Student and preceptor resources

Click here to access the Nursing Student and Preceptor Long-Term Care program resources

Care Transitions

• Care Transitions
  This best practice guideline (BPG) is designed to apply to all domains of nursing practice, including clinical, administration, and education. Assisting nurses to become more confident and competent when caring for clients undergoing care transitions.
• SBAR Tool
  The SBAR (Situation-Background-Assessment-Recommendation) technique provides a framework for communication between members of the health care team about a patient's condition.

Conflict Management

• Managing and Mitigating Conflict in Health-care Teams
  This BPG focuses on nursing teams and processes that foster healthy work environments.
• Tips for Managing and Mitigating Conflict in Health-care Teams
  Tips on how to manage and mitigate conflict (e.g., how to be “self-aware” during conflict, five responses to conflict, steps to resolve conflict, questions to ask when conflict arises and barriers to resolution, etc.).

Continence and Constipation

• A Proactive Approach to Bladder and Bowel Management in Adults
  This BPG provides evidence-based recommendations for effective strategies to support adults (aged 18 years and older) living with urinary incontinence, fecal incontinence and/or constipation that will improve quality of care and lead to positive health outcomes. It includes practice statements on conducting an initial assessment and recommendations that address the following: toileting strategies, physical activity, adequate intake of fibre and/or fluids, interprofessional approach and bowel protocol.
• Bladder and Bowel Problems in People Living with Dementia
  This leaflet on bladder and bowel incontinence 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. (The Canadian Continence Foundation. No date. Bladder and Bowel Problems in People Living with Dementia. Accessed Mar. 18, 2018. Copyright © 2018 The Canadian Continence Foundation)
• Fecal Incontinence
  This fact sheet from The Canadian Continence Foundation provides an overview of fecal incontinence, lifestyle changes and treatments. (The Canadian Continence Foundation. 2010. Fecal Incontinence.  Accessed June 13, 2018.)

Delirium, Dementia and Depression

• Delirium, Dementia and Depression in Older Adults: Assessment and Care
  This BPG 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.
• Attitudes, Skills, and Knowledge That Are Beneficial for Communication in Dementia Care
  This table helps reflect on our own attitudes, skills and knowledge about dementia and provides tips for successful interpersonal skills when caring for residents with dementia.
• BP Blogger Myth Busting: Dementia Care Issue
  This BP Blogger enhances learning about dementia care.
• BP Blogger Myth Busting: The Delirium Issue
  This BP Blogger enhances learning about delirium.
• BP Blogger Myth Busting: The Wandering Issue
  This BP Blogger enhances learning about wandering.
• Comparison of the Clinical Features of Delirium, Dementia, and Depression
  This table distinguishes the differences and commonalities between: delirium, dementia and depression. 

Elder Abuse

• Preventing and addressing abuse and neglect of older adults: Person-Centred, Collaborative, System-Wide Approaches
  This BPG focuses on preventing and addressing abuse and neglect of older adults throughout various health-care institutions and community settings in Canada.
• Addressing Abuse of Older Adults- An RNAO Initiative
  This Toolkit contains easy-to-use resources to support uptake of the guideline. It contains practical videos to assist with understanding abuse and neglect in the LTC environment.
• Every Resident Bill of Rights for people who live in Ontario long-term care homes
  This booklet outlines the LTC Resident Bill of Rights.

End-of-Life Care

• A Palliative Approach to Care in the Last 12 Months of Life
  This BPG provides evidence-based recommendations to nurses and the interprofessional health team who support adults (18 years and older) experiencing the last 12 months of a progressive life-limiting illness, their families and their caregivers.
• End-of-life care during the last days and hours
  This BPG 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.

Falls

• Prevention of Falls and Reducing Injury from Falls, Fourth Edition
  This BPG outlines evidence-based approaches for preventing falls and reducing fall injuries for adults (>18 years) at risk for falls and receiving care from nurses and other health-care providers across the health-care continuum.
• Purposeful Hourly Rounding in long-term care
  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.)
• Frailty eLearning Module
  This module provides the learner background information about causes and risk factors for falls. It reviews both extrinsic and intrinsic risk factors for falls, as well as the interdisciplinary health-care team that can be utilized to prevent falls in the geriatric population. Registration is required to access RGPs of Ontario's eLearning Modules.
• GERAS Centre for Aging Research's Long-Term Care Video Series - Personal Support Worker (2018):
  • How to Safely Transfer Out/In Bed
    A two-minute Osteoporosis Canada video that discusses and demonstrates how to safely transfer residents in and out of bed.
  • Proper Positioning for Sitting
    A one-and-a-half-minute Osteoporosis Canada video discusses and demonstrates how to properly position residents for sitting.

