The Secret to Excellence in Nursing

There’s nothing mysterious about how to be the best nurse you can be: helping to advance the profession’s standards is key.

Nursing is self-regulating. And since the public needs to be confident that the largest health profession in Canada is dedicated to upholding professional practice, Canadian nurses must be leaders in standard and best practice development.

Code of Ethics for Registered Nurses
Nurses face a variety of ethical situations in their day-to-day practice, and seven values —articulated in the Code of Ethics for Registered Nurses by the Canadian Nurses Association—act as guideposts for the profession.

They include:

  • Providing safe, compassionate, competent and ethical care
  • Promoting health and well-being
  • Promoting and respecting informed decision-making
  • Preserving dignity
  • Maintaining privacy and confidentiality
  • Promoting justice
  • Being accountable 

Nursing Practice Standards 

The seven coded values also underscore nursing practice standards created by the College of Nurses of Ontario (CNO), which go one step further to ensure safe, effective and ethical nursing care.

CNO’s practice standards and guidelines contain the professional expectations for all Ontario nurses, and they apply in a variety of practice settings and situations. The establishment of practice standards helps nurses understand their responsibilities, make effective decisions in their practice and ultimately, provide better care.

Nursing Best Practice Guidelines
The Registered Nurses’ Association of Ontario ‘Best Practice Guidelines’ (BPGs) — there are more than 50 currently — take the standards yet another step further. BPGs provide nurses with guidance on client care and management decision-making.

Since 1999, thousands of Ontario nurses and health-care organizations have contributed to the development, implementation and evaluation of BPGs, all of which advance excellence in care. The RNAO documents are developed in five phases: planning, development, implementation, evaluation and dissemination.


What’s the difference between Practice Standards and BPGs?

The BPGs provide evidence-based recommendations to inform nursing practice that exceeds the CNO’s expectations. For example, a related BPG and CNO Document is “Prevention of Falls and Fall Injuries in the Older Adult Population” (BPG) and Restraints Practice Standard (CNO). Another example: “Risk Assessment and Prevention of Pressure Ulcers” (BPG) and Infection Prevention and Control Practice Standard (CNO).

Why do BPGs matter?

BPGs are critical to the advancement of nursing care excellence because they are evidence-based. Evidence-based health interventions are proven to be effective because they are based on systemic empirical research.

The RNAO Nursing BPGs are influencing nurses’ clinical, education, research, administrations and policy practices provincially, nationally and even internationally.

Can I be involved directly with BPGs?

Yes. Nurses play key roles in the development and implementation of BPGs — and in the creation of evidence-based cultures. They are actively involved as:

  • expert panel members
  • external stakeholder reviewers
  • (champions) ambassadors of evidence-informed decision-making in nursing practice, academia,management and policy leaders of interprofessional implementation teams
  • evaluators of practice change 

How do BPGs help me?

Improved education
Nursing professors are integrating BPGs into their curricula and are showing their students how they can take the latest evidence and research beyond the classroom and into a system where patients, families, nurses and other health-care providers are all part of the mix.

Pat Sevean, a nursing professor at Lakehead University, says the guidelines have changed the way she teaches because they offer students accessible, real-life examples of evidence-based practice.

Advance work environments
Best Practice Spotlight Organizations®, another RNAO program, offers support to health-care organizations and academic settings who commit to implement multiple RNAO BPGs and evaluate their impact on patient and organizational outcomes or academic results.

More than 15,000 RNs are involved in the implementation of BPGs in Spotlight Organizations each year. RNAO BPGs have been put in place across 371 sites nationally and internationally, with more than one million patients affected by improved care as a result.

Bottom line: the spread of evidence-based practice across a variety of organizations, vastly improves the role of nurses and the positive impact they have on patient care.

How can I get involved with BPGs? 

  • Become a member of a future guideline development panel, or part of a guideline review team (each published guideline will be reviewed every five years).
  • Provide stakeholder feedback on one of the topic-specific guidelines.
  • Become a local Best Practice Champion within your own organization, by promoting evidence-based practice and spearheading the implementation of RNAO nursing best practice guidelines. Best practice champions will receive training, necessary resource tools and will enjoy networking opportunities with other Ontario nurses.
  • Write for RNAO’s various newsletters, website, or the RN Journal. Share your stories of guideline implementation.
  • Spread the news! Share information about the RNAO initiative with your peers and your organization. RNAO can provide promotional materials for Nurses' Week activities, meetings, in-house newsletters, in-services, workshops and local media. 

 Learn more by getting in touch with the RNAO.