Recommendation 1

Develop a genuine partnership with families by:

• Recognizing the family’s assessment of the situation as essential
• Acknowledging and respecting the important role of family in health care situations
• Determining the desired degree of family involvement
• Negotiating the roles of both nurse and family within the partnership

Recommendation 2

Assess individuals in the context of the family (as they define it) to identify whether assistance is required by the nurse to strengthen and support the family. While a family assessment should include information in the following areas, it should be tailored to address the uniqueness of each family through examining:

• Family structure
• Environmental data
• Family strengths
• Family supports

Recommendation 3

Identify resources and supports to assist families address the life event, whether this is expected or unexpected. Resources should be identified within the following three categories:

• Intrafamilial
• Interfamilial
• Extrafamilial

Recommendation 4

Educate and provide information to nurses, families, policy-makers and the public to assist families to manage expected or unexpected life events.

Recommendation 5

Sustain a caring workplace environment conducive to family-centred practice by:

• Ensuring that nursing staff are oriented to family-centred care, including family assessment
• Ensuring that nurses have the awareness and ability to effectively access resources
• Providing ongoing opportunities for professional development for nursing staff, including knowledge and skills regarding family-centred care

Recommendation 6

Support the implementation of family-centred practice in the workplace by:

• 
  Ensuring appropriate staffing levels, assignments, and staffing categories
• 
  Implementing family-centred practices and policies
• Creating and maintaining physical work environments that are conducive to promoting family involvement
• 
  Developing employee assistance programs promoting family health

Recommendation 7

Advocate for changes in public policy by:

• Lobbying for public discussion on family caregiving and the development of a public position on what level of caregiving is reasonable to expect from family caregivers, and at what point the public might expect the health care system to step in to provide care
• Lobbying for public education about the value and legitimacy of the role of family caregivers
• 
  Lobbying for a full range of adequate and effective respite care programs which facilitate family caregiving
• Lobbying for consistency in funding, availability, and delivery of respite care programs across Ontario
• Lobbying for the funding of research projects that examine family as the recipients of care, caregiving and respite care, family as caregivers, and the application of lessons learned from this research into public policy and program development
• Lobbying for mechanisms within organizations for families to dialogue with one another in an open forum

Recommendation 8

Nursing best practice guidelines can be successfully implemented only if there are adequate planning, resources, organizational and administrative support, as well as the appropriate facilitation. Organizations may wish to develop a plan for implementation that includes:

• An assessment of organizational readiness and barriers to education
• 
  Involvement of all members (whether in a direct or indirect supportive function) who will contribute to the implementation process
• 
  Dedication of a qualified individual to provide the support needed for the education and implementation process
• 
  Ongoing opportunities for discussion and education to reinforce the importance of best practices
• 
  Opportunities for reflection on personal and organizational experience in implementing guidelines.

In this regard, RNAO (through a panel of nurses, researchers and administrators) has developed the Toolkit: Implementation of Clinical Practice Guidelines, based on available evidence, theoretical perspectives and consensus. The Toolkit is recommended for guiding the implementation of the RNAO nursing best practice guideline on Supporting and Strengthening Families Through Expected and Unexpected Life Events.