Intraprofessional Collaboration

• Intra-professional Collaborative Practice among Nurses
  The goal of this BPG is to strengthen collaborative practice among nurses, because effective collaborative practice is essential for working in health-care organizations. The guideline focuses on collaborative practice amongst three types of nursing professionals – registered nurse (RN), registered practical nurse (RPN) and nurse practitioner (NP) – and explore what fosters healthy work environments for them, aware that collaboration must align with the needs of the patient or client.
• Managing and Mitigating Conflict in Health-care Teams
  This BPG 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.
• Eight ways to stop unprofessional behaviour: Powerful scripts of healthcare leaders
  This article provides scripts health-care leaders can use when addressing unprofessional behaviours. Eight common disruptive situations are provided followed with scripts on how to handle them. (Healthy Workforce Institute (2020). Eight ways to stop unprofessional conduct: Powerful scripts for healthcare leaders.) 

Leadership

• Developing and sustaining nursing leadership (Second edition)
  This healthy work environment BPG is intended to assist nurses and others performing both formal and informal nursing leadership roles. Gain knowledge about leadership practices that result in healthy outcomes for nurses, patients/clients, organizations and systems.
• Recommendations for Individuals Embracing Diversity in Health Care
  This resource identifies recommendations for individuals embracing diversity in health-care.
• Point-of-Care Leadership Tips and Tools for Nurses
  This brochure describes evidence-based practices for nurses in formal, and informal nursing leadership roles can use to enhance their skills.

Oral Health

• Oral Health: Supporting Adults Who Require Assistance
  This BPG provides 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.
• Approaches for oral care - interventions for residents in long-term care
  This table provides approaches and interventions that staff can use for providing oral care for residents with responsive behaviours, communication or functional impairment. (Scott, D., Van der Horst, M. L., & Bowes, D. (2007). Approaches of oral care: Interventions for residents in long-term care with responsive behaviours, communication or functional impairments.)
• Medications that impact oral health
  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.)
• Three-part video series on how to perform an oral assessment in long-term care (MacDonald, I. & Peachman-Faust, T. (2015)):
  • Part 1 - The Normal mouth
    This 25-minute video discusses available oral assessment tools and demonstrates a method for performing an oral assessment. Pictures of variations of normal findings, how to check denture fit and challenges in oral care are presented.
  • Part 2 - Unhealthy changes and common abnormalities
    This 25-minute video shows a range of unhealthy changes and common abnormalities found during an oral assessments of residents living in long term care homes. 
  • Part 3 - Best practices for oral care interventions in LTC
    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

Ostomy Care

• Supporting adults who anticipate or live with an ostomy
  This BPG 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.
• Hollister Ostomy Care – eLearning Lessons
  This online course in Ostomy Care offers healthcare professionals lessons in this specialized area of care. There are five lessons with an assessment at the conclusion of each lesson.  Topics include: 1: Ostomy overview, 2: Pouching systems, 3: Ostomy accessories, 4: Problem solving, 5: Education and resources 
• Ostomy Documentation Tips – Wound Care Advisor
  This article provides 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. (Wound Care Advisor. 2016. 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)

Pain

• Assessment and management of Pain (Third edition)
  This BP guideline contains recommendations for the assessment and management of pain for Registered Nurses (RNs) and Registered Practical Nurses (RPNs).
• BP Blogger Myth Busting: The Pain Issue
  A succinct, 2-page newsletter that covers myths and facts about pain.
• Brief Pain Inventory (BPI)
  The BPI tool can be used 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. (Copyright - Dr Charles S. Cleeland (1991)
• Abbey Pain Scale
  Abbey Pain Scale is an assessment tool for the measurement of pain in people with dementia who cannot verbalize. (Abbey, J. et al. Funded by the JH & JD Gunn Medical Research Foundation 1998 – 2002). This document may be reproduced with this acknowledgment retained). Source: Dementia Care Australia Pty Ltd. 
• Pain Assessment in Advanced Dementia Scale (PAINAD)
  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. 

Person and Family Centred Care

• Person and Family Centred Care
  This BPG can be used to enhance a quality partnerships between health-care providers with individuals accessing care and ultimately improving clinical outcomes.
• BP Blogger Myth Busting: Consent and Capacity
  A Best Practice (BP) Blogger presents credible bite-size pieces of information on clinical topics related to LTC.

Professionalism

• Professionalism in nursing
  This healthy work environment BPG helps identify the organizational culture, values and relationships and the structures and processes required for developing and sustaining effective professional practices. Professional practice involves structures and processes needed to achieve outcomes.
• Practice Education in Nursing
  The purpose of this BPG is to provide evidence-based recommendations that promote and sustain the undergraduate nursing student’s application of knowledge to practice in a variety of clinical learning environments. The BPG explores the relationships among and between students and nursing educators, nursing staff, preceptors, and diverse health-care team members, and it considers their influence on the quality of practice education, professional socialization, and nursing excellence.
• College of Nurses of Ontario's Critical inquiry and evidence-informed practice webcast
  In a 48-minute interview, two executive nurse leaders discuss the concepts of critical inquiry and evidence-informed practice and how they apply to nursing.  The regulatory requirements for evidence based informed practice along with how critical inquiry supports a safe practice are discussed by way of examples. (College of Nurses of Ontario. (2015).  Critical inquiry and evidence-informed practice webcast.)
• College of Nurses of Ontario's Medication practice standard: An overview webcast
  This webcast reviews the medication practice standard as outlined by the College of Nurses of Ontario. (College of Nurses of Ontario. (2019). Medication practice standard: An overview webcast.) 
• College of Nurses of Ontario's Documentation: An overview webcast
  This webcast reviews the standards for documentation outlined by the College of Nurses of Ontario. (College of Nurses of Ontario. (2012). Documentation: An overview webcast.)

Restraints

• Promoting Safety: Alternative Approaches to the Use of Restraints
  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 BPG offers nurses a model which will help them to examine their approach to the use of restraints within their practice.
• College of Nurses of Ontario's Documentation Practice Standard
  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's Understanding Restraints
  This link included information and documents to helps nurses understand their responsibilities and legal obligations to enable them to make safe, effective and ethical decisions when practicing. A link is included to the practice standard which aims to help nurses understand their responsibilities and make decisions regarding the use of restraints.
• Best Practice Jeopardy: Alternative to Restraints edition
  A sample Jeopardy game, a fun way to evaluate your learning with classmates.

Skin and Wound Care

• Assessment and Management of Pressure Injuries for the Interprofessional Team, Third Edition
  This BPG presents 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. 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.
• Assessment and Management of Foot Ulcers for People with Diabetes, Second Edition
  This BPG provides nurses and the interprofessional team with evidence-based recommendations on the assessment and management of people at risk of or with an established diagnosis of diabetic foot complications.
• Best Practices for Prevention of Medical Device-Related Pressure Ulcers in Long-Term Care
  This one-page document describes the areas that should be assessment when using medical devices in LTC in order to prevent pressure related injuries. (National pressure ulcer advisory panel (2013). Best Practices for prevention of medical device-related pressure ulcers in long-term care. Copyright 2013.) 
• Braden Risk Assessment Scale
  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. (Braden Scale (1988). © Copyright Barbara Braden and Nancy Bergstrom, 1988).
• Skin and Wound Care Refresher for LTC 
  This three-part webinar series is suitable for registered staff working in LTC. It also includes an additional video of Q&A’s that were asked of the presenters following the presentations. Topics covered in the webinars include: assessment of skin, pressure management and pressure ulcers.
• Positioning Techniques in Long-Term Care: Self-directed learning package for health care
  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 incidence of pressure injuries and contractures. 
• International Skin Tear Advisory Panel (ISTAP) Skin Tear Classification
  This tool was developed and validated by the ISTAP to support a universal language for identifying and documenting skin tears. It also addresses medications that can affect the skin; a skin tear algorithm and a product selection guide. Note: Permission must be obtained for re-use. (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)
• Skin tears: Best practices for care and prevention
  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.