022 Ontario Agency for Health Protection and Promotion

     

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    This is a comprehensive list of reasons for delirium that need to be considered before assuming that a change in mental status is due to a UTI. 

    Public Health Ontario (2019).UTI Program (PHO)- Causes of Delirium and Mental Status Changes retrieved from https://www.publichealthontario.ca/-/media/Documents/U/2016/uti-delirium-mental-status.pdf?sc_lang=en

    © 2022 Ontario Agency for Health Protection and Promotion

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    Webinar Presentation by Vision Nursing Home's Kathleen Waller, BPSO Lead and Charge Nurse An overview of Vision Nursing Home's journey through their BPSO year one candidacy while implementing the Best Practice Guideline on Prevention of Falls and Fall Injuries in the Older Adult. It highlights strategies and processes during implementation and for sustainability, includes challenges and successes, data collection, monitoring and evaluation.

    Kathleen Waller. [Registered Nurses' Association of Ontario]. (2016, Jan 28). Best Practice Spotlight Organization's journey in implementing the Prevention of Falls in the Elderly best practice guideline. [Video]. YouTube. https://youtu.be/gSqA_7fduWA

     

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    This is a brightly coloured, one page pamphlet/poster that describes signs of elder abuse and gives resources. This is one of a suite of resources from Elder Abuse Ontario in the Helping Seniors section of their website.

    Reference: Elder Abuse Ontario. 2015. Warning Signs of Elder Abuse. Accessed Feb. 2, 2017 from http://www.elderabuseontario.com/what-is-elder-abuse/help-for-seniors/educational-materials-for-seniors/

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    This two-page card provides a risk assessment scoring system that can be used to determine the resident's risk for pressure ulcers. The reverse side provides guidance on nursing care, types of preventative aids associated with the three levels of risk status, wound assessment and dressings.

    One side illustrates the risk assessment scoring system click here One side illustrates the risk assessment scoring system click here http://www.judy-waterlow.co.uk/downloads/Waterlow%20Score%20Card-front.pdf  

    The reverse side provides guidance on nursing care, types of preventative aids associated with the three levels of risk status, wound assessment and dressings click here http://www.judy-waterlow.co.uk/downloads/Waterlow%20Score%20Card-back.pdf

    The separate sides of the card may be printed off/downloaded for Free http://www.judy-waterlow.co.uk/the-waterlow-score-card.htm  

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    This pamphlet has an algorithm to help decide on whether and to whom to report elder abuse, as well as elder abuse resources in Ontario. This is one of a suite of resources from Elder Abuse Ontario in the Helping Seniors section of their website.

    Web Source: Elder Abuse Ontario. 2015. What To Do If You Suspect Elder Abuse. http://www.elderabuseontario.com/what-is-elder-abuse/help-for-seniors/educational-materials-for-seniors/

    Reference: Elder Abuse Ontario. 2015. What To Do If You Suspect Elder Abuse. Accessed Feb. 2, 2017 at file:///C:/Users/sumani/Downloads/What-To-Do-If-You-Suspect-Elder-Abuse-2016.pdf

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    This Hamilton Health Sciences patient education resource provides an overview of ostomies, signs of malnutrition and dehydration and offers food and fluid choices to try, explaining possible effects of these choices and the reasons for these choices.

    Reference: What to eat and drink when you have a high output ostomy. (Nov. 2009). Hamilton Health Sciences. Retrieved from: http://www.hamiltonhealthsciences.ca/documents/Patient%20Education/HighOutputOstomyWhatToEat-trh.pdf  

    © Hamilton Health Sciences, 2009 PD 6629 - 11/2009 dpc/pted/HighOutputOstomyWhatToEat-trh.doc dt/November 4, 2009

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    This pamphlet is helpful in preparing families and caregivers for understanding the final stage of life.  

    Prepared by Ida Tigchelaar, RN, Palliative Care Pain & Symptom Management/Education Consultant, Oxford & Elgin Counties of Ontario.

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    This document offers talking points on the connection between oral and overall health. Oral health can influence other body systems, while therapies for chronic diseases can have an impact on the oral cavity and nurses can use this fact sheet while talking to residents and families about the importance of oral hygiene.  

    The Canadian Dental Hygienist Association. (2015). Talking points – whole body health requires oral health. [Fact sheet]. Retrieved from https://files.cdha.ca/profession/resources/FactSheet_WholeBody_printerFriendly_final2.pdf

    Source: Canadian Dental Hygienists Association www.cdha.ca.

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    This CNO document discusses nurses’ role when working with unregulated care providers.

    Reference: College of Nurses of Ontario (2013) Working With Unregulated Care Providers Retrieved from http://www.cno.org/globalassets/docs/prac/41014_workingucp.pdf

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    This WHO site consists of suicide data, prevention videos and the mhGAP Intervention Guide with a module on self-harm/suicide.

    Reference: Retrieved from http://www.who.int/mental_health/suicide-prevention/en/  

    © Copyright World Health Organization (WHO), 2017. All Rights Reserved.

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    Wound swabbing Techniques is found as Appendix J of the RNAO BPG, Assessment and Management of Foot Ulcers for People with Diabetes. Pg 127.

    Note following Appendix in BPG identifies that this resource was reprinted with permission from C. Harris at Care Partners.

    Reference: Registered Nurses’ Association of Ontario. (2013). Appendix J of Assessment and Management of Foot Ulcers for People with Diabetes. Toronto, Canada: Author. p. 127.

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    Wounds Care (formally CAWC) s a non-profit organization dedicated to the advancement of wound prevention and management by being the leading knowledge mobilization organization relating to wounds in Canad

    Wounds canada. (n.d.). https://www.woundscanada.ca/

    The wounds canada website provides information on the role of the organization and educational offerings that support the advancement of wound care in Canada.

     

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    This easy-to-read, highly illustrated booklet from the Canadian Continence Foundation is for people who have continence issues. It aims to teach about the signs and symptoms, types of incontinence; diagnosis; and how to improve it.

    Web Source: The Canadian Continence Foundation. 2012. The Source Your Guide to Better Bladder Control. http://www.canadiancontinence.ca/pdfs/The-Source.pdf  

    Reference: The Canadian Continence Foundation. 2012. The Source Your Guide to Better Bladder Control. Accessed Apr. 24, 2017. http://www.canadiancontinence.ca/pdfs/The-Source.pdf

    Copyright © 2017 The Canadian Continence Foundation www.canadiancontinence.ca  Acknowledge where resources come from, The Canadian Continence Foundation, and include a link to our url. www.canadiancontinence.ca

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    This Canadian Stroke Best Practices guide is for adults who have had a stroke, their care partners, family and friends. It helps in understanding stroke, providing strategies for recovery, living with changes, preventive measures, support and resources.