RNAO Best Practice Spotlight

Thunder Bay Regional Health Sciences Centre achieved the Best Practice Spotlight Organization Designation (BPSO) with the Registered Nurses Association of Ontario (RNAO) in May 2013.

To date, the following Best Practice Guidelines have been implemented;

Establishing Therapeutic Relationships
We are currently doing a pilot of Transfer of Accountability (Shift Report) on 3C Neuro. Nurses will be doing their shift to shift report with the patient/family at the bedside.
Integrating Smoking Cessation into Daily Nursing Practice
Nurses will screen all patients on admission for their smoking history and our Smoking Cessation Nurse will come to do a bedside consultation for those people who are interested in quitting smoking. We offer Nicotine Replacement Therapy for all patients who wish to be smoke free while on our Smoke Free Grounds during their admission.
Assessment and Management of Pain
Updates coming soon!
Prevention of Falls and Fall Injuries in the Older Adult
We screen all patients on admission for Fall risk and repeat this daily and with any change to their condition. Outpatient areas use universal fall risk strategies to decrease the incidence of a fall.
Assessment and Device Selection for Vascular Access
We have updated our Nurse Led PICC line insertion technique to include up to date verification technology. This will improve our flow process and reduce the amount of x-rays for location verification purposes.
Care and Maintenance to Reduce Vascular Access Complications

We instituted a policy with all peripheral IVs expected to be in place for greater than 3 hours will be dressed with a securement device.

Central Venous Access Device Research Project in the Critical Care is evaluating the use of Normal Saline to maintain patency.

Promoting Safety: Alternative Approaches to the use of Restraints
We have updated our restraint policy to ensure that our nurses are using Non Violent Crisis Intervention training (unit specific) and other aggressive management techniques to reduce the use of physical restraints.
Risk Assessment and Prevention of Pressure Ulcers
All patients admitted are screened using the Braden Skin Assessment Tool or the Braden Q Tool (Paediatrics) to assess for pressure ulcers.
Screening for Delirium, Dementia and Depression in the Older Adults
Pilot on 2B using the Confusion Assessment Method tool. This tool is an early indicator for development of delirium.
Collaborative Practice Among Nursing Teams
Our Spring Hire incorporates both the RN and RPN graduates. We offer employment opportunities for all nurses at Thunder Bay Regional Health Sciences Centre.

Additional Resources

Visit the Registered Nurses Association of Ontario website at www.rnao.ca