Registed Nurses' Association of Ontario

Evidence Boosters: Tilbury Manor Nursing Home Implements BPGs to Improve Resident Care and Create a Healthy Work Environment

Project / Initiative: 
Long-Term Care Best Practices Program
Type of Guideline: 
Healthy Work Environments
Publish Date: 
About this Guideline:


As public reporting of quality indicators became a greater focus in the long-term care sector, long-term care home (LTCH) leaders and staff sought new ways to improve resident outcomes.

Tilbury Manor is a 75-resident LTCH in the Erie St. Clair Local Health Integration Network (LHIN), Ontario, Canada. Sara Le, Director of Care (DOC) began her role with aspirations of enhancing resident quality of life, family experience and staff work-life balance and experience. She was supported by RNAO's long-term care best practice     co-ordinator (LTC BPC), Beverly Faubert.

The interprofessional team used gap analysis tools to review current practices in relation to the best practice guideline (BPG) recommendations and create action plans to improve outcomes.  Existing policies, resident care practices and documentation were reviewed to determine the extent to which screening, assessment and re-assessment tools aligned with best practices.

Since November 2014, Tilbury Manor has implemented practice changes based on the recommendations within 12 RNAO BPGs: 

  • Assessment and Management of Pain (2013)
  • Assessment and Management of Stage I to IV Pressure Ulcers (2007)
  • Caregiving Strategies and Screening for Older Adults with Delirium, Dementia and Depression (2010) – published as two separate BPGs
  • End-of-Life Care During the Last Days and Hours (2011)
  • Oral Health: Nursing Assessment and Interventions (2008)
  • Person-and Family-Centred Care (2015)
  • Prevention of Constipation in the Older Adult Population (2011)
  • Prevention of Falls and Falls Injuries in the Older Adult (2011)
  • Promoting Continence Using Prompted Voiding (2011)
  • Promoting Safety: Alternative Approaches to the Use of Restraints (2012)
  • Risk Assessment and Prevention of Pressure Ulcers (2011)