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What are the best practice guidelines?

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The Best Practice Guidelines are like a recipe. They’re not strict rules — they provide a template of care.

Recipes provide a guide for creating a tasty dish while leaving room for the individual cook to make small changes to achieve a particular flavour they like.

The BPGs are similar. They provide a template for care while allowing nurses to incorporate their professional experience and clinical judgement as an important part of the “BPG recipe.”

Breaking Down the Terms

Best

“Best” in this context means that the suggestions will produce the most desired outcome. It also means that the effectiveness of the suggested actions is supported by evidence.

Practice

“Practice” is the combination of actions and conduct, of an individual or group, that differentiates or defines the group and its role from others.

Guidelines

“Guidelines” are a collection of suggestions for actions and/or conduct. A guideline provides a path to follow to help us achieve an outcome or a goal. It’s more flexible, and less rigid than a rule.

A Note on Terminology

It’s also important to note that throughout this website, we use terminology consistent with the RNAO BPG program in which the term person-centred care is used when referring to an individual who is seeking care or services. Depending on the practice setting, different terms may be used when referring to those seeking care e.g. patients, clients, families, communities. RNAO acknowledges that person- and family-centred care focuses on the whole person as a unique individual and not just on their illness or disease. In this website, the terms patient/client/person may be used interchangeably in case studies or examples but the focus of care remains on the whole person.

Quick Facts

The BPGs are outlined in PDF documents that can be downloaded in The BPGs Section.

They’re are…
Best Practice Guidelines
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Each BPG document looks at a specific aspect of care and provides suggestions for clinical practice.

Health Care

The goal of each BPG is to achieve the most desirable outcomes for patient care.

Summaries of the recommendations for each BPG can be found in the BPGs section.

Who uses the Best Practice Guidelines?

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Evidence-Based Practice

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The Best Practice Guidelines are informed by evidence.

This means that the recommendations they provide are based on expert opinion and a rigorous analysis of data collected through a scientific study. They’re developed by teams of researchers, clinicians, and educators who have expertise in the topic area of each specific BPG. The teams are often interprofessional and as a result, have a wide range of knowledge and clinical expertise.

Goals of Evidence-based Practice

The Best Possible Care
Professional Accountability
Job & Professional Satisfaction

How the BPGs are Developed

Step 1: Conduct Literature Review

The team conducts a literature review. This involves collecting and reviewing academic publications that provide evidence for approaches and procedures within clinical practice.

Step 2: Evaluate Evidence

After gathering information from academic sources, the team evaluates the evidence based on strength and merit. For example, research that's backed by a lot of data is given greater weight.

Step 3: Synthesize & Summarize

The evidence is then summarized and synthesized into a series of recommendations for how to approach clinical situations.

Step 4: Review Recommendations

The recommendations are reviewed by an external panel of experts. The panel determines what changes need to be made to the recommendations, working until they reach a consensus.

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Learning & Studying the BPGs

If you’re feeling overwhelmed by the amount of information that’s in each BPG PDF — you’re not alone. To help you get started learning about and implementing the best practice guidelines, we’ve developed some tips and tricks.

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You don’t need to read every single BPG document. Each Best Practice Guideline covers a specific area of nursing care, so not every BPG will be relevant your practice. Our advice is to identify and focus on the BPGs related to the care scenarios you’re most likely to encounter during practice. Check out The BPGs section to browse the best practice guidelines by category.

Instead of reading the entire BPG document, focus on the Practice Recommendations section. The BPGs are designed for healthcare organizations and individual nurses alike. This means that some sections in the BPG documents aren’t relevant to individual nurses. Most BPGs have a Practice Recommendations section, which is likely the most useful section for practicing nurses and nursing students.

Find small pockets of extra time in your week to review the BPGs. When learning something new, you don’t necessarily need to devote large chunks of time to studying. In fact, an extra 30 minutes a week can go a long way in building your knowledge around a particular subject. Look for small pockets of time you might be able to devote to reading the recommendations for a particular BPG. Your daily commute is the perfect time for reviewing a BPG recommendations and allows you to look up answers to questions that may have arisen during your shift.

Break the BPG recommendations into chunks and study them one section at a time. Most of the BPG practice recommendations are structured into the categories: Assessment & Planning, Implementation and Evaluation. Use this structure to break down the recommendations into manageable chunks. By tackling the recommendations in chunks, you’ll slowly familiarize yourself with the BPG while working to build the new knowledge into your practice. And it won’t feel as overwhelming as trying to memorize, understand and implement all the recommendations at once.

Before implementing the BPG recommendations, familiarize yourself with your healthcare organization’s policies and procedures. The BPG recommendations are meant to fill the gaps, not replace the policies and procedures already established by a healthcare organization. If the policies and procedures don’t cover a particular care scenario or you need more detailed information, the BPG recommendations can be extremely helpful.

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Nursing Student Q&A

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We spoke to a few Ryerson nursing students about their experience working with the BPGs.

We asked them about their challenges learning and implementing the guidelines, what they found most useful and what advice they had for current students who are just starting their BPG learning journey. They had some solid advice that we think will be useful.

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Frequently Asked Questions

No, the BPGs are not strict rules. Instead, think of them as templates of care. They provide a path to follow to achieve a goal – but they’re designed to be flexible.

A great analogy is cooking with a recipe. Recipes provide step-by-step instructions, but individual cooks may choose to modify the process and ingredients to suit their taste preferences. They may add more salt to a dish or adjust the cooking time. In the same way, nurses apply the BPGs using their clinical judgement – making sure to consider the unique health care context they’re in, and adhere to patient and family wishes.

Both! Scanning through the BPG PDF documents, you’ll notice that some of the recommendations are geared towards health service organizations and some will be for individual nurses. As a result, not all the BPGs will be relevant to you as an individual – knowing this will help you focus on the recommendations most relevant to you and your situation.

No, not every healthcare organization uses the Best Practice Guidelines. When entering practice, you may encounter healthcare professionals that don’t have much familiarity with the BPGs. But the BPGs are becoming more and more prevalent, and there are many Ontario health care organizations that have used the BPGs to develop their policies and procedures.

The Best Practice Spotlight Organization® designation is for health service and academic organizations that partner with RNAO to promote the use of BPGs.

Because there are over 40 BPGs, it’s likely you won’t be able to read all of them. That’s totally fine. Not all the BPGs will be relevant to your area of practice – so it’s best to focus on the ones more relevant to you.

Within the BPG documents, not every section will be relevant to you. For example, each BPG PDF will have a section that outlines the evidence that supports the recommendations. While it’s important to understand the value of evidence-based practice, you may not need to know all the evidence that was gathered.

Instead, familiarize yourself with the different sections to locate the information that will be most useful. Likely, this information will be the Practice Recommendations section – here you’ll find information about specific actions and processes that you can incorporate in your practice